Category: A – Neutral

Contributor: Todd Charest

“Behavioral health is fundamentally and profoundly different than acute physical or medical care. Often in Behavioral Health and Human Services, goals and objectives are framed up in terms of behaviors and not procedures. Conditions are more difficult to diagnose and care is more complex and dependent upon environmental factors and relationships that go beyond the physical body. As a result, when you’re talking about thriving under a value-based care model, behavioral healthcare providers need to consider different data points and use a set of tools that are designed to support their unique needs.”

– Todd Charest, Chief Product Officer, Qualifacts

Value-based care makes sense. While a departure from the traditional fee-for-service model, it has the potential to help our industry support better outcomes, reduce waste in the system and curb ballooning costs. We want to reward providers for the treatments that deliver better health.

That said, it does require a different approach in the delivery and management of care. You can’t simply maintain the status quo to thrive in these new business models.

In recent years, Qualifacts has worked with many behavioral healthcare provider organizations to audit their existing processes and implement new technology-enabled processes designed to help them evolve within value-based care reimbursement models. While every agency is unique, below includes the three strategies that we’re seeing a lot of customers leverage to get improved results:

1. Comprehensive outcomes assessment tools that “pull” data throughout documentation.

As you know, value-based care is centered around outcomes. Supporting them. Documenting them. Reporting them. Providing care to clients with a behavioral health issue such as depression and addiction is often a long-term process with the goal of optimizing their quality of life versus curing a disease. Given that, clinicians need assessment instruments that can help them monitor how clients are responding to therapies and course-correct as needed. And to ensure that information is accurately analyzed over time to make data-driven decisions, many leading organizations are seeking electronic health record platforms that can automatically pull that information into the treatment plan as well – forming a continuous feedback loop.  

2. Clinical decision support tools that can help you apply the most recent, evidence-based therapies.

If your organization’s revenue is tied to outcomes, you are always likely searching for new ways to elevate care quality and support better outcomes. Many leading behavioral health organizations are configuring business rules that actually trigger alerts within existing workflows and at the point of care. This enables providers to consistently leverage proven best practices throughout the care continuum.

3. Consumer engagement tools that empower clients and lower costs.

With value-based care, it’s about improving the quality of care while also managing the cost of care delivery. This is one of the reasons why I’ve seen the popularity of consumer engagement tools in behavioral health grow in recent years. You can put a tool in the client’s hands that they can access 24/7 to supplement your existing plan of care. And, for a relatively low cost. One important thing to note is that integration capabilities vary dramatically by vendor and by system. If you are shopping for a new EHR, I would highly recommend that you evaluate the interoperability of each vendor candidate and ask about their prior integrations projects.

If your organization is struggling to face the new challenges associated with value-based care, you’re not alone. Though, with the right technology partners, you can simplify the complexity associated with delivering the best care possible to help your clients move towards their personal goals and objectives. To learn more, I invite you to read a recent article I contributed for Health IT Outcomes which talks about using technology in this new era of value-based care.

If you work in the behavioral health field, you’re likely passionate about helping individuals in need. People in your community who are often overlooked – those with intellectual and developmental disabilities, mental health issues and a history of substance use and abuse.

But, with increasing regulatory constraints and accreditation requirements, finding more hours in the day to provide quality client care is likely top-of-mind. That’s why many leading providers are starting to leverage clinical decision support tools to – in a way – amplify their own clinical expertise.

“Behavioral health organizations are doing some really innovative things with clinical decision support tools right now to improve the quality of care. It’s interesting to see how the industry will be able to expand the reach of these tools in the coming years.”

– Christy Winter, Manager of Clinical Informatics and Outcomes at Qualifacts

Clinical decision support tools are designed to help solve for a wide variety of challenges. There has been a lot of conversation lately about the benefits of leveraging this new technology and the following includes three of the powerful use cases we’ve seen our customers successfully leverage to improve clinical care and boost efficiencies.

1. Standardize clinical best practices within your organization.

One of the most common use cases for clinical decision support tools involves sharing and reapplying clinical best practices within and across care teams. Agencies often configure these tools (based on business rules) to trigger medication, assessment and therapeutic recommendations.

Using this approach, evidence-based best practices are more likely to be leveraged on a consistent basis.

2. Enable clinicians to earn CME credits in their normal workflows.

Many behavioral healthcare providers are required to maintain their accreditation by investing in Continuing Medical Education coursework. To help clinicians support their goals of continuing education, some clinical decision support platforms actually help clinicians earn credits by simply using these tools during business hours. This reduces the burden of earning credits during personal time – on nights and weekends. One huge benefit? Improved staff retention and professional satisfaction.

