Repository Data Based On PAPERS Framework

This document provides summaries of data related to the most widely used outcome measurement tools in primary care for the measurement of behavioral health outcomes. Original peer-reviewed research was summarized and organized using the PAPERS framework proposed by Stanick and colleagues. Dynamic interaction with the data is possible with a ChatGPT custom chatbot created by CFHA: The Integrated Care Association.

This work was supported by membership and spearheaded by the Research and Evaluation Committee (REC) and the Measurement Based Care (MBC) workgroup. Dr. Andrea Barnes did the primary research for the document. The MBC workgroup performed the original member survey that helped lead to selection of tools to review. The REC initiated the idea of a measurement repository. Special thanks as well to Mirah for sharing their source list of tools.

This position statement from the Collaborative Family Healthcare Association (CFHA) outlines our organizational commitment to Measurement-Based Care (MBC) as a foundational element of integrated healthcare. MBC is presented not simply as data collection, but as a dynamic, evidence-based clinical process that enhances outcomes, promotes equity, and strengthens team-based care. Read more about CFHA’s call for its widespread adoption across systems, settings, and stakeholders.

There are a variety of self-assessment tools available to help a practice assess their current state and progress towards an integrated, team-based approach to care. Here are some considerations for practices to consider as they implement the use of these tools:

1. Choose from one of these tools versus creating your own tool. These tools have been field tested, have varying degrees of research rigor and are likely to be more helpful than a customized assessment.
2. Set a baseline by using the assessment tool at the start or close to the initiation of practice transformation efforts. Then reassess at regular intervals, such as every 6-12 months for newer efforts or every 2-3 years for more established programs.
3. In most cases, it is more useful to have a variety of personnel representative of the care team and administration, to complete the self-assessment. Results can either be aggregated or reported on separately. Personnel will vary by site but can include registration staff, nurses, medical assistants, clinic managers as well as clinical personnel.
4. The real utility of the tools is the initiation of conversations among team members about what is actually occurring at the practice level. Coalescing an implementation team is an important step in using these tools effectively.
5. Don’t get hung up on subtle score changes. The tools are not that refined to measure small numerical differences. The directionality of change is what is really being measured.
6. Remember that not every practice can or should attempt the highest level of integration. Practice characteristics vary greatly so the goal should be optimizing the team-based efforts of a practice. In some cases practices may need to rely on external team members, such as external mental health clinics with which they have contracts/ MOUs.
7. While the assessments are oriented towards collecting data from within practices, remember that patients are teammates as well. You should be assessing patient perspectives as part of your assessment efforts.