Complete Transcript of Event
AHRQIX: Our first TweetChat will begin shortly. We’ll be joined by @miller7 & @norskedoc to talk about behavioral health & primary care #ahrqix
Wed, 29 Aug 2012 19:53:13
AHRQIX: We're also joined by Judi Consalvo, Project Lead for the #Innovations Exchange. She'll be following along with us. #ahrqix
Wed, 29 Aug 2012 19:54:38
AHRQIX: We’re using #AHRQIX for the chat. Please include it in your tweets #ahrqix
Wed, 29 Aug 2012 19:56:12
AHRQIX: If you have a question and want to tweet during the chat, make sure your tweets are not protected. #ahrqix
Wed, 29 Aug 2012 19:57:31
IdaliaMassa: Looking forward to this discussion! #ahrqix
Wed, 29 Aug 2012 19:59:10
AHRQIX: We may collect, save & post transcripts from this chat on our site. See our privacy policy: http://t.co/Kli7t9Y6 #ahrqix
Wed, 29 Aug 2012 19:59:12
socialibriumm: Excited u r making a return for this chat! MT @norskedoc: have been away from Twitter for some time, will tweet away @ #AHRQIX chat #ahrqix
Wed, 29 Aug 2012 19:59:41
AHRQIX: . @miller7 and @norskedoc will be tweeting along with us, so please follow the stream of tweets at http://t.co/nPjhP01A #ahrqix
Wed, 29 Aug 2012 19:59:59
socialibriumm: RT @AHRQIX: We’re using #AHRQIX for the chat. Please include it in your tweets #ahrqix
Wed, 29 Aug 2012 20:00:38
AHRQIX: Welcome to our Twitter Chat to discuss behavioral health and #primarycare! #ahrqix
Wed, 29 Aug 2012 20:00:42
AHRQIX: I’m Nicole from the AHRQIX team & I’ll be moderating the @AHRQIX handle during this chat #ahrqix
Wed, 29 Aug 2012 20:01:07
AHRQIX: I’m also pleased to be joined today by Ben Miller (@miller7) and Gary Oftedahl (@norskedoc) #ahrqix
Wed, 29 Aug 2012 20:01:48
AHRQIX: Dr. Miller (@miller7) is an assistant professor at the Univ. of Colorado School of Medicine & will be hosting today’s chat #ahrqix
Wed, 29 Aug 2012 20:02:05
NACHC_Dirk: @AHRQIX Bill Reidy and Dirk Bokeloh listening in from @NACHC #AHRQIX
Wed, 29 Aug 2012 20:02:39
AHRQIX: He focuses on studying the impact of collocated mental health, #behavioralhealth & substance abuse in #primarycare settings #ahrqix
Wed, 29 Aug 2012 20:02:48
miller7: @NACHC_Dirk Welcome, Bill and Dirk! #AHRQIX Good to "see" you.
Wed, 29 Aug 2012 20:03:13
AHRQIX: Our guest is Gary Oftedahl (@norskedoc), who runs @ICSIorg’s DIAMOND program to improve #healthcare for people with #depression #ahrqix
Wed, 29 Aug 2012 20:03:18
AHRQIX: To learn more about DIAMOND, visit the website here: http://t.co/XQsHMLK2 #ahrqix
Wed, 29 Aug 2012 20:03:35
norskedoc: I'm here and as ready to go as I'll ever be. Welcome everyone. But it may be too strong to say I "run" the program. #AHRQIX
Wed, 29 Aug 2012 20:03:48
WestatHC: RT @AHRQIX: Welcome to our Twitter Chat to discuss behavioral health and #primarycare! #ahrqix
Wed, 29 Aug 2012 20:03:55
AHRQIX: . @miller7 and @ norskedoc will answer any of your more technical questions. Please note that we can’t provide medical advice. #ahrqix
Wed, 29 Aug 2012 20:03:59
AHRQIX: We're going to hand it off to @miller7 now -- take it away! #ahrqix
Wed, 29 Aug 2012 20:04:27
miller7: Welcome all to the first #AHRQIX tweetchat; I am looking forward to moderating today's exciting topic
Wed, 29 Aug 2012 20:04:35
2healthguru: @norskedoc what's this about Gary? #AHRQIX
Wed, 29 Aug 2012 20:04:38
norskedoc: DIAMOND is a huge example of a "collaborative approach, and we'll talk more about that as we go... #AHRQIX
Wed, 29 Aug 2012 20:04:42
miller7: @2healthguru @norskedoc Welcome, Gregg!! #AHRQIX
Wed, 29 Aug 2012 20:04:55
miller7: #AHRQIX stands for the AHRQ Innovations exchange: http://t.co/QOHsAFEe a place for #healthcare #innovation to be shared
Wed, 29 Aug 2012 20:05:01
norskedoc: STay tuned, we're trying something new... RT @2healthguru: @norskedoc what's this about Gary? #AHRQIX
Wed, 29 Aug 2012 20:05:10
miller7: #AHRQIX is an @AHRQNews sponsored project developed in partnership with @westatHC
Wed, 29 Aug 2012 20:05:16
miller7: Today’s #AHRQIX #healthcare #innovation will be on integrating #mentalhealth and #primarycare with a national expert, @norskedoc
Wed, 29 Aug 2012 20:05:40
WestatHC: RT @miller7: #AHRQIX is an @AHRQNews sponsored project developed in partnership with @westatHC
Wed, 29 Aug 2012 20:05:55
2healthguru: hey, hey, ho, ho! @miller7 @norskedoc #AHRQIX
Wed, 29 Aug 2012 20:06:12
miller7: For background on #mentalhealth and& #primarycare & why matters for #healthcare #innovation see here: http://t.co/TtQlO5fY #AHRQIX
Wed, 29 Aug 2012 20:06:22
DrFinnerty: RT @miller7: Welcome all to the first #AHRQIX tweetchat; I am looking forward to moderating today's exciting topic
Wed, 29 Aug 2012 20:06:25
DrFinnerty: RT @miller7: Today’s #AHRQIX #healthcare #innovation will be on integrating #mentalhealth and #primarycare with a national expert, @nors ...