3. Simplify access to the latest research publications.

Every provider wants to deliver the best care possible that leverages insights from the latest clinical research. Though, there are only a finite amount of hours in the day. To help solve for this challenge, many behavioral health agencies leverage clinical decision support tools that are integrated with their electronic health record. Through this integration, alerts can be displayed that publish the most relevant and up-to-date research related to client care.

If your organization is interested in optimizing care with the help of clinical decision support tools, we invite you view this informative webinar: Clinical Decision Support: Leveraging Data in Your Clinical Practice , featuring two Qualifacts subject matter experts and Teresa Trammell, a pediatric nurse practitioner and Health Clinical Solutions Executive at EBSCO Health, an industry leader in clinical decision support. You’ll learn how your organization can design effective plans of care leveraging science-based interventions and develop data-driven treatment plans using this technology.

Behavioral health and human services organizations are starting to think differently about revenue cycle management. One of the primary factors driving this change is that fee-for-service is being replaced by more complex, alternative payment models like bundled and capitated payments. Given these seismic shifts, provider organizations need the right tools, data and insights to ensure that they can keep their doors open and deliver quality care.

Prioritizing the financial health of your organization is one important dimension of supporting better outcomes. By getting paid the right amount and at the right time for the services you provide, your organization can make important investments. More beds, more specialists, a lower staff to client ratio. Better outcomes.

Here are just a few of the most impactful trends we’re hearing our customers talk about.

1. Behavioral healthcare providers are taking a more holistic view of the revenue cycle

No longer is it just about generating a claim and sending it off for review and reimbursement. Today, when leadership teams are tasked with optimizing their financial well-being, most are taking a broader view that includes insurance verification, coding and patient statements. Virtually every aspect of internal operations have some degree of influence on the bottom line.

2. More agencies are placing a greater emphasis on optimizing the revenue cycle to support better care

A few years ago, talking about and paying attention to the revenue cycle in behavioral healthcare was almost taboo. All of that is changing. More organizations now see it as less about revenue and more about improving care. With more money, you can hire more staff, extend service lines, etc.

3. Alternative payment models are becoming the new normal

It’s interesting that they are being called alternative payment models, when they are actually becoming the most common in terms of reimbursement. Instead of a flat fee, alternative payment models offer an incentive payment for higher quality and cost effective care delivery. In a report originally delivered by the the American Health Care Association, the Centers for Medicare and Medicaid Services (CMS) reports that their reimbursement goals for alternative payment models shot up from 30 to 50 person just in the last two years.

As a vendor partner to behavioral health and human organizations around the nation, the Qualifacts team is continuing to invest in new technology-enabled solutions designed to streamline revenue management processes for our customers.

“I saw these trends start in acute care several years ago. Hospitals and health systems have been pioneering revenue cycle management strategies for some time now.” said Eric Krepfle, Revenue Cycle Solutions Product Manager at Qualifacts. “It’s interesting to see how behavioral health teams are adopting these strategies and even creating their own unique approaches. I’m proud to help these teams who are passionate about client care – get the funding that they need to help others. It’s really terrific.”

While funding sources and models will continue to evolve, the increased focus on revenue cycle management optimization will continue to increase traction as providers keep pace with regulatory changes. To deliver optimal care, you need the right resources to attract and retain a dedicated team of professionals.

If your organization is looking for a proven strategies to succeed under these new payment models, check out this on-demand webinar, Scaling the Managed Care Mountain, to learn more about transitioning to value-based care.

Many studies have explored the strong link between behavioral health issues and substance use disorders – also known as a dual diagnosis or co-occurring disorders. Recently researchers conducted a study to identify other factors that may also be prevalent among individuals with that diagnosis.

Scientists at the University of Manitoba interviewed 210 students to see if individuals dealing with addiction and depression are a higher risk of reporting feelings of shame. They reviewed student data over the period of one month and noticed the students with alcohol and gambling problems tended to also self-report feelings of shame.

In the coverage of this research published in PsyPost online, one of the lead researchers, Elena Bilevicius, talked about implications of their findings. “It is important to note that we were unable to establish directionality or causality in our study, meaning we do not know whether higher depressive symptoms caused feelings of shame, and whether feelings of shame caused addiction,” Bilevicius said. “Similarly, it is possible that shame came before depression, rather than after as modelled in our study. For these reasons, it is important to establish temporal precedence to gain the most complete understanding of the relationship between depression, shame, and addiction.”

As additional research is conducted, it will be interesting to see if shame actually plays a risk factors in developing other disorders or it is actually a byproduct.

