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THE BASICS

What is Measurement-Based Care?

Measurement-Based Care is transforming the quality of behavioral healthcare by empowering clients, clinicians, and organizations with the data and insights they need to increase client engagement, collaborate on care decisions, and improve outcomes.

Measurement-Based Care 101

The time for MBC is now, here’s why:

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Measurement-Based Care involves tracking client progress throughout treatment, using consistent Patient-Reported Outcome Measures (PROMS). It provides an avenue for clinicians and their clients to regularly check in with each other, reflect on objective symptom change data together and uncover insights or patterns that can inform treatment decisions. The uptake of MBC is growing rapidly, with it being viewed as a core component of evidence-based behavioral healthcare. National accrediting bodies like the Joint Commission are making a major push to drive its adoption.

It’s important to remember that Measurement-Based Care is a clinical process, not just simply the collection of PROMS. The process of incorporating data and insights into clinical discussions and decision making is where the real value lies.

Measurement-Based Care empowers people in care, providers, organizations, and health systems with objective client and program specific data and insights that they’ve never had before. The Result? Clients are more engaged in care, providers can make evidence-based clinical decisions, organizations can innovate and improve their services, and health systems can better serve everyone in their population.


Everyone benefits. Everyone thrives.

The Measurement-Based Care Fundamentals.

There are four fundamental principles to Measurement-Based Care which we like to call Greenspace’s Four C’s. Each ‘C’ is imperative to clients and clinicians getting the most out of MBC.

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Consistent

Effective Measurement-Based Care needs to be consistent throughout a persons care, with the regular collection (usually every 2 weeks dependent on client needs or the recommended frequency for specific assessments) of patient-reported outcomes. Consistent and frequent collection gives clinicians and their clients a strong understanding of client experiences, symptom changes that are occurring over time, and most importantly, allows a clinician and client to dig in and explore why symptom changes are occurring.

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Customized

Having a set group of assessments applied to every client, clinician, clinic or program allows you to understand outcomes across all of your clients, an entire clinic or within a certain program to help inform care improvement and innovation. That said, it’s important that clinicians have the ability to customize their measurement process to the presenting issues, symptoms and goals of individual clients. A customizable process allows clinicians to develop a deep understanding of the challenges a client may be facing and to inform their care process based on data that is unique to each clients experience.

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Client Visibility

Client visibility refers to just that; the client having full visibility into their results so they can better understand how they’re progressing throughout treatment. Providing clients access to their personal outcome data empowers them to better understand their mental health, communicate their needs, bring up topics they may not have otherwise, and be an active participant in their care process.

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Collaboration

Clinical decisions are informed by a clinician’s clinical expertise, client insights and experience, and objective data. Outcome data on its own doesn’t tell the full story, it’s there for a client and clinician to explore and learn from together. Elevating the clients voice in session allows them to be partners in their care process and empowers them and their clinician to identify symptom-change patterns or adjustments needed in treatment plans, which leads to collaborative discussions, elevated therapeutic alliance and an improved quality of care.

The Difference Greenspace is Making

The 4 C’s are essential to effective Measurement-Based Care, but it takes powerful and intuitive technology to make it possible. That’s where Greenspace comes in.

Providers

We make Measurement-Based Care easy. Automated delivery, customizable assessments, and rich insights help to inform your clinical decision making, reduce client drop-out and improve outcomes.

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Clients

Elevate client voices and empower them in care. Greenspace gives clients visibility into their results so they can assess their own progress and actively engage in their care process.

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Organizations

Access more powerful data than ever before. Leverage clinical insights to assess program effectiveness, inform supervision, improve quality of care and demonstrate value to funders and stakeholders.

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Clients really like being able to see the progress and the changes that they are making.

Mary Rimi, LCPC, NCC

Outpatient Mental Health Clinic Program Director, Leading by Example

The Supporting Research

Greenspace was built on research that identifies consistent progress measurement as having a dramatic impact on client treatment outcomes, regardless of modality.

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higher overall improvement in clinical symptoms
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higher likelihood that a client experiences reliable change
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lower dropout or cancellation rates

1. Michael J Lambert, “Outcome in Psychotherapy: The Past and Important Advances” (2013). 2. Slade, et al., “Improving Psychotherapy Outcome: The Use of Immediate Electronic Feedback and Revised Clinical Support Tools” (2008). 3. Bohanske, R. T., & Franczak, M., "Transforming public behavioral health care: A case example of consumer-directed services, recovery, and the common factors" (2010).

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Symptom Improvement
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CASE STUDY: CMAP HEALTH

Building a New Practice With MBC At It’s Core

CMAP Health improves treatment adherence, client engagement, and overall outcomes with Greenspace Measurement-Based Care.

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CASE STUDY: PATHSTONE

Using Measurement-Based Care to Improve Client Engagement and Reduce Dropout

Pathstone transforms their measurement process from a pre-and-post model to consistent Measurement-Based Care, elevating the quality of their care delivery.

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CASE STUDY: HOMEWOOD HEALTH

Simplifying MBC for Clients & Service Providers

Homewood Health leverages MBC to streamline and simplify their data collection process, so they can better track client progress over time.

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FREQUENTLY ASKED QUESTIONS

Why is measuring progress important?

Consistent progress monitoring throughout treatment has many benefits. It provides both the client and therapist with insight into treatment progress which increases client engagement, reduces symptom deterioration, and improves client outcomes (Lambert et al., 2005). MBC can also be used as a guide to adjust clinical plans based on how a person is responding to treatment. When symptoms are consistently measured, it is easier for both the client and clinician to recognize when treatment plans are not effective, and outcomes are not being met (UBC Department of Psychiatry, 2020).

