Project Title

Collaborative National Network Examining Comparative effectiveness Trials (CONNECT)

Shortened Title

CoNNECT

Publication Date

9-1-2012

Author Information

Benjamin Miller, PsyD
Assistant Professor; Director of the Office for Integrated Healthcare Research and Policy
Department of Family Medicine
University of Colorado School of Medicine

Abstract

Purpose. There are three main objectives of the CoNNECT Project: to establish and test the CoNNECT infrastructure; to demonstrate the effectiveness of the infrastructure and its capacity by conducting research to evaluate care of expensive chronic disease complicated by comorbid mental health, behavioral health and substance abuse; and to evaluate the strength, weaknesses, and potential for extensive comparative effectiveness research.

Scope. CoNNECT will create the capacity to build a base for mental health in primary care comparative effectiveness research using electronic connectivity to generate retrospective and in time prospective clinical data.

Methods. The study will be a two-arm longitudinal comparison of primary care practices using a state-of-the-art integrated care model (intervention practices) to primary care practices providing usual (referral-based) behavioral healthcare (control practices).

Results. Results from CoNNECT indicate that it is indeed possible to extract data from electronic medical records to study patients with multiple chronic conditions, including mental health conditions. A total of 188,690 patients were included within the study from the first data pull. There were 29,953 patients who met the inclusion criteria (one mental health condition and one chronic disease). Our project concluded that there was little difference in primary care practices who had integrated mental health from those who did not in rates of identification. In addition, findings around which patients initiated treatment for mental health were relatively small across all sites.

EHR/EMR System or Vendor

Cerner, Allscripts, EPIC, eclinicalworks, centricity, nextgen

Healthcare Settings

Primary care or ambulatory clinics

Data Types

Electronic Health/Medical Records (EHR or EMR)

Geographic scope type

National

Population Network Size

Each practice is listed below by number with the total number of patients who were in the project: 1) 4283 2) 8778 3) 8801 4) 4631 5) 60160 6) 3158 7) 2601 8) 2574 9) 17021 10) 5801 11) 43579 12) 17230 13) 10064 These are from patients who met the inclusion criteria of having both a mental health diagnosis and chronic disease.

Major Partners

CINA-USA, The American Academy of Family Physicians National Research Network

CER/PCOR Study Priority Populations

Individuals who need chronic care, Depression and other mental health disorders (Mental health), Diabetes mellitus (Diabetes), Obesity, Substance abuse (Alcohol and drug abuse)

Treatment Comparators

This was an infrastructure grant therefore while we had comparators, we did not analyze them in the traditional way since this was technically not research, per se.

Outcome(s) of Interest

Results from CoNNECT indicate that it is indeed possible to extract data from electronic medical records to study patients with multiple chronic conditions, including mental health conditions. A total of 188,690 patients were included within the study from the first data pull. There were 29,953 patients who met the inclusion criteria (one mental health condition and one chronic disease). Our project concluded that there was little difference in primary care practices who had integrated mental health from those who did not in rates of identification. In addition, findings around which patients initiated treatment for mental health were relatively small across all sites. Electronic medical records offer an important opportunity to better understand how practices can address patients with comorbid mental health and chronic illness using innovative models that integrate mental health providers into primary care.

Suggested Reading

Miller BF, Kessler R, Peek CJ, Kallenberg GA. A National Research Agenda for Research in Collaborative Care: Papers from the Collaborative Care Research Network Research Development Conference. AHRQ Publication No. 11-0067. 2011. http://www.ahrq.gov/research/collaborativecare/

Acknowledgement of Funders

This work was funded by AHRQ grant R24 HS19462-01

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