Wed, 29 Aug 2012 20:06:32
miller7: @AHRQIX has addressed the integration topic directly here: http://t.co/sJkxmvbX #AHRQIX
Wed, 29 Aug 2012 20:06:44
ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/BYV6B5RY #ahrqix
Wed, 29 Aug 2012 20:06:49
ePatientDave: RT @miller7: Today’s #AHRQIX #healthcare #innovation will be on integrating #mentalhealth and #primarycare with a national expert, @nors ...
Wed, 29 Aug 2012 20:06:56
miller7: Let me tell you about today’s #AHRQIX tweetchat –focusing on integration, I will be asking our expert, @norskedoc questions as well as you
Wed, 29 Aug 2012 20:07:01
ePatientDave: RT @norskedoc: DIAMOND is a huge example of a "collaborative approach, and we'll talk more about that as we go... #AHRQIX
Wed, 29 Aug 2012 20:07:10
miller7: @ePatientDave Hey trouble, thanks for sharing! #AHRQIX
Wed, 29 Aug 2012 20:07:18
michaelrusso: RT @ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/BYV6B5RY #ahrqix
Wed, 29 Aug 2012 20:07:31
ePatientDave: RT @AHRQIX: Welcome to our Twitter Chat to discuss behavioral health and #primarycare! #ahrqix
Wed, 29 Aug 2012 20:07:34
norskedoc: @ePatientDave Hello Dave, not surprised to see you here...join in as you see fit. #AHRQIX
Wed, 29 Aug 2012 20:07:37
ePatientDave: RT @AHRQIX: To learn more about DIAMOND, visit the website here: http://t.co/XQsHMLK2 #ahrqix
Wed, 29 Aug 2012 20:07:41
socialibriumm: RT @ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/rNEPbl9i
#ahrqix
Wed, 29 Aug 2012 20:07:44
miller7: OK, let’s get this #AHRQIX tweetchat started with some introductions – who do we have here today?
Wed, 29 Aug 2012 20:07:44
2healthguru: RT @miller7: OK, let’s get this #AHRQIX tweetchat started with some introductions – who do we have here today?
Wed, 29 Aug 2012 20:07:57
ePatientDave: RT @miller7: #AHRQIX is an @AHRQNews sponsored project developed in partnership with @westatHC
Wed, 29 Aug 2012 20:08:24
MsWZ: Happy to join #AHRQIX today!
Wed, 29 Aug 2012 20:09:09
miller7: I am Ben, moderating #AHRQIX today; blog here: http://t.co/LVYjJlLk and jealous of @DanaMlewis #hcsm moderating skills
Wed, 29 Aug 2012 20:09:10
MsWZ: RT @ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/BYV6B5RY #ahrqix
Wed, 29 Aug 2012 20:09:17
miller7: @MsWZ Welcome, Whitney! #AHRQIX
Wed, 29 Aug 2012 20:09:26
HealthJusticeCT: @drzoobs, this may be of interest MT @miller7: Today’s #AHRQIX #healthcare #innovation will be on integrating #mentalhealth & #primarycare
Wed, 29 Aug 2012 20:09:51
yayayarndiva: RT @miller7: #AHRQIX stands for the AHRQ Innovations exchange: http://t.co/QOHsAFEe a place for #healthcare #innovation to be shared
Wed, 29 Aug 2012 20:09:52
norskedoc: I'm Gary, and I'm just jealous in general, but interested in sharing our experiences with DIAMOND and where it's going... #AHRQIX
Wed, 29 Aug 2012 20:10:05
MsWZ: RT @miller7: I am Ben, moderating #AHRQIX today; blog here: http://t.co/LVYjJlLk and jealous of @DanaMlewis #hcsm moderating skills
Wed, 29 Aug 2012 20:10:19
2healthguru: Tweep alert! follow #ahrqix for a tweetchat moderated by the very capable @miller7 & @norskedoc
Wed, 29 Aug 2012 20:10:26
norskedoc: Compliments appreciated... RT @2healthguru: Tweep alert! follow #ahrqix for a tweetchat moderated by the very capable @miller7 & @norskedoc
Wed, 29 Aug 2012 20:10:54
lauranewmanny: looking forward to more substantive discussion soon! #ahrqix
Wed, 29 Aug 2012 20:11:01
miller7: Let's get started here with Let’s start with @norskedoc – tell us why addressing #mentalhealth in #primarycare is so important #AHRQIX
Wed, 29 Aug 2012 20:11:07
norskedoc: Primary care is in reality the de facto mental health provider for many—need to become more proficient. http://t.co/eudGfWQ7 #AHRQIX
Wed, 29 Aug 2012 20:11:50
norskedoc: Experience in 2003-4 at ICSI identified huge gap in depression mgmt in primary care—drove early work. #AHRQIX
Wed, 29 Aug 2012 20:12:02
miller7: MT @norskedoc: #Primarycare is de facto #mentalhealth provider for many—need to become more proficient. http://t.co/L1KNwgk0 #AHRQIX
Wed, 29 Aug 2012 20:12:19
norskedoc: Unique “partnership research” approach of DIAMOND highlighted combining implementation science and research. http://t.co/kjjBF4Us #AHRQIX
Wed, 29 Aug 2012 20:12:32
miller7: Those joining us here what have your experiences been with #mentalhealth and #primarycare? #AHRQIX
Wed, 29 Aug 2012 20:13:18
norskedoc: We spent over 3 years identifying many challenges faced in managing depression in primary care, which required different approach. #ahrqix
Wed, 29 Aug 2012 20:13:38
2healthguru: RT @norskedoc: Experience in 2003-4 at ICSI identified huge gap in depression mgmt in primary care—drove early work. #AHRQIX
Wed, 29 Aug 2012 20:14:00
norskedoc: In visiting many of primary clinics in 2003-4, identified lack of interest or model for addressing depression. Quite frustrating. #ahrqix
Wed, 29 Aug 2012 20:14:49
laura3530: RT @ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/BYV6B5RY #ahrqix
Wed, 29 Aug 2012 20:15:04
miller7: @norskedoc What were some of the reasons they gave you as to why they were not interested? #AHRQIX
Wed, 29 Aug 2012 20:15:31
AHRQIX: Integrated #behavioralhealth reduces #depression & anxiety, improves quality of life and reduces costs http://t.co/YgIOTccR #ahrqix
Wed, 29 Aug 2012 20:15:52
laura3530: RT @AHRQNews: Join @AHRQIX live on the state of behavioral health & primary care. Today at 4PM ET. Use #AHRQIX to join!
