The Feasibility of Computerized Patient Self-assessment at Mental Health Clinics
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Improving the quality of care for severe mental illness (SMI) has been difficult because patients’ clinical information is not readily available. Audio computer-assisted self-interviewing (ACASI) supports data collection by asking patients waiting for appointments clinical questions visually and aurally. It has improved outcomes for many disorders. While reliable and accurate for SMI in research settings, this study assesses questions about ACASI’s feasibility in usual care.
Patient and provider surveys and provider focus groups after 12 months of ACASI implementation.
Two outpatient mental health clinics in Los Angeles, one run by the Department of Veterans Affairs and the other by Los Angeles County Department of Mental Health.
266 patients with SMI and 14 psychiatrists.
Patients completed an ACASI survey on symptoms, drug use, medication adherence and side-effects by internet using a touch-screen monitor. A 1-page report summarizing each patient’s results was printed and given to providers by patients during appointments.
Main Outcome Measure
Feedback surveys (patients and psychiatrists) and focus groups and interviews (psychiatrists) assessed usability, usefulness, effects on treatment, and barriers to sustaining ACASI.
Patients believed the PAS was enjoyable, easy to learn and use, and that it improved communication with their psychiatrists. Providers believed the PAS was easy to use, had a small impact on care, could be improved by being more detailed and comprehensive, and requires outside support to continue its use.
ACASI was easy to use and enhanced communication. Systems like this can be a valuable part of quality improvement projects.
- Barnett, G. O., Winickoff, R., Dorsey, J. L., Morgan, M. M., & Lurie, R. S. (1978). Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system. Medical Care, 16(11), 962–970. CrossRef
- Boekeloo, B. O., Becker, D. M., Levine, D. M., Belitsos, P. C., & Pearson, T. A. (1990). Strategies for increasing house staff management of cholesterol with inpatients. American Journal of Preventive Medicine, 6(2 Suppl), 51–59.
- Cherry, J. C., Moffatt, T. P., Rodriguez, C., & Dryden, K. (2002). Diabetes disease management program for an indigent population empowered by telemedicine technology. Diabetes Technology & Therapeutics, 4(6), 783–791. CrossRef
- Chinman, M., Hannah, G., Wandersman, A., Ebener, P., Hunter, S. B., Imm, P., et al. (2005). Developing a community science research agenda for building community capacity for effective preventive interventions. American Journal of Community Psychology, 35(3–4), 143–157. CrossRef
- Chinman M, Young, AS, Hassell J, Davidson L. (2006). Toward the implementation of mental health consumer providers services. Journal of Behavioral Health Services & Research, 33, 2, 176–195. CrossRef
- Chinman, M., Young, A. S., Schell, T., Hassell, J., & Mintz, J. (2004). Computer-assisted self-assessment in persons with severe mental illness. The journal of Clinical Psychiatry, 65(10), 1343–1351. CrossRef
- Cummings, K. M., Frisof, K. B., Demers, P., & Walsh, D. (1985). An appointment reminder system’s effect on reducing the number of hypertension patients who drop out from care. American Journal of Preventive Medicine, 1(5), 54–60.
- Day, J. C., Wood, G., Dewey, M., & Bentall, R. P. (1995). A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients. The British Journal of Psychiatry, 166(5), 650–653. CrossRef
- De Leeuw, E. D. (1992). Data quality in mail, telephone, and face-to-face surveys. Amsterdam: TT Publications.
- Des Jarlais, D. C., Paone, D., Milliken, J., Turner, C. F., Miller, H., Gribble, J., et al. (1999). Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial. Lancet, 353(9165), 1657–1661. CrossRef
- Dick, R. S., Steen, E. B., & Detmer, D. E. (1997). The computer-based patient record: an essential technology for health care. Washington, DC: National Academy Press.
- Eisen, S. V., Normand, S. L., Belanger, A. J., Spiro, A. 3rd, & Esch, D. (2004). The revised behavior and symptom identification scale (BASIS-R): reliability and validity. Medical Care, 42(12), 1230–1241. CrossRef
- Feldman, J., Wilner, S., & Winickoff, R. (1982). A study of lithium carbonate use in a health maintenance organization. QRB Quality Review Bulletin, 8(9), 8–14.
- Garland, A. F., Kruse, M., & Aarons, G. A. (2003). Clinicians and outcome measurement: what’s the use?. The Journal of Behavioral Health Services & Research, 30(4), 393–405. CrossRef
- Gilbody, S. M., House, A. O., & Sheldon, T. (2002). Routine administration of Health Related Quality of Life (HRQoL) and needs assessment instruments to improve psychological outcome–a systematic review. Psychology Medicine, 32(8), 1345–1356. CrossRef
- Green, L. W., Kreuter, M. W., Deeds, S. G., & Partridge, K. B. (1980). Health education planning model (PRECEDE). In L. W. Green, M. W. Kreuter, S. G. Deeds & K. B. Partridge (Eds.), Health education planning: A diagnostic approach. Mountain View, CA: Mayfield Publishers.
