The MInD-I (Maternal-Infant Dyad Implementation) project, led by Ian Bennett, MD, PhD, and Jürgen Unützer, MD, MPH, (co- PI) and funded through a five-year National Institute of Mental Health (1R01MH108548-01) grant, is testing the effectiveness of a novel implementation strategy — longitudinal remote consultation (LRC) — to improve the implementation effectiveness of collaborative care for perinatal depression. Other department faculty participating in this study include Amy Bauer, MD, MPH, and Amritha Bhat, MD, with training and implementation support led by Ann Shields and the AIMS Center. In the US, perinatal depression, including mood disorders occurring in pregnancy and the first year postpartum, affects as many as 45% of low income and racial/ethnic minority women during the perinatal period. Despite depression being a major source of morbidity and role impairment among pregnant women, few from low income groups receive effective treatment.

MInD-I aims to enroll up to twenty federally qualified health centers (FQHCs) that are part of the national OCHIN health information network. OCHIN provides a shared electronic health record to its 300+ primary care center members nationally. The focus of these sites on vulnerable populations provides an important opportunity to improve mental health care for a perinatal population in primary care clinics. Enrolled FQHCs will receive 15 months of significant support and training from the UW AIMS Center to help implement and sustain the Collaborative Care model for their perinatal patient populations. Half of the sites will be randomly selected to also receive the LRC intervention.

During the first year of the project, the research team completed the primary goal of building a care management registry tool within the OCHIN EPIC system, based on functionalities from the AIMS Center’s Care Management Tracking System (CMTS). The registry is a key component of delivering collaborative care and will be used by the participating FQHCs. Working together, the UW research team, the UW AIMS Center and OCHIN EPIC programmers developed the registry with key functionalities and workflows to support collaborative care such as population-based caseload review and tracking PHQ-9 scores over time.

To date, six FQHC sites have enrolled and completed pre-implementation work, including building their care teams, learning about collaborative care fundamentals, and sending care teams to a two-day training in Portland. The training included specific perinatal collaborative care information as well as OCHIN EPIC training on the new Care Manager tool. Following the two-day training, all sites started working towards launching care and enrolling perinatal patients.

During the next year, the AIMS Center will provide ongoing technical support to enrolled FQHCs including calls with care manager trainers, psychiatric consultant trainers, and billing/sustainability experts. In addition, half of the sites were randomly selected to receive the LRC intervention support. Additional sites will be enrolled over the next year.