Jessica Passini presenting at APHA 2018
Jessica Passini, ISER researcher, shared work being done at ISER and its Center for Behavioral Health Research Services at the American Public Health Association’s Annual Meeting in San Diego. Passini presented a poster developed with co-authors Rosyland Frasier and Diane King, on how health care practitioners’ use of data in Electronic Health Records is important to the successful implementation of SBIRT – an evidence-based practice to identify patients who misuse alcohol and help them reduce their drinking.

The U.S. Preventive Services Task Force recommends providers screen and counsel all adult patients for excessive drinking at least annually. But adoption of SBIRT (Screening, Brief Intervention, and Referral to Treatment) – an evidence-based practice to do this, has been slow. ISER researchers partnered with health care providers in Alaska to implement SBIRT. Implementation strategies included externally facilitated planning sessions, monthly monitoring of alcohol screening rates from Electronic Health Records (EHR), and check-in calls to support problem solving.

ISER researchers found that practices that used their Electronic Health Record (EHR) data to identify and address issues at multiple levels (i.e., modify EHR, refine procedures, and provide “booster” training) achieved and sustained the highest patient reach (92.5%). Practices that used their data to solely address EHR issues, or to “remind” providers and staff to screen patients, were less successful in improving and sustaining patient reach (46.8%).

Analysis of monthly SBIRT EHR data created a quality improvement feedback loop that allowed evaluators and clinic providers to monitor implementation, adapt, and improve SBIRT processes; identify barriers and challenges to implementation and sustainability; and facilitate effective communication based on specific metrics.