From Brain Care Discovery to Brain Care Delivery in Less Than a Decade! Malaz Boustani, MD MPH Founding Director, Chief Innovation & Implementation Officer,

Slides:

Advertisements

Similar presentations

Indianapolis Discovery Network for Dementia Comparative Effectiveness Research Trial of Alzheimers Disease Drug: COMET-AD.

Advertisements

Patient Engagement in Design, Delivery, & Discovery 8 th Annual Utah Health Services Research Conference February 25, 2013 Lucy A. Savitz, Ph.D., MBA Director,

Family Doctor for All Overview & Research Opportunities Kristin Anderson Director, Primary Health Care Branch Applied Health Research.

Care Coordination in the Patient-Centered Medical Home New York Academy of Medicine May 24, 2011.

Indianapolis Discovery Network for Dementia Enhancing Care for Older Adults with Acute & Chronic CI Malaz Boustani, MD, MPH.

Current and Future Challenges in Designing Behavioral Interventions: From Randomized Trials to Community Implementation Current and Future Challenges in.

Indianapolis Discovery Network for Dementia Current State of Dementia Care & Research In Indiana Malaz Boustani, MD, MPH Eugene Lammers, MD, MPH Indianapolis.

1. * Integrated care is becoming increasingly prevalent * Managed care will be asking for shorter treatment lengths, and more concrete results * We have.

2.11 Conduct Medication Management University Medical Center Health System Lubbock, TX Jason Mills, PharmD, RPh Assistant Director of Pharmacy.

Efficient & Rapid Translation of Dementia Discovery IDND-PBRN Malaz Boustani, MD, MPH Chief Director of Research Indianapolis Discovery Network for Dementia.

Non-pharmacological management of agitation in dementia Kathy Fletcher RN DNP GNP-BC FAAN Director Geriatric Nursing Programs Riverside Health System Clinical.

Indianapolis Discovery Network for Dementia Translating PREVENT Into Your Practice Caring for your patients with dementia J. Eugene Lammers, MD, MPH Clarian.

Safety Net Medical Home Initiative The Commonwealth Fund Webinar December 10, 2014 Integrating Behavioral Health into Primary Care.

Indianapolis Discovery Network for Dementia Forecasting the Future Impact of Early Detection and Management Program for Alzheimer.

Indianapolis Discovery Network for Dementia Comparative Effectiveness Research Trial of Alzheimer’s Disease Drugs: COMET-AD.

Robert Margolis, M.D. Chairman & CEO HealthCare Partners ACO’s – Getting from Here to There Benefits / Risks / Opportunities.

A stroke is the leading cause of permanent impairment and disability. Pending a radical cure, patients recovering from a stroke will continue to require.

Home VIVE Dr. Jay Slater A Day in the Life.

The Role of Health Coaches in Population Health Lauren Scherer, MS, Medical Home Developer 4/21/2017.

Indianapolis Discovery Network for Dementia The ABC Medical Home - Creating a Culture for Success Catherine A. Alder, JD, MSW Project Manager, CMS Innovation.

The Indianapolis Discovery Network in Dementia: The IDND Project June 12, 2006 Third IDND Meeting Malaz Boustani, MD, MPH Stephanie Munger, BS IUCAR, Regenstrief.

Treatment for Adolescents With Depression Study (TADS)

ADAPT serving geriatric populations in rural communities. Project ADAPT Assessing Depression and Proactive Treatment The Minnesota Area Geriatric Education.

ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH Engaging Hospitals in Research: Implementation Science Jose Azar, MD Medical Director,

Home Based Palliative Care Richard D. Brumley, MD Gretchen Phillips, MSW Kaiser Permanente Downey, CA Practice Change Fellows January 24, 2008.

Applying Science to Transform Lives TREATMENT RESEARCH INSTITUTE TRI science addiction Mady Chalk, Ph.D Treatment Research Institute CADPAAC Conference.

A Dementia Case‐Finding Program for Veterans: Applying Lessons Learned to Improve Dementia Recognition in Primary Care Practice Laura O. Wray, PhD, Director.

Overview of CAHPS ® and the National CAHPS ® Database Assessing Patients’ Experiences with Care: Using CAHPS ® as a Standardized Quality Metric Dale Shaller,

Exclusively serving Indiana families since Population Health Management from the Managed Care Entity Perspective IPHCA Annual Conference 2015.