Wed, 29 Aug 2012 20:15:53
2healthguru: @norskedoc Gary, you are talking to me my friend! #ahrqix
Wed, 29 Aug 2012 20:15:57
norskedoc: Perhaps that term actually represented discomfort with topic, lack of clear model or approach to use. #ahrqix
Wed, 29 Aug 2012 20:16:12
norskedoc: Also, for many, there had not been a great deal of training or experience with mental health conditions. #ahrqix
Wed, 29 Aug 2012 20:16:39
norskedoc: Third, the "stigma" which was associated with condition had a suppressive effect on even addressing. #ahrqix
Wed, 29 Aug 2012 20:17:10
miller7: MT @norskedoc: Also, for many (#primarycare), there was not great deal of training or experience with mental health conditions. #ahrqix
Wed, 29 Aug 2012 20:17:20
2healthguru: RT @norskedoc: Third, the "stigma" which was associated with condition had a suppressive effect on even addressing. #ahrqix
Wed, 29 Aug 2012 20:17:27
socialibriumm: RT @AHRQIX: Integrated #behavioralhealth reduces #depression & anxiety, improves quality of life reduces costs http://t.co/nWPDxWU1 #ahrqix
Wed, 29 Aug 2012 20:17:35
kennylinafp: Primary care clinicians are good at prescribing drugs for depression, not so good at cognitive therapy. #ahrqix
Wed, 29 Aug 2012 20:17:43
norskedoc: Also, in many cases, past history of "carve out" which precluded payment if prim care MD diagnosed depression...all contributed. #ahrqix
Wed, 29 Aug 2012 20:17:53
AHRQIX: Placing #mentalhealth specialists in #primarycare settings enhances engagement & produces favorable results http://t.co/GChmDNTy #ahrqix
Wed, 29 Aug 2012 20:18:04
norskedoc: @kennylinafp Your comment on prescriptions bespeaks of an additional issue, which we've confronted. #ahrqix
Wed, 29 Aug 2012 20:18:28
miller7: @kennylinafp This is often do to training and limitations placed on them by the #healthcare system? #AHRQIX
Wed, 29 Aug 2012 20:18:32
2healthguru: @norskedoc yup, carveout and cap. great way to pass buck! #ahrqix
Wed, 29 Aug 2012 20:18:58
miller7: @2healthguru What ways do you see to tackle the issue, Gregg? #AHRQIX
Wed, 29 Aug 2012 20:19:25
2healthguru: And completely miss point of behavioral medicine. #ahrqix
Wed, 29 Aug 2012 20:19:39
norskedoc: I could go on, but suffice it to say we identified many barriers, which supported what I call "learned helplessness." #ahrqix
Wed, 29 Aug 2012 20:19:42
kennylinafp: @miller7 Yes, agree. Would be great to be able to place mental health professionals in community primarycare offices. #ahrqix
Wed, 29 Aug 2012 20:20:03
AHRQIX: Collaboration between #mentalhealth & #primarycare: A planning & implementation toolkit for HCPs http://t.co/tPBPfcd1 #ahrqix
Wed, 29 Aug 2012 20:20:25
2healthguru: RT @miller7: What ways do you see to tackle the issue, Gregg? #AHRQIX > parity and real team based care. population perspective!
Wed, 29 Aug 2012 20:20:28
TDSHealth: RT @ePatientDave: Hey Twitter: AHRQ Innovation Exchange has a live tweetchat going on right now! #AHRQIX URL: http://t.co/BYV6B5RY #ahrqix
Wed, 29 Aug 2012 20:20:30
miller7: RT @kennylinafp: Yes, agree. Would be great to be able to place mental health professionals in community #primarycare offices. #ahrqix
Wed, 29 Aug 2012 20:20:38
kennylinafp: @AHRQIX This model can work in academic and govt settings - has it been tried outside of those? #ahrqix
Wed, 29 Aug 2012 20:20:42
norskedoc: DIAMOND arose from early work at ICSI in 2004-5, identified evidence based model, IMPACT http://t.co/egZvMZ6l #AHRQIX
Wed, 29 Aug 2012 20:21:18
2healthguru: @miller7 single driver of Rx or Tx compliance?? >> mood! #ahrqix
Wed, 29 Aug 2012 20:21:53
laura3530: Any tips for how providers can incorporate #BH integration into their other #PCMH practice change intiatives #ahrqix
Wed, 29 Aug 2012 20:21:55
miller7: @kennylinafp Absolutely! Look at the DIAMOND program @norskedoc is talking about http://t.co/9KLft96Z #AHRQIX
Wed, 29 Aug 2012 20:22:09
miller7: @laura3530 Welcome, Laura! #AHRQIX
Wed, 29 Aug 2012 20:22:19
norskedoc: Important to note that DIAMOND used psychiatrist as "liaison" in panel mgmt, care manager, not behavioral health trained... #ahrqix
Wed, 29 Aug 2012 20:22:41
2healthguru: @norskedoc for political or clinical reasons? just curious....#ahrqix
Wed, 29 Aug 2012 20:23:33
norskedoc: DIAMOND built on idea (Wagner's CCM), an invention (IMPACT) but moved to innovation--scalable, financially sustainable. #ahrqix
Wed, 29 Aug 2012 20:23:40
IdaliaMassa: why psychiatrists and not psychologists? #ahrqix
Wed, 29 Aug 2012 20:24:01
norskedoc: @2healthguru If you're questioning the use of psychiatrists, it was because that was the evidence based model available (IMPACT). #ahrqix
Wed, 29 Aug 2012 20:24:31
