Our expert answers 3 Questions
I develop interventions to help implement - or translate - research into real-world settings. I like getting effective programs off the academic shelf and into real-world practices. We developed an implementation intervention called Enhanced Replicating Effective Programs, or eREP, which was originally developed by the Centers for Disease Control (CDC). Recently we applied eREP to translate evidence-based care models for mood disorders in community practices nationally. eREP includes three core components: (1) translation, or "packaging" of an effective program into user-friendly language, (2) provider training, and (3) ongoing facilitation, which involves technical assistance and building relationships in real-world practices to better personalize treatments. Through eREP, we realized that it not only takes leadership support to translate effective programs into routine practice, but input and engagement of frontline providers and end-users to help us adapt the programs to fit their needs and goals.
We don't see enough effective treatments get into the hands of patients or their providers. In fact, it often takes decades for a proven-effective treatment to reach those who need it. This research-to-practice gap is especially pronounced in mental healthcare, because many providers don't have access to trainings in evidence-based practice outside the academic setting. Without the right tools to help implement these effective programs, millions of research dollars go to waste and ultimately don't reach the populations who need them. In response to this urgent need for more rapid translation, we used eREP to facilitate the uptake of Life Goals, a collaborative care model for bipolar and other mood disorders. eREP was used to translate Life Goals into a telemedicine program for the Veterans Administration (VA) as well as a program for the National Network of Depression Centers. More recently, we used eREP to implement a population management program for veterans with mental illness lost to follow-up care (SMI ReEngage). In the future, we hope to continue to apply eREP to promote the uptake of other evidence-based practices as well as inform implementation science methods, notably through adaptive intervention trials and mixed-methods analyses.
We expanded eREP to help healthcare organizations develop business models for effective programs, including Life Goals and other care models. We are currently working with several states including Michigan and Colorado to develop the business case for these effective programs, including bundled payment and blended fee-for-service models for community mental health and primary care providers.