Measurement Feedback Systems in Mental Health: Initial Review of Capabilities and Characteristics

Saturday 2:30 – 3:45 Breakout F2

Presentor: Aaron Lyon and Meredith Boyd

Meredith Boyd, Indiana University; Abigail Melvin, Indiana University; Aaron Lyon, University of Washington; Cara Lewis, Indiana University; Freda Liu, University of Washington; Nathaniel Jungbluth, University of Washington



Measurement Feedback Systems (MFS) are emerging Health Information Technologies (HIT) that provide feedback to clinicians about client progress and outcomes, allowing for data-driven clinical decision-making. Moreover, HITs like MFS provide avenues for efficient methodological approaches to data collection in the context of implementation. Despite the existence of many MFS and strong evidence of benefits of their use, information about system functionality is fragmented, limiting uptake and utility. This project sought to identify every MFS available and document their specific features. 50 MFS were identified and coded for 56 capabilities and characteristics informed by relevant literature and feedback from experts and community stakeholders. Our review of systems suggests incredible variability in MFS. For example, 10 systems are highly customizable, allowing for the addition of new tools and measures. The remaining 40 offer a set library of measures that cannot be altered. Our findings emphasize the critical need for MFS information consolidation and comparison. Our methodology provides researchers and stakeholders with rich information supporting an efficient approach to MFS selection. Results will be discussed with respect to system capabilities, alignment with Feedback Intervention Theory (Kluger & Denisi, 1996), and the use of MFS as an efficient methodology for supporting implementation-related data collection.

A Qualitative Investigation of Case Managers’ Attitudes Toward Implementation of a Measurement Feedback System in a Public Mental Health System for Youth

Saturday 2:30 – 3:45 Breakout F2

Presentor: Amelia Kotte, Ph.D.

Amelia Kotte, Ph.D., University of Hawaii at Manoa; Kaitlin A. Hill, B.A., University of Hawaii at Manoa; Albert C. Mah, B.A., University of Hawaii at Manoa; Priya A. Korathu-Larson, B.S., University of Hawaii at Manoa; Janelle R. Au, B.A., University of Hawaii at Hilo; Sonia Izmirian, M.A., University of Hawaii at Manoa ; Scott S. Keir, Ph.D.; Brad J., Nakamura, Ph.D., Charmaine K. Higa-McMillan, Ph.D.


Hawaii’s Child and Adolescent Mental Health Division (CAMHD) initiated a state-wide quality improvement effort for administering the Ohio Scales (OS). The OS is a brief and free youth- and parent-report questionnaire administered on a monthly basis as part of a measurement feedback system (MFS). Surveys are collected by system case managers (CM). Reports are generated monthly to longitudinally track youth outcomes and increase client-level data-driven decision-making. This qualitative study seeks to understand barriers and facilitators associated with implementing an MFS.

CMs received training on OS administration and MFS interpretation prior to implementation. They were interviewed on their experiences three months after training and implementation. Interviews were transcribed and coded by seven trained coders using an open inductive approach and an external auditor. Of the 24 completed interviews, 13 have been coded. Central themes related to facilitators of implementation included perceptions that the OS adds to clinical decision-making and facilitates good practices. Most common barriers were: perceptions that clinical leads do not support implementation by omission of OS/MFS in supervision and utilization management meetings, and that administration of the OS is too time consuming. All facilitator and barrier themes, as well as large scale MFS implementation recommendations will be discussed.


Evidence-Based Quality Improvement to Reduce Information Delays

Saturday 2:30 – 3:45 Breakout F2

Presentor: Steven E. Lindley

Steven E.Lindey, Stanford University/VA Palo Alto HCS; Dan Y. Wang, Ph.D., VA Palo Alto HCS; Maya Kopell, MD, VA Palo Alto HCS; Linsey E. Zimmerman, Ph.D., NC-PTSD; Dissemination and Training Division; Eve B. Carlson, Ph.D., NC-PTSD; Dissemination and Training Division; Ann Lefevre, Ph.D., LCSW, BCD


Most veterans from the wars in Afghanistan and Iraq (OEF/OIF) diagnosed with PTSD and/or depression currently do not receive an adequate course of an evidence-based treatment (EBT).  This problem persists despite availability of Veterans Health Administration providers trained to deliver EBTs.  Combining lean-design process improvement methods with rapid automated data extraction, we sought to reduce the time between an intake session and receiving of an EBT in a large mental health system with more than 15,000 patients treated each year.  Analyses of administrative data identified our current state of EBT psychotherapy delivery.  Utilizing A3 management processes and other quality improvement tools, a group of clinic providers developed a SMART goal, hypothesized potential key drivers, and specified countermeasures to improve timely access to EBTs.  We then provided rapid feedback to system stakeholders on the progress of improvement.  Initial implementation in one large clinic approximately doubled the proportion of new patients receiving timely EBT.  Based on these preliminary results, we are adapting a measurement-based care software tool (COMMEND, Landes et al, 2015) to provide daily updates on process-improvement variables.  Our goal is to sustain this quality improvement effort through ongoing, rapid presentation of feedback data to system decision makers, clinicians, and staff.