Understanding Bipolar DisorderPsychiatric EMR Process Efficiency - Applications to Military Mental Health
Military Mental Health in Crisis
An Army contract finalized June 2007 calls for spending $33 million to add about 200 mental health professionals be added to the 600 mental health professionals now working at three dozen Army medical centers. In June 2007, the Senate Armed Services Committee voted unanimously to expand brain screenings and counseling for wounded veterans of the Iraq war and to reduce red tape for service members moving from Pentagon to Veterans Affairs care. This legislation is called the "Dignified Treatment of Wounded Warriors Act". Separately, the VA recently announced that it would bolster programs to prevent suicide among veterans by hiring additional counselors at each of its 153 medical centers after an internal review found that current VA programs were inadequate. Availability of Mental Health Providers is Limiting Factor Shortage of psychiatric care is not unique to the military. Mental health care is in crisis across the country due to shortage of psychiatrists. The Department of Health said a report commissioned in 2003 that 900 extra psychiatrists would be needed by 2009, and this shortage has since accelerated. Overwhelmed by the number of soldiers returning from war with mental problems, ever-increasing funds are available. President Bush's 2007 VA budget asks Congress for a record $3.3 billion for mental health care, a $340 million increase over 2006. However, the limiting factor is availability of mental health professionals. Without substantial improvements to process efficiency, increased mental health funding is unlikely to produce satisfactory results for traumatized soldiers. The IconoChart is a recent innovation by IconoPsych Care LLC iconopsych.com. The efficient process entails completion of a pre-visit electronic questionnaire by the soldier, which is tailored to the type of appointment, whether it be screening, comprehensive evaluation, or follow-up treatment of a specific psychiatric condition. The iconic dashboard is constructed for the doctor before the patient's chart is opened. The "data dense" visual display (as well as a condensed text component) is constructed from the patient questionnaire, extraction from the underlying EMR, and a medical reference database. Time needed to retrieve relevant data is decreased 40-60%. Time to input data is also slashed by 40-60%, as much of this work is done for the doctor by the patient, and formatted for rapid assimilation by IconoChart. The time required for the doctor to personally enter data is also decreased by 20-30%, as much of this can be accomplished by simple manipulation of visual elements on the user interface. In addition to the dire need for improvement, the DoD healthcare system is ideally suited to this process for several practical reasons. Essentially all soldiers have the basic literacy and computer skills to complete the questionnaire. The regimented environment and brevity of appointments makes it likely that soldiers will comply with the questionnaire.
