“We explain [to them that] this is not just a one-time thing,” said Dr. Unützer, chair of psychiatry and behavioral sciences at UW. “We [will] keep with them until they are well.”
Patients are enrolled in the patient portal on UW’s Epic records system to facilitate communication. The system sends out follow-up reminders, and sometimes it is used to send PHQ-9s directly to patients.
“We have automated this as much as possible.” When there’s no response, patients often are sent text messages or called by phone to make sure that they are doing OK and taking their medicine, he said.
Chart reviews are used to identify patients who are not improving. “We reach out to primary care and say, ‘We think you could use some help.’ It’s not always ”a comfortable conversation. “A lot of us like to assume our patients are getting better,” Dr. Unützer said.
Overall, “this notion of population-based care – the idea that ... you have a whole bucket of patients out there you might have seen at some point” but are still responsible for – “is a total change for most of us who are practicing clinicians,” he said.
Dr. Unützer did not report any disclosures.