miller7: @laura3530 @AHRQNews had a nice white paper that discussed why integrate #mentalhealth and #PCMH http://t.co/r7CuU4Kh (pdf) #AHRQIX
Wed, 29 Aug 2012 20:24:40
norskedoc: Again, b/c we were attempting to take an EBM model, and implement...RT @IdaliaMassa: why psychiatrists and not psychologists? #ahrqix
Wed, 29 Aug 2012 20:25:18
norskedoc: Some questioned the use of psychology vs. psychiatrist, but felt need to have fidelity to Unutzer's IMPACT model to engage payers. #ahrqix
Wed, 29 Aug 2012 20:26:13
miller7: Those interested in the evidence for what @norskedoc is talking about can look here http://t.co/aT9Dq2DY #AHRQIX
Wed, 29 Aug 2012 20:26:19
2healthguru: RT @miller7: Those interested in the evidence for what @norskedoc is talking about can look here http://t.co/aT9Dq2DY #AHRQIX
Wed, 29 Aug 2012 20:26:51
norskedoc: I apologize if I'm jumping around but trying to keep up with the great comments, and challenged in 140 characters. #ahrqix
Wed, 29 Aug 2012 20:27:15
norskedoc: Also important to note that care manager role is served in many of DIAMOND clinics by CMA--with supervision, with great success. #ahrqix
Wed, 29 Aug 2012 20:27:54
miller7: @norskedoc With this unique approach what were some of the challenges of implementing DIAMOND? #AHRQIX
Wed, 29 Aug 2012 20:28:12
norskedoc: ICSI provided training, based on IMPACT training for all sites (over 80) which implemented DIAMOND, and have sustained support. #ahrqix
Wed, 29 Aug 2012 20:28:38
norskedoc: With regard to challenges, many, and I'll try to list a few... first, needed to get critical mass of payers to come to table . #ahrqix
Wed, 29 Aug 2012 20:29:39
norskedoc: Need to address needed payment model redesign in face of antitrust issues, and engaging multiple commercial payers #AHRQIX
Wed, 29 Aug 2012 20:29:45
norskedoc: Significant professional cultural differences between primary care and mental health are challenge to address. #AHRQIX
Wed, 29 Aug 2012 20:30:07
miller7: Yes! RT @norskedoc: Significant professional cultural differences between #primarycare & #mentalhealth are challenge to address. #AHRQIX
Wed, 29 Aug 2012 20:30:27
AHRQIX: To read more about Unutzer's IMPACT model, check out the Q&A on our website: http://t.co/SD4t6HWE #ahrqix
Wed, 29 Aug 2012 20:30:37
norskedoc: Engaging psychiatrist in a “liaison” role, managing patient panels, not direct pt. contact was major challenge to existing roles. #AHRQIX
Wed, 29 Aug 2012 20:30:45
ePatientDave: @miller7 What's the URL to the half-day town hall on integration, from AHRQ's annual meeting? #ahrqix
Wed, 29 Aug 2012 20:31:20
norskedoc: Providing set of tools for diverse primary care practices in different settings was challenge. http://t.co/269uX1sE #AHRQIX
Wed, 29 Aug 2012 20:31:25
miller7: @ePatientDave http://t.co/TLh1m1KC #AHRQIX
Wed, 29 Aug 2012 20:32:10
norskedoc: Despite successes, inability to engage CMS and provide coverage for Medicare patients limited implementation. #AHRQIX
Wed, 29 Aug 2012 20:32:12
norskedoc: While we had the commercial payers supporting this effort, not engaging CMS limited creating systemic approach needed for some. #ahrqix
Wed, 29 Aug 2012 20:32:49
norskedoc: Initially, we encountered some negative reaction from mental health providers, fearing we were intruding on their turf. #ahrqix
Wed, 29 Aug 2012 20:33:20
socialibriumm: RT @AHRQIX: To read more about Unutzers IMPACT model, check out the Q&A on our website: http://t.co/v2fSNwEn #ahrqix
Wed, 29 Aug 2012 20:33:22
miller7: @mellojonny Awesome! Do you have links we can see about this approach? #AHRQIX
Wed, 29 Aug 2012 20:33:31
norskedoc: However, we've overcome that and actually are training many BH clinics in MN in collaborative model, CQI. #ahrqix
Wed, 29 Aug 2012 20:33:56
mellojonny: Majority of our schizophrenic patients are managed by ourselves. We meet with local psychiatry every 6w @miller7 @kennylinafp #ahrqix
Wed, 29 Aug 2012 20:34:28
norskedoc: Important to understand ICSI role as "neutral convener" and catalyst for the multiple conversations needed over a 2 yr planning. #ahrqix
Wed, 29 Aug 2012 20:34:33
AHRQIX: Better access to care for low-income people with mental illness leads to improved physical & #mentalhealth http://t.co/ysAMZt56 #ahrqix
Wed, 29 Aug 2012 20:35:03
norskedoc: Unique “partnership research” approach of DIAMOND highlighted combining implementation science and research. http://t.co/kjjBF4Us #AHRQIX
Wed, 29 Aug 2012 20:35:23
MsWZ: RT @socialibriumm: RT @AHRQIX: To read more about Unutzers IMPACT model, check out the Q&A on our website: http://t.co/v2fSNwEn #ahrqix
Wed, 29 Aug 2012 20:35:30
miller7: @mellojonny Is 6 weeks sufficient? How much of this is due to system model vs. available workforce? #AHRQIX
Wed, 29 Aug 2012 20:35:30
