Implementation of Digital Mental Health Tools in Ambulatory Care Coordination

护理协调服务已经发展起来，为以下患者提供更安全、更有效的护理： 很难管理他们的医疗保健。护理管理人员（CM）在护理协调中的作用是 旨在全面了解患者并提高医疗保健系统的效率，但仍然存在 这项工作效率上的几个差距。CM通常很难为他们的患者找到资源，特别是在 抑郁症管理的领域。资源有限，等待服务的名单很长，许多病人 不愿寻求心理健康护理。我们的研究小组与 西北医学中心的门诊护理协调服务-一个大型综合服务系统， 超过3,500名医生，为100万名患者提供服务。目前，CM，主要是受过培训的护士，提供远程 协调服务的病人谁通常有多种身体和精神健康状况。他们报告 在支持抑郁症患者方面面临很多挑战。数字化心理健康干预 在抑郁症患者管理系统中， 适合CM工作。拟议项目的总体目标是适应和实施数字心理 健康干预，以改善门诊治疗中精神卫生服务的获得和协调 协同具体而言，本研究旨在：1）适应数字心理健康平台和服务模式， 解决护理协调中的实施障碍，2）制定并随后优化 多组件实施策略，以及3）进行随机推广有效性实施 在联合国4个区域小组试用数字化心理健康平台和维持试点期 门诊护理协调服务。在整个项目中收集的数据将用于开发一个 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心理 提供医疗服务，为患者提供全面的支持。

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.