Through its collaborative care program for depression, NYC Health + Hospitals, our largest partner, has significantly increased psychiatric consultations and treatment for depression in primary care, more than tripling the rate of depression improvement among patients enrolled in the program. In 2015, the public health system screened about 225,000 adult primary care patients for depression—more than 90 percent of patients who visited a NYC Health + Hospitals site. Nearly 15,000 of those patients—6.7 percent—screened positive. The program’s key clinical outcome metric focused on the depression improvement rate, which increased from 17.7 percent in the second quarter of 2015 to 57.6 percent in the first quarter of 2016.
“Across NYC Health + Hospitals, we’ve sought to meet patients where they are by coordinating care for medical and behavioral health conditions in a single setting,” said Dr. Dave Chokshi, Chief Population Health Officer, OneCity Health, a subsidiary of NYC Health + Hospitals focused on population health, care management, and implementation of the State’s Delivery System Reform Incentive Payment program.
“We’re honored to receive this award, which recognizes the dedicated work of our frontline staff to identify and manage patients with depression in primary care,” said Dr. Jesse Singer, Assistant Vice President of Care Models and Analytics, OneCity Health.
Depression affects 13 percent of Americans and 20 percent of Medicaid recipients in their lifetimes. However, when mental health specialists are not co-located in the primary care setting, only 10 percent of patients follow-up on a referral to a provider.
The collaborative care program for depression was launched under the New York State Hospital Medical Home Demonstration Project in 2014. NYC Health + Hospitals implemented a two-step process to better identify and treat patients with depression. First, the system began universal depression screening for adults in medical and primary care clinics. Second, patients who screened positive for depression were enrolled in the collaborative care program to receive treatment right in the primary care setting. The system’s goal is to ensure that at least 50 percent of patients enrolled demonstrate clinically significant improvement in depression symptoms.
“To ensure patients are receiving excellent care, we provide training and coaching to staff on the ground in depression screening and evidence-based treatment interventions,” said Jessica Black, MPH, MSW, Collaborative Care Program Manager, OneCity Health, who accepted the award on behalf of the health system at a ceremony in Chicago. “We also generate data to support patient outreach and treatment workflows. A newsletter and monthly webinars serve as vehicles to share best practices, such as the warm handoff amongst collaborative care teams.”
“The collaborative care program has had a significant impact,” said Dr. Michelle Izmirly, Consultant Psychiatrist, NYC Health + Hospitals/Lincoln. “Our new workflows ensure we begin to speak with patients who are depressed, but who have never talked to anyone about it before, thinking their condition was normal or not treatable. Our nurses and social workers ensure follow-up occurs, breaking down barriers that once prevented this type of care.”
To learn more about the collaborative care program, please view the following video: