A lot of barriers exist when it comes to use of health outcomes, be it in mental health or other medical disciplines. Canvassing via a quick and easy straw poll suggested that the biggest barriers relate to poorly developed systems that fail to exploit the advantages technology can confer. Yes! It is only 20 votes, but there is considerable face-validity to the sentiments picked as seen below.
Imagine doing away with the costs associated with the old ways –
- printing questionnaires
- sending these to parents/patients by post
- hand scoring them or using a host of excel spreadsheets
- Scan and upload responses
- Shred the paper
- Expenditure of postage
- Inefficient use of a clinicians time or an assistant psychologist in the NHS (they could be using their precious time for seeing patients or doing R&D/audits)
- Expenditure on secretarial time or investing in data entry clerks to manually enter data from pen-paper exercises
Can we over-do use of Patient Rated Outcome Measures?
There is a risk that this may happen, especially if Commissioners / Fund holders seek to apply outcomes of a certain kind blindly. For instance, clinically, it is unlikely a Strengths and Difficulties Questionnaire is appropriate for someone with an Eating Disorder, but it is incredibly helpful to have this information as a part of an ADHD assessment.
We would caution ‘spinal’, weekly use of outcomes for the sake of doing so, the process needs to be clinically relevant and meaningful. Questionnaires are not diagnostic in themselves but an aid or a toll in the assessment process.
Around 25% clinicians suggest they may not want to bother with use of measures at all. Experience suggests that use of questionnaires can help collate lot more information in much shorter time, open up conversations with people who struggle to narrate their stories and at times make way for new insights – for instance patient’s may come across ‘well’ but the ratings suggest significant underlying difficulties.
On balance, judicious use of right scales and measures can help, clearly what we need is improved IT support that empowers practice rather than makes it clunky, time consuming and costly through lack of automation and poorly designed user-interface.