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Why does the Golden Thread matter for addiction treatment professionals?

When addiction treatment professionals are able to follow a client from intake through different services and treatments to an outcome, they are said to be following a “Golden Thread” of information.

This Golden Thread should be able to “pull” relevant client data from one service or stage of treatment to the next. Proper documentation and progress notes are vital to this process.

How does the Golden Thread work in addiction treatment?

Addiction treatment can be a lengthy process that brings together different professionals to guide a client through the process.
Clients may receive different services or enter different programs, such as residential treatment centers, group therapy sessions, and medication-assisted treatment. They will interact with clinicians, therapists, social workers, medical assistants, and others in the process.
All these different addiction treatment services require some form of documentation, whether basic client demographics or complex progress notes.
The Golden Thread weaves all of a client’s relevant clinical information into all their documentation.
The Golden Thread of addiction treatment begins with the intake assessment, including symptoms and a diagnosis.
Once the problem is identified, the Golden Thread then connects to client and provider goals, as well as the creation of a treatment plan with different interventions.
The Golden Thread then pulls together progress notes that list the services provided, how they were appropriate to the addiction treatment plan, and what the outcomes were.

Like an embroidery pattern, the Golden Thread should weave information into client documentation to tell the story of their addiction treatment journey.

Why is the Golden Thread important in addiction treatment?

Among addiction treatment professionals, the Golden Thread is valuable for ensuring compliance, aiding reimbursement, and improving quality of care.

Billing: Maintaining the Golden Thread through client documentation helps ensure correct billing for addiction treatment providers and payers. Information will be correct and thorough regarding a client’s symptoms, diagnosis, and progress notes.
Auditing: Addiction treatment providers will benefit from the Golden Thread in case of an audit by insurers, regulators, and other entities. Auditors can follow client data to get a full picture of intake, symptoms, diagnosis, and how patients are being treated.
Patient care: The Golden Thread requires addiction treatment providers to help clients establish goals and objectives for their addiction treatment. It also calls for providers to create and follow their clients’ progress notes, which helps track them from intake to discharge. Providers can gain better insight into what is or is not effective in a particular patient’s treatment plan.
Best practices: One of the best ways to maintain the Golden Thread is collaborative documentation, a process recommended by the U.S. Substance Abuse and Mental Health Services Administration. With collaborative documentation, both clinicians and clients are engaged in documenting assessments, services, and progress notes. This can help addiction treatment professionals work with clients to create a Golden Thread “narrative.”

The right EHR pulls the Golden Thread.

The Golden Thread requires thorough, effective documentation, which makes efficient EHR software highly valuable. Addiction treatment providers require EHR systems that have the reporting capabilities to add and track relevant client information.

Bestnotes EHR has the reporting capabilities necessary to collect data and create progress notes so addiction treatment providers can follow the Golden Thread through each client’s documentation. Contact us today to learn more about our EHR solutions can save you time and effort.

date:  Dec 17, 2018
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Is Drug Rehab a Better Alternative to Prison for Offenders With Substance Abuse Issues?

Sending offenders to rehab instead of prison could have numerous benefits, some research suggests. Drug and alcohol rehabilitation may provide some relief for the ongoing opioid crisis, prison overpopulation, and rising government debt.

Drug rehab and addiction treatment for offenders saves money for communities and individuals.

An estimated 50 percent of the U.S. prison population has a drug addiction issue, but only about 10 percent actually get the necessary help. Sending many of these offenders to rehab rather than jail or prison could help save money in the following ways:

Individuals in addiction recovery are less likely to be arrested again, which reduces costs related to arrest and incarceration
Fewer crimes committed also would reduce court costs and lawyer fees
Initial drug rehab and addiction treatment is less costly than prison
Addiction treatment and recovery improve health overall, which then reduces healthcare costs in both the short- and long-term
Addiction treatment and recovery would reduce costs associated with lost work productivity, either from incarceration or drug-related injury and illness
Recovery would save resources spent on caretaking for children of offenders or addicts

Prisons are not equipped for rehabilitation.

The U.S. Department of Justice estimates that 15 percent to 20 percent of the United States’ 2 million prisoners have a mental illness. Unlike clinics and hospitals, however, the prison system was not built to address serious mental-health needs.

Psychologists and, to a lesser extent, psychiatrists do provide mental health care to prison inmates, and may provide helpful rehabilitative services. Such programs, however, are difficult for prison-based therapists to implement on top of their already heavy caseloads. There are also not enough mental-health professionals to address every need in U.S. prisons.

Rehab programs for inmates are also difficult to create and implement because of philosophical and priority differences. While psychology is focused on treating and rehabilitating patients, the current criminal justice system is focused on punishing offenders.

What does the research on addiction treatment show?

Research dating back to the 1970s has shown that the prison environment itself has a major effect on behavior and mental health. The Stanford Prison Experiment, published in 1973, demonstrated that a prison-like environment can bring out depressive or sadistic behavior in even psychologically healthy individuals. This alone suggests the benefits of rehabilitation over incarceration, especially for less serious offenses.

