No technological innovation is a panacea: a case series in quality improvement for primary care mental health services.
Evaluations of quality improvement efforts targeted at mental health services in primary care pediatrics are rare. We evaluated a short-targeted educational session, a Web-based system, the Child Health and Development Interactive System, and a local area mental health services resource guide. Most physicians believed the information in the educational session was at least somewhat likely to change their practice. However, only 9.2% of the families invited to complete the Web-based system did so. Physicians found access to the Web-based system time consuming and, because the billing code for the screening activity was carved out of most of Ohio's privately-insured contract, physicians received no reimbursement for the screenings. Physicians were unenthusiastic about the local resource guide because the resources were not rated for quality. This quality improvement effort demonstrates that there are not easy solutions to practice change and highlights the need for implementation support when introducing new technology.
Horwitz
Sarah McCue
SM
Department of Pediatrics and the Center for Health Policy and Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California 94305-6019, USA, sarah.horwitz@stanford.edu
Hoagwood
Kimberly Eaton
KE
Garner
Andrew
A
Macknin
Michael
M
Phelps
Thomas
T
Wexberg
Steven
S
Foley
Conrad
C
Lock
Joseph C
JC
Hazen
Jacalyn E
JE
Sturner
Raymond
R
Howard
Barbara
B
Kelleher
Kelly J
KJ
D002648:Child; D003661:Decision Support Techniques; D006801:Humans; D020407:Internet; D008605:Mental Health Services / Q000191:economics / Q000592:standards*; D009820:Ohio; D010372:Pediatrics / Q000191:economics / Q000592:standards*; D011320:Primary Health Care / Q000191:economics / Q000592:standards*; D012051:Reimbursement Mechanisms