Is Measurement-Based Care meant to replace therapy or clinical judgement?

Absolutely not. MBC is a clinical tool designed to help enhance clinical decision making. As Dr. Amber Wimsatt Childs from the Yale Measurement-Based Collaborative explains in this video, the clinicians training, experience, and expertise are really what brings MBC to life.

The data and insights collected throughout treatment give the clinician a better understanding of how clients are progressing, what they may be struggling with, and what aspects of treatment are and are not working.

In having access to their results, clients are able to better understand their own mental health and feel empowered in their care process, but the real work begins when they can discuss this with their clinician in session.

Will my clients engage with Measurement-Based Care?

Absolutely! The key to ensuring clients engage in treatment with MBC is to make it meaningful. Dr. Sandy Resnick from the Yale Measurement-Based Care Collaborative uses a metaphor about Starbucks Rewards to draw parallels to the value provided to clients through the MBC process, watch the video here.

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How do I introduce Measurement-Based Care to clients?

Communicating the concept of Measurement-Based Care is an important part of introducing Greenspace to clients and will inevitably increase engagement and completion of assessments, making the program more beneficial for both you and the client.

We have three primary recommendations when introducing Progress Measurement to patients (click to learn more)

1. Explain what the measurement process is.
2. Explain the purpose of implementing an ongoing measurement process.
3. Explain how Greenspace works and how to get started.

What is an example of measurement-based care?

There are many examples of Measurement-Based Care in physical health care, where symptoms are monitored and data is gathered throughout treatment. We do so when treating diabetes, where patients with type 1 have the ability to self-monitor their glucose ad hemoglobin levels at home, with blood sugar meters that will indicate whether or not their numbers are within a safe range. This data can then be used to inform their nutrition, insulin distribution, and conversations with their practitioner— ensuring they can maintain good health and that nothing gets missed.

When it comes to mental healthcare, data hasn’t historically been used in the same way. But, the tides are shifting as providers implement Measurement-Based Care into practice, due to a clear focus in behavioral healthcare on transparency of outcomes, quality improvement, and value-based care discussions. As an example of Measurement-Based Care in practice within a mental health setting, our partners Merakey are using MBC to get the information they need to understand their clients’ experience and identify areas for improvement across their programs. In doing so, they are able to provide tailored, high-quality care to more than 50,000 individuals and families across the U.S. each year. 

What are the benefits of Measurement-Based Care?

There are my benefits of Measurement-Based Care that are well documented in research and proven in practice across every type of behavioural health setting and service. We’ve listed four of the most widely applicable benefits below, and there are many others in addition to those listed. Reach out anytime if you’d like to further explore the benefits of MBC for your organization.

  • Enhanced client care: Measurement-Based Care is proven to increase engagement, enhance therapeutic alliance, reduce drop-out rates and no-shows, and improve treatment outcomes for people in care.
  • Objective data to inform treatment: With regular, objective clinical insights, providers can evaluate treatment progress, case-manage off-track clients, and enhance clinical decision-making.
  • Equitable care delivery: Measurement-Based Care helps level the playing field in treatment, by ensuring that clients are empowered as partners in their care process and can effectively understand and communicate their needs and experiences throughout — regardless of their background, education, or comfortability with mental health services.
  • Service improvement: Measurement-Based Care helps to foster a learning environment among clinical teams, where providers collaborate on cases, and can continually learn what works best with different conditions, demographics, background, etc. The organization itself can also leverage their data to identify and reports on services that are improving the mental health of their clients, and prioritize innovation to services where improvement may be needed.
What is the difference between Measurement-Informed Care (MIC) and Measurement-Based Care (MBC)?

There is no difference! MIC and MBC are terms often used interchangeably. While there is a subtle difference in the naming convention, the two refer to the same process.

At their core, both involve the systematic collection and use of measurement tools (like patient-reported outcome measures or PROMs) throughout care to inform and improve the quality of mental health treatment.

Both MBC and MIC emphasize the consistent collection and integration of outcome measurements (collected through PROMS, clinical interviews, or physiological assessments) to inform the therapeutic process and treatment planning. By definition, MIC involves using measurement data to collaboratively inform treatment decisions, set goals, and engage clients in their care by encouraging a more dynamic and collaborative approach between clinician and client. The emphasis in MIC, as it is with MBC, is on the therapeutic relationship and using outcome data as a tool to guide the therapeutic process, fostering shared decision-making and enhanced patient engagement throughout their treatment.

Though some believe MBC is less focused on leveraging data throughout the care process, this isn’t the case. Most experts, like our partners at the Yale Measurement-Based Care Collaborative (YMBCC), emphasize the collaborative nature of MBC. The YMBCC uses ‘Collect, Share, Act’ to define this process, where ‘Share’ is focused on leveraging data during sessions with clients and getting curious about their symptom changes together, in order to inform treatment decisions. At Greenspace, we often refer to the ‘4 C’s of MBC’, where Collaboration is a foundational component of any successful MBC implementation.

To summarize, both MIC and MBC share the overarching goal of improving the quality and effectiveness of mental healthcare services through the collection of PROMs and collaborative use of outcome data throughout care. Whichever term your clinical team uses, what matters is that you’re using an evidence-based approach to treatment that centers the client’s voice in care and empowers them to be active partners in the process, which is proven to have a significant and positive impact on client engagement and clinical outcomes.

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See the impact MBC had on Naomi Richter, Director of Care at GreeneStone

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