Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care

Elisa Fisher, Michael Hasselberg, Yeates Conwell, Linda Weiss, Norma A. Padrón, Erin Tiernan, Jurgis Karuza, Jeremy Donath, Jose Pagan

Research output: Contribution to journalArticle

Abstract

Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO® (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health) - a remote learning and mentoring program - is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

Original languageEnglish (US)
Pages (from-to)342-347
Number of pages6
JournalPopulation Health Management
Volume20
Issue number5
DOIs
StatePublished - Oct 1 2017

Fingerprint

Geriatrics
Primary Health Care
Mental Health
Delivery of Health Care
Community Health Services
Outpatients
Patient Acceptance of Health Care
Insurance Claim Review
Interviews
Costs and Cost Analysis
Case Management
Rural Population
Health Insurance
Practice Guidelines
Health Care Costs
Curriculum
Prescriptions
Hospital Emergency Service
Patient Care
Learning

Keywords

  • care management
  • distance learning
  • geriatric mental health
  • primary care
  • rural health care

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Fisher, E., Hasselberg, M., Conwell, Y., Weiss, L., Padrón, N. A., Tiernan, E., ... Pagan, J. (2017). Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care. Population Health Management, 20(5), 342-347. https://doi.org/10.1089/pop.2016.0087

Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care. / Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A.; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagan, Jose.

In: Population Health Management, Vol. 20, No. 5, 01.10.2017, p. 342-347.

Research output: Contribution to journalArticle

Fisher, E, Hasselberg, M, Conwell, Y, Weiss, L, Padrón, NA, Tiernan, E, Karuza, J, Donath, J & Pagan, J 2017, 'Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care', Population Health Management, vol. 20, no. 5, pp. 342-347. https://doi.org/10.1089/pop.2016.0087
Fisher E, Hasselberg M, Conwell Y, Weiss L, Padrón NA, Tiernan E et al. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care. Population Health Management. 2017 Oct 1;20(5):342-347. https://doi.org/10.1089/pop.2016.0087
Fisher, Elisa ; Hasselberg, Michael ; Conwell, Yeates ; Weiss, Linda ; Padrón, Norma A. ; Tiernan, Erin ; Karuza, Jurgis ; Donath, Jeremy ; Pagan, Jose. / Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care. In: Population Health Management. 2017 ; Vol. 20, No. 5. pp. 342-347.
@article{20a79b765e144f889f49718ce91a609b,
title = "Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care",
abstract = "Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO{\circledR} (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health) - a remote learning and mentoring program - is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.",
keywords = "care management, distance learning, geriatric mental health, primary care, rural health care",
author = "Elisa Fisher and Michael Hasselberg and Yeates Conwell and Linda Weiss and Padr{\'o}n, {Norma A.} and Erin Tiernan and Jurgis Karuza and Jeremy Donath and Jose Pagan",
year = "2017",
month = "10",
day = "1",
doi = "10.1089/pop.2016.0087",
language = "English (US)",
volume = "20",
pages = "342--347",
journal = "Population Health Management",
issn = "1942-7891",
publisher = "Mary Ann Liebert Inc.",
number = "5",

}

TY - JOUR

T1 - Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care

AU - Fisher, Elisa

AU - Hasselberg, Michael

AU - Conwell, Yeates

AU - Weiss, Linda

AU - Padrón, Norma A.

AU - Tiernan, Erin

AU - Karuza, Jurgis

AU - Donath, Jeremy

AU - Pagan, Jose

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO® (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health) - a remote learning and mentoring program - is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

AB - Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO® (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health) - a remote learning and mentoring program - is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

KW - care management

KW - distance learning

KW - geriatric mental health

KW - primary care

KW - rural health care

UR - http://www.scopus.com/inward/record.url?scp=85030151800&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030151800&partnerID=8YFLogxK

U2 - 10.1089/pop.2016.0087

DO - 10.1089/pop.2016.0087

M3 - Article

C2 - 28106511

AN - SCOPUS:85030151800

VL - 20

SP - 342

EP - 347

JO - Population Health Management

JF - Population Health Management

SN - 1942-7891

IS - 5

ER -