Multi-sector Policy Recommendations to Create a Culture of Whole Person Health: Results from a Multi-method Investigation Emma C. Gilchrist, MPH Program.

Specialised Geriatric Services Heather Gilley Sharon Straus.

Plenary III: There is No Health Without Mental Health.

Comorbidity of 10 common conditions Guthrie B et al. BMJ 2012;345:bmj.e6341.

Shaping the Future of Healthcare | CERTIFIED TECHNOLOGY COMPARISON TASK FORCE JIGNESH SHETH MD, MPH THE WRIGHT CENTER.

Improving Care in Care Homes Application of the Newcastle Model in Dementia Care Ann Scott Practice Development Facilitator Homefirst Community Trust.

Update on Medicaid Integration in SW Washington January 7, 2016 Erin Hafer, MPH Director, New Programs Integration & Network Development.

Jitender Sareen MD, Tanya Sala MD, Jacquelyne Wong MA, Debbie Whitney PhD, Jolene Kinley PhD.

Dementia Care - a Forward View and a note on the Nottinghamshire Healthcare Strategy Professor Martin Orrell Director, Institute of Mental Health 1.

The Patient Centered Medical Home. Learning Objectives Identify the attributes of a patient centered medical home Describe some processes that facilitate.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment

Funded in part by a grant from the EJC Foundation Presented in partnership by GERIATRIC EDUCATION SERIES.

Learning Health Systems: Working at the Intersection of Research, Operations and Big Data Welcome May 5, 2017.

RCHC Developmental Screening and Referral project for Children 0-5 served by Sonoma County Community Health Centers.

The behavioral pathology in Alzheimer's Disease Scale; BEHAVE-AD

The Role of the Contemporary Nursing Leader

A stroke is the leading cause of permanent impairment and disability

A Foundation for Paul Grundy MD, MPH IBM Chief Medical Officer Director, Healthcare Transformation Healthcare Industry A Foundation.

Cheryl Schraeder, RN, PhD, FAAN Health Systems Research Center

CONTROLLING THE COSTS OF HEMOPHILIA

Opioid Management in Primary Care Michael Parchman, MD, MPH

Table 1: Patient Demographics

VOLTAMAC HOME HEALTH SERVICES

MacColl Center for Health Care Innovation

Telepsychiatry: Cost Effective Solution to Integrated Care

From Brain Care Discovery to Brain Care Delivery in Less Than a Decade! Malaz Boustani, MD MPH Founding Director, Chief Innovation & Implementation Officer,

LeadingAge Maryland October 31, 3017

Annual Business Meeting & Class of 2017 Fellows

Management of Agitation in Dementia

What is InSight? $17 million five-year SAMHSA grant

Using the SafeMed model for transitions of care approach

National Academies of Science, Engineering & Medicine

Extending Case Management Using Telehealth

IMPROVING OUTCOMES IN FEE FOR SERVICE MEDICARE

Medicaid Services in Schools: Individualized Education Plans School Based Health Centers Medicaid Rehab Option.

Caregiving for the Seriously Ill: Overview and Impacts

Using the SafeMed model for transitions of care approach

Only 28% of U.S. Primary Care Physicians Have Electronic Medical Records; Only 19% Advanced IT Capacity, 2006 Percent reporting 7 or more out of 14 functions*

West Virginia Bureau for Medical Services (BMS)

North Florida/South Georgia Veterans Health System

Presentation transcript:

From Brain Care Discovery to Brain Care Delivery in Less Than a Decade! Malaz Boustani, MD MPH Founding Director, Chief Innovation & Implementation Officer, Sandra Eskenazi Center for Brain Care Innovation Indiana University Center for Health Innovation and Implementation Science

IU Team Mentors and Peers Chris Callahan Greg Sachs Mary Austrom Siu Hui Daniel Clark Su Gao Lisa Harris Patrick Monahan Wanzhu Tu Anthony Perkins Mentees Noll Campbell Babar Khan Nicole Fowler Michael LaMantia Richard Holden Daniel Bateman Sophia Wong Ashley Overlay Nadia Adams Cathy Alder Ben Zarzour

Potential Conflict of Interest in the past 12 months Hold equity in a preferred population health management (PPHM), LLC. PPHM is the distributing network for the IU ABC program. Member of the Beacon Advisory Board for Astra-Zeneca.

