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Thanks for watching this video We’ll send you links to videos with demonstrations of the features described in this video if you contact us at info@bcfpi.com When you contact us, please tell us which features you’d like to see, and which organization you work with 1999-2000 Researchers at an Ontario Teaching hospital (Chedoke McMaster) developed an efficient (6 items per ‘disorder’) CMH Intake screening interview based on OCHS item pools, for use as an intake and triage tool in the in the teaching hospital Chapters 9 – 11 of its manual (attached) documented the psychometric qualities of the items based on the OCHS survey 2000 This tool was given the name of Brief Child and Family Phone Interview… BCFPI and was Efficient Item sets re Mental Health, Functioning and Risk Any useful intake needs to gather and report re the referral’s basic mental health symptoms, functioning and risk items BCFPI Inc. has developed the smallest set (3 – 6 items per domain) of items able to provide a standardized screening estimate of common CMH problem severity with reasonable reliability and validity #3 Useful Descriptive items The interview records data re 23 ‘Other concerns’*, abuse, demographics, readiness and service barriers These all enhance the scope and value of the intake report The list of ‘Other Concerns’ is periodically updated, based on field input Narrative and item comment The informant’s own description of the problem, its history, previous coping attempts and reasons and expectations re current referral can be recorded Comments can be elicited to clarify significant responses ‘Tell me more about how he ‘often’ worries about the future’ #4aSystem Responsiveness Field data indicates that ~30% of CMH referrals to a primary setting could be most cost-effectively served by evidence-based parent training The conclusion of the interview indicates if the client is eligible for such a service It requires the interviewer to record if they offered it to the client, and their response #4b System Responsiveness The system can expedite referrals of consenting eligible cases This can increase service system capacity by >15% and minimize waiting periods for these cases Managers can use ‘Complex Search’ to assess extent to which eligible cases are being offered and accepting these services #4c System Responsiveness A primary agency with 500 referrals per year could immediately identify and successfully serve ~ 75 cases/yr with such groups Thus, ~75 cases have immediate access to effective service, rather than an assessment WL Assessment and treatment slots are preserved for an additional 75 cases #4d System Responsiveness The system serving 500 referrals/yr… Can expedite immediate access to evidence-based service for ~75 of these referrals Frees up assessment and treatment spaces for an additional 75 cases per year { this requires that evidence-based parent training services are available in the agency or community e.g. COPE, Stronger Families, Connect, Triple P, Friends, etc.} #5 On-line Follow-ups @ $0 At end of interview informant is asked for consent to be contacted in 6 months to provide follow up data, and if consents to provide contact info, including e-mail address System then sends out e-mails with link to secure checklist every 6 months for 2 years #5b On-line Follow-ups @ $0 Analysis links these results to enrolment events (agency and program admissions and discharges) Site thus obtain n.c satisfaction, discharge and follow-up scores for cases attending agency and programs This can be supplemented by active pursuit of non-responding cases if more representative samples are needed Standard Case Report When the interview is completed the system provides a graphical summary of scores, together with the informants’ narrative, questions and responses This includes scores and responses re CMH scales, child functioning, family adjustment, Parent mood, Family functioning It also includes descriptive responses re 23 ‘Other Concerns’, Abuse, Service Readiness and Barriers, and Demographics #6 Evidence-based Services MH scores and case age are cross-referenced with a database of evidence-based interventions (database can be updated on web version only) Interventions targeting disorders corresponding to BCFPI scales scored >70 are reported in an annotated list, including descriptions, hot-linked references to NLM for manuals and peer-reviewed evidence These are relevant if clinical assessment confirms disorders for BCFPI scores >70 #7 Comparative Case reports A case’s progress over time can be examined by selecting multiple interviews and plotting lines showing scores for each interview Multiple views of a case at a point in time (e.g., mother, father, youth, teacher) can be compared Scores for elected individuals (e.g. a few group members) can be compared #8 ‘Convenient’ Case Files Users can easily view all case interviews, enrolments, messages, inter-agency sharing and file access logs in a single location #9 Complex Searches Cases and interviews can be retrieved for review or action based on Age Sex Enrolment status and dates Scale scores Responses to selected items e.g., teens with high mood scores, with concerns re thought problems, who are still waiting for service 90 days after referral # 10 File sharing Central Intake sites and community agencies can share consenting case files and interviews. Cases do not need to ‘tell their story’ twice, if served in more than 1 setting Agencies seeing the same case, over time, can view the cumulative case history -> better assessment and treatment # 11a ‘Real time’ Statistics The non-identifying stats database is refreshed at the end of each week Results can be grouped or filtered by multiple, user-selected case, agency, program, enrolment, scale scores and item values 11b ‘Real time’ Statistics # of Referrals, Admissions, Discharges