measurement based care behavioral health is an important component of behavioral health care and has become a standard in many healthcare settings. However, it is a relatively underutilized approach in mental health, and its importance is often underappreciated.
Symptom-Based Assessments Are Essential for MBC
A key aspect of measurement based care is symptom-focused questionnaires and feedback. Rating scales can help provide an objective perspective on a patient’s symptoms and give the clinician more information to consider when making clinical decisions. In addition, they can be used to assess progress during treatment and identify areas for improvement.
Using validated symptom rating scales is the first step in implementing measurement based care. Choosing the right scales is crucial to ensuring that the outcome measures are valid, reliable, and sensitive to change. In addition, collaborating providers can easily access these data in their client’s chart as numerical indicators of clinical progress.
Timely Symptom Feedback
To be effective, measurement based care must be implemented with frequent symptom ratings and feedback. Having a cadence of assessments allows clinicians to monitor baseline changes more closely and adjust treatment plans accordingly. It is also critical to ensure that the therapist has access to current symptom ratings. Asynchronous feedback is ineffective as symptom scores fluctuate over time and are less likely to be complete. Having clients complete their rating scales during or right before sessions is more effective and ensures that clinicians have access to updated information.
In-session Feedback is Vital for MBC
A major challenge in the use of measurement based care is that therapists often do not receive feedback during the clinical encounter. In fact, in some studies patients who filled out symptom scales via mail every three months did not improve compared to those who completed the symptom scale during the counseling session (34).
This lack of real-time feedback leads to inefficient treatment practices and can result in a variety of costs and financial inefficiencies for both clinicians and payors. These include under- or overtreatment of clients, poor therapist matching, and inefficient responses to symptom deterioration (eg, not addressing the underlying cause).
MBC programs must be designed and operated to ensure that fidelity monitoring is conducted on a regular basis and that patients are receiving accurate, consistent, and timely feedback. Fidelity monitoring has traditionally been costly, but can be streamlined by using the electronic health record and other technologies.
The Electronic Health Record enables a more efficient implementation of measurement based care by automating the administration of outcomes measures and providing easy access to the results. Having this information on-hand gives clinicians the ability to evaluate treatment effectiveness, case manage off-track clients, and inform clinical decision making.
As behavioral health care becomes more and more complex, it is increasingly vital to have the most up-to-date information available about a client’s health to facilitate optimal outcomes. Having the ability to collect, analyze, and share information through a robust EHR system streamlines the process of delivering measurement based care to clients and provides a platform for a more integrated model of patient-centered care.