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Wellness for Behavioral Health Clinicians: Addressing Burnout

Clinicians have had a rough time during the COVID-19 pandemic, and many have been experiencing provider burnout. Burnout may involve:

Job dissatisfaction
Physical and/or emotional exhaustion
Increased cynicism
Lower motivation
Lower empathy
Feeling ineffective

So how can clinicians recover from burnout? Better still, are there ways to prevent it?

Risk factors for clinician burnout

Some of the most common risk factors for clinician burnout include:

Heavy workloads: High demand for behavioral health services can lead to overloaded schedules and unrealistic expectations, all of which can create exhaustion and stress for clinicians.
Poorly designed workflows: Inefficient work systems and administrative demands can frustrate providers, especially when they have many tasks that they consider distractions or a lower priority.
Sustained psychological effort: Behavioral health can be emotionally draining, even when the clinician finds it meaningful and rewarding. Attending to a client’s needs can take a serious mental toll, especially if a client dies or has a serious medical event.
Lack of autonomy: Providers who do not feel some level of control or flexibility in their roles, or freedom to make decisions, can become discouraged and anxious.
Poor client relationships: Not all behavioral health clients follow their clinician’s suggestions. If a client ignores medical advice, demands unnecessary medical care, or otherwise behaves disrespectfully, providers are more likely to experience lower job satisfaction and higher emotional exhaustion.

A thorough review of the risk factors can be found in the 2019 book, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

Recovering from burnout

Are you or a partner experiencing burnout? Here’s what to try before quitting your job:

Form healthy habits: Don’t neglect your physical health. Proper diet, sleep, and physical exercise go a long way toward helping you recover from burnout. Start with small decisions, such as taking a brisk, ten-minute walk, or choosing healthy meals over comfort foods.
Don’t suffer in silence: If you are experiencing burnout, talk to your management or partners about it and brainstorm changes you could make at your practice. Confide in a close friend or consider seeing a counselor yourself.
Start small: It’s likely that many different factors, rather than one big event, contributed to your burnout. In the same way, recovery may involve small steps and gradual improvements.

Preventing clinician burnout

Behavioral health practices have several options for preventing burnout in their staff. (These options can also help alleviate burnout that has already happened.)

Consider hiring temporary staff. Many employers are struggling to fill workforce gaps, so this can be tricky. But even if you can’t afford or find a full-time staff member, consider hiring a temporary or part-time employee, or even a virtual assistant, to help reduce the workload.
Look for opportunities to streamline or automate. This can reduce the need for providers to perform administrative tasks so they can focus more on client care. Appointment reminders, for example, can help nurture client relationships while lightening provider load.
Consult available expert resources. For example, The Ohio State University has been promoting wellness initiatives among clinicians to help reduce burnout. One of these is Mindfulness in Motion, an 8-week program offers resiliency tools to help improve functionality and stress coping.

Frustrating, ineffective technology is a common cause of clinician burnout. Make sure your EHR software is designed specifically for your needs as a behavioral health provider. BestNotes offers customized solutions and documentation options to help your organization be more efficient and less stressful. Contact us today to learn more.

date:  Aug 03, 2021
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Eating Disorder Research: Risk Factors, Kidney Damage, and Other News

Recent research has found that eating disorders increased in 2020, like many other behavioral health disorders. Further research can help identify and treat these disorders. Here are some of the latest eating disorder studies from around the world.

Risk Factors of Common Eating Disorders

Experts remain unsure about the risk factors for eating disorders, partly because they often overlap with other behavioral health disorders. A team of researchers from Europe and Canada reviewed nine observational studies published prior to 2020. The studies focused on risk factors for anorexia nervosa (AN), bulimia nervosa, and binge eating disorder.

The review was published in the Brazilian Journal of Psychiatry. The analysis found no strong evidence for any of the risk factors included. However, results suggested an association between childhood sexual abuse and bulimia nervosa. There was also an association between being bullied about one’s appearance and developing any eating disorder.

Kidney Dysfunction and Anorexia Nervosa

Many adolescents with AN experience changes in their kidney function. In a recent study, researchers analyzed glomerular filtration rate (GFR) in 148 adolescents with AN who were hospitalized for severe malnutrition. Results were published in Clinical Nutrition ESPEN.

More than three-quarters of the patients had Stage 1 kidney damage at admission (27 percent) or Stage 2 (59 percent). The entity of kidney damage correlated with body-mass index (BMI), but not the rapidity of weight loss. More severe kidney damage corresponded to major biochemical and hormonal changes. The researchers recommended that kidney functionality tests become part of routine care in patients with AN.

Involving the Family in Anorexia Nervosa Treatment for Adolescents

In a new study, researchers compared standard inpatient hospital care with an intervention known as family treatment apartment (FTA). With FTA, meal support is the parents’ responsibility, not the hospital staff’s. Researchers compared patients with AN who received either FTA or regular psychiatric inpatient care.