mellojonny: We care for nearly 100 patients on methadone out of practice pop of 12k & 84 with schizophrenia plus diabetes @miller7 @kennylinafp #ahrqix
Wed, 29 Aug 2012 20:35:51
MsWZ: RT @norskedoc: Need to address needed payment model redesign in face of anti-trust issues, and engaging multiple commercial payers #AHRQIX
Wed, 29 Aug 2012 20:36:01
norskedoc: One of true accomplishments of DIAMOND was getting prim. care and BH into same room, beginning to address issues. #ahrqix
Wed, 29 Aug 2012 20:36:51
miller7: MT @norskedoc: One of true accomplishments of DIAMOND was getting #primarycare and BH in same room, begin to address issues. #ahrqix
Wed, 29 Aug 2012 20:37:23
MsWZ: what were the first steps to intro this new approach to payers @norskedoc? Did they want evidence? Partners? Patients? #AHRQIX
Wed, 29 Aug 2012 20:37:35
reitzrandall: I've been following the #AHRQIX tweet chat. Great data and resources. #CFHA
Wed, 29 Aug 2012 20:37:37
mellojonny: 6 weeks works fine. Here is gateway info for local #primarycare practices & mental health services @miller7 #ahrqix
Wed, 29 Aug 2012 20:37:43
norskedoc: Also, while some criticize for single disease approach, I believe this allowed prim. care to "succeed" in BH issue. #ahrqix
Wed, 29 Aug 2012 20:37:48
2healthguru: RT @norskedoc: Despite successes, inability to engage CMS and provide coverage for Medicare patients limited implementation. #AHRQIX
Wed, 29 Aug 2012 20:37:50
miller7: @reitzrandall Welcome, Randall. #AHRQIX
Wed, 29 Aug 2012 20:37:51
kennylinafp: MT @AHRQIX: Better access to care for low-income people with mental illness improves physical & #mentalhealth http://t.co/VcRR6LFG #ahrqix
Wed, 29 Aug 2012 20:37:56
JuliaPronx: RT @mellojonny: 6 weeks works fine. Here is gateway info for local #primarycare practices & mental health services @miller7 #ahrqix
Wed, 29 Aug 2012 20:38:06
AHRQIX: Re: methadone -- A #Baltimore initiative expands access to heroin treatment through partnerships & trainings http://t.co/XiFebTPu #ahrqix
Wed, 29 Aug 2012 20:38:22
2healthguru: RT @norskedoc: However, we've overcome that and actually are training many BH clinics in MN in collaborative model, CQI. #ahrqix
Wed, 29 Aug 2012 20:38:25
norskedoc: For many, successfully implementing DIAMOND was basis for proceeding with medical home work--many of same issues, different topic. #ahrqix
Wed, 29 Aug 2012 20:38:25
yayayarndiva: RT @AHRQIX: To learn more about DIAMOND, visit the website here: http://t.co/XQsHMLK2 #ahrqix
Wed, 29 Aug 2012 20:38:41
kennylinafp: Great! RT @mellojonny: We care for nearly 100 patients onmethadone out of practice pop of 12k & 84 with schizophrenia plus diabetes #ahrqix
Wed, 29 Aug 2012 20:38:45
2healthguru: RT @norskedoc: Need to address needed payment model redesign in face of anti-trust issues, and engaging multiple commercial payers #AHRQIX
Wed, 29 Aug 2012 20:39:07
miller7: It appears that experts have called for #mentalhealth #primarycare integration for some time http://t.co/meQRliir #AHRQIX
Wed, 29 Aug 2012 20:39:12
2healthguru: RT @norskedoc: One of true accomplishments of DIAMOND was getting prim. care and BH into same room, beginning to address issues. #ahrqix
Wed, 29 Aug 2012 20:39:16
norskedoc: In approaching payers, they wanted evidence of success, but extremely focused on total cost of care, potential savings. #ahrqix
Wed, 29 Aug 2012 20:39:19
2healthguru: RT @norskedoc: Also, while some criticize for single disease approach, I believe this allowed prim. care to "succeed" in BH issue. #ahrqix
Wed, 29 Aug 2012 20:39:40
norskedoc: We are still collecting cost data, and as often with research, that lags behind our implementation--can be a problem. #ahrqix
Wed, 29 Aug 2012 20:39:54
mellojonny: This is the medically unexplained symptom/ psychology service set up with the Tavistock http://t.co/J4MWndFr @miller7 #ahrqix
Wed, 29 Aug 2012 20:40:22
reitzrandall: Dr Lin's point about acad and safety-net is an important. The only system-wide solution is insurance reform of the PCMH variety. #AHRQIX
Wed, 29 Aug 2012 20:40:41
miller7: Wow, what excellent information - @norskedoc! Where is DIAMOND headed & how do you foresee changing #healthcare policy? #AHRQIX
Wed, 29 Aug 2012 20:40:42
norskedoc: In 2006, we were able to engage payers, b/c the gap btw where we were and where we needed to be was so huge.. #ahrqix
Wed, 29 Aug 2012 20:40:57
AHRQIX: Onsite care teams enhance access to medical & #mentalhealth / substance abuse services for the homeless http://t.co/hvQCy8c1 #ahrqix
Wed, 29 Aug 2012 20:40:59
bernmck06: Success stories?#ahrqix
Wed, 29 Aug 2012 20:41:05
miller7: @reitzrandall @kennylinafp Absolutely! Payment reform important for integration! #AHRQIX
Wed, 29 Aug 2012 20:41:32
