Precision Guided Care

Precision Guided Behavioral Care (PGBC) is an
automated, personalized medicine tool that combines
traditional outcomes with patient-specific daily
monitoring of symptoms and goals.

Precision Guided Behavioral Care


Precision Guided Behavioral Care (PGBC) is an automated, personalized medicine tool that combines traditional outcomes with patient-specific daily monitoring of symptoms and goals. The tool is available on smart phones and mobile devices. PGBC is not a digital therapist or an app designed to replace the therapist. It is predicated on the centrality of the therapist/patient relationship. This new tool extends the therapeutic process by providing the clinician with a greater understanding of the patient’s circumstances outside the therapy session; and promotes better communication and active collaboration on shared goals. The end result, we hope, will be greater patient satisfaction and better outcomes, achieved more quickly.

Psychotherapy research indicates outcomes tracking improves care when clinicians are alerted that a patient is deteriorating or not making adequate progress, but this applies to only about 8% of patients. Outcomes feedback has not shown benefit to the other 92% of patients.* We think this is because standard outcomes measures do not provide fine-grained clinically actionable information.

Personalized progress tracking uses what’s called ecological momentary assessment/intervention to sample data in real time, either daily or throughout the day (our initial version will sample data once a day).** This expands the range of data available to the clinicians giving them a better handle on how treatment is affecting the patients’ most salient symptoms and how they are progressing toward their goals when they are not being seen in therapy.

Here’s how it works.

In addition to responding at regular intervals (weekly/monthly) to a standard outcome measure such as the PHQ-9 or GAD-7, the patient will respond daily to a small set of patient-specific questions. Clinicians select questions from a library (they can also create their own) and review the results before or during the treatment session. The library of questions is organized into categories: depression, anxiety, relationships, functioning, medication adherence, etc.

Initially, there will be up to 4 questions answered with a slider bar and a textbox. Patients can respond in a matter of seconds. All measures are “pushed” to the patient’s smartphone at the end of the day and the patient is reminded to take a followup.

Research has shown that awareness and behavior are altered when a person is observed, or even with self-monitoring. By drawing the patient’s attention to problematic cognitions/behaviors, outside the therapy hour, we expect the patient to gain a better understanding of themselves and their symptoms; at the same time the therapist is given access to information that can provide a deeper appreciation of the patient’s functioning outside the consulting room.

The initial release of the system focuses on adult issues; we will add child and adolescent measures and symptom/goals in the near future. In addition, we will be conducting ongoing evaluation of the system on outcomes, patient engagement, and persistence in treatment.

From Our Community

"I have been in practice full or part time as a Psychologist for over 28 years. The CarePaths system is the most efficient system of record keeping, patient and practice management, authorization tracking, claims management, and billing that I have ever used. With the addition of features recently added to the system, my office will be nearly paperless. As I anticipate retiring in several years, the problem of record repository will not be a significant issue. The customer service at CarePaths is exceptional. Any processing difficulty is usually solved within a day. This system is head and shoulders an improvement over the two forms of proprietary practice management systems I used in the past."

~Patrick Quigley, PhD, LSAC

“I have used many systems and yours is a hidden gem! I really love the functionality, features, and layout!”

~Melissa D. Michel, MSCP, NCC, LPC

“The referral portal is a huge benefit. The Cleveland Clinic uses it to schedule next day appointments for us from the emergency department. It's worked wonderfully.”

~Cara Daily , Ph.D.

"I am a very satisfied user… and I would like to express my strong satisfaction with your product."

~Loren Andrews, LCSW