- Guendelman, S., Meade, K., Benson, M., Chen, Y. Q., & Samuels, S. (2002). Improving asthma outcomes and self-management behaviors of inner-city children: A randomized trial of the Health Buddy interactive device and an asthma diary. Archives of Pediatrics & Adolescent Medicine, 156(2), 114–120.
- Hochstim, J. R. (1967). A critical comparison of three strategies of collecting data from households. Journal of the American Statistical Association, 62, 976–987. CrossRef
- Kiesler, S., Siegel, J., & McGuire, T. W. (1984). Social psychological aspects of computer-mediated communication. American Psychologist, 39(10), 1123–1134. CrossRef
- Kiesler, S., & Sproull, L. S. (1986). Response effects in the electronic survey. Public Opinion Quarterly, 50(3), 402–413. CrossRef
- Kissinger, P., Rice, J., Farley, T., Trim, S., Jewitt, K., Margavio, V., et al. (1999). Application of computer-assisted interviews to sexual behavior research. American Journal of Epidemiology, 149(10), 950–954.
- Kissling, W. (1994). Compliance, quality assurance and standards for relapse prevention in schizophrenia. Acta Psychiatrica Scandinavica. Supplementum, 382, 16–24.
- Krueger, R. A. (1998). Analyzing and reporting focus group results. Thousand Oaks, CA: SAGE Publications, Inc.
- Lewis, J. R. (1995). IBM computer usability satisfaction questionnaires: psychometric evaluation and instructions for use. International Journal of Human-Computer Interaction, 7, 57–78. CrossRef
- Lingjaerde, O., Ahlfors, U. G., Bech, P., Dencker, S. J., & Elgen, K. (1987). The UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatrica Scandinavica. Supplementum, 334, 1–100.
- Locke, S. E., Kowaloff, H. B., Hoff, R. G., Safran, C., Popovsky, M. A., Cotton, D. J., et al. (1992). Computer-based interview for screening blood donors for risk of HIV transmission. Jama, 268(10), 1301–1305. CrossRef
- Metzger, D. S., Koblin, B., Turner, C., Navaline, H., Valenti, F., Holte, S., et al. (2000). Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET Vaccine Preparedness Study Protocol Team. American Journal of Epidemiology, 152(2), 99–106. CrossRef
- Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., Snyder, K. S., & Doane, J. A. (1986). Expressed emotion, affective style, lithium compliance, and relapse in recent onset mania. Psychopharmacology Bulletin, 22(3), 628–632.
- Riley, E. D., Chaisson, R. E., Robnett, T. J., Vertefeuille, J., Strathdee, S. A., & Vlahov, D. (2001). Use of audio computer-assisted self-interviews to assess tuberculosis-related risk behaviors. American Journal of Respiratory and Critical Care Medicine, 164(1), 82–85.
- Rogers, E. M. (1995). Diffusion of innovations (4th edn.). New York: Free Press.
- Rogers, J. L., Haring, O. M., Wortman, P. M., Watson, R. A., & Goetz, J. P. (1982). Medical information systems: assessing impact in the areas of hypertension, obesity and renal disease. Medical Care, 20(1), 63–74. CrossRef
- Short, J., Williams, E., & Christie, B. (1976). The psychology of telecommunications. London: Wiley.
- Simpson, D. D. (2002). A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment, 22(4), 171–182. CrossRef
- Stillman, F. A. (1992). Focus group research: an overview. In D. M. Becker, D. R. Hill, J. S. Jackson, D. M. Levine, F. A. Stillman & S. M. Weiss (Eds.), Health behavior research in minority populations: access, design and implementation. NIH Pub. No. 92–2965. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health.
- Strauss, A. L., & Corbin, J. M. (1990). Basics of qualitative research: grounded theory procedures and techniques. Newbury Park, CA: Sage Publications.
- Sullivan, G., Wells, K. B., Morgenstern, H., & Leake, B. (1995). Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi. The American Journal of Psychiatry, 152(12), 1749–1756.
- Tierney, W. M., McDonald, C. J., Martin, D. K., & Rogers, M. P. (1987). Computerized display of past test results. Effect on outpatient testing. Annals of International Medicine, 107(4), 569–574.
- Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H., & Sonenstein, F. L. (1998). Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science, 280(5365), 867–873. CrossRef
- The Feasibility of Computerized Patient Self-assessment at Mental Health Clinics
Administration and Policy in Mental Health and Mental Health Services Research
Volume 34, Issue 4 , pp 401-409
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- Computer-assisted self-interviewing
- Severe mental illness
- Author Affiliations
- 1. VA Desert Pacific Mental Illness Research, Education, & Clinical Center, 11301 Wilshire Blvd. MIRECC 210A, Los Angeles, CA, 90073, USA
- 2. The Leavey Center for the Study of Los Angeles, Loyola Marymount University, Los Angeles, CA, USA
- 3. Los Angeles County Department of Mental Health, 11080 W. Olympic Blvd., West Los Angeles, CA, 90064, USA
- 4. UCLA Semel Institute of Neuroscience & Human Behavior, 300 UCLA Medical Plaza, Suite 1544, Los Angeles, CA, 90095-7057, USA
- 5. UCLA Department of Psychiatry, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA, 90024, USA