CRI

Hillel Sapir

 

This week I will primarily be completing the Federal Clinical Registration data.  As stated before, the BE Well Program is a federally sponsored and financed research project.  As with any research project, the sponsors generally require a certain level of periodic information or insight so as to determine how well their money is being utilized; no government would be pleased to realize their money is being embezzled or being used instead to rent a yacht in the Bahamas.  The US government offered this 2 million dollar grant to Centerstone's BE Well Program with the goal of reducing emergency room visits and government medical spending.  Using other methods this program is designed to help reduce individual patient medical costs and therefore accomplish the government's goals. 

 

To continually assess the program's progress the government requires clinical data at regular intervals.  Due to the significant amount of data this program has per patient, the government has very specific guidelines on what data they deem relevant.  Wishing to simply reduce monetary costs and streamline services for clients, the government wishes be informed concerning:

 

1.  How many times patients are seen by paid employees, registered nurses, psychologists, medical professionals, case managers, therapists, etc.

 

2.  Medical visits: hospital emergency rooms, hospital visits, clinical visits

 

3.  Medications: increases and decreases in medications, types of medications (both for mental and physical health), treatment planning, and other medication management

 

3. Substance Abuse: how substance abuse affects the patients, amount of counseling and peer support groups

 

4. Healthy Group Activities and Meetings: education seminars (diabetes, smoking, cooking and nutrition courses, etc), physical activity and exercise, etc

 

5.  Therapy: Types of therapy used to help the patient (Cognitive Behavioral, Interpersonal Psychotherapy, Dialectical Behavior Therapy, Comprehensive Case Management, Integrated Dual Diagnosis Treatment, Motivational Interviewing, etc)

 

While this seems fairly simple and straight forward, this information must be assessed for each recorded patient visit (patients are seen for a variety of reasons ranging from group meetings to individual therapy to full physical and mental examinations, this may lead to vast changes in their medications or other treatment forms which the government needs to examine).  Depending upon the patient’s progress, intimacy with the program, personal will and physical/mental state, the amount of clinical visits may be incredibly different between patients.  As an example (using fictitious figures), patient may be seen 60 times by licensed professionals within a 90 day period, with a standard deviation (SD) of 10 visits.  While a majority of the patients fall within this norm of 50-70 visits, some may be seen 150 times, almost 3 times as often.  The government requires a complete log of each one of these visits, and therefore this coding takes an extraordinary amount of time.  The patient for which I am currently entering data has already taken 2 days code, and will most likely require another day to complete. 

 

While these requirements take an amazing amount of time and energy, they are quite complete and incredibly useful.  With the conclusion of these databases, one will be able to easily assess a patient's clinical visits in a comprehensive, yet simple fashion.  The data can be easily arranged to produce pictorial images and graphs, so as to easily display shifts in medication usage and other changes.