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There is a serious unmet need in healthcare to improve patient adherence to medical treatment. 

As many as 50% of patients with one or more chronic illnesses do not take their medications or keep their appointments. A few of these patients will have a serious and persistent mental illness, but the majority do not need to be referred to a mental health specialist.


  1. Half of all patients with chronic illnesses do not follow their prescribed treatment plans. 

  2. A major reason for the non-compliance is unrecognized mental health issues that are common in the chronic disease population.

  3. PSYCHeDECISION is designed to recognize which patients are likely to be non-compliant due to their underlying psychosocial situation. 

  4. Once recognized, intervening in the patient’s mental health status can make a significant improvement in their chronic disease status.


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Several years ago, a primary care doctor referred a diabetic patient to Saul Rosenberg, PhD, for a psychological evaluation. The patient was unable to adhere to her treatment regimen and complained of stress.  Her doctor had prescribed a tranquilizer, which provided no relief and she was at risk of developing serious complications from her diabetes

Dr. Rosenberg administered a battery of tests to assess relevant factors such as depression, anxiety, sleep problems and interpersonal problems. The patient had depressed mood but was not clinically depressed; the patient had anxiety, but not an anxiety disorder. The patient’s lack of social support and self-motivation were significant problems which a tranquilizer alone could not solve. Dr. Rosenberg was struck that her doctor had clinical practice guidelines and decision support tools for caring for her diabetes, but had no decision support tools for assessing the behavioral issues that were the root cause of her lack of adherence.

The solution was to create decision support tools for primary care that provides primary care practices with the information needed to compensate for these particular roadblocks to successful outcomes -- the result is PSYCHeDECISION.


The Accountable Care Act provides real incentives to drive healthcare towards better outcomes, better patient experience and lower cost. This is sometimes called the Triple Aim.

On August 16, 2014, The New York Times reported that in January 2015 Medicare will pay monthly fees to doctors who manage care for patients with two or more chronic conditions.  These are the patients that account for 93% of Medicare spending. We know that 50% of these patients do not adhere to their treatment plan, because they have psychosocial problems that rob them of their energy, attention and motivation.

To receive this payment, doctors will be required to assess patients’ medical, psychological and social needs. The most important health policy makers in the country have realized exactly what Dr. Rosenberg identified as the most productive way to improve the patients’ quality of life and outcomes as well as reduce overall health care costs.

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