Effects of electronic psychiatric consultations on primary care provider perceptions of mental health care: Survey results from a randomized evaluation

Ezra Golberstein, Sarah Kolvenbach, Hilary Carruthers, Benjamin Druss, Paul Goering

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Primary care is the main point-of-entry for identifying and treating mental health problems. This research examines the effect of a new model of supporting primary care providers (PCPs) treating mental health disorders, the electronic consultation (eConsults), a standard process for communication between PCPs and psychiatrists through an electronic health records system. Methods: A cluster-randomized evaluation of the psychiatric eConsults model, as implemented in a large integrated delivery system. Web survey data before and after the implementation of psychiatric eConsults were collected on PCPs’ perceptions of their capability and skill to deliver mental health services, and analyzed with linear regression models. Results: At baseline PCPs had mixed assessments of perceived support for delivering mental health services and of the availability of specialist consultations, but had relatively high perceived self-efficacy and skill for identifying, diagnosing and treating depression. PCPs in the Treatment group had statistically significant 18%, 13%, and 16% improvements in perceived support for diagnosing mental health problems, making treatment decisions, and changing treatment regimens, respectively; and 24% improved perceived ease of access to consultations for mental health, compared to the Control group. Evidence of effects on self-efficacy and perceived skill around depression was more limited. Conclusions: The psychiatric eConsults model improved PCPs’ perceptions of support for delivering mental health care and perceptions of access to specialist consultations. Implications: Electronic consultations may be a promising approach to support the delivery of mental health services in primary care settings. Level of evidence: Pre- and post-intervention web surveys from a cluster-randomized trial.

Original languageEnglish (US)
Pages (from-to)17-22
Number of pages6
JournalHealthcare
Volume6
Issue number1
DOIs
StatePublished - Mar 2018

Bibliographical note

Funding Information:
This study was funded by a grant from the Abbott Northwestern Hospital Foundation (# 15-8012 ). Dr. Golberstein had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors are grateful for assistance from Patricia Carlson and Jessica Jeruzal in implementing this study.

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