Translating the Languages of

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Translating the Languages of
Mental Health and Medicine

Tai J. Mendenhall, PhD, LMFT, CFT

Assistant Professor & Coordinator of Behavioral Medicine Education

University of Minnesota Medical School


Jennifer L. Hodgson, PhD, LMFT

Associate Professor, East Carolina University


Angela L.
Lamson
, PhD, LMFT, CLFE

Associate Professor & Director of MFT (MS) and
MedFT

(PhD) Programs

East Carolina University

Collaborative Family Healthcare Association 13
th

Annual Conference

October 27
-
29, 2011 Philadelphia, Pennsylvania U.S.A.

Session
# I4a

October
29,
2011

10:30
AM

Faculty Disclosure

I/We
have not

had any relevant financial relationships

during the past 12 months.



Need/Practice Gap & Supporting Resources

Contemporary calls for integrated care are increasingly
facilitating mental health providers’ entry into medical
contexts.


However, most training programs do not teach the medical
language/terminology and structured formats necessary to
effectively collaborate with medical colleagues.


This workshop will introduce participants to what they need to
know to “talk medicine.”

Objectives

Discuss how contemporary calls for integrated care are quickly
advancing mental health providers’ entry into medical
contexts, and how this trend is outpacing most established
training programs.

Introduce common medical terminology and related knowledge
that is necessary to read and understand care/visit
-
records
and/or collaborative communication.

Outline common formats (e.g., the SOAP format


Subjective,
Objective, Assessment, Plan) in which medical charting is
carried out.

Discuss common electronic medical records and platforms (e.g.,
Allscripts
,
gMED
) used for inter
-
professional communication,
patient/family advocacy, and billing.


Expected Outcome

At the conclusion of this workshop, participants will be able to
:


Cite medical terminology that is necessary in order to
understand medical charts.


Employ standard medical chart
-
formatting that is requisite for
effective communication and collaboration with medical
colleagues.


Describe common electronic medical record (EMR) platforms
that are necessary for the effective integration of multiple
providers’ notes in integrated care/collaboration, patient/
family advocacy and billing.


Communicate verbally with medical providers using language
and terminology that is relatable and translatable.

Contemporary Calls for Integrated Care


Calls for integrated care are advancing
behavioral health providers (e.g., MFT/
MedFT
,
Psychology, Social Work) into medical contexts
more today than ever before


Healthcare is outpacing conventional
behavioral health training programs


Training regarding language/terminology


Training regarding structured formats of inter
-
professional communication

Can you translate what this
physician has said?

S: 67 y/o male c/o chest pain and SOB x 2 h. Pain is severe (8 out of 10),
centered under sternum, and radiates to the L arm and jaw. Pain
woke patient from sleep, and is w/o D with movement or breathing.

O: Pt. has a h/o ASHD, MI 1/15/01, HTN, and DM. Meds include ASA,
insulin,
lasix
, and
lisinopril
. Allergic to PCN. On exam pt is A+O x 4,
diaphoretic, and anxious. HEENT: PERL. Neck:


JVD, positive use of
accessory muscles. Chest: BS crackles at bases, + retractions.
Abdomen: soft, non
-
tender. Extremities: ¾ edema/clubbing/cyanosis.

A: r/o chest pain of cardiac origin

P: Oxygen (15L NRB), IV NS TKO, cardiac monitor, monitor V.S., transport
position of comfort, NTG x 3 and MS 2 mg IV with decrease in pain
from an 8 to a 3, ASA deferred as patient had a dose today.

Two Different Worlds,

Two Different Languages


Physicians say things like…


MDD,
qd
,
qhs
, PRN,
b.i.d
.,
t.i.d
., iii, ii,
i
, x, HEENT, A1c, BP,
CQI, BPD, c,
Cx


Therapists say things like…


cross
-
generational triangulation, disengaged parent,
enmeshed interpersonal boundaries, anger turned
-
inward,
differentiated

The American Recovery and
Reinvestment Act (ARRA)


The ARRA is
the legislation that became law in 2009,
also known as the “Stimulus
Act.” It authorizes
the
Centers for Medicare & Medicaid Services (CMS) to
provide financial incentives to eligible professionals
and hospitals that demonstrate “meaningful use” of
certified electronic health record (EHR) technology.


The
final regulation outlining the requirements for
receiving the incentives was released on July 13,
2010, and defines how the incentive program works.

http://www.ama
-
assn.org/resources/doc/hit/faq
-
ehr
-
incentive
-
programs.pdf

ARRA Eligibility


In
general, an eligible professional will be
considered a meaningful EHR user during an
EHR reporting period in a payment year if
they:


1. Use certified EHR technology


2. Demonstrate electronic exchange of specific
information (to the satisfaction of the CMS)


3. Report on specific clinical quality measures

Meaningful Use


“Meaningful use, in the long
-
term, is when
EHRs are used by health care providers to
improve patient care, safety, and quality.”