norskedoc: I'm often amazed at where DIAMOND has brought us and where it's going....will highlight a few of what I think are outcomes. #ahrqix
Wed, 29 Aug 2012 20:41:32
kennylinafp: MT @reitzrandall: Point about acad and safety-net is important. Only system-wide solution is insurance reform of #PCMH variety. #ahrqix
Wed, 29 Aug 2012 20:41:55
norskedoc: First, if nothing else, there's less "stigma" surrounding depression b/c of our work, many don't even see that, but it's real. #ahrqix
Wed, 29 Aug 2012 20:42:03
miller7: @bernmck06 We are hearing more and more success stories weekly! One example from #Colorado http://t.co/QBSOEOq7 #AHRQIX
Wed, 29 Aug 2012 20:42:28
MsWZ: RT @miller7: @reitzrandall @kennylinafp Absolutely! Payment reform important for integration! #AHRQIX
Wed, 29 Aug 2012 20:42:35
norskedoc: Second, as a result of DIAMOND, we're extending this approach with 2 partners in AHRQ grant using SBIRT, for substance abuse. #ahrqix
Wed, 29 Aug 2012 20:42:58
mellojonny: Every generalist is (or ought to be) a medically-unexplained symptom specialist! http://t.co/erv3lyCV @miller7 #ahrqix
Wed, 29 Aug 2012 20:43:22
2healthguru: @norskedoc insome academic settings, family medicine considered not a real specialty. whereas psychiatry is merely tolerated..#ahrqix
Wed, 29 Aug 2012 20:43:23
norskedoc: Third, DIAMOND exemplifies the "team" approach, has prepped many for medical home. #ahrqix
Wed, 29 Aug 2012 20:43:31
MsWZ: RT @miller7: @bernmck06 We are hearing more and more success stories weekly! One example from #Colorado http://t.co/QBSOEOq7 #AHRQIX
Wed, 29 Aug 2012 20:43:32
miller7: RT @mellojonny: Every generalist is (or ought to be) a medically unexplained symptom specialist! http://t.co/ulyB6uYN #ahrqix
Wed, 29 Aug 2012 20:43:38
norskedoc: ICSI recently awarded CMMI Innovation Challenge grant to expand DIAMOND model with partners across country. http://t.co/QZSgUQm1 #AHRQIX
Wed, 29 Aug 2012 20:44:02
2healthguru: @norskedoc behavioral health, not even on the radar. has it changed? #ahrqix
Wed, 29 Aug 2012 20:44:08
kennylinafp: RT @mellojonny: Every generalist is (or ought to be) a medically unexplained symptom specialist! http://t.co/vEwqi7uP #ahrqix
Wed, 29 Aug 2012 20:44:26
MsWZ: #AHRQIX @norskedoc How are pharmacists included in the DIAMOND approach effort for the PCMH? cc: @Miller7
Wed, 29 Aug 2012 20:44:37
miller7: MT @norskedoc @ICSIorg recently awarded @CMSinnovates grant to expand DIAMOND model across country http://t.co/Byx3OFzX #AHRQIX
Wed, 29 Aug 2012 20:44:38
norskedoc: Also, DIAMOND has led to relationships btw prim care and BH which not seen before. #ahrqix
Wed, 29 Aug 2012 20:44:40
miller7: @MsWZ Great question! #AHRQIX
Wed, 29 Aug 2012 20:44:53
AHRQIX: Nurse-led visits promote self-care & improve the #health of diabetic adults with severe mental illness http://t.co/EtGAWF8W #ahrqix
Wed, 29 Aug 2012 20:45:03
norskedoc: While pharmacists not formally part of program, many are beginning to use them in working with patients. #ahrqix
Wed, 29 Aug 2012 20:45:15
norskedoc: I apologize but likely missing some of questions due to high volume, but greatly appreciate the discussion. #ahrqix
Wed, 29 Aug 2012 20:45:46
miller7: @norskedoc That's great as clinical pharmacists are being more integrated into #healthcare http://t.co/5ppWzfqI cc @MsWZ #AHRQIX
Wed, 29 Aug 2012 20:46:14
norskedoc: Personally, I believe this really addresses need for "relationship" based models, rather than frequent "expert" models used. #ahrqix
Wed, 29 Aug 2012 20:46:33
mellojonny: Apols, here is the primary care mental health gateway/ partnership model for our GPs http://t.co/IJkIX6oP @miller7 #ahrqix
Wed, 29 Aug 2012 20:46:37
2healthguru: RT @mellojonny: Apols, here is the primary care mental health gateway/ partnership model for our GPs http://t.co/IJkIX6oP @miller7 #ahrqix
Wed, 29 Aug 2012 20:46:48
reitzrandall: The research base is growing. Hot off the presses with largest ever study on relational correlates in heart dx http://t.co/clAPhOXD #ahrqix
Wed, 29 Aug 2012 20:47:04
norskedoc: It is important to understand this is much more than colocation...#ahrqix
Wed, 29 Aug 2012 20:47:39
MelissaColeHTR: RT @mellojonny: Apols, here is the primary care mental health gateway/ partnership model for our GPs http://t.co/IJkIX6oP@miller7 #ahrqix
Wed, 29 Aug 2012 20:47:46
miller7: MT @norskedoc: It is important to understand this (integration) is much more than colocation... #ahrqix
Wed, 29 Aug 2012 20:47:55
miller7: @norskedoc Right, it seems that only colocation of #mentalhealth would simply replicate some of problems seen on outside #AHRQIX
Wed, 29 Aug 2012 20:48:36
