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Annals of Family Medicine 2:301-304 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.102
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Going to Scale: Re-Engineering Systems for Primary Care Treatment of Depression

Allen J. Dietrich, MD1, Thomas E. Oxman, MD1, John W. Williams, Jr, MD, MHSC2, Kurt Kroenke, MD3, H. Charles Schulberg, PhD4, Martha Bruce, PhD4 and Sheila L. Barry1

1 Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
2 Center for Health Services Research in Primary Care and the Division of General Internal Medicine, Durham Veterans Affairs Medical Center and Duke University, Durham, NC
3 Regenstrief Institute for Health Care and Indiana University School of Medicine, Indianapolis, Ind
4 Weill Medical College of Cornell University, White Plains, NY



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  		Figure 1. The Three Component Model.

* Primary Care Clinician (PCC) follow up visits typically at 2, 6, and 12 weeks and as needed; PHQ-9 = Patient Health Questionnaire

{dagger} After each patient contact, Care Manager sends report to PCC and discusses in psychiuatry supervision call.

{ddagger} Discussed with psychiatrist or referral to specialty care.

 


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  		Figure 2. The process of change strategy.

 




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