Implementing Matching of Patients to Mental Healthcare Therapists’ Strengths

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

	This PCORI-funded implementation project is expanding the use of a system called TOP Match—shown to improve patient mental health outcomes—to connect patients with therapists based on therapists’ strengths.
Mental health centers often assign patients to therapists based on practical things like which therapist can see a patient first. But some therapists have more success in treating certain mental health concerns, like depression or substance use. Considering therapists’ strengths when assigning patients can help improve patient outcomes.

What is the goal of this implementation project?

TOP Match is a system that pairs current patients with therapists based on how well a therapist has treated patients with the same concerns in the past. A PCORI-funded research study found that patients paired with therapists through TOP Match had greater reductions in their primary mental health symptoms, less overall distress by the end of treatment, and more consistent treatment results than patients paired without using TOP Match.

This project is expanding the use of TOP Match to 62 mental health clinics in more than 30 states to improve care for patients with mental health concerns.

What will this project do?

In phase 1 of this project, the project team is putting TOP Match in place at nine clinics in Pennsylvania.

The project team is working with staff at these clinics to create report cards for therapists. These report cards rate therapists as effective, neutral, or ineffective in each of 12 mental health concerns like depression. The ratings are based on how much their past patients report improving on a routine measure called the Treatment Outcome Package, or TOP. Matching has different levels. For example, at the highest level, therapists have been rated effective on the patient’s three top concerns and not ineffective on other concerns.

Then, using the report cards, a coordinator is working with each new patient to select a therapist who is well matched.

At each site, the project team is also:

• Training clinic staff on how to use TOP Match to assign therapists, using online materials and videos
• Adding TOP Match to the electronic health record, or EHR, system for clinic staff to use to screen and assign patients
• Working with champions at each site to promote the use of TOP Match among therapists and clinic staff
• Providing support to the clinics as needed

In phase 2 of the project, the project team is using materials and lessons learned from phase 1 to expand TOP Match to 53 clinics in other states across the country. The team is helping these sites create new procedures to collect patients’ TOP data for use in matching. The team is also working with phase 2 clinics to train staff, add TOP Match to EHR systems, work with champions, and provide support.

To support further use of the TOP Match program, the project team is also:

• Creating software that makes it easy for TOP Match to work with any EHR system
• Updating online training materials for broader use

What is the expected impact of this project?

This project will demonstrate what’s required to put TOP Match in place at diverse mental health clinics. Clinics vary in terms of size, staff, and patients served. They are also located in all parts of the United States.

In phase 1 of this project, at least 140 therapists and 10,000 patients will use TOP Match. Phase 2 will reach at least an additional 700 therapists and 50,000 patients. The project evaluation will confirm that TOP Match works as intended to improve patient mental health symptoms.

More about this implementation project: