Getting to Data-Driven Decision-Making with CoCM
Measurement-based care offers real-time data to guide your clinical interventions for patients with behavioral health needs.
The Collaborative Care Model (CoCM) is built upon the foundation of data-driven decision-making – in behavioral health, this is often referred to as Measurement-Based Care or MBC.
Much in the same way that blood test results or blood pressure readings drive your day-to-day clinical care for your patients, results from CoCM measurements can provide useful information to support your clinical interventions.
Mirah’s CoCM platform was built to support this, making it easy to administer, score, and interpret a wide range of behavioral health measurements. This can give the care team real-time access to understand who is doing well and who may need a change in their care plan.
Maximizing MBC for Your CoCM Patients
Ready to get started? Great! Here’s how to bring measurement-based care into your collaborative care workflow.
Let your Care Manager (CM) know which set of symptoms (depression, anxiety, or ADHD) most closely fit for each patient you refer into the CoCM program. Your CM can then ensure that the most salient symptoms are monitored throughout their enrollment. They will select the assessments that are most appropriate based on the patient’s age.
If you are concerned about other symptoms or diagnoses for a particular patient, inform your CM; they can also assign supplemental measures to assist with differential diagnoses and/or monitor those symptoms over the course of treatment. Additionally, you can request specific measurement tool(s) from the Mirah library to be administered for any of your patients enrolled in CoCM. Learn more about Mirah’s measurement library here »
Review your patient's progress on CoCM measures.
Review a summary of CoCM measurement results in your EHR or ask your CM for updates on your patients. Each organization will document results of the CoCM measurements differently, so ask your CM for more details about where you can find the latest measurement results. Your CM can also show you the charts and graphs for your patients in the Mirah platform.
Alternatively, you can review assessment results directly in Mirah’s CoCM platform: While your CoCM program does not depend on providers directly accessing Mirah, many PCPs find the information available highly valuable in assessing and monitoring patient progress. If you don’t have login information and would like to learn more, reach out to your CM or CoCM program lead.
If any of your patients are not making progress in CoCM, they may require a care plan adjustment or diagnosis change. Patients who are not making the expected progress in treatment after 2-3 months should be discussed in the team’s weekly case consultation meeting. Remember: As the primary care provider, you can request to have a patient reviewed in the weekly meeting whenever you have specific questions or concerns.
Patients who have started a new medication for behavioral health symptoms and have not shown improvement in the expected time (based on the expected response time for the specific medication) may benefit from a dosage titration or addition of psychotherapeutic interventions.
Patients who are engaged in psychotherapeutic interventions and are not showing improvement after 2 months may benefit from a change in type, frequency, or intensity of interventions. Addition of psychotropic medications may also be considered.
The Truth About Measurement in CoCM
CoCM works (at least in part) because it allows quick identification of patients who are not making the expected progress in treatment. Measurement-based care is the foundation to this.
Most patients will require at least one change in their care plan in CoCM.
Changes in a patient’s care plan are not signs of failure – they are a sign that the program is working as intended.
The Mirah platform can help you understand when changes in a patient’s condition (in either direction) are meaningful or not. Mirah uses color-coding to show when a patient moves between severity levels (e.g., from moderate to mild levels of depression) and uses flags to alert you to changes that meet the threshold of clinical significance (e.g., significantly better or worse score since the last measurement or at intake).
