OnTrackNY’s learning healthcare system

Abstract

Worldwide, early intervention services for young people with recent-onset psychosis have been associated with improvements in outcomes, including reductions in hospitalization, symptoms, and improvements in treatment engagement and work/school participation. States have received federal mental health block grant funding to implement team-based, multi-element, evidence-based early intervention services, now called coordinated specialty care (CSC) in the USA. New York State’s CSC program, OnTrackNY, has grown into a 23-site, statewide network, serving over 1800 individuals since its 2013 inception. A state-supported intermediary organization, OnTrackCentral, has overseen the growth of OnTrackNY. OnTrackNY has been committed to quality improvement since its inception. In 2019, OnTrackNY was awarded a regional hub within the National Institute of Mental Health-sponsored Early Psychosis Intervention Network (EPINET). The participation in the national EPINET initiative reframes and expands OnTrackNY’s quality improvement activities. The national EPINET initiative aims to develop a learning healthcare system (LHS); OnTrackNY’s participation will facilitate the development of infrastructure, including a systematic approach to facilitating stakeholder input and enhancing the data and informatics infrastructure to promote quality improvement. Additionally, this infrastructure will support practice-based research to improve care. The investment of the EPINET network to build regional and national LHSs will accelerate innovations to improve quality of care.

OnTrack Chile for People With Early Psychosis: a Study Protocol for a Hybrid Type 1 Trial

“…The training approach for the OTCH teams will follow the established training strategies utilized by the OnTrack Central training team at the Center for Practice Innovations, for training teams in the state of New York and nationally [19]. The training will be delivered primarily through an online learning platform that will allow for virtual meetings focused on individualized and group consultation and coaching, didactic webinars, opportunities for sharing and learning from each other, and discussing data to help maximize the quality of the implementation.…”

“…Training then continues following a set monthly schedule of role and team-based learning collaborative calls, so that each team receives the same amount of training and information on a regular basis (Table 3). Learning collaboratives have traditionally been used in health care and are increasingly used in behavioral health care [19]. Fundamental elements of a learning collaborative include a number of organizations working together, using quality improvement methods to close the gap between potential and actual performance, learning from experts as well as from one another, and using data to track performance [19].…”

“…Learning collaboratives have traditionally been used in health care and are increasingly used in behavioral health care [19]. Fundamental elements of a learning collaborative include a number of organizations working together, using quality improvement methods to close the gap between potential and actual performance, learning from experts as well as from one another, and using data to track performance [19]. This will be complemented with resources for self-paced learning that teams can access through the virtual learning platform.…”

“…Following the recommendations by McRae et al (18) and Giraudeau et al (19) on administering consent forms in cluster RCTs, there will be two different consent forms: one for participants from interventions clinics and another one for participants from controls clinics. In addition, we will have other consent forms for policy makers, health directors, providers, and family members.…”

“…All interviews and focus groups will be audio recorded with participant's informed consent. We will employ a purposive sampling approach to identify and invite key informants representing each group of participants (17)(18)(19).…”