According to best practices and industry standards, a key indicator of quality treatment care is having valid and reliable measurement systems in place to track patients' response to treatment. In the absence of standardized metrics, it is impossible to adequately document treatment outcomes and demonstrate any kind of meaningful impact. National recognition of the importance of protracted outcomes monitoring is evidenced by a number of leading health care payers (e.g., Aetna, Anthem, Inc., Blue Cross Blue Shield, Cigna, Magellan Health, UnitedHealth Group, among others)—who collectively serve nearly a quarter of a billion patients—already showing their commitment to the “National Principles of Care” for the treatment of addiction. The Principles were derived from the U.S. Surgeon General’s Report on Alcohol, Drugs, and Health, and are backed by decades of empirical research. Of particular interest, 1 of the 8 guiding Principles specifically addresses the need for long-term engagement following the primary treatment episode with regular monitoring of outcomes to adjust the nature and intensity of care accordingly.
With any well-designed outcomes monitoring system, patients receive scheduled contacts at pre-determined intervals to complete a comprehensive assessment of multiple areas of functioning. Given we know that recovery encompasses more than simply cessation of alcohol and drug use, all outcomes monitoring systems should assess for improvements in health and social functioning, as well as reductions in numerous threats to public health and safety. Our outcomes monitoring systems use a multi-domain approach in which key data from various relevant areas of interest (e.g., clinical, employment, social, legal, quality of life, patient satisfaction) are collected from patients on a regular basis. In addition to traditional measures of substance use (class, quantity, frequency, route of administration, etc.) and opioid use disorder medication dose and compliance (if applicable), patients are assessed for several relapse risk indicators from other pertinent domains of functioning. Relapse risk indicators include formal, psychometrically sound measures of craving, readiness to change, motivation, depression, etc. Patients are also administered structured questionnaires assessing health care utilization, occupational functioning, legal involvement, social functioning, quality of life, and motor vehicle accidents, among other areas. Personalization of monitoring systems in which specific outcomes areas are targeted is also an available option. Providers may elect to go with our standard outcomes interview, or hand-select which domains and established measures to include.
Professional, comprehensive Outcomes Summary Reports can then be prepared on a regular basis (e.g., quarterly, annually) based on the collected longitudinal data in the selected areas. Routine reports include a detailed clinical and demographic profile of patients served. For larger treatment systems with multiple locations, analyses are broken down by site to allow for comparisons. Our Principal Consultant (Dr. Steven Proctor) is responsible for cleaning and formatting the database and conducting the appropriate statistical analyses in order to write up the findings in an easy-to-read comprehensive Outcomes Summary Report. The content areas included in our reports are sure to be of interest for internal use (e.g., presentation to relevant stakeholders at performance improvement meetings) and/or external use (e.g., marketing or sales materials). Empirical evidence documenting the effectiveness of your treatment services from an independent evaluator will also prove helpful for health insurers, funders, as well as prospective patients or their loved ones who may be reluctant to seek professional help.
Outcomes Monitoring
† Scholarly Publication Option. In addition to Outcomes Summary Reports prepared personally by Dr. Proctor, programs have the option of possibly commissioning a scientific article suitable for publication in a peer-reviewed academic journal. One or more scholarly articles or peer-reviewed publications based on a treatment provider’s services––and derived from the provider’s patient data––will prove extremely useful for a number of reasons. From a sheer marketing standpoint, given that a peer-reviewed journal will not publish articles that fail to meet the standards established for a particular discipline, peer-reviewed articles that are accepted for publication exemplify the best research practices in a field and are held in higher esteem relative to articles published in White papers, magazines, newsletters, online blogs, or other less formal outlets. Dr. Proctor has an extensive publication record and has published a number of peer-reviewed articles in top scientific journals based on clinical outcomes data from numerous treatment agencies. Programs interested in exploring options for publication can communicate with Dr. Proctor directly regarding possible areas of investigation and the potential for publication.