norskedoc: I've also had fascinating conversations with Judy Hibbard, creator of the Patient Activation Measure--linking this to depression... #ahrqix
Wed, 29 Aug 2012 20:48:42
kennylinafp: More details, please. RT @norskedoc: It is important to understand this (integration) is much more than colocation. @miller7 #ahrqix
Wed, 29 Aug 2012 20:49:06
miller7: Those not familiar with the Patient Activation Measure http://t.co/RRtgUqTU #AHRQIX
Wed, 29 Aug 2012 20:49:13
norskedoc: Many may be familiar with the "adaptive" model of Ron Heifetz which addresses adaptive challenges--we focused on that in DIAMOND. #ahrqix
Wed, 29 Aug 2012 20:49:43
miller7: @kennylinafp (1) If we only colocate a #mentalhealth provider in #primarycare and ask them to have same "function" as on outside #AHRQIX
Wed, 29 Aug 2012 20:49:53
2healthguru: RT @miller7: Those not familiar with the Patient Activation Measure http://t.co/RRtgUqTU #AHRQIX
Wed, 29 Aug 2012 20:50:00
AHRQIX: @laura3530 Check out this innovation on #mentalhealth services in health plan centers: http://t.co/PSYOiHSS #ahrqix
Wed, 29 Aug 2012 20:50:16
norskedoc: We were also successful in "retiring" HEDIS measures, and focusing on outcomes--based on PHQ-9, now used as state measure. #ahrqix
Wed, 29 Aug 2012 20:50:27
miller7: @kennylinafp (2) we see them deliver traditional #mentalhealth services rather than seamlessly collaborate on team #AHRQIX
Wed, 29 Aug 2012 20:50:29
norskedoc: Adaptive work require addressing existing beliefs, values, habits, and thinking outside the system--it created valuable framework. #ahrqix
Wed, 29 Aug 2012 20:51:25
MelissaColeHTR: Great reference via @ePatientDave RT @miller7: Those not familiar with the Patient Activation Measure http://t.co/zRckHpyK #AHRQIX
Wed, 29 Aug 2012 20:51:48
norskedoc: Media coverage has been useful in driving effort, not our usual approach in past. http://t.co/RsKH6D6B #AHRQIX
Wed, 29 Aug 2012 20:52:05
miller7: MT @norskedoc: Media coverage has been useful in driving #integration effort; not usual approach in past. http://t.co/44utgCgi #AHRQIX
Wed, 29 Aug 2012 20:52:44
MsWZ: RT @miller7: Those not familiar with the Patient Activation Measure http://t.co/RRtgUqTU #AHRQIX
Wed, 29 Aug 2012 20:52:47
norskedoc: Seeing some comments on PAM, and I'm very interested in pursuing learning more about potential value of that tool also.. #ahrqix
Wed, 29 Aug 2012 20:52:52
MsWZ: @kennylinafp @norskedoc @miller7 It's not just being in the same room, its about doing something together while you are there? #AHRQIX
Wed, 29 Aug 2012 20:53:30
AHRQIX: RT @miller7: @norskedoc Thats great as clinical pharmacists are being more integrated into #healthcare http://t.co/XlTER9MV cc @MsWZ #ahrqix
Wed, 29 Aug 2012 20:53:30
norskedoc: On occasion, I’ve addressed the potential value of DIAMOND in blog postings… http://t.co/i3xj2ptT #AHRQIX
Wed, 29 Aug 2012 20:53:39
miller7: @MsWZ @kennylinafp YES! All about collaboration! #AHRQIX
Wed, 29 Aug 2012 20:54:04
norskedoc: @kennylinafp Agree totally, which is the adaptive change I'm talking about, would love to discuss issues in this area further. #ahrqix
Wed, 29 Aug 2012 20:54:33
2healthguru: @MsWZ @kennylinafp @norskedoc @miller7 in other words, 'real team based' care. #ahrqix
Wed, 29 Aug 2012 20:54:42
norskedoc: And if not "collaboration" at least coordination and cooperation. RT @miller7: @MsWZ @kennylinafp YES! All about collaboration! #AHRQIX
Wed, 29 Aug 2012 20:55:02
miller7: We are running out of time on today's inaugural #AHRQIX chat with @norskedoc; let's start to wrap up with final thoughts
Wed, 29 Aug 2012 20:55:05
miller7: Interested in learning more about #integrated #mentalhealth & #primarycare? You can follow @AHRQAcademy http://t.co/pH0sj4F9 #AHRQIX
Wed, 29 Aug 2012 20:55:55
norskedoc: Final thoughts--we've obviously resonated, but what we don't know is much larger than what we know...need to work together. #ahrqix
Wed, 29 Aug 2012 20:56:02
AHRQIX: We’ll be closing the live chat in 5 mins but you can find more resources on this topic on our site: http://t.co/moc13738 #ahrqix
Wed, 29 Aug 2012 20:56:05
2healthguru: @norskedoc @miller7 @MsWZ @kennylinafp kinda like 'religious tolerance'? Need go further, no? Self righteousnous is a 'dis-ease' #ahrqix
Wed, 29 Aug 2012 20:56:45
norskedoc: For me, starting with a concrete topic--depression--enabled clinics to feel they could address it, not like tackling world peace. #ahrqix
Wed, 29 Aug 2012 20:56:46
kennylinafp: MT @miller7: Interested in learning more about #integrated #mentalhealth & #primarycare? Follow @AHRQAcademy http://t.co/LUzTg4wV #ahrqix
Wed, 29 Aug 2012 20:56:51
MsWZ: #AHRQIX re: Patient Voice - for the first time, my allergist asked me yesterday if I'd like a copy of the report to go to my PCP~Baby steps!
