Each year, only 10-20% of 18.5 million Americans with depression receive appropriate, effective care. Psychiatric Assessment Systems (PAS) seeks to address poor quality of care for this common, debilitating disorder by developing a tool to help psychiatrists more effectively treat patients with depression. Psychiatrists have little incentive now to use clinical assessment tools, but emerging demands to show improved practice are creating a market for reliable practice assessment tools. PAS plans to capitalize on this trend with a product to meet the needs of potentially thousands of psychiatrists AND be a mechanism to improve quality of care without added effort or cost. PAS will partner with the PI and his research team, who have >10 years' experience in R&D of outcomes assessment instruments, to develop their Depression Outcomes Module (DOM) and its web-based system into an accountability tool, using DOM technology to monitor essential quality improvement data (patient characteristics, processes of care, outcomes of care). The key issue for Phase I feasibility is how PAS can change this outcomes assessment tool with proven reliability and validity into an accountability tool to meet psychiatrists' needs for re-licensing, re-privileging, and re-certification (specific aim-to determine feasibility of adapting an existing provider-focused assessment tool into a tool to effectively assess abilities to meet new practice requirements). PAS plans to determine needed modifications (research to identify broad/specific content needs [face and limited content validity]), develop/test a paper-based prototype (refine by limited field testing), and develop a web-based version of the paper-based prototype and supporting data acquisition processes (web-based technical decisions). After modifying DOM into a web-based accountability form in Phase 1, PAS plans to develop data processing and reporting components and test the overall system for scientific validity, reliability, and feasibility in Phase II to produce a web-based application with proven reliability and validity in monitoring and data collection. This technologically innovative product (a dual-use, user-friendly method to monitor factors needed to improve care and a mechanism to verify improved practice) will have commercial viability as a web-based subscription service. The product will have significant public health and NIMH importance because of its potential to improve treatment for the world's 2nd leading cause of disability (public health) and transform recovery from mental disorders (NIMH). Widespread implementation of a scientifically sound method to analyze accuracy of diagnoses, guideline concordance of care, and relative success of approaches to clinical treatment of major depression would also be an important step toward a quality-centered healthcare industry. ? ? ? ? ?
