Download July 24, 2008 SBIRT follow up Meeting

Citizens Health Initiative
Unhealthy Alcohol Use –SBIRT Conference Follow Up
July 24, 2008 Meeting Summary
Attended: Susan McKeown, Patti Fowler, Ray Goodman, Jim Shagelaris, Joe Harding, Suzanne
Bulter, Viking Hedberg, Ardis Olsen, Tricia Lucas, Maria Gagnon, Susan Barnard, Alicia Soucy,
Donna Fleming (via phone), John Bunker, Laura Davie
1) Those who participated in the SBIRT conference on June 24th were asked to share the
major “take-away” from the event:
a. Surprised by how many SBIRT initiatives are already happening in NH
b. Took from the key-note-the number how could benefit from SBI
c. Not aware of how much research is available to support SBIRT
d. SBIRT occurs as part of a larger system- need to make sure the WHOLE system has
capacity
e. There is still not clear evidence on how to deliver pediatric SBIRT- more talk than
evidence
f. NH is behind MA and other states
g. SBIRT is for alcohol AND other drugs
2) What has to happen for Hospitals to implement SBIRT:
a. Start with one large hospital and one small
b. Address economic impact to hospitals (is there research, what does it say)
c. Need leadership engaged- raise awareness
d. Identify champions and train them
e. Alcohol and other drugs system needs to be a part of the effort
f. Mental Health system needs to be part of the effort
g. 3 year versus 5 year implantation strategy- possible logic model from tobacco
program
h. Legislative mandate
i.
Who benefits from SBIRT financially (mcaid, law enforcement, schools, county
corrections…)
j.
Use of St. Joseph’s Hospital ER model
k. Marketing
l.
Possibility of providing incentives for early participation
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m. Information Technology needs to implemented in hospitals
n. Training as a requirement in job descriptions so that when a person leaves the
program can continue.
o. Enhancement of data collection
3) What needs to happen for PCP’s to implement SBIRT:
a. Understanding of the two main types of practices (systems vs. small operations)
b. Reimbursement for care management once screening takes place
c. Every letter needs a code
d. Similar to the hospital list:
e. Education
f. Training
g. Incentives
h. Office wide understanding-who else besides the physicians can screen?
i.
What/how will screening benefit practice
j.
Regional models
k. Concurrent plan with hospitals
l.
HIT/HIE needs to be enhanced
m. Potential barrier: system change is difficult in PCP practices- many done have
meetings to implement system changes.
n. Alcohol and other drug and depression- screening implemented together- 15 different
screening tools, one for each problem, will not work.
o. Pilot structure which documents what steps a practice needs to take to implement
SBIRT
p. Tools: one set verses many- which one will be recommended and by whom?
q. What would be the target population in a PCP setting
r. Parent screening
4) Who are the stakeholders not here:
a. Legislators
b. Corrections
c. Mental Health Leaders- State and Community Mental Health Centers
d. Educational System-high schools both public and private
e. Social Workers in ER’s
f. Physician Assistants
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5) Recommendations for next steps:
a. Citizens Health Initiative is submitting a report to the legislator in Nov.
Recommendation will be to implement SBIRT over the next 3-5 years.
b. Look at what other states are doing for easy wins
c. Learn from other PCP and hospital based initiatives that have been done
d. Sustainability- $ for pilots but then how to fund long term system change
e. What can each of us do- who, what, where
f. Develop the economic case
g. Develop communications plan
h. Find short term planning money
i.
Implement changes in medical school and residency training programs for real
change
6) Short term next steps and responsible party:
a. Recommendation in Initiative report to legislator- Laura
b. Find out from local foundations about applying for a planning grant- EFH and NHCFJohn
c. Arrange a meeting with Dr. Bernstein- 2 hour meeting in NH—John will contact Dr.
Bernstein and Laura will arrange a location and possibility of taping or transmitting
live
i. John will call Palmer Jones from the Medical Society for a PCP and ER
Physician recommendation to attend
ii. Shawn LaFrance should attend
iii. Group will let John know what times are not good for a September meeting
with Dr. Bernstein.
d. Fact Sheets on SBIRT: Tools for each letter, Systems needs, ethicality data, Costeconomic impact
i. First one on what is SBIRT and economic picture between PCP and Hospital
programs- Laura
e. SBIRT group should meet in Oct to follow up on these action steps and
develop next steps. The group would ultimately like to develop a plan for
implementing a SBIRT pilot in PCP and hospital and then roll out SBIRT state
wide. An Oct date will be determined soon.
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