Depression screening in a VA primary care clinic

In 1998 the U.S. Department of Veterans Affairs (VA) mandated annual depression screening at all VA primary care clinics. The VA Medical Center, New Orleans, implemented a four-item screening tool. The authors report on an evaluation of the screening program. Of 1,100 patients visiting the clinic during a one-month period, 1,068 (97 percent) were screened at that visit or at some point in the previous 12 months. Of the 70 patients who screened positive for depression, 50 (71 percent) were offered at least one treatment modality or psychiatric referral. The findings establish benchmarks for screening administration and for follow-through on positive screens. The authors describe features of the electronic medical record that contributed to the successful implementation of this best practice.