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Research ArticleResearch Brief

Warm Handoffs and Attendance at Initial Integrated Behavioral Health Appointments

Christine A. Pace, Katherine Gergen-Barnett, Alysa Veidis, Joanna D’Afflitti, Jason Worcester, Pedro Fernandez and Karen E. Lasser
The Annals of Family Medicine July 2018, 16 (4) 346-348; DOI: https://doi.org/10.1370/afm.2263
Christine A. Pace
1Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
MD, MSc
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  • For correspondence: Christine.pace@bmc.org
Katherine Gergen-Barnett
2Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
MD
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Alysa Veidis
3Commonwealth Care Alliance, Boston, Massachusetts
RN, MSN, NP-BC
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Joanna D’Afflitti
1Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
MD, MPH
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Jason Worcester
1Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
MD
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Pedro Fernandez
4Department of Psychiatry, University of Texas Southwestern, Dallas, Texas
MD
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Karen E. Lasser
1Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
MD, MPH
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  • Surprising results: Warm handoffs and attendance at integrated behavioral health
    Jeffrey Scherrer
    Published on: 16 July 2018
  • Published on: (16 July 2018)
    Page navigation anchor for Surprising results: Warm handoffs and attendance at integrated behavioral health
    Surprising results: Warm handoffs and attendance at integrated behavioral health
    • Jeffrey Scherrer, Professor

    I applaud Pace et al.'s novel study of warm handoffs. The authors demonstrate the value of expanding measures in the electronic health record (EHR) by tracking whether patients received a warm handoff. This study would be very difficult had the investigators manually abstracted 2, 690 charts to identify warm handoffs. By adding more process of care measures and patient level data, the EHR can be employed in more sophi...

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    I applaud Pace et al.'s novel study of warm handoffs. The authors demonstrate the value of expanding measures in the electronic health record (EHR) by tracking whether patients received a warm handoff. This study would be very difficult had the investigators manually abstracted 2, 690 charts to identify warm handoffs. By adding more process of care measures and patient level data, the EHR can be employed in more sophisticated health services and epidemiological studies. Conversely, the unexpected findings that warm handoffs were not associated with initial appointment highlights what is missing in the EHR. Without a means to track patients' reasons for not attending an appointment (a measure that would be difficult to obtain as the patient departs for the door) it is not possible to determine why the warm hand-off did not improve attendance at initial appointment. Maybe the investigators will be able to conduct a follow-up study contacting patients who did not attend and those who did attend to identify reasons behind these decisions. Maybe it is as simple as not having the time to remain at the clinic or time to reflect on engaging in behavioral therapy. If patients need time to reflect on other treatment decisions (e.g. surgery) we should expect they need time to think about starting behavioral therapy. Future research should determine if patients need time to make a decision about their behavioral health treatment options, if so, warm-handoffs might inadvertently create a barrier to care.

    Competing interests: None declared

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 16 (4)
The Annals of Family Medicine: 16 (4)
Vol. 16, Issue 4
July/August 2018
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Warm Handoffs and Attendance at Initial Integrated Behavioral Health Appointments
Christine A. Pace, Katherine Gergen-Barnett, Alysa Veidis, Joanna D’Afflitti, Jason Worcester, Pedro Fernandez, Karen E. Lasser
The Annals of Family Medicine Jul 2018, 16 (4) 346-348; DOI: 10.1370/afm.2263

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Warm Handoffs and Attendance at Initial Integrated Behavioral Health Appointments
Christine A. Pace, Katherine Gergen-Barnett, Alysa Veidis, Joanna D’Afflitti, Jason Worcester, Pedro Fernandez, Karen E. Lasser
The Annals of Family Medicine Jul 2018, 16 (4) 346-348; DOI: 10.1370/afm.2263
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