The cost for writing one scientific article suitable for publication depends on the scope of work. Total cost applies only to the work directly related to the production of the manuscript. That is, following manuscript completion, Dr. Proctor does not charge for the additional time required to identify an appropriate peer-reviewed academic journal, format the manuscript accordingly per journal guidelines, revise if accepted for publication pending minor revisions, or identify another potential journal should the submitted manuscript initially fail to be accepted for publication.
Just as the treatment of hypertension involves regular assessment of blood pressure, treatment providers must routinely collect "addiction & mental health vital signs."
- Design and implementation of a personalized outcomes-based program evaluation system
- Evaluation and documentation of treatment outcomes
- Data collection and management for multisite or single site evaluations
- Identification of at-risk patients for referral back to the provider for further assessment
- Preparation of comprehensive Outcomes Summary Reports for internal or external use
- Staff development for outcomes evaluation readiness
- † [Scholarly Publication Option] Preparation of scientific articles suitable for publication in peer-reviewed academic journals
What are the benefits of monitoring outcomes?
Documentation of Outcomes: With the current landscape concerning the delivery and reimbursement of substance use disorder treatment services, the ability for treatment providers to systematically monitor and document treatment outcomes remains of paramount importance. Treatment providers are increasingly being tasked with the expectation to not only measure patient performance, but to demonstrate the success of their clinical services. At the industry level, treatment providers are operating in a highly competitive environment in which cost and efficiency are no longer the main selling point; quality of services now takes precedence. At the patient level, individuals seeking addiction treatment care, as well as their families, are becoming increasingly more savvy and informed in their search for a treatment provider with documented evidence of effectiveness to ensure they achieve the best possible outcome. Outcomes monitoring with regular feedback regarding treatment effectiveness and patient satisfaction can improve the overall quality of treatment care and ensure accountability to stakeholders by documenting outcomes and maintaining treatment quality.
Reduces Staff Burden: Unfortunately, in the cost-conscious times in which many addiction treatment programs operate, it is unrealistic to expect counselors to routinely collect robust outcomes data from their caseload in addition to their typical day-to-day clinical responsibilities. Despite the tremendous value in monitoring patients from baseline through post-discharge and documenting outcomes, monitoring efforts are often hindered by relying on existing clinical staff to collect data considering that their primary responsibility understandably revolves around providing direct evidence-based patient care. Engaging clinical staff in the process of monitoring patient outcomes can also be difficult.
Cost Effective: Contracting your outcomes monitoring services is a viable, cost-effective option, affording you with the capacity to conduct more thorough and frequent assessments than would be possible with existing program staff or alumni coordinators. In other words, most treatment programs relying on existing staff to contact patients and collect outcomes data often lack the resources to handle the patient volume possible with a contracted solution. With PRO Health Group, your treatment system can also benefit from regular reporting from a PhD-level clinical researcher and licensed clinical psychologist with the experience and qualifications necessary to produce timely, clinically-meaningful reports, who essentially serves as a personal advisor to your treatment program(s).
Linkage back to the Provider: Routine contacts completed during the primary treatment episode and continuing through 12 months post-discharge offers the added benefit of identifying patients in crisis or those who may have recently experienced a lapse or relapse. Such patients may be appropriate for placement at a higher level of care (e.g., residential, intensive-outpatient). Patients appropriate for—or expressing interest in—readmission can therefore be connected to the provider’s Admissions Department to facilitate the process of readmission without delay.
Patient Support: Planned contacts provide patients support, direction, and personal accountability as they transition from the acute phase of care and leave the “safe” structured confines of treatment to return to their home environment (i.e., the “real world”). This also allows the opportunity for exchanging program-specific information (alumni events, etc.), monitoring progress and patient adherence, recognizing complications and barriers to recovery early, and providing reassurance to patients throughout the continuing care phase. Routine contacts with clinical staff in which patients receive ongoing support also has the potential to reduce stigma.
Services
We work with addiction treatment programs to develop valid & reliable patient monitoring systems—compliant with national accreditation and industry standards—capable of documenting treatment outcomes and providing clinically-meaningful, actionable data to inform clinical care, meet reporting requirements, and conduct rigorous scientifically-sound research studies.