“We’ve seen the industry change in recent years in terms of how co-occurring conditions are addressed,” said Christy Winter, LMSW and Product Manager at Qualifacts. “Instead of treating conditions and symptoms in silos, whole-person care is emphasized. It’s all interrelated. We need to see more research like this that investigates other potential linkages to behavioral health issues. Armed with this information, providers can potentially develop more accurate ways to diagnose and treat these conditions.”

The behavioral health and human services community has made great strides in client outcomes by taking a more macro versus micro view of a client. And, in recent years this holistic view has been expanded beyond the client. Care providers now emphasize integrated care – taking into consideration episodes of care that extend beyond their own doors. This approach is particularly evident among Certified Community Behavioral Health Clinics.  

If your organization leverages a collaborative care model to help clients diagnosed with a range of issues, download Thriving in the CCBHC Model. This resource was developed by our clinical experts to help you and other leading Certified Community Behavioral Health Clinics simplify the complexity of delivering quality care to support better client outcomes.

New research indicates that maternal stress experienced as a result of losing a loved one can actually increase the child’s risk of developing mental health issues later on in life.

Two Stanford researchers, Maya Rossin-Slater, PhD, assistant professor of health research and policy, and Petra Persson, PhD, assistant professor of economics, evaluated the medical records of Swedish children born between 1973 and 2011. Specifically, they analyzed families where the mother experienced a death of a close relative during pregnancy. They found that among mothers who grieved during pregnancy, their children were more likely to take anti-anxiety and anti-depression medications in adulthood.

In the coverage of this research in the Stanford Medicine News Center, Persson talked about the implications of their findings.

[“Of course, you cannot prevent family members from dying, and we certainly do not want our findings to constitute yet another source of stress for expecting mothers, who already face rather intense pressure to eat the right foods, avoid activities deemed harmful and experience an avalanche of health advice,” Persson said. “But our findings potentially point to the importance of generally reducing stress during pregnancy, for example through prenatal paid maternity leave and programs that provide resources and social support to poor, pregnant women.”]

While additional studies are needed, we can extrapolate from this study that perhaps, exposure to stress-related hormones in utero can indeed contribute to an increased risk of mental health issues in adulthood.

So, how can we apply these learnings? While stress can’t be completely avoided, there is an opportunity to support better outcomes by helping families navigate the complexities of daily life and provide the resources they need to cope with potentially stressful situations. Especially for parents looking to expand their families.

“We continue to learn more each day about the underpinnings of behavioral health issues. Studies like this can help the entire care community advance towards our goals of improving outcomes by gaining a better outstanding of the biological and environmental influences,” said Mary Givens, Product Manager at Qualifacts. “Quantitative data like this is only going to continue to become more important in the delivery of care.”

Related to that, if you’d like to learn how you can help support the well-being of clients under your care, download 5 Strategies for Supporting Better Outcomes Using Clinical Quality Measures (CQM). This resource was developed by our clinical experts to help you leverage CQM metrics in your clinical practice.

In a few years, will the intake process for individuals with behavioral health issues include a simple blood test or MRI as the first step in building an effective treatment plan? Today, most behavioral health diagnoses are formed using client-reported information. Though, we may start to see new care models that actually analyze their condition at the molecular level and practice what was pioneered in acute care – precision medicine.

Precision medicine is rapidly being leveraged in acute care facilities where diagnostic testing is employed to help select the optimal therapies based on individual’s genetic makeup and biomarkers –  and with great success. Data-driven, personalized care. Building on that momentum is a growing desire to apply those same methodologies in the areas of behavioral healthcare. One clear advantage is that clients can access the most effective plan of care for their unique needs more quickly. It’s also a win for the entire healthcare system as a whole since costly, unnecessary and ineffective therapies and medications can be avoided entirely.

Signaling a significant investment in this area totaling $5 million in grants, just last month Stanford announced that it is establishing a Center for Precision Mental Health and Wellness. 35 researchers at the center will research how brain function impacts mental health and more importantly, use those insights to diagnose mental health issues earlier and identify the most effective treatments based on the individual using quantitative data.

Scientists at the center will initially focus on clients with depression and later explore other mental and behavioral health disorders including Post-Traumatic Stress Disorder (PTSD) and substance use.

Leanne Williams, PhD, a professor of psychiatry and behavioral sciences at Stanford, will be investigating the role of brain function and mental health at the center and talked about one of the first research projects that the center is funding. “Different networks in the brain regulate our emotions, our thoughts and decisions, and our self-reflection or how we reflect on our own thoughts. Those networks usually function in a normal range that keeps us going every day. But what we see in depression is a disruption of one or more of these networks: they can become over-active or short-circuit or get stuck, depending on the individual.”