Dr. David Blumenthal, national coordinator
for health information technology, U.S.
Department of Health & Human
Services




Example of Meaningful Use
Objectives


Record
patient demographics



Record and chart changes in vital
signs


Maintain active medication allergy
list


Maintain an up
-
to
-
date problem list of current
and active diagnoses



Maintain active medication list



Generate
and transmit electronic prescriptions
for non
-
controlled
substances


PATIENT COMMUNICATION







Medical Language


Context / History


The first written accounts of medical experience
are found in the Egyptian Papyri (Clending1).


Global / Latin
-
based


Process / Efficiency / Brevity


Abbreviations / Acronyms


Like concealing what saying


Universal


Common Medical Charting


S.O.A.P. notes


Subjective, Objective, Assessment, Plan


Tracking daily health


Vital signs, intake, output, pupils, limb(s)
capability


Intake vs. Progress notes

Medical Records & Communication


Electronic Medical Records


Health information and data


Result management


Order management


Decision support


Electronic communication and connectivity


Patient support


Administrative processes


Reporting


Records & Communication,
con’t


Types/Examples of EMRs


Allscripts


Medicfusion


MedWorxs

Records & Communication,
con’t


Communicating through the EMR


Colleague
-
to
-
colleague “tasking”


Constructing standard case summaries and
diagnostic data


In
-
house vs. cross
-
site collaboration


Patient/family advocacy


Billing


PCP to patient


Medical Abbreviations and
Resources


Common Medical Abbreviations
:
http://
bit.ly/nbGpJg


Prescription Abbreviations
:
http://
bit.ly/puCpRv


Flashcards:
http
://
bit.ly/nvYcU4


Acronym Finder:
http
://
bit.ly/nChCfj



How Abbreviated Are You?


Common Medical Terminology


Take quiz


http://www.sheppardsoftware.com/dynamic_MC
_med_voc_web.html


Common Medical Abbreviations / Acronyms


Take quiz


http://teacherweb.com/TX/TaylorHighSchool/Roy
Champion/response2.aspx

Back to that note




Translating Exercise

S: 67 y/o male c/o chest pain and SOB x 2 h. Pain is severe (8 out of 10),
centered under sternum, and radiates to the L arm and jaw. Pain
woke patient from sleep, and is w/o D with movement or breathing.

O: Pt. has a h/o ASHD, MI 1/15/01, HTN, and DM. Meds include ASA,
insulin,
lasix
, and
lisinopril
. Allergic to PCN. On exam pt is A+O x 4,
diaphoretic, and anxious. HEENT: PERL. Neck:


JVD, positive use of
accessory muscles. Chest: BS crackles at bases, + retractions.
Abdomen: soft, non
-
tender. Extremities: ¾ edema/clubbing/cyanosis.

A: r/o chest pain of cardiac origin

P: Oxygen (15L NRB), IV NS TKO, cardiac monitor, monitor V.S., transport
position of comfort, NTG x 3 and MS 2 mg IV with decrease in pain
from an 8 to a 3, ASA deferred as patient had a dose today.

Conclusions / Summary


Contemporary calls for integrated health care
are facilitating the entry of mental health
providers more than ever before


Mental health providers who wish to work in
medical contexts must learn how to “speak
medicine”


General practices/contexts


Specialized practices/contexts


Discussion and Q & A


Learning Aids and Resources

Henderson, B., & Dorsey, J. (2009). Medical Terminology for Dummies. Wiley
Publishing: Indianapolis, IN.


Steiner, S. (2003). Quick Medical Terminology: A Self
-
Teaching Guide (4th
edition). Wiley & Sons: Hoboken, NJ.


TeacherWeb

(2011). Medical Terminology Quiz. Available at:
http://teacherweb.com/TX/TaylorHighSchool/RoyChampion/response2.aspx


Turley, S. (2010). Medical Language: Immerse Yourself. Prentice Hall: Upper
Saddle River, NJ

Contact Information

Tai Mendenhall,
Ph.D.

717
Delaware St.
SE

University of
Minnesota

Medical School

Family Medicine &
Community Health

Minneapolis, MN 55414

mend0009@umn.edu

612
-
624
-
3138

Angela
Lamson
, PhD

150 Rivers Building

East Carolina University

Child Development & Family
Relations

lamsona@ecu.edu

252
-
737
-
2042


Jennifer Hodgson, PhD

150 Rivers Building

East Carolina University

Child Development & Family
Relations

Greenville, NC 27858
-
4353

Hodgsonj@ecu.edu

252
-
328
-
1349

Session Evaluation

Please complete and return the

evaluation form to the classroom monitor
before leaving this session.

Thank you!