Min, max, avg, Median days to admission, discharge # Waiting or Active on date Min, max, avg, Median days waiting or active 11c ‘Real time’ Statistics Average scores Prevalence > 65, 70 Responses X items Cross tab scores or responses E.g., for each scale, # cases referred in Q2 with scores >70, grouped by age For Q2 referrals with mood scores >65, distribution of ‘Other Concerns’ and Abuse responses #12* Data Extracts SQL table views of all BCFPI data for managers and researchers Within #12* Data Extracts SQL table views of all BCFPI data for managers and researchers Within agency identifying data is available to restricted agency staff (or designates) with Identifying Extract privileges Non-identifying agency or *system data available to designated service system managers and qualified researchers # 13- 15 BCFPI and Researchers Qualified Researchers with ERB approved projects can access system non-identifying aggregate reports or SQL extracts Researchers can have their own ‘agencies’ to record and analyze BCFPI checklist data they collect Clinical sites can share consenting cases and data to research sites for project use and analysis Research sites can use BCFPI’s automated Follow-up system to initiate on-line check lists or manage customized follow-ups with BCFPI’s follow-up management system sample of more than 3000 children (4 – 16 yrs of age) to investigate mental health of Ontario children It developed pools of survey items (20 – 30 per disorder), for recording the presence and severity of symptoms related to child mental health disorders and risk factors 1983-1998 Over this period, many projects and studies were published based on the OCHS items and data These were conducted by academic researchers, Mental Health Associations and agency managers These confirmed the utility of the OCHS framework, items and data 1999-2000 Researchers at an Ontario Teaching hospital (Chedoke McMaster) developed an implemented as the teaching hospital’s CMH intake tool 2000 (2) The Ontario Government wanted to ensure hi-quality, consistent Intake processes in all funded CMH agencies It commissioned a Toronto University Health Unit Global Survey of Intake tools, seeking a standardized tool with good reliability and validity, which could be used efficiently, by all Ontario agencies 2000 (3) The survey was completed and the Ontario government accepted the recommendation that BCFPI would be an efficient Intake tool for use in all Government funded CMH service providers 2000-2006 BCFPI Inc. was formed to develop the hospital tool so that it could be used provincially Children’s Mental Health Ontario (previously OACMHC) disseminated the tool and provided training to Ontario agencies The tool was implemented in ~ 250 Ontario agency, hospital, clinic and school systems 2000-2006 (2) The BCFPI team expanded to include academic researchers and systems developers and integrators They initiated a study, based on current field data, to determine the tool’s field psychometric qualities, when used as an intake tool in multiple sites At the same time. CMHO gathered data from the agencies and provided the funder with quarterly referral and wait-list reports 2006 (3) The Ontario government requested BCFPI Inc. to upgrade the stand-alone desktop BCFPI to a secure web-based version, at an agreed upon cost. The purposes were… - to facilitate interagency collaboration (at case and system levels) - to facilitate ‘real-time’ provincial reports re referral and waiting patterns - to comply with emerging requirements and best practices re privacy and data integrity and security 2007-2010 BCFPI Inc. completed and disseminated the updated version of the tool, across Canada and in the EU. The initial release was ‘on time’ and in accordance with the estimated cost Academics and the BCFPI team published JCP&P articles in 2009 reporting on the psychometric qualities of the tool as observed in 58,000 interviews conduced in 138 agencies 2011 The BCFPI Inc. team includes academic researchers, system developers, integrators, trainers and support staff Partners include CMHO, and 3rd party: Software developers, Host Providers (Vancouver and London) and advanced security system providers 2011 (2) BCFPI Inc. continues to develop the measurement, screening, triaging, outcomes, analytical and database capacities of the tool We continue to expand the dissemination of the tool, and support the development of inter-agency and interregional collaboration, and training and support services BCFPI Goals, 2011 Our first goal is to provide a tool to CMH service providers and researchers, which will assist them in their efforts to optimize the delivery of CMH services, at a case and systems level, and to advocate for the public’s continued support of the CMH system Our 2nd goal is to continue to enhance BCFPI’s capacity to provide this assistance, within the limits of our resources How BCFPI supports service optimization The next slides describe how BCFPI supports service optimization Numbered items are exclusively available in the current web version or significantly improved compared to the 2000 - 2006 desktop version (still in use in some locations) The order of these items reflects the order in which they are used in routine field work #1 2 factor authentication* A password and ‘1 time 8 digit passcode’ is required to access the system This is explicitly required by EU privacy regulations, and would be valuable in all patient databases The passcode is provided when the user presses the button on their personalized key fob, to access BCFPI #2 Structured ‘Add Interview’ The ‘Add Interview’ wizard searches for previous occurrences of the case before adding a new interview and case. It also checks for open enrolments before creating new enrolments. This minimizes the registration of duplicate cases and incomplete enrolments which undermines accurate case and statistical reporting