Source of Funding: For Brain Care Discovery: For Brain Care Delivery: K23AG026770; R01AG029884; R01AG040220; R01AG034205; P30AG024967; R01HS019818; and R01HS10884. For Brain Care Delivery: R24MH080827; 1C1CMS331000-01-00; 1L1CMS331444-01-00; and Eskenazi Health Foundation.

Objectives Describe the structure and the tools, including new staffing models, and effectiveness of the IU Aging Brain Care model Discuss the challenges in shortening the time to translate a Brain Care discovery to a Brain Care Delivery Describe implementing a change in a complex adaptive human network

Aging Brain Care in the USA (Primary Care and Hospital Settings) Any Cognitive Impairment 25% - 40% Unrecognized cases: 60% to 80% Behavioral Symptoms 32% to 82% Drugs with Adverse Cognitive Effects: 22% to 26% FDA approved Drugs: 5% to 10% Off label psychotropics: 20% to 25% ER visit per year: 49% (pts) / 21% (Caregivers) Hospitalization per year 26% (pts) / 11% (Caregivers) Length of Hospital Stay: 5.9 to 9.2 days LaMantia et al, ADAD 2015; French et al, Health Affairs 2014; Khan et al JHM 2012; Boustani et al, JGIM 2012; Boustani et al, Aging and Mental Health 2011; Boustani et al, JHM 2010; Schubert et al, JGIM 2008; Schubert et al, JAGS 2006; Callahan et al, JAMA 2006; Boustani et al, JGIM 2005; Boustani et al, Ann Int Med 2003

Current Discovery to Delivery Translational Cycle

Indiana University Reaction Developed the Aging Brain Care Model (ABC beta ) (2000-2001). Evaluated the model in RCT* (2001-2006). Translated the model into a local clinical program (ABC 1.0) (2007). Served 1,000 patients in Indianapolis (2012). Developed a scalable version (ABC 2.0) (2012). Served 5,000 patients in Indiana (2015). Active distribution of the ABC 2.0 (2015) Developing an advanced scalable version (ABC 3.0) (2016) *RCT: Randomized Controlled Trial

The Aging Brain Care Model (ABC beta) BPSD: Behavioral and psychological symptoms ChEIs: Cholinesterase inhibitors Callahan et al, JAMA 2006; Austrom et al, Gerontologist 2004; Boustani et al, JCIA 2006

Work Force for ABC Model from 1.0 to 3.0 Today ABC 2.0: : M-F 8-5 p.m. about $ 100 p.m.p.m., focusing on dementia / depression Future ABC 3.0: 24/7 about $ 50 p.m.p.m., almost all brain conditions p.m.p.m.=per member per month; MD=medical doctor; RN=registered nurse; SW=social worker; CCA=care coordinator assistant; eMR ABC=electronic medical record ageing brain care (a specialized software application for the model)

IT Support of ABC Model from 1.0 to 3.0

Standardized Minimum ABC 2.0 Care Callahan et al, Aging & Mental Health 2011; Boustani et al, Aging & Mental Health 2011; LaMantia et al, JAGS 2015

The Current Tools of ABC 2.0 Mobile office HABC Monitor for both self and Caregiver report eMR-ABC population management software Mobile HABC App for Informal Caregiver ABC Replication Manual ABC Caregiver Booklet Anticholinergic Cognitive Burden Scale LaMantia et al JAGS 2015; Frame et al eGEMS 2013; Monahan et al, JCIA 2010; Monahan et al JCIA 2012; Boustani et al, JCIA 2009

The ABC beta version Efficacy NNT: Number Need to Treat; NPI: Neuropsychiatric Inventory; CG: Caregiver Callahan, Boustani et al, JAMA 2006

ABC 1.0 Performance ABC; Aging Brain Care patients; PCC: primary care center patients Boustani et al, Aging & Mental Health 2011

ABC 1.0 Performance ABC; Aging Brain Care patients; PCC: primary care center patients Boustani et al, Aging & Mental Health 2011

ABC 1.0 Annual Cost Savings Per Patient French et , Health Affairs 204 (In Press)

ABC 2.0 Performance LaMantia et al, JAGS 2015