The New York State Center for Technology in Government (CTG) today released a report showing the results of a project designed to assist physicians in the assessment of psychiatric patients in a hospital emergency room. CTG, in cooperation with the Office of Mental Health and the University at Albany's Center for Policy Research, developed computer software that supports a physician in the decision to admit or discharge a psychiatric patient.
Over 135,000 people receive emergency psychiatric services in New York State each year, yet research shows wide variability in physicians' referrals for inpatient care. Each admission to psychiatric care averages seventeen days, at a cost to the mental health system of about $10,000. Inappropriate admissions are not only costly, they do not serve the patient's best interests. On the other hand, inappropriate discharges lead to lack of needed care, recidivism, and sometimes, costly incidents of violence in the community. The decision model does not replace the physician's professional judgment, but it assures that physicians ask and evaluate all the appropriate questions needed to make a correct admission decision.
An expert panel composed of mental health professionals, consumer advocates, family members, and social workers cooperated with the research team to define a formal decision model. The model was then translated into prototype decision support software. The software prompts practitioners to gather and enter specific information needed to make an admissions decision. The system was field tested at Westchester Medical Center to identify strengths, weaknesses, and needed refinements. Eventually it may be used to train health care professionals to deal with crisis mental illness situations, as well as help practitioners examine assessment data.
According to Bruce Way, Evaluation Specialist at the New York State Office of Mental Health, "the project represented both practitioners and clients of mental health services and resulted in consensus on key areas of emergency psychiatric assessments." CTG Director Sharon Dawes said that the project was "a unique mixture of decision science, computer science, and public policy development." Jeryl Mumpower, Director of the Center for Policy Research, cautioned that the project "is still a work in progress, but has great potential for both professional education and clinical practice."
The mission of the Center for Technology in Government at the University at Albany is to foster public sector innovation, enhance capability, generate public value, and support good governance. We carry out this mission through applied research, knowledge sharing, and collaboration at the intersection of policy, management, and technology.