• Karen L Margolis, Leif I Solberg, A Lauren Crain, Robin R Whitebird, Kristin A Ohnsorg, Nancy Jaeckels, Gary Oftedahl, and Russell E Glasgow.
• HealthPartners Research Foundation, 8170 33rd Avenue South, Minneapolis, MN 55425, USA. karen.l.margolis@healthpartners.com
• J Gen Intern Med. 2011 Sep 1; 26 (9): 9991004999-1004.

BackgroundPractice system tools improve chronic disease care, but are generally lacking for the care of depression in most primary care settings.ObjectiveTo describe the frequency of various depression-related practice system tools among Minnesota primary care clinics interested in improving depression care.DesignCross-sectional survey.ParticipantsPhysician leaders of 82 clinics in Minnesota.Main MeasuresA survey including practice systems recommended for care of depression and chronic conditions, each scored on a 100-point scale, and the clinic's priority for improving depression care on a 10-point scale.Key ResultsFewer practice systems tools were present and functioning well for depression care (score = 24.4 [SD 1.6]) than for the care of chronic conditions in general (score = 43.9 [SD 1.6]), p < 0.001. The average priority for improving depression care was 5.8 (SD 2.3). There was not a significant correlation between the presence of practice systems for depression or chronic disease care and the priority for depression care except for a modest correlation with the depression Decision Support subscale (r = 0.29, p = 0.008). Certain staffing patterns, a metropolitan-area clinic location, and the presence of a fully functional electronic medical record were associated with the presence of more practice system tools.ConclusionsFew practice system tools are in place for improving depression care in Minnesota primary care clinics, and these are less well-developed than general chronic disease practice systems. Future research should focus on demonstrating whether implementing these tools for depression care results in much-needed improvements in care for patients with depression.

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