14.3 Leveraging Technology to Support Training, Treatment Adherence, and Outcomes

Objectives: Use of fidelity and outcome monitoring in the dissemination of evidence-based psychosocial treatments (EBTs) in community settings has become gold standard in taking EBTs to scale. Sustainability of EBT posttraining is high stakes to agencies and providers. Over time, adherence to EBTs tends to drift, thereby diluting program effectiveness. To support clinicians in implementing EBTs with fidelity, effective measurement methods that are feasible within service settings, as well as a feedback system coupled with supportive quality improvement, are needed. Strong interest lies in using technology to support real-time fidelity assessment and the collection of client-level data to document service dose and content. Technology-based outcome monitoring can enhance the integration of outcome measurement into care, as it enables rapid use of outcome reports, decision support tools, and measurement feedback systems. Mandates in the Affordable Care Act will require practicing clinicians to consistently use EBTs and demonstrate quality of care through systematic assessment of client outcomes. NIMH small business innovation research pilot data will be presented in an online implementation support system (EBT Performance Outcome Platform, EBTPOP, 2.0) for trauma-focused (TF)-CBT that supports high-fidelity clinical service delivery and ongoing monitoring of performance and outcomes at the case and aggregate level. Methods: Authors will review features of EBT-POPs and present feasibility/utility data from focus groups of clinicians (n = 50) and senior leaders (n = 10) using a beta version of the software, as it was applied during a nine-month learning collaborative on TF-CBT. Participants in focus groups were asked to reflect on EBT-POP feasibility in their primary service setting (i.e., acceptability, usability, appropriateness, and value), as well as its utility in increasing fidelity to TF-CBT and engaging in implementation of quality improvement based on fidelity assessment and feedback. Results: Agency providers and administrators reported that EBT-POP is a highly needed, valuable form of treatment and practice tool that offers substantial innovation over currently available alternatives, not only for enhancing training, but also for ongoing sustainability of the adopted EBT. Conclusions: Authors will provide application to future use for community agencies, state, and managed care organizations.