Based on feedback from the TAG and clinical and quality measure development experts, we determined that the information needed to calculate the measure was not available from claims or medical records and would therefore require primary data collection in the form of a survey. To reduce respondent burden, and based upon feedback from clinicians with data collection expertise, we also determined the survey would be web-based, with paper versions provided upon request. Below, we summarize the other data sources considered.
Administrative claims data. Although administrative claims-based measures require comparatively lower levels of resources from organizations than measures that utilize other data sources, there are no data on the specific elements of psychotherapy captured in claims.
Health record data. Information on the use of specific psychotherapies is sometimes documented in clinician case notes; however, there is a lack of standardization in the type and specificity of information provided. Further, TAG members expressed concerns that the cost associated with reliably manually abstracting the necessary information would likely present significant barriers to the adoption of the measure. The use of electronic health records to capture information on the use of specific psychotherapies may increase the feasibility and reliability of the measure; however, the current state of electronic health records in the mental health field does not support the implementation of this type of measure at this time.
Although implementing surveys can be resource intensive relative to measures developed with other data sources, they provide a forum to collect treatment implementation information that is not available in administrative or health record data. They also have the added benefit of providing a mechanism to gather information on the quality of psychotherapy from multiple stakeholder perspectives.