Advances in Psychiatry

Psychiatrists at NewYork-Presbyterian/Columbia University Irving Medical Center in partnership with avoMD, a next-generation clinical decision support platform, have developed an interactive smartphone application that provides point-of-care treatment algorithms for major depression. The app – known as Columbia Psychiatry Pathways – supports and strengthens the ability of clinicians to provide critical mental health services in an outpatient setting.

Dr. J. John Mann

“Depression is fast becoming the leading cause of disability worldwide, and the frontline of treating professionals for major depression are primary care physicians and internists,” says J. John Mann, MD, the Paul Janssen Professor of Translational Neuroscience in the Departments of Psychiatry and Radiology at Columbia and Director of Molecular Imaging and the Neuropathology Division at the New York State Psychiatric Institute. “The Columbia Psychiatry Pathways app is designed to help clinicians treat depression more effectively, monitor the patient response, and identify when a referral may be indicated.”

One of the challenges of screening for depression, particularly in primary care, is that providers don’t always know what to do next. “Scientific papers and clinical guidelines are constantly evolving. It’s difficult for healthcare providers to stay up to date,” says Ravi N. Shah, MD, co-inventor and Chief Innovation Officer, Columbia Psychiatry. “This app combines the world-class expertise of Columbia Psychiatry with avoMD’s next-generation decision support technology to put the latest scientific knowledge in the hands of clinicians, serving as an interactive playbook to treat depression quickly and effectively.”

Dr. Ravi Shah

The clinical decision support tool is intended for use by psychiatrists, primary care physicians, internists, nurse practitioners, physician assistants, medical students, residents, and trainees in outpatient settings as they treat patients with major depression.

“The Columbia Psychiatry Pathways app is designed to help clinicians treat depression more effectively, monitor the patient response, and identify when a referral may be indicated.” — Dr. J. John Mann

Available as a mobile app and on desktop devices, the evidence-based platform updates prior depression treatment guidelines. The algorithm focuses on faster medication adjustments with emphasis on the seven best-tolerated generic antidepressants. It measures symptom severity using built-in calculators based on the Columbia Depression Scale and includes screenings for bipolar disorder and suicide risk.

Available as a mobile app and on desktop devices, the Columbia Psychiatry Pathways app updates prior depression treatment guidelines.

Research has shown that primary care physicians who integrate behavioral health into their practices can improve clinical outcomes and even save lives. In a systematic review of suicide prevention strategies, psychiatrists at NewYork-Presbyterian/Columbia found that training primary care physicians in depression recognition and medication treatment prevents suicide, often halving the risk.

Though primary care physicians are frequently on the frontlines of managing patients’ depression, they may feel inadequately trained or under-resourced to effectively treat and monitor to prevent relapse. David Buchholz, MD, Senior Founding Medical Director, Primary Care, at NewYok-Presbyterian/Columbia, believes primary care practitioners will welcome the Columbia Psychiatry Pathways app into their practice.

“Treating major depression in a primary care setting, especially in a patient with comorbid conditions, is challenging,” says Dr. Buchholz. “An app that serves as a virtual consult at the point of care can validate a primary care physician’s knowledge and give us confidence that we can do a good job caring for patients.”