Disclosures. Book Royalties Lippincott, Williams & Wilkins

Transcription

1 Update on OPAL-K DATE: October 20, 2016 PRESENTED BY: Keith Cheng, M.D., Clinical Associate Professor Department of Psychiatry, Oregon Health & Science University

2 Disclosures Book Royalties Lippincott, Williams & Wilkins

3 Learning Objectives: Identify the most common psychiatric diagnoses prompting child psychiatry consultation for the pediatric medical home Identify the most common psychotropic medications used in the pediatric medical home Understand the ubiquitous role of trauma in psychiatric presenting symptoms

4 OPAL-K Dashboard Oregon Psychiatric Access Line about Kids (OPAL-K) 9-5/M-F Child Psychiatry Phone Consultation Service Months of service = 27 months Number of Medical Home Consultations provided = 1146 More than 50% of consultations are from repeat callers Some PCPs have called over 20 times

5 Gender (n=1146)

6 Age Range (n=1146)

7 Non-medical Interventions (n=1146)

8 Diagnoses Discussed (n=1146)

9 Trauma (n=1146)

10 Medications Discussed (n=1146)

11 Survey on Accessing Mental Health Services Prior to Opal-K Reported by Medical Providers in Oregon n= 955 No Survey Item Strongly Disagree Disagree Agree Strongly Agree 1 There is adequate access to child psychiatry for my patients With existing resources, I am usually able to meet the needs of children with psychiatric problems I am able to consult with a child psychiatrist in a timely manner

12 Sample Feedback Comments by PCPs The more I use this service the more valuable it has become. Quick Access to mental health guidance for primary care pediatricians is a godsend!

13 OPAL-K Post Service Survey n= 385 No Survey Item Strongly Agree Neutral Disagree Strongly agree Disagree 1 I find the OPAL-K consults to be useful The team member who answered the phone treated me professionally I was able to connect to an OPAL-K consultant in a timely manner 4 I am very satisfied with the process of being connected to an OPAL-K consultant 5 My patient received mental health assistance more quickly because of the OPAL-K program. *6 I am better able to care for my patient after consulting with OPAL-K *7 I am more comfortable addressing mental health issues in my practice knowing I have OPAL-K consultants available. *n= 169 for questions # 6 and 7, these two questions were added much later in the program

14 Foster Care Program (n=111) Criteria for Inclusion: Polypharmacy 4 or more medications used Above FDA Maximum Dose Recommendation Antipsychotic treatment without FDA indication Treatment of youth with psychotropics under 6 years Two or more psychotropics from the same category

15 New Anti Psychotic Prescriptions for U 18 Medicaid Oregon x 1 0,0 P M P M40 s s y c h o tic 30 n tip A rt S ta e w 20 N 10 0 Figure 1 New start antipsychotic rate in children in the Oregon Medicaid program Key: PMPM = Per Member Per Month. Denominator = All eligible children in Oregon Medicaid under 18 years old. Numerator = All eligible children in Oregon Medicaid under 18 years old with a newly started antipsychotic Total Linear (Total)

16 Number of Youth in Foster Care on > 3 psychotropic medications last quarter first quarter 2015

17 Child Psychiatry Project ECHO Consultation Clinic 1000/50/25 (50% were OPAL-K callers) Started August 1 st So far 10 Sessions Completed Average attendance 20/25 Didactic, Case presentation, Medication of the week, Resource of the week Panel = 2 Child psychiatrists, pharmacist, Master s level therapist, pediatrician Guest speaker: psychologist

18 NNCPAP National Network of Child Psychiatry Access Programs 28 members: AR, CA, CO, CT, DL, GA, IL, IA, LA, ME, MD, MA, MI, MN, MO, NH/VT, NJ, NY, NC, OH, OR, PA, TX, VA, WA, DC, WA, WI, WY First program started in 2002 in New England Services Provided: Telephonic Consultation, Referral Service, Telepsychiatry Assessments, ECHO clinics, co-location, Perinatal assessment Now a 501(c)(3)

19 OPAL-K Contact Information Website: Program Toll-free phone number: ( OPAL-K) Program Director- Keith Cheng, MD Project Manager-Behjat Sedighi, QMHP Consulting Pediatrician-Teri Pettersen, MD Administrative Coordinator- Elisa Ross

20 Thank You