Implementation of Digital Mental Health Tools in Ambulatory Care Coordination

已经开发了护理协调服务，以便为以下患者提供更安全和更有效的护理 难以管理他们的医疗保健。护理经理(CMS)在护理协调中的作用是 旨在从整体上看待患者并提高医疗系统效率，但仍存在 这项工作的效率存在几个差距。CMS经常难以为他们的患者找到资源，特别是在 抑郁症管理领域。资源有限，等待服务的名单很长，许多患者 对寻求心理健康护理犹豫不决。我们的研究小组与 西北医疗的门诊护理协调服务-更多的大型集成交付系统 3500多名医生，为100万名患者提供服务。目前，CMS主要是受过培训的护士，提供远程 为通常有多种身心健康状况的患者提供协调服务。他们报告说 在支持抑郁症患者方面面临着大量的挑战。打包的数字心理健康干预 在患者管理系统中，抑郁症将满足对抑郁症管理资源的需求 并适应CM工作。拟议项目的总体目标是适应和实施数字心理 改善门诊精神卫生服务可获得性和协调性的健康干预 协调。具体地说，本研究旨在：1)调整数字心理健康平台和服务模式，以 解决护理协调中的实施障碍，2)制定并随后优化 多组件实施战略，以及3)进行随机部署有效性--实施 数字心理健康平台的试行和维持试点期在4个区域工作队 门诊护理协调服务。在整个项目中收集的数据将用于制定 实施指南，能够被其他医疗保健系统使用，因为他们扩展了他们的智力 提供健康服务，为患者提供全方位的支持。

Care coordination services have been developed to provide safer and more effective care for patients who have difficulty managing their healthcare. The role of care managers (CMs) working in care coordination is intended to take a holistic view of patients and to improve healthcare system efficiency, yet there remain several gaps in the efficiency of this work. CMs often struggle to find resources for their patients, particularly in the realm of depression management. Resources are limited, waitlists for services are long, and many patients are hesitant to seek mental health care. Our research group has developed a productive partnership with the Ambulatory Care Coordination service at Northwestern Medicine – a large integrated delivery system of more than 3,500 physicians, serving 1 million patients. Currently CMs, primarily nurses by training, provide remote coordination services to patients who typically have multiple physical and mental health conditions. They report abundant challenges in supporting patients with depression. A digital mental health intervention packaged within a patient management system for depression would fill the need for depression management resources and fit into CM work. The overarching aim of the proposed project is to adapt and implement a digital mental health intervention to improve access to and coordination of mental health services in Ambulatory Care Coordination. Specifically, this study aims to: 1) adapt a digital mental health platform and service model to address implementation barriers within care coordination, 2) develop and subsequently optimize a multicomponent implementation strategy, and 3) conduct a randomized rollout effectiveness-implementation trial of the digital mental health platform and a sustainment pilot period in the 4 regional teams of the Ambulatory Care Coordination service. Data gathered throughout this project will be used to develop an implementation guide, capable of being used by other for healthcare systems as they expand their mental health service offerings to provide holistic support for patients.