Barriers to use of Health Outcomes

A lot of barriers exist when it comes to use of health outcomes, be it in mental health or other medical disciplines. Canvasing via a quick and easy straw poll suggested that the biggest barriers relate to poorly developed systems that fail to exploit the advantages technology can confer. Yes! Its only 20 votes, but there is considerable face-validity to the sentiments picked as seen below.

poll

Can we over-do use of Patient Rated Outcome Measures?

There is a risk that this may happen, especially if Commissioners / Fund holders seek to apply outcomes of a certain kind blindly. For instance, clinically, it is unlikely a Strengths and Difficulties Questionnaire is appropriate for someone with an Eating Disorder, but it is incredibly helpful to have this information as a part of an ADHD assessment.

We would caution ‘spinal’, weekly use of outcomes for the sake of doing so, the process needs to be clinically relevant and meaningful. Questionnaires are not diagnostic in themselves but an aid or a toll in the assessment process.

Around 25% clinicians suggest they may not want to bother with use of measures at all. Experience suggests that use of questionnaires can help collate lot more information in much shorter time,  open up conversations with people who struggle to narrate their stories and at times make way for new insights – for instance patient’s may come across ‘well’ but the ratings suggest significant underlying difficulties.

On balance, judicious use of right scales and measures can help, clearly what we need is improved IT support that empowers practice rather than makes it clunky, time consuming and costly through lack of automation and poorly designed user-interface.

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