While it is now widely accepted that eMH services and resources can improve individual and system outcomes, there is growing evidence that collecting and using data meaningfully can be just as essential.
At Stepped Care Solutions, we believe these are both/and choices rather than either/or.
In the Stepped Care 2.0 (SC2.0®) model, care seekers are empowered to make decisions about their own care. Services are delivered in a way that prioritizes choice and autonomy for people, including eMH. This person-centric approach offers a greater range of options and supports informed choice through ongoing data collection opportunities that benefit care seekers along their wellness journey.
At a system level, building data-informed decision making (DIDM) into the model of care – especially through co-designed implementation – helps keep everyone’s focus on outcomes while identifying system challenges and areas for improvements. A model like SC2.0 provides needed modernization alongside collaborative decision-making.
Data-Informed Decision Making
There are a number of names for data collection approaches, both as a process and within larger models. In SC2.0, we use the term data-informed decision making (DIDM) for a few reasons.
First, using data to inform care decisions is not limited to services where people engage with clinicians. For instance, data can be collected, reviewed and used by a person engaging with self-directed resources, or online supports where a care provider is not directly involved. For this reason, a term like measurement-based care isn’t entirely accurate.
Further, the primary reason for collecting data is to support care seeker decision-making, engagement, and to improve outcomes, whether it involves self-directed programming or care-planning conversations with a service provider. We want to emphasize the importance of using data in all types and contexts of treatment and care decisions at all levels of the system, and we believe data-informed decision-making captures this well.
Five essential elements of DIDM
In SC2.0, data collection is:
- Routine: Ideally, data is collected each time a person connects with a service.
- Person-Centric: No matter the type of service, data collection is utilized to help care seekers make decisions and be supported in tracking and navigating their own unique wellness journey.
- Across a Continuum of Care: Data helps care seekers monitor their mental health and consider which services are their best fit options both initially and when they may want to try something different.
- Facilitated by Technology: Technology simplifies data collection, analysis and monitoring. eMH systems, in particular, can streamline these processes and reduce burdens on care seekers and providers.
- Inclusive of Multiple Types of Data: Several data types are collected to inform decision making. These can include top-of-mind concerns, symptoms, functioning, strengths, capacities, resources, readiness, satisfaction and engagement.
Autonomy in Care
In a system of care based on the SC2.0 model, people are encouraged to be actively involved in their wellness plan and receive support that meets their needs. Whether people track their own wellness or do so with a service provider, the data provides useful information for people to make decisions about their care[1].
When a care seeker and provider review data results together, it can help the co-creation of more individualized plans that are responsive to the person’s changing needs, allowing for adaptations as needed[2].
This is important because we know that monitoring the progress of people accessing care leads to better outcomes[3]. Research shows that as many as 25% of people continue to use services even when they report no measurable improvement[4]. Tracking outcomes regularly can help people quickly identify when something isn’t working. And the sooner they know, the sooner the issue can be addressed.
An example of how eMH systems of care are particularly well-suited to utilize DIDM comes from Wellness Together Canada (WTC). WTC was Canada’s first and only 24/7 online portal providing high-quality MHSUH resources and support at no cost for all people across the country. The portal exemplified a person-centric SC2.0 system.
When people visited the portal, they were invited to complete a self-assessment. It took less than two minutes and asked care seekers to think about their current mood, overall wellbeing, and functioning. Results were automatically analysed and visualized to help people interpret their scores and choose appropriate resources. The portal also allowed care seekers to opt-in to complete the assessment at an interval of their choice, such as every two or eight weeks, to monitor their mental health.
This approach benefits care seekers, helping them develop awareness of their wellbeing, an understanding of strategies that are working for them, and when more resources may be needed from others, including peer support and professional counselling.
Incorporating DIDM across a system of care can help people manage their wellness journey, focus care conversations, track and evaluate progress and outcomes[5], and guide both individual and program decisions. It can provide valuable insights into service use and improvement opportunities for clinical supervision, therapeutic programs and the overall care system.
Data is a Tool to Improve Outcomes
When facilitating SC2.0 implementation, we see the greatest successes when care providers and system leaders are focused on the positive outcomes a DIDM approach can create for their work and care seekers. One such example is utilizing data to identify and address inequities and discrimination in MHSUH systems.
Research shows that people from underserved and marginalized populations face disparities in MHSUH access, use, literacy and diagnosis. It’s also important to note that data can be misinterpreted. So, it’s understandable that some groups may be hesitant to participate in DIDM processes[6]. In the SC2.0 model, data-informed decision making can mean using various forms of information to understand the root of such disparities and to help identify creative solutions to improve equity.
To use data equitably, we need to validate experiences without making assumptions[7], engage people in their interpretation of their data, and involve them in deciding what data is collected and how the data is used. Involving people and communities in their data collection and the review process ensures that care is tailored to their unique needs and experiences. The goal is a system in which data is used on an ongoing basis to improve the services and how they are delivered[8].
As eMH becomes a standard feature of mental health and substance use health care systems, we can achieve even better access and better outcomes when data collection is facilitated through digitization.
About Stepped Care Solutions
Stepped Care Solutions is a mission-driven not-for-profit organization, and the creators of Stepped Care 2.0 (SC2.0®) – an innovative and transformative model that leverages collaborative efforts and technology to transform mental health and substance use health systems for better access and outcomes. SCS exists to help organizations and communities reframe, rethink, and redesign the delivery of mental health care services.
For more information about the SC2.0 model of care, and our implementation and training approaches, please visit the Stepped Care Solutions website.
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