Over the past 7 years CORE IMS has developed unique expertise in helping service providers and commissioners introduce best practice in routine outcome measurement with the help of a range of bespoke resources. These include training for routine measurement; bespoke IT software to enhance data quality and resource appropriate feedback; outcome data management training and support; and the management of a unique national research database to resource benchmarking for comparative service performance appraisal. Staffed by a small dedicated team of 9, CORE IMS serves over 250 UK services estimated to comprise of over 3500 psychology, psychotherapy and counselling practitioners across a range of clinical settings.
In 1993, following a conference for the Mental Health Foundation a multicentre collaborative group, led by Professor Michael Barkham won a competitive tender to develop an outcome measure (OM), and Clinical Outcomes in Routine Evaluation (CORE) was born. Its phenomenal success came not only from being in the right place at the right time for outcome monitoring, nor by making the measures royalty free, but through understanding what users need in order to make the system accessible and useful.
Building on a robust, clinically responsive measure, CORE Information Management Systems Ltd (CORE IMS) now provides information technology (IT) tools in the form of CORE PC, its online counterpart CORE Net, various different questionnaires and comprehensive training packages and support for organisations adopting the CORE system.
The success of CORE has been marked by the rapidity with which organisations, particularly those in the fields of primary healthcare and the psychological therapies, have integrated the system into routine practice, and the willingness of purchasers and commissioners to accept CORE data as a valid performance indicator. Along the way, CORE OMs are generating scientifically important findings concerning therapeutic change in clinically representative settings. In its evolved form, the CORE methodology scores highly in ease of use and external validity, but its demonstrated overlap with other measures brings non-empirical factors into play for those choosing between CORE and competing comparable measures. In addition, as recognised from the outset by its developers, CORE may need to be complemented by domain-specific measures to do justice to complex clinical situations. It is important not to reify apparent exactitude, in risk assessment. As was also recognised from the outset, CORE is not a substitute for clinical judgement.
Service providers are in the midst of a revolution in accountability. If the challenging move towards payment by results is completed, account will have to be given of what was done for whom and to what effect. CORE is well placed to play a central role in this process, and to help clinicians reflect on individual results. Equally, services will be assisted in comparing benchmarks with peers, and in undertaking pragmatic practice-based research into who and what works best. Each step brings closer an exciting future of outcome-informed practitioners. |