Working alongside other researchers, Williams plans to explore therapeutic options on a more granular level. “These are subtypes of depression. We can use a specific type of brain scan to determine a person’s subtype. And we can use data from our research to determine with 75 percent accuracy which treatment would be most effective for that individual, based on the subtype – which type of medication, or behavioral or psychological therapy, or even newer therapies, like brain stimulation techniques.”

As a partner to many behavioral health and human services organizations, we are interested to see this and other investments being made to advance the field of research and help clinicians make more informed, data-driven decisions.

Related to that, if you’d like to learn how you can integrate data into your clinical practice, download Strategies for Integrating Outcomes Into Your Clinical Practice Worksheet. This resource was developed by our clinical workflow experts to help you build more targeted, precise and effective plans of care.

May 14, 2018

NASHVILLE, Tenn. —Lifeline Connections, a substance use and mental health treatment organization serving the Pacific Northwest, announced a strategic partnership with Qualifacts, a leading provider of electronic health records (EHR) for Behavioral Health and Human services providers, to raise the bar in client care.

By adopting CareLogic as their EHR platform, providers at Lifeline Connections can now collaborate more easily and make data-driven decisions by having client data at their fingertips. “In just five short months, we were able to go from paper-based records to CareLogic,” said Brandy Branch, Chief Clinical Officer at Lifelife Connections. “Clients often receive treatment from multiple therapists simultaneously and now our whole team can work together much more easily.”

Successfully implementing new technology can be challenging in any industry especially when internal information technology resources are already stretched this. To help clients overcome these barriers, Qualifacts has developed a proprietary and proven implementation methodology. Within 90 days of going live on the platform, 97% of customers achieve best practice performance in regards to key clinical, operational and financial metrics.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), almost eight million American adults have both a mental health and a substance use disorder, also known as co-occurring disorders. Given the prevalence of the increasing number of individuals in need of help, more behavioral health organizations are turning to technology to streamline workflows – enabling providers to spend more time treating clients.

“Behavioral health and human services organizations operate very differently than the broader medical community. And, as a result, they need an EHR that can help them access the right information that can help them deliver quality care,” said Todd Charest, Chief Product Officer at Qualifacts. “We’re proud to help support organizations like Lifeline Connections who support life saving changes for people affected by substance use and mental health conditions”

Lifeline Connections
Lifeline Connections specializes in treatment for those with substance use disorders related to the use of opioids and alcohol by offering medication to assist in the recovery process (e.g. Suboxone® and Vivitrol®). We emphasize the importance of regular medical care, family counseling, support groups, one-on-one and group therapy in our medication assisted treatment program. For more information, visit lifelineconnections.org.

About Qualifacts Systems, Inc.
At Qualifacts, we empower our behavioral healthcare partners to achieve better client outcomes. We help simplify complexity through our responsive customer service and robust enterprise EHR solutions, ensuring our customers have the tools and insights needed to deliver quality care and demonstrate clinical and financial value. For more information visit www.qualifacts.com.

Qualifacts, Xpio Health and Excelsior Join Forces to Create an Innovative Partnership in Washington State

SPOKANE, WA, Gig Harbor, WA and NASHVILLE, Tenn., April 30, 2018 — Excelsior, an integrated healthcare and education organization serving youth and their families through a variety of behavioral health, education and therapeutic recreation programs and services; Xpio Health, a leading provider of services and solutions for state and community behavioral health and human services organizations; and Qualifacts, a provider of electronic health records (EHR) designed specifically for behavioral health and human services providers, today announced an innovative alliance to create an Integrated Managed Care Collaborative (IMCC) in Washington State.

The IMCC brings together these three organizations within the behavioral healthcare space to serve a greater purpose: driving greater efficiency and enhancing outcomes through the use of advanced EHR technology and analytics. By sharing implementation resources and clinical expertise among providers in that region, this alliance breaks down the barriers to EHR adoption and expands the use of technology that would otherwise be unavailable to a number of healthcare providers across the state.

The collaborative is being led by Excelsior, one of the first behavioral health provider organizations in Eastern Washington to adopt integrated care which provides primary, mental health and substance abuse services to children, adolescents and young adults across both outpatient and residential treatment settings.

Part of Excelsior’s focus is delivering quality care and positive outcomes by ensuring provider partners have access to the right tools and data. “Our goal is to help build a community wellness alliance to connect families to their future,” said Andrew Hill, CEO of Excelsior. “In an effort to make this happen, the partnership with Xpio and Qualifacts is key to enabling the IMCC to deliver on its mission.”

