TY - JOUR
AU - M. I. Franco
AU - E. M. Staab
AU - M. Zhu
AU - W. Deehan
AU - J. Moses
AU - R. Gibbons
AU - L. Vinci
AU - S. Shah
AU - D. Yohanna
AU - N. Beckman
AU - N. Laiteerapong
A1 - 
AB - OBJECTIVES: To integrate a computerized adaptive test for depression into the electronic health record (EHR) and establish systems for administering assessments in-clinic and via a patient portal to improve depression care. MATERIALS AND METHODS: This article reports the adoption, implementation, and maintenance of a health information technology (IT) quality improvement (QI) project, Patient Outcomes Reporting for Timely Assessment of Life with Depression (PORTAL-Depression). The project was conducted in a hospital-based primary care clinic that serves a medically underserved metropolitan community. A 30-month (July 2017-March 2021) QI project was designed to create an EHR-embedded system to administer adaptive depression assessments in-clinic and via a patient portal. A multi-disciplinary team integrated 5 major health IT innovations into the EHR: (1) use of a computerized adaptive test for depression assessment, (2) 2-way secure communication between cloud-based software and the EHR, (3) improved accessibility of depression assessment results, (4) enhanced awareness and documentation of positive depression results, and (5) sending assessments via the portal. Throughout the 30-month observational period, we collected administrative, survey, and outcome data. RESULTS: Attending and resident physicians who participated in the project were trained in depression assessment workflows through presentations at clinic meetings, self-guided online materials, and individual support. Developing stakeholder relationships, using an evaluative and iterative process, and ongoing training were key implementation strategies. CONCLUSIONS: The PORTAL-Depression project was a complex and labor-intensive intervention. Despite quick adoption by the clinic, only certain aspects of the intervention were sustained in the long term due to financial and personnel constraints.
AD - Department of Medicine, University of Chicago, Chicago, IL 60637, United States.; UChicago Medicine, Chicago, IL 60637, United States.; Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, United States.; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL 60637, United States.
AN - 39473829
BT - JAMIA Open
C5 - HIT & Telehealth
CP - 3
DA - Oct
DO - 10.1093/jamiaopen/ooae094
DP - NLM
ET - 20240924
IS - 3
JF - JAMIA Open
LA - eng
N2 - OBJECTIVES: To integrate a computerized adaptive test for depression into the electronic health record (EHR) and establish systems for administering assessments in-clinic and via a patient portal to improve depression care. MATERIALS AND METHODS: This article reports the adoption, implementation, and maintenance of a health information technology (IT) quality improvement (QI) project, Patient Outcomes Reporting for Timely Assessment of Life with Depression (PORTAL-Depression). The project was conducted in a hospital-based primary care clinic that serves a medically underserved metropolitan community. A 30-month (July 2017-March 2021) QI project was designed to create an EHR-embedded system to administer adaptive depression assessments in-clinic and via a patient portal. A multi-disciplinary team integrated 5 major health IT innovations into the EHR: (1) use of a computerized adaptive test for depression assessment, (2) 2-way secure communication between cloud-based software and the EHR, (3) improved accessibility of depression assessment results, (4) enhanced awareness and documentation of positive depression results, and (5) sending assessments via the portal. Throughout the 30-month observational period, we collected administrative, survey, and outcome data. RESULTS: Attending and resident physicians who participated in the project were trained in depression assessment workflows through presentations at clinic meetings, self-guided online materials, and individual support. Developing stakeholder relationships, using an evaluative and iterative process, and ongoing training were key implementation strategies. CONCLUSIONS: The PORTAL-Depression project was a complex and labor-intensive intervention. Despite quick adoption by the clinic, only certain aspects of the intervention were sustained in the long term due to financial and personnel constraints.
PY - 2024
SN - 2574-2531
SP - ooae094
ST - Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression
T1 - Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression
T2 - JAMIA Open
TI - Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression
U1 - HIT & Telehealth
U3 - 10.1093/jamiaopen/ooae094
VL - 7
VO - 2574-2531
Y1 - 2024
ER -