A registry performs a number of functions, both on an individual and clinic-wide level. Depending on the data input, it can keep professionals informed about their client’s progress; generate appointment reminders; track medications and other treatments; provide feedback about the effectiveness of treatment approaches; indicate allocation of clinic resources; generate information about cost-effectiveness; track caseloads; and assess clinician effectiveness. Clinics should establish a process to enter data, to ensure its accuracy, and to access information in ways that are helpful both to individual clients and to overall operations.
As an example, The HITS program, developed as part of the IMPACT initiative, registers:
- Weekly accumulated enrollment into the program;
- Number of clients who have had an initial assessment;
- Number of clients broken down by diagnoses;
- Number of clients broken down by site and by individual caseload;
- Number of active patients;
- Mean PHQ-9 (depression) scores (which can be accessed by total, by clinic and by individual clinician);
- Mean OASIS (anxiety) score;
- Number of clients who received follow-up, and type of follow-up (in-person or via the telephone);
- Last available PHQ-9 and/or OASIS score;
- Mean number of treatment/follow-up sessions the client has received and type: counseling alone, counseling and medications, or medications alone;
- Number of clients requiring psychiatric consultation or in-person psychiatric session;
- Number of clients who achieved a 50% or more improvement in their PHQ-9 scores after ten weeks.
Data can be accessed in the aggregate for an overall picture, or by clinic, by clinician or by individual client.
As part of its Small County Collaborative Care Initiative, CiMH developed a Powerpoint presentation about the functions of a registry and its use and benefits in improving client care. IBHP’s Advancing Clinical Information Systems to Support Care Coordination and Improved Outcomes for Individuals with Mental Health and Substance Use Disorders offers suggestions about what to include in registries and IT systems.