Madison, Wis. — A new partnership will significantly expand dissemination of screening and intervention for alcohol abuse, drug abuse and depression in primary care clinics in Wisconsin, Minnesota and Pennsylvania.
The partnership, funded through a three-year, $3.5 million grant from the federal Agency for Healthcare Research and Quality, involves three regional health coalitions—the Pittsburgh Regional Health Initiative, the Institute for Clinical Systems Improvement in Minnesota and the Wisconsin Collaborative for Healthcare Quality (WCHQ).
The WCHQ will partner with the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL), a national leader in screening and brief intervention programs for alcohol and drug abuse. The Minnesota and Pittsburgh organizations are widely recognized as leaders in implementing similar programs targeting depression. All the programs are made available in primary care clinics.
The new partners will demonstrate how to spread and sustain better patient care in areas that typically have poor patient outcomes and significant healthcare system waste.
"The partners will help up to 90 primary care practices in Wisconsin, Minnesota and Pennsylvania implement behavioral health screening and early intervention," says Dr. Richard L. Brown, WIPHL project director.
WIPHL is administered through the Department of Family Medicine (DFM) at the UW-Madison School of Medicine and Public Health and the Wisconsin Department of Health Services. Assistance will include training practice teams, building patient and community awareness, developing patient registries to track patient progress and working with clinics and insurance companies to assure appropriate reimbursement, Brown says.
The WCHQ will develop and implement quality measures among participating Wisconsin health plans to ensure effectiveness. WIPHL has already implemented its "Screening, Brief Intervention, Referral, and Treatment" (SBIRT) services for alcohol and drug abuse at 21 sites across Wisconsin.
With the brief screening, each patient is asked four questions once a year during a routine clinic appointment. Patients who score positive meet with an on-site WIPHL-trained health educator who administers a longer set of questions indicating levels of risk and degree of the problem. The health educators interview patients who score positive and are at risk, helping many reduce their risky drinking.
The SBIRT program has its origins in research conducted by Brown and others in the DFM. The National Commission on Prevention Priorities has ranked SBIRT fourth among all preventive services for cost-effectiveness and prevention potential—higher than screening for high blood pressure, high cholesterol, diabetes and various cancers.
"We know that this simple screening is impacting patient drinking in a positive way," says Brown. "Expanding the program to a wider circle of clinics will clearly benefit many more patients."