An EPIC transition: Rapid conversion of a measurement feedback system in behavioral health

Abstract

Measurement-based care (MBC), while an evidence-based clinical practice, can be difficult to integrate into behavioral healthcare settings. Even when MBC has been successfully implemented in an organization, there are many challenges that create a need for rapid adaptation. As measurement feedback systems (MFSs) are increasingly hosted on dynamic digital platforms, there is always a risk of technological changes and adaptations, whether the system is prepared for them or not. This point of view is focused on managing organizational changes to continue use of MBC through a case example in adult behavioral healthcare. A hospital policy change, informed by financial considerations, led to the rapid de-implementation of the external MFS platform in favor of a system integrated into the electronic health record (EHR). Our team responsively developed a plan for maintaining MBC through this transition including written guidelines and face-to-face training to support clinical staff, while determining the best way to maintain research gains and collect data in the EHR. This manuscript discusses the challenges in switching MBC platforms and the downstream consequences of this policy change from clinical, training, and research perspectives.

Keywords: Measurement-based care (MBC); ambulatory behavioral health; de-implementation; electronic health record; measurement feedback system (MFS).