The FTA group experienced fewer readmissions due to weight loss within six months of discharge. They also scored lower on general psychiatric pathology and higher on quality of life compared to the standard group. However, there was no difference in eating disorder pathology between the groups more than 14 years after admission. The researchers noted in Frontiers in Psychiatry that FTA can help teach families and individuals better skills and provide a greater sense of security compared to standard inpatient treatment.

Eating Disorders May Affect the Brain Reward Response

New research published in JAMA Psychiatry suggests that the behaviors of an eating disorder can change the brain’s reward processing and food intake control circuitry. Researchers performed a functional brain imaging study on 197 women with eating disorders and 120 healthy controls. The researchers examined their brain reward responses to a sweet-taste task. The study also looked at the brain response’s association with circuits related to food intake control.

There were no significant associations found among healthy controls. Among the women with eating disorders, however, higher BMI and binge-eating behaviors were associated with lower response to the taste reward task. Eating disorder behaviors and excessive weight changes may affect the brain in ways that reinforce eating disorder behaviors.

Behavioral health providers know that each client has different lifestyles, needs, and definitions of success. Appropriate documentation ensures that you are making the best decisions for each client, at each stage of the treatment process.

BestNotes EHR solutions include an up-to-date documentation feature that helps you track your client’s progress from assessment to discharge. Get in touch with us today to learn more.

date:  Jul 30, 2021
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Venture Funding Increases for Behavioral Health Services and Technology

Demand for behavioral health services has skyrocketed in recent years, and especially during the COVID-19 pandemic. As a result, venture capital is pouring into mental health apps and other startups.

According to Forbes, about 42 percent of U.S. adults reported symptoms of anxiety or depression in December 2020. By that time, venture investors had provided a record $1.5 billion for mental health-related startups. This level of funding has persisted through 2021; startups received $795 million in the first quarter of the year.

Behavioral Health Funding Recipients

Despite federal laws requiring insurance parity for mental health, many clients struggle with a lack of coverage for behavioral health services. Burlingame, Calif.-based Lyra Health aims to provide real mental health benefits to large employers. The company recently raised $200 million at a $4.6 billion valuation, led by investment firm Coatue Management.

Besides a network of virtual or in-person providers, Lyra customers also have access to a virtual platform that supports mental health with cognitive behavioral therapy and other methods. The company’s network includes more than 90,000 providers in 180 countries.

Pediatric behavioral health startup Brightline, launched in California in 2020, recently raised $72 million in a Series B funding round. The company offers a behavioral health platform that offers virtual therapy, medication support, and other digital resources for children, teenagers, and caregivers. The company has expanded into Massachusetts and plans to reach nationwide expansion by the end of 2021.

Digital health company Ksana Health has raised $2 million in seed funding. The company also accepted an invitation to join the Anthem Digital Incubator to pilot a new digital health solution known as Vira. This solution aims to change the way behavioral health is monitored and studied by converting behavioral patterns collected by smartphones into real-world insights for providers.

The Spanish-language mental health app Yana recently announced that it has more than 5 million users and has raised $1.5 million in funding. The company had already raised $315,000 from previous investors, and about $10,000 through a crowdfunding campaign. CEO Andrea Campos originally created Yana as a personal project to help herself cope with depression. The app now offers access to mental health tools, including a chatbot, mood tracker, and meditation guidance.

Mental Health Technology Not a Cure-All

Will all this investment and new technology alone fix the nation’s behavioral healthcare system? Many experts have expressed doubts.

Without sufficient research into the effectiveness of mental health apps and other technology, consumers and providers may be unprepared to decide which options are the most suitable. Additional studies are needed to compare the different options currently on the market.

Virtual therapy sessions and mental-health apps may have an important role as a stopgap or supplementing a supplement to more traditional interventions. However, many researchers and clinicians believe they cannot replace in-person sessions.

“There’s a lot more to emotions and connecting with people, reading people and diagnosing people than just looking at their face,” says Jessi Gold, a psychiatrist and assistant professor at Washington University in St. Louis, as quoted in Forbes.

Whether you are providing in-person or virtual behavioral health services, the software you use can make a big difference to your clients’ experiences. BestNotes EHR solutions are tailored specifically to the needs and standards of behavioral health and addiction treatment professionals to help your practice succeed. Contact us today to learn more.

date:  Jul 20, 2021
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What is “Information Blocking,” and how does it affect behavioral health providers?

Understanding the proper use and disclosure of electronic health information (EHI) can get complicated. Federal laws, including HIPAA and the 21st Century Cures Act, add complicated layers and language.

One concept that can confuse both clinicians and patients in recent years is “information blocking.” Here are the basics that behavioral health providers should know.

Why information blocking matters

The term “information blocking” refers to anything that limits or prevents the sharing or access of EHI between clinicians and patients. It may be deliberate or unintentional.

Some examples of information blocking include:

An EHR system that places a hold on a behavioral health client’s records or progress notes while the clinician decides which EHI is appropriate to include
Providers that restrict EHI access beyond HIPAA and state law
Poor interoperability that prevents providers from sharing EHI with clients or other providers
An IT provider that charges excessive fees to create EHR connections with other health IT

Information blocking can prevent facilities or clinicians from sharing EHI with each other, which can hinder care coordination and lower the quality of care. It can also prevent clients from getting their own health information in a timely manner, preventing them from taking control over their own care.

