Comments on: Having a Real IMPACT on Depression http://www.jhartfound.org/blog/?p=868 The John A. Hartford Foundation blog Tue, 07 Sep 2010 15:02:38 -0400 http://wordpress.org/?v=2.9.1 hourly 1 By: Chris Langston http://www.jhartfound.org/blog/?p=868&cpage=1#comment-3978 Chris Langston Mon, 19 Oct 2009 13:47:20 +0000 http://www.jhartfound.org/blog/?p=868#comment-3978 As usual, Dr. Unutzer is far too modest. Not only is IMPACT one of the most successful planed changes in health care systems, but in the University of Washington’s new AIMS Center (Advancing Integrated Mental-Health Solutions), Jurgen and his colleagues plan to use what they have learned to support the translation of a wide range of evidence-based integrated care models into general practice. It is an ambitious goal, reported last month to the membership of Grantmakers in Health (http://www.gih.org/usr_doc/Integrated_MH_Care_Overview_for_GIH_Sept_2009.pdf). At the Hartford Foundation we are very proud to be affiliated with this work. As usual, Dr. Unutzer is far too modest. Not only is IMPACT one of the most successful planed changes in health care systems, but in the University of Washington’s new AIMS Center (Advancing Integrated Mental-Health Solutions), Jurgen and his colleagues plan to use what they have learned to support the translation of a wide range of evidence-based integrated care models into general practice. It is an ambitious goal, reported last month to the membership of Grantmakers in Health (http://www.gih.org/usr_doc/Integrated_MH_Care_Overview_for_GIH_Sept_2009.pdf). At the Hartford Foundation we are very proud to be affiliated with this work.

]]> By: Jurgen Unutzer http://www.jhartfound.org/blog/?p=868&cpage=1#comment-3969 Jurgen Unutzer Mon, 19 Oct 2009 06:27:20 +0000 http://www.jhartfound.org/blog/?p=868#comment-3969 Over the past 5 years, we have been fortunate to have support from the John A. Hartford Foundation to train 3,500 individuals in more than 200 health care practices in the United States and abroad in the IMPACT program (http://impact-uw.edu). As a group of academicians, we have learned many lessons about moving from science to practice. 1. It can take more time, skills, and resources to effectively disseminate an evidence-based intervention than to develop and test it in the first place. 2. Implementers need more than facts published in peer reviewed journal articles. They need support with adapting the ideas and approaches tested in research studies into their own settings of care and with the practice change that is invariably required to implement such evidence-based approaches in diverse health care settings. They also need stable sources of funding for changing their practices to accommodate and implement new programs and for sustaining these programs in the long run. 3. Academic medical centers are not well prepared to provide this kind of ‘real world’ translation and implementation support. To address this limitation, we have developed a number of strategic partnerships with organizations well positioned to help translate inventions from research to large scale practice change. One outstanding example is a partnership we have developed with the Institute for Clinical Systems Research (ICSI) in Minnesota. ICSI has taken the ideas we tested in IMPACT and created a state-wide initiative called DIAMOND (Depression Improvement Across Minnesota: a New Direction; see http://www.icsi.org/health_care_redesign_/diamond_35953/ ). This partnership involves several large Minnesota Health Plans who have agreed on a new case-rate payment mechanism to finance this evidence-based model of depression care and over 20 large Medical Groups who have agreed to train staff in this new model of care. Working closely with experts at the IMPACT Implementation Center, ICSI has developed a superb program to provide the training, technical assistance, and implementation support required to implement this program with over 500 primary care physicians in more than 80 primary care clinics around the state of Minnesota. Over the past 5 years, we have been fortunate to have support from the John A. Hartford Foundation to train 3,500 individuals in more than 200 health care practices in the United States and abroad in the IMPACT program (http://impact-uw.edu). As a group of academicians, we have learned many lessons about moving from science to practice.

1. It can take more time, skills, and resources to effectively disseminate an evidence-based intervention than to develop and test it in the first place.

2. Implementers need more than facts published in peer reviewed journal articles. They need support with adapting the ideas and approaches tested in research studies into their own settings of care and with the practice change that is invariably required to implement such evidence-based approaches in diverse health care settings. They also need stable sources of funding for changing their practices to accommodate and implement new programs and for sustaining these programs in the long run.

3. Academic medical centers are not well prepared to provide this kind of ‘real world’ translation and implementation support. To address this limitation, we have developed a number of strategic partnerships with organizations well positioned to help translate inventions from research to large scale practice change. One outstanding example is a partnership we have developed with the Institute for Clinical Systems Research (ICSI) in Minnesota. ICSI has taken the ideas we tested in IMPACT and created a state-wide initiative called DIAMOND (Depression Improvement Across Minnesota: a New Direction; see http://www.icsi.org/health_care_redesign_/diamond_35953/ ).
This partnership involves several large Minnesota Health Plans who have agreed on a new case-rate payment mechanism to finance this evidence-based model of depression care and over 20 large Medical Groups who have agreed to train staff in this new model of care. Working closely with experts at the IMPACT Implementation Center, ICSI has developed a superb program to provide the training, technical assistance, and implementation support required to implement this program with over 500 primary care physicians in more than 80 primary care clinics around the state of Minnesota.

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