Performance/Quality Improvement

Conference Presentation: Destination: Patient Outcomes – Our Journey to Improving Patient Care

Derail Depression: A Quality Improvement Program - The Good, Bad and Ugly

Tuesday, January 23
10:00 AM - 11:00 AM
Location: Mediterranean 3

Physician Credits: 1.0

Nursing CE Credits: 1.0

Pharmacy Credits: 1.0

ACPE UAN: 0809-9999-18-103-L04-P (Knowledge)

CHCP Exam Designation: CHCP Professional Exam

Session Description
So, you really want to do a QI program?  Get ready for a roller coaster ride with ups and downs but a possible photo finish!

Responding to an industry RFP, we partnered with multiple stakeholders to create a program in Major Depressive Disorder (MDD). MDD is a common cause of disability in people ages 15-44, resulting in 400 million disability days per year. Symptoms are often easy to misdiagnose and undertreat in the primary care setting, where most patients present.

Additionally, there two were specific key points that needed to be addressed concerning our program design and our approach to outcomes assessment: (1) most PCPs do not use measurement-based care through depression-monitoring tools (eg, PHQ-9), limiting their ability to monitor whether therapies are successfully managing their patients; and (2) many PCPs do not know when to change or update treatment, failing to recognize when adjunctive therapy and/or mental health consultation are necessary. Our resulting program utilized a unique approach, combining online education, collaboration/on-site training with key stakeholders, a patient-centered app, as well as employing an advanced analytic design (predictive modeling) in order to measure and validate the that the changes observed in the EHR data were attributable to the educational components of the program and not outside sources.

Through a panel discussion of the above program, this session will help participants understand how to design and execute a successful QI project with multiple stakeholders and challenges.

Specifically, we will detail and discuss:

After attending this program, participants will understand what it takes to create an effective QI program.

Learning Objectives:

Dean Beals

President & CEO
New York, New York

Dean has been working in CME for over 20 years. He began his career partnering with Tufts University School of Medicine, where he developed numerous CME activities in sedation, GERD, Alzheimer’s disease, and HIV. Dean’s award-winning Principles of Pediatric Sedation program, developed with Tufts University School of Medicine, was required viewing at over 20 hospital centers across the country.

In 2002 Dean founded DKBmed, a continuing medical education company operated by an experienced team of medical education professionals. Through the company’s longstanding relationships with accredited providers (Johns Hopkins, Baylor, NYU, Tufts, PIM), Dean and his colleagues partner with the country’s finest expert faculty in a variety of specialties. DKB’s goal is to provide health care professionals with effective medical education that closes identified practice gaps and helps them deliver optimal patient care.
Dean and DKBmed specialize in employing the most advanced learning modalities, delivering CME with a focus on adult learning. Dean was an early adopter of using case scenarios with recorded and live actors, 3D animation, webcasts, podcasts, e-mail, and smart phone applications for clinicians and patients. These forward-thinking approaches enable users to learn using the latest state-of-the-art techniques and access educational programs in a manner that is most convenient and appropriate for them.

In response to opioid epidemic, Dean testifed before the U.S. Food and Drug Administration in 2016 and 2017 regarding the importance of CME focused ons safely using prescription opioids. He shared the successes and challenges faced in implementing Risk Evaluation and Mitigation Strategy (REMS) education.

Many of Dean’s programs are designed as part of longitudinal curriculums that use continuous, segmented approaches that can be measured by robust outcome metrics demonstrating change in knowledge and practice. DKBmed's programs are accessible through the company's web site ( They reach more than 50,000 clinicians in a variety of specialties, including neonatology, cystic fibrosis, diabetes, infectious disease, dermatology, ophthalmology, rheumatoid arthritis, pulmonary disease, nephrology, hematology, multiple sclerosis, gout, ulcerative colitis, depression, viral hepatitis, eating disorders, and pain management. Dean has produced a number of programs in Europe and Asia including activities at the European Cystic Fibrosis Society annual congresses and worked with Asian radiologists on a comprehensive educational resource.

Working with accredited providers, Dean has created a number of unique program formats to close key gaps in practice and knowledge. These include eleven programs under the very successful Johns Hopkins eLiteratureReviewTM brand, The AOTC Cystic Fibrosis series, several QI program in pain and depression and the launch of mobile applications for Epocrates MobileCME and the iCases educational platform.
Dean has published in Pharmaceutical Executive and has presented at several Alliance for Continuing Education in the Health Professions and other industry meetings. He is a member of ACEHP, The National Association of Medical Education Companies and the CME Coalition


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Caroline Thomas Barnhart

Manager of Integrated Behavioral Health
Lancaster General Health/Penn Medicine
Lancaster , Pennsylvania

Caroline Thomas Barnhart, MSS, LCSW is the Manager of Integrated Behavioral Health at Lancaster General Health/Penn Medicine in Lancaster Pennsylvania. She is committed to using measurement based tools to improve screening, identification and treatment of depression in primary care. As a project leader she partnered with DKBmed and realCME to develop and launch continuing medical education on depression management, leveraged the electronic health record (EPIC) to provide decision support to primary care providers, implemented referral coordination to improve counseling access and continues to promote the use of a mobile app for patients to complete depression screening as a means of monitoring progress and communicating the scores to their provider via the electronic health record.


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Steven Haimowitz

Chief Executive Officer
New York, New York

Steven Haimowitz, MD is the president of RealCME. He earned his medical degree from Downstate Medical Center in New York and did his clinical training at Albert Einstein College of Medicine. He entered the field of educational technology fifteen years ago and developed some of the earliest online health-focused education platforms for providers and patients.

In 2007, Dr. Haimowitz co-founded RealCME, a Software-as-a-Service (SaaS) company focused on using online and mobile educational technology and advanced analytics to spread the adoption of innovation, best practices, and new care delivery models. The RealCME platform enables the design, authoring, publishing, delivery, and assessment of engaging educational interventions.

Previous to starting RealCME, Dr. Haimowitz was founder and CEO of Healthology, an online health education and publishing company, acquired by NBC Universal in 2006.


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Derail Depression: A Quality Improvement Program - The Good, Bad and Ugly

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