Who must follow information blocking rules

The Cures Act includes provisions to reduce information blocking, promote interoperability, and improve client EHI access. The Cures Act’s Final Rule applies to anyone with access to EHI, though it aims at healthcare providers, health information networks or exchanges, and health IT developers.

Some of the healthcare providers under the rule include:

Community Mental Health Centers
Practitioners (including physician assistants and nurse practitioners)
Clinical social workers
Clinical psychologists

For the full list, check out this PDF. Any entity that does not comply with the Final Rule could see financial penalties.

Deadlines for information blocking compliance

The deadline to comply with the information blocking provisions was extended to April 5, 2021, due to the COVID-19 pandemic. EHR vendors are working hard to update their products to support the access, exchange, and use of all data elements.

Here’s where it gets more complicated. For 24 months after the Final Rule was published in the Federal Register on May 1, 2020, it only covers data that is defined within the USCDI v1.0 standard, a set of interoperability standards for nationwide health information exchanges. After those 24 months, the Final Rule covers any electronic protected health information as defined by HIPAA, regardless of whether the records involve a covered entity.

A few other deadlines include:

December 31, 2022: This is the deadline for the 2015 edition of health IT certification criteria updates and new standardized functionalities.
During the COVID-19 pandemic, compliance dates and timeframes were revised to three months after each initial compliance date or timeline identified in the Final Rule.

If you aren’t sure about how the Cures Act applies to your behavioral health practice, contact your EHR vendor. They can discuss how this will affect your software and what changes, if any, are needed. You may also want to consult with a legal expert who specializes in healthcare.

When regulatory changes affect your behavioral health practice, your EHR system should take the headache out of compliance. The BestNotes EHR solution receives regular, automatic updates that comply with federal and state changes, so users are confident that their software follows the highest clinical and regulatory standards. Contact us today to learn more or to schedule a free demo.

date:  Jul 09, 2021
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How to Conduct an Internal Investigation of Your Behavioral Health Residential Program

In a previous blog post, we discussed how residential treatment programs should respond to requests for information regarding resident safety. These requests often come from licensing agencies, payers, and other parties.

Sometimes, however, a behavioral health facility can launch an internal investigation. Here’s what you should know about conducting one in your organization.

Conduct internal investigations regularly

They say that “prevention is better than a cure,” and that’s true for behavioral health facilities. Instead of waiting for a whistleblower to call attention to a serious issue, you can identify areas for improvement before they become big problems.

Internal investigations might seem inconvenient, disruptive, and time-consuming. However, consider the potential risks of not conducting one:

Failure to discover or correct problems that can impact client outcomes
Negative effects on the provider’s reputation and public image
Burdensome, potentially indefinite monitoring of the facility by outside parties
Licensing agencies may suspend admissions or revoke your license
Reduced referral sources and potential non-payment from payers, creating financial burdens

Have a plan for your behavioral health investigation

Establishing a goal and intentions for the internal audit are crucial for its success. This will help guide your process.

A few key questions can help you plan.

What is your purpose for the investigation?
Who should lead and conduct the investigation?
When should the investigation be performed? (Consider the potential disruption that things like staff interviews may have on the workday)
How will you respond to any issues you find?
To whom should you report your findings?

Make sure the investigation targets specific issues. Have a clear definition or description of what those issues are.

Start your internal audit as soon as possible. Make sure you can wrap up before any reporting deadlines you may need to follow.

Interview staff members in your investigation. If some individuals are hesitant to speak up, consider developing a way to request feedback anonymously. Review all relevant documentation, including clinical and billing, as well as video footage. Be aware of HIPAA rules regarding the disclosure of protected health information.

Consider outside counsel for your behavioral health facility

Even when you’re conducting an internal investigation, you don’t have to go it alone. Hiring legal counsel has many benefits, and can help ensure a better outcome for any investigation. An outside legal expert can:

Help preserve independence and objectivity during an inquiry
Encourage behavioral health staff to speak more freely about their issues or concerns
Show that the organization is serious about addressing resident safety concerns
Help identify improvement and training opportunities
Represent the organization to other groups

Maintain a transparent behavioral health work environment

Outside of conducting regular internal audits, behavioral health facilities should encourage a transparent, professional environment in which staff, clients, or families with a concern can speak up. If violations are found, behavioral health organizations should disclose them voluntarily.

Taking safety concerns seriously can help behavioral health providers stay compliant and keep problems small. This will ensure the best outcome for both the providers and their clients.

Conducting an internal investigation? Appropriate documentation goes a long way in helping your inquiry go smoothly. The BestNotes EHR solution offers a documentation app that follows federal, state, and accreditation standards, updating changes automatically, so you can maintain compliant records without anxiety. Contact us today to learn more, or schedule a free demo.

date:  Jul 06, 2021
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