Connecting Psychiatric and Primary Care in Epic

Up to 45% of individuals who die by suicide have visited their primary care physician within a month of their death. Cone Health providers ask patients about depression or suicidal ideation during primary care visits, and if patients are experiencing depression or anxiety, communication in Epic and a collaborative care model reduce the time it takes to connect them with a psychiatrist. Cone Health has reduced complex ED visits for these patients by 8%, and has seen improvements in patients’ reported depression and anxiety.

Patients answer PHQ-9 (depression) or GAD-7 (anxiety) questionnaires during their primary care appointments. Patients in crisis are connected with a psychiatrist while still at the clinic, often within 30 minutes of physicians entering the request. For patients who are not in crisis but could benefit from intervention, a behavioral health clinician follows up after the appointment. In addition, primary care physicians can request consults for medication review when the patient needs a related medication adjusted but doesn’t need an additional appointment with a psychiatrist.

“Providing these services at primary care increases access and reduces costs,” said Dr. Archana Kumar, a psychiatrist with Cone Health. “With Epic, information is very accessible between behavioral health and primary care, allowing the psychiatrist to provide quick medication review and consultation. This reduces the burden on primary care physicians.”

A number of Epic community members have incorporated depression screening into their primary care workflows, including UCLA, Rush University Medical Center, and Institute for Family Health.

Epic community members can learn more from Cone Health’s UGM slides and audio.