Wed, 29 Aug 2012 20:56:58
MelissaColeHTR: It takes a village :) RT @norskedoc: coordination & cooperation. RT @miller7: @MsWZ @kennylinafp YES! All about collaboration! #AHRQIX
Wed, 29 Aug 2012 20:57:09
AHRQIX: We have more than 90 #innovations & hundreds of online tools relating to #mentalhealth on our site http://t.co/moc13738 #ahrqix
Wed, 29 Aug 2012 20:57:19
miller7: Final thought - we need to create a #healthcare system that can support comprehensive patient-centered team-based care #AHRQIX
Wed, 29 Aug 2012 20:57:23
yayayarndiva: RT @miller7: Those not familiar with the Patient Activation Measure http://t.co/RRtgUqTU #AHRQIX
Wed, 29 Aug 2012 20:57:54
AHRQIX: If you would like to review this chat, please search under #AHRQIX on Twitter #ahrqix
Wed, 29 Aug 2012 20:58:15
miller7: Many thanks to @norskedoc @AHRQnews @AHRQIX for today’s first #AHRQIX chat
Wed, 29 Aug 2012 20:58:32
mellojonny: The best thing we did for #primarycare & #mentalhealth was introducing a ‘usual doctor’ system to ensure continuity @kennylinafp #ahrqix
Wed, 29 Aug 2012 20:58:35
norskedoc: I couldn't agree more, and let's remember we should include patients on team--they were part of all DIAMOND work.. #ahrqix
Wed, 29 Aug 2012 20:59:17
MelissaColeHTR: +1 RT @miller7 Final thought: we need to create a #healthcare system that can support comprehensive patient-centered teambased care #AHRQIX
Wed, 29 Aug 2012 20:59:19
AHRQIX: We'd like to thank @miller7 & @norskedoc for joining us for today's chat! Lots of great info discussed. #ahrqix
Wed, 29 Aug 2012 20:59:58
norskedoc: You're welcome, this has been a whirlwind hour...hope to do again... #ahrqix
Wed, 29 Aug 2012 20:59:59
kennylinafp: And thanks @miller7 too! RT @miller7: Many thanks to @norskedoc @AHRQnews @AHRQIX for today’s first #AHRQIX chat #ahrqix
Wed, 29 Aug 2012 21:00:02
miller7: Check out upcoming @AHRQconf that will address many of #mentalhealth #primarycare topics addressed today http://t.co/bRPaj1Hc #AHRQIX
Wed, 29 Aug 2012 21:00:04
miller7: Also, check out October #CFHA http://t.co/KEcjOdJC? meeting which focuses on integrated #mentalhealth & #primarycare #AHRQIX
Wed, 29 Aug 2012 21:00:32
2healthguru: @AHRQIX or you can click here: http://t.co/y7WNXmmZ 247 tweets generated 733,885 impressions with audience of 72,207 #ahrqix
Wed, 29 Aug 2012 21:00:37
miller7: Look for another #AHRQIX tweetchat next month with @tedeytan !! #healthcare #innovation
Wed, 29 Aug 2012 21:01:04
reitzrandall: Thanks for the informative chat all #ahrqix @norskedoc @miller7 @kennylinafp @mswz
Wed, 29 Aug 2012 21:01:05
2healthguru: RT @AHRQIX: We'd like to thank @miller7 & @norskedoc for joining us for today's chat! Lots of great info discussed. #ahrqix
Wed, 29 Aug 2012 21:01:54
socialibriumm: RT @miller7: Look for another #AHRQIX tweetchat next month with @tedeytan !! #healthcare #innovation
Wed, 29 Aug 2012 21:01:56
AHRQIX: Sept. 13, follow us for more info RT @miller7: Look for another #AHRQIX tweetchat next month w/ @tedeytan !! #healthcare #innovation #ahrqix
Wed, 29 Aug 2012 21:04:05
IanatPHP: RT @mellojonny: Every generalist is (or ought to be) a medicallyunexplained symptom specialist! http://t.co/erv3lyCV @miller7 #ahrqix
Wed, 29 Aug 2012 21:10:21
BHPCIntegration: Very important MT @norskedoc: 1st there's less "stigma" surrounding depression b/c of our work, many don't see that, but it's real. #ahrqix
Wed, 29 Aug 2012 21:22:15
tedeytan: RT @AHRQIX: Sept. 13, follow us for more info RT @miller7: Look for another #AHRQIX tweetchat next month w/ @tedeytan !! #healthcare #in ...
Wed, 29 Aug 2012 21:24:10
BHPCIntegration: RT @norskedoc: 2nd, as a result of DIAMOND, we're extending this approach w/2 partners in AHRQ grant using SBIRT for substance abuse #ahrqix
Wed, 29 Aug 2012 21:26:00
tedeytan: Excited to co-host @AHRQIX tweetchat next month w Brigid McCaw, MD - expert in family violence prevention #AHRQIX : http://t.co/2GnYN17i
Wed, 29 Aug 2012 21:27:31
BHPCIntegration: Great model to replicate/build upon RT @norskedoc: 3rd, DIAMOND exemplifies the "team" approach,has prepped many for medical home. #ahrqix
Wed, 29 Aug 2012 21:27:59
BHPCIntegration: Vital 4 imprvd outcomes,access&costs RT @norskedoc: Also, DIAMOND has led to relationships btw prim care & BH which not seen before. #ahrqix
Wed, 29 Aug 2012 21:30:07
DrPlumEU: @miller7 @norskedoc #Primarycare #mentalhealth #AHRQIX I am GP...
Wed, 29 Aug 2012 21:31:25
DrPlumEU: @miller7 @norskedoc #Primarycare #mentalhealth #AHRQIX arguably 90% clinical psychiatric conditions (cont) http://t.co/BQdG69yJ
Wed, 29 Aug 2012 21:33:08
BHPCIntegration: RT @norskedoc: It is important to understand this is much more than colocation... #ahrqix
Wed, 29 Aug 2012 21:37:43
jptingle: RT @AHRQIX: Sept. 13, follow us for more info RT @miller7: Look for another #AHRQIX tweetchat next month w/ @tedeytan !! #healthcare #in ...
Wed, 29 Aug 2012 21:47:59
PilgrimPip: RT @mellojonny: Every generalist is (or ought to be) a medically unexplained symptom specialist! http://t.co/erv3lyCV @miller7 #ahrqix
Wed, 29 Aug 2012 21:55:18
terrieynon: RT @mellojonny: Every generalist is (or ought to be) a medically unexplained symptom specialist! http://t.co/erv3lyCV @miller7 #ahrqix
Wed, 29 Aug 2012 22:07:36
SilvijaKrebs: RT @miller7: Final thought - we need to create a #healthcare system that can support comprehensive patient-centered team-based care #AHRQIX
Wed, 29 Aug 2012 23:06:53
KPpregnancydoc: RT @tedeytan: Excited to co-host @AHRQIX tweetchat next month w Brigid McCaw, MD - expert in family violence prevention #AHRQIX
Wed, 29 Aug 2012 23:28:06
burayw0a: RT @miller7: Final thought - we need to create a #healthcare system that can support comprehensive patient-centered team-based care #AHRQIX
Thu, 30 Aug 2012 04:19:25
ClinicalPosters: RT @kennylinafp: Primary care clinicians are good at prescribing drugs for depression, not so good at cognitive therapy. #ahrqix
Thu, 30 Aug 2012 05:21:14
AHRQIX: RT @tedeytan: Excited to co-host @AHRQIX tweetchat next month w Brigid McCaw, MD - expert in family violence prevention #AHRQIX
Thu, 30 Aug 2012 17:08:20
