Real-World Implementation of Collaborative Care for Depression: Process, Outcomes, and Economics

Abstract: Purpose


This presentation will provide learners with a comprehensive understanding of the process of implementing the Collaborative Care Model (CoCM), from patient engagement and enrollment through outcomes, as well as important considerations such as health care costs and value.





Background





CoCM, an integrated model for psychiatric health in primary care, has well established efficacy and effectiveness for depression in large clinical trials. This integration overcomes many barriers to traditional psychiatric settings and has been demonstrated to reduce healthcare disparities.





Since efficacy and effectiveness of CoCM have been established, focus has shifted to determining components of effective program implementation. Studies have shown that organizations receiving similar CoCM training and resources had substantial variability in quality indicators and clinical outcomes. Specific implementation strategies adapted for individual settings and patient populations are needed to ensure successful implementation of CoCM.





Northwestern and Duke have established large CoCM programs, and the presenters will discuss their real world experiences implementing this evidence-based strategy. The CoCM program at Duke, a component of the Duke Primary Care Behavioral Health Program, will present principles of CoCM, techniques and tips to ensure best-practices, and their program’s clinical outcomes. Research is ongoing at Northwestern on a funded implementation trial of CoCM in twelve primary care clinics. Presenters will discuss the strategies, process, and challenges of setting up the program as well as barriers within the clinical cascade for referred patients. Our presentation will also include information about the associated costs and value of CoCM. There will be time for audience participation and discussion.





Topics and Speakers





The session will be moderated by Dr Lisa J. Rosenthal, who established the CoCM program at Northwestern. She will spend 5 minutes introducing the speakers and the topics.





(15-17 minutes/person)


• Dr. Nathan Copeland from Duke will provide a brief overview of CoCM, best practice guidance built on the five principles of CoCM, and clinical outcomes from the Duke Primary Care Behavioral Health Program.


• Dr. Jeffrey Rado from Northwestern will provide an overview of the implementation process and present data on acceptability, feasibility, barriers and facilitators of collaborative care implementation. Data were collected via stakeholder interviews and surveys as well as rates of program referral, engagement and completion.


• Dr. Andrew Carlo will outline the CoCM enrollment cascade, discussing how patients proceed from referral and engagement to program completion. Additionally, Dr. Carlo will identify strategies to engage diverse populations at various points in the cascade.


• Dr. Neil Jordan, a health economist, will discuss the costs, benefits, and reimbursement considerations associated with implementing CoCM.





There will be 20-30 minutes after the presentation for audience discussion and participation from the panel, moderated by Dr Rosenthal.