Measurement-based care (MBC) in behavioral health is intended to improve the effectiveness of care through routine monitoring of patient symptoms to inform treatment and engage patients. This report documents the findings from qualitative interviews that assessed clinician and patient perspectives on various options for displaying MBC data.

Displaying Behavioral Health Measurement-Based Care Data

Identifying Key Features from Clinician and Patient Perspectives

Kimberly A. Hepner, Carrie M. Farmer, Stephanie Brooks Holliday, Sarika Bharil, Rachel E. Kimerling, Pearl McGee-Vincent, Shannon E. McCaslin, Craig Rosen

ResearchPublished Sep 4, 2019

Measurement-based care (MBC) in behavioral health is intended to improve the effectiveness of care through routine monitoring of patient symptoms to inform treatment and engage patients. Repeated assessment of patient symptoms, such as depression symptoms, yields multiple scores over time. Little is known about the best methods to display MBC data in a way that is clear and useful to both clinicians and patients. This report documents the findings from qualitative interviews that assessed clinician and patient perspectives on various options for displaying MBC data, with the goal of identifying core features of MBC data displays. Visual data displays were various graphs of depression or posttraumatic stress disorder symptoms over time.

Key Takeaways

  • Clinicians preferred a downward-trending line graph to indicate improvement, as did more than half of patients.
  • Clinicians and patients preferred the inclusion of interpretive ranges that indicated the severity of depression symptoms (e.g., mild, moderate) on the graph. Both preferred color displays of these ranges over a black-and-white display, as they were viewed as clearer and more engaging.
  • Clinicians preferred the inclusion of a threshold line indicating the level of symptoms associated with a probable posttraumatic stress disorder diagnosis, but patient perceptions were more mixed.
  • Clinicians and patients preferred the inclusion of treatment milestones on the display (such as medication changes or aspects of psychotherapy). Clinicians desired the ability to customize the types of milestones that could be included. Clinicians and patients also wanted the option to display life-event milestones, such as job loss.

Recommendations

  • Visual displays of MBC data, such as graphs of scores over time, can support clinicians sharing the results of data with their patients to facilitate discussions of progress, reinforce patient changes, and support shared decisionmaking about treatment adjustments.
  • Optimal displays incorporate a downward-trending line to indicate improvement, interpretive guidance (severity ranges or a diagnostic threshold), use of color, and treatment milestones.

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Hepner, Kimberly A., Carrie M. Farmer, Stephanie Brooks Holliday, Sarika Bharil, Rachel E. Kimerling, Pearl McGee-Vincent, Shannon E. McCaslin, and Craig Rosen, Displaying Behavioral Health Measurement-Based Care Data: Identifying Key Features from Clinician and Patient Perspectives. Santa Monica, CA: RAND Corporation, 2019. https://www.rand.org/pubs/research_reports/RR3078.html.
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This research was funded by the U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and carried out within the Quality Measurement and Improvement Program of RAND Health Care.

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