Following an extensive evaluation process, Excelsior selected Qualifacts’ CareLogic as the technology centerpiece of the collaborative. Excelsior will utilize CareLogic’s enterprise EHR platform to serve its clients and build value-added services for other behavioral health agencies in Washington State. “Excelsior has an exciting vision for providing innovative services and technology for providers across Washington,” said David Klements, CEO of Qualifacts. “We’re honored to be part of this collaborative model and we look forward to working with other organizations who are also taking a similar approach to solve complex problems facing behavioral health providers.”

The partnership will leverage CareLogic’s leading clinical capabilities including its proprietary IMPACT™ outcomes management tools, Golden Thread-driven Treatment Plan and Clinical Integration Hub™ to provide enterprise-level support to providers of all sizes across the region, including small providers that wouldn’t otherwise have access to an enterprise-level solution.

Xpio Health will also serve a critical role within the collaborative. The Xpio team will focus on streamlining the implementation process, configuring clinical workflows and training staff on how to use CareLogic to ensure successful rollouts. In addition, Xpio will drive an overarching data analytics environment, which will allow for tracking population health management and measurable outcomes. “We anticipate this alliance will make a significant impact for providers across the eastern side of the state – regardless of size,” said Randy Wills, COO at Xpio Health.

For additional information about each company, visit the following websites respectively: www.excelsioryouthcenter.com, www.qualifacts.com and www.xpiohealth.com.

About Excelsior Youth Center

Excelsior has a host of different programs focusing on health and wellness of youth, young adults and families. We have a specialty medical clinic with integrated behavioral health services, a transition age program for youth 17-21, and offer many hospital diversion programs, co-occurring enhanced outpatient and residential services, an on-site fully accredited middle school and high school, nutrition services, therapeutic recreation, and are seeking certification for our 30-acre Arboretum with a specialized recreation and therapeutic environment.

About Xpio Health

Xpio Health believes in the unlimited possibilities of ideas and in helping customers meet their most important goal; ensuring the individuals they serve receive quality healthcare services. Our focus is technology for Behavioral Health. We are a nationally recognized expert on EHR implementations and support; HIPAA and Regulatory Compliance; Meaningful Use as it applies to Behavioral Health; and have helped numerous clinics, mental health agencies and psychiatric hospitals with their EHR and information management needs.

About Qualifacts Systems, Inc.

At Qualifacts, we empower our behavioral healthcare partners to achieve better client outcomes. We help simplify complexity through our responsive customer service and robust enterprise EHR solutions, ensuring our customers have the tools and insights needed to deliver quality care and demonstrate clinical and financial value. For more information visit www.qualifacts.com.

If you’re a behavioral health and human services care provider, the art and science of crafting an effective treatment plan is, without a doubt, one of the most important aspects of your role. It’s a powerful tool that can help clients work towards their own individual goals and outline how they want to achieve these goals.

While it is critical to involve the client in creating the treatment plan, it’s also important to take into consideration a variety of influences including family circumstances, acute or chronic medical conditions, life stressors and the client’s individual strengths and weaknesses. Given the complexity and scope of treatment planning, there is always an opportunity to take a fresh look at your process to identify potential opportunities for improvement.

Culled from the Severe and Persistent Mental Illness Treatment Planner, here are just a few treatment plan components to re-consider when crafting and managing your treatment plans.

1. Family Conflicts

Family relationships can often be complex and should be factored into the treatment planning process when appropriate. Identify if your client has estranged relationships or exhibits abusive or intimidating behavior toward family members. If so, it may be helpful to establish long-term goals such as rebuilding important family relationships and learning how to behave in a direct, assertive and loving way towards close relatives.

2. Self-determination issues

Clients with self-determination deficits often have limited experience with making decisions and exhibit poor planning skills. If individuals under your care lack these necessary skills for living independently, consider adding long-term goals as part of the treatment planning process to help them develop goal-setting skills and maximize available choices in all aspects of life.

3. Social skills challenges

Clients who repeatedly demonstrate inappropriate social behaviors may be dealing with social skills deficits. To help address these issues, consider including relevant long-term goals such as establishing interpersonal relationships and learning advanced social skill techniques in your treatment plan.

If you’re interesting in learning even more strategies for optimizing your treatment plans, please join us March 28, 2018 for The Art and Science of Treatment Planning. In this webinar, Heather Geerts, the Director of Clinical Services at Zumbro Valley Health Center, and Christy Winter, Manager of Clinical Informatics and Outcomes at Qualifacts, will be leading a discussion about crafting truly powerful treatment plans to support better outcomes.

For more tips, listen to our webinar The Art and Science of Treatment Planning.