Screening Guidelines and Best Practices

When you look across the range of screening guidelines and best practices, there are some common concepts. First, the earlier the detection, the better the treatment results and lower the cost. Second, medical training focuses on acute care while a bio-psycho-social approach treats the whole person, resulting in better health and lower costs. Third, managing health confidence engages the patient and is the most effective way to promote health and manage cost. Screening using apps supports all these concepts.

Early Childhood Development

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The benefits of early detection are impressive when it comes to early childhood development. So much so that the AAP recommends 3 developmental screenings by the age of three and 2 autism screenings in the second year (ASQ-3, ASQ:SE-2, M-CHAT-2). Organizations like HMG and ABCD help implement these fundamental screening guidelines. But it’s not just about clinical measures. Some would argue that the primary benefit of early childhood screening is that it educates parents and helps develop parenting skills. Either way, if you are not doing developmental screening, you should start.

 

Integrated Behavioral Health (IBH)

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Medical training at its core is designed to treat acute conditions. A broader view is that the medical community produces health. In this broader view, mental and behavioral health become as important as a patient’s medical condition. Being able to integrate the two together is the focus of many practices. To do this cost-effectively, screening and detection of psychological distress electronically is pivotal (PHQ-9, GAD-7, AUDIT-10, DAST-10). Being able to follow up with an in-depth assessment electronically helps even more, making the warm hand off based on full information (QPD).

 

Pain Management And Workers Comp

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The interconnection of mental and physical is extraordinary when it comes to pain management. So much so, that a bio-psycho-social model is essential to treating pain cost-effectively (BBHI-2, BHI-2). For example a meta-study showed that the State of Colorado’s Worker’s Comp saved $780,000,000 in the 18 months after implementing bio-psycho-social guidelines. Colorado’s Worker’s Comp now reimburses $80 for a psychological screening (depression, anxiety, etc.) at the initial visit and set periods after. ACOEM guidelines in California, similarly promote the use of a bio-psycho-social model.

 

Health Confidence

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Based on work with the HYH screening assessment, meta studies have shown health confidence is key. Simply screening and managing patient’s health confidence across the entire patient population is more cost-effective than disease management programs that focus on the high utilizers. If you are able to implement both, that’s great. However if you have to chose one, managing health confidence is the better strategy.

 

Other Screening Guidelines

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Similar to IBH or using the bio-psycho-social model, screening for psychological distress helps uncover underlying issues. The USPSTF recommends annual depression screenings for adults, post-partem depression screenings during pregnancy and up to a year after giving birth. The NCCN recommends screening for psychological distress and fatigue during cancer treatment. Reflected in the mental health parity regulations, screening and managing the mental state of patient can be as important as their medical condition.