The eCHAT Program to Facilitate Healthy Changes in New Zealand Primary Care

This article describes eCHAT (electronic case-finding and help assessment tool), designed to improve health and well-being through systematic screening and intervention for modifiable lifestyle and mental health issues in primary care populations and monitoring to inform continuous quality improvement. eCHAT allows patients to identify unhealthy behaviors (risky substance use, gambling, being subject to abuse, physical inactivity) and negative mood states (depression, anxiety, anger) with which they would like help before a visit using an iPad in the waiting room or via the Internet in the community. Family physicians access summarized results, including scores and interpretations of screening tests at the point of care. eCHAT stimulates conversations between patients and clinicians about life changes they might make, encouraging active participation in decision making and engagement in self-management. Stepped-care clinical decision support tools offer interventions through self-management options to primary care interventions through to secondary care referral. As well as systematically screening and intervening in individual practice populations, anonymous collated and encrypted data also can be used to measure the mental health and lifestyle risk factors and interventions provided at practice network, regional, and national levels to monitor system and organizational performance improvements, identify regional and national variations, benchmark service delivery, and support quality improvement.