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In physical health conditions, such as diabetes, medical records often contain data that identify which patients could benefit from starting treatments and which patients are not improving. These data are used by clinicians, managers, and policymakers to tailor care to individual patient's needs. In mental health, medical records have not reliably contained such information. The EQUIP (Enhancing Quality of care In Psychosis) study is a Mental Health (MH) QUERI research partnership among investigators, clinicians, and leadership to improve care for Veterans with schizophrenia. A one-year trial, EQUIP enrolled 801 Veterans and 171 clinicians. Veterans participated at eight VA medical centers in four VISNs, and were assigned to the study intervention or usual care. The intervention included kiosk-based patient self-assessment, clinician and patient education, clinician feedback, and evidence-based quality improvement teams. Part of the findings from this study showed that patient-facing kiosks that were implemented into routine care proved to be a valuable tool.
To allow this approach to be disseminated more broadly, EQUIP investigators applied for and received a VA Innovations grant to link kiosk-based self-assessment with the existing VA Computerized Patient Record System (CPRS). This grant was used to fund a software vendor, with technical assistance from the EQUIP team. The vendor produced software that implemented the EQUIP patient interface on standard kiosk hardware, and connected these kiosks with the Mental Health Package—computer software that is deployed at all VA facilities. With this new system, VA staff developed specifications for kiosk-based surveys and education. The surveys are completed by Veterans at kiosks before they meet with their clinicians. For example ––
Survey data are then placed into the VA medical center computer system, where they generate electronic notes in the CPRS for VA healthcare providers. This system also provides tailored education to Veterans, based on their responses to the surveys. Therefore, this new system is providing valuable data for both mental health care providers and Veterans with mental illness.
For more information about VA/HSR&D's Quality Enhancement Research Initiative, visit the QUERI website.
