Measurement-Based Care (MBC), a patient-centred approach powered by technology, is transforming the landscape of mental health care. MBC offers a significant leap forward in personalized treatment by making patients active participants in their recovery.
Shannon Remers, Director of Research and Outcomes at Homewood Health (pictued left) has spearheaded the adoption of MBC across this national mental health organization. This process involves collecting and analyzing patient progress, symptoms, functioning, and quality of life, empowering clinicians to tailor treatments for the best possible outcomes. MBC has shown considerable promise in supporting the treatment of a broad spectrum of conditions, including substance use, anxiety, depression, trauma, eating disorders, and concurrent disorders. Remers emphasizes the critical role of MBC in healthcare: “MBC allows clinicians to understand the specific needs of the individuals they are serving and make real-time improvements to healthcare systems."
The Journey of MBC at Homewood
The MBC initiative at Homewood commenced with a research project in 2015, aiming to explore its feasibility within a single treatment program at the Homewood Health Centre in Guelph Ontario. Supported by the Homewood Research Institute (HRI), the Addiction Medicine Program was chosen for the pilot. This pilot project utilized a paper-based set of tools to monitor patient progress from intake to discharge and then for up to a year post-discharge.
This pilot project validated the concept and provided crucial insights into applying MBC in an inpatient setting for substance use treatment. It helped gather data on substance use types, quantities, and severities and monitored treatment gains for up to a year after discharge.
Advancements with Homewood Touchpoint
The year 2018 marked a significant advancement in MBC's application with the deployment of Homewood Touchpoint, a state-of-the-art electronic measurement, and data visualization tool. This technology enabled clinicians to gain deeper insights into patients' needs, identify gaps in treatment, and monitor changing trends and outcomes. Remers explains the impact of Touchpoint: “This new technology has empowered clinicians to understand our population's needs better... We sought to answer critical questions on increases in depression severity, increases in anxiety severity after certain events, and ways we can better support patients."
The adoption of Homewood Touchpoint into the Addiction Medicine Program led to a more sophisticated understanding of patient needs and the development of tailored treatment interventions. Learning from this electronic MBC platform directly supported future program design and evolution with the launch of the Addiction Medicine Program - Mood, Anxiety, and Concurrent (AMP-MAC), catering specifically to the high need for more complex concurrent disorder treatment – a specialty of Homewood Health treatment programs.
A Testament to MBC's Impact
Remers recalls a compelling case where MBC directly influenced a patient's treatment outcome. A patient, initially disengaged and intending to leave the program early, was shown a graphical progress report revealing an increase in cravings but a mild decrease in mood and anxiety. This review provided a key interaction to re-engage the patient in their treatment. After reviewing and adjusting their medication, the patient completed the program, highlighting a pivotal moment in their recovery journey.
The Role of Clinician and Leadership Support
For MBC to succeed, clinician and leadership engagement is crucial. Remers advises, “If data is being captured, it needs to be shared with the clinician." This approach fosters clinician buy-in through firsthand experience of MBC's clinical utility, encouraging proactive patient care conversations.
Looking ahead, Remers aims to establish benchmark standards using MBC data to enhance mental health treatment quality further. Currently, Homewood's Touchpoint electronic MBC platform supports over 25,000 clients and 1,430 therapists across the country in 20 programs, including specialized inpatient facilities and outpatient services.
Embracing the Future of MBC
For healthcare organizations considering MBC integration, Remers advocates for a proactive, iterative approach: “Just start! Embrace the trials and errors and keep iterating your processes until patients feel the positive impact of your work." This mindset underscores the ongoing journey of innovation in mental health care, highlighting the critical role of MBC in shaping the future of patient treatment and recovery.