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State Mental Health Policy: Implementation of Computerized Medication Prescribing Algorithms in a Community Mental Health System

The authors are affiliated with the Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., SPC 5740, Ann Arbor, MI 48109 (e-mail: kmilner{at}med.umich.edu). Dr. Milner and Dr. Healy are also with the Washtenaw Community Health Organization, Ypsilanti, Michigan. Dr. Barry and Dr. Blow are also with the Serious Mental Illness Treatment Research and Evaluation Center, Department of Veterans Affairs, Ann Arbor. Dr. Irmiter is also with the American Medical Association, Chicago. Fred C. Osher, M.D., is editor of this column.

This column describes a Michigan initiative to implement medication prescribing algorithms for schizophrenia, bipolar disorder, and major depression. The algorithms were incorporated into the electronic medical records system of a four-county community mental health system. Guideline adherence of 30 providers who treated nearly 3,000 patients was measured at mid- and endpoints of the first year. They were adherent for about a third of their patients in the first six months (32%) and more than half in the second (52%). Scores on scales measuring providers' perceptions of algorithm ease of use and usefulness were in the midrange at both time points.

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