What an excellent question.
It's interesting. The reason I say, “Thank you for asking the question”, is that all too often in mental health we look at outputs, but we don't look at outcomes. We look at how many hamburgers we put through the door, but are they edible?
We've been concentrating on developing a way to track veteran self-reported outcomes. We have a national server-based system set up, which allows veterans on their way to a session to answer a couple of brief questionnaires. That data goes to a secure server, it's scored, the results are analyzed, a report is generated, and that report is ready for the vet by the time they show up at the clinic. The system is called CROMIS. It uses industry-standard measures that track their overall well-being, but can also track specific outcomes with respect to the identified primary conditions like post-traumatic stress disorder or major depression.
When you're talking about outcomes, that is one of our primary measures. Now it's not the only one. Of course, we're looking at the other domains, social and vocational satisfaction, and their medical well-being as well. That's why the clinics are organized using interdisciplinary teams, so that each person does the assessment, we come together, and we look at the person in as well-rounded a manner as possible. As we intervene, we're trying to iteratively evaluate the outcomes, so that we can make real-time decisions and adjust the treatment plans, so it's really tailored to that particular person.
That's very important because people tend to talk a lot about best practices, but all those best practices data are all based on group outcomes. The reality is that in a clinical intervention, you always need to adapt those best practice interventions to the particular needs of that particular person. The best way to do that is to track their vital signs, just like they do in medicine, so it's like tracking blood pressure or body temperature.
We're the only network that uses that. I believe DND is working on starting up their own version, but we actually specifically track outcomes in real time and report the results back collaboratively with the veterans.