A more recent study suggests that sending just 10 percent of eligible offenders to community-based treatment programs instead of prison could save $4.8 billion. If 40 percent of eligible offenders were sent to the programs over prison, it would save $12.9 billion.

Researchers based their findings on a lifetime simulation model of a cohort of 1.14 million state prisoners. The model accounted for chronic substance abuse, estimated the lifetime benefits of treatment, and calculated costs related to policing, trial, and incarceration. The study was published in “Crime & Delinquency” in 2012.

Provide better addiction treatment with better solutions.

Whether you’re making the switch from paper to EHR or looking for a new EHR solution, BestNotes EHR and CRM software is designed with behavioral health and addiction treatment providers in mind. Talk to us today to find out more and request a free demo.

date:  Dec 10, 2018
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How the Lack of Addiction Treatment Options Created a Suboxone Black Market

As opioid overdose plagues many areas of the United States, addiction treatment remains out of reach for many individuals. The result is a growing black market for buprenorphine, used in medication-assisted treatment (MAT).

Buprenorphine in Medication-Assisted Treatment (MAT)
MAT combines prescribed medications with counseling and behavioral therapies to help treat opioid use disorders (OUD). The FDA has approved three drugs for use in MAT for opioid dependence: buprenorphine, methadone, and naltrexone.

Prescribers currently must be certified and obtain a special waiver to prescribe buprenorphine, also known by the brand name Suboxone. Under federal rules, prescribers can only treat a certain number of people with buprenorphine.

Current guidelines, issued under the Obama administration, allow nurse practitioners and physician assistants, as well as physicians, to apply for a waiver to prescribe buprenorphine for OUD. Some doctors can treat up to 275 patients.

Congress is currently working on a bill that would increase the number of patients a physician can prescribe for.

Barriers to MAT and Buprenorphine Use

Despite the reported effectiveness of MAT, however, its use remains limited for several reasons.

Although most insurers must cover addiction treatment benefits, not all plans cover every medication available for MAT. Some plans limit the number of dosages or refills available to each MAT patient. These limitations may make MAT too costly for some patients, especially those who may need MAT indefinitely.

Social stigma remains another barrier to MAT. Many addiction recovery circles believe that total abstinence should be the goal for all patients struggling with opioid addiction. Because buprenorphine is itself a type of opioid, some groups argue that MAT simply substitutes one addiction for another.

Evidence shows that MAT is an effective treatment for OUD, but may also require lifelong use for some patients. This has led to debates and disagreements about how to accurately define “addiction recovery.”

Creation of a Buprenorphine Black Market
Some regulators and law-enforcement officials argue that buprenorphine should be more tightly controlled. They believe that stricter control of buprenorphine can prevent diversion, which occurs when a patient sells or gives away their prescription.

According to many health professionals, however, the lack of addiction treatment options encourages buprenorphine diversion. If someone cannot obtain the appropriate treatment for opioid addiction, they may seek out buprenorphine on the black market to help control withdrawal symptoms.

While some people obtain diverted prescriptions as a way to get high, research shows that most people use buprenorphine as an alternative to more dangerous substances, such as heroin and fentanyl. One study at Harvard Medical School found that when people with opioid dependency illicitly use buprenorphine, they are most likely treating themselves for OUD, pain, and depression.

Help for Addiction Treatment Professionals
Does your behavioral health practice offer medication-assisted treatment for opioid use? BestNotes EHR/CRM solutions allow you to track and manage treatment plans, medications, and aftercare. Contact us today to learn more!

date:  Dec 03, 2018
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What is the Electronic Health Record Association (EHRA) and why does it matter for your practice?

Did you know there’s an association for EHR developers in the United States? When looking for an EHR provider, there are good reasons to first consider a member of the Electronic Health Record Association (EHRA).

What is EHRA?

The EHRA was created in 2004 to help EHR developers collaborate and resolve common concerns among their businesses and customers. The association believes that widespread EHR adoption can improve patient care and healthcare productivity.

The association also encourages open dialogue and collaboration between health IT companies and providers, including clinicians and hospitals.

EHRA members support ideas that include:
Rapid adoption of EHRs and other healthcare IT
Improved EHR interoperability and usability
Safety in healthcare delivery
Continued EHR and healthcare IT innovation
Conducting business with integrity
Healthcare research and transformation
High quality and efficiency of care
Developing health IT standards and certification processes
Representing customers’ needs and points of view
Transparency in business

Requirements for EHRA membership

To become or remain a member of the Electronic Health Record Association, a company must fulfill several requirements:

Be a HIMSS (Healthcare Information and Management Systems Society) Corporate Member “in good standing”
Design, develop, and market its own proprietary EHR software
Be a legal, reputable EHR vendor
The member’s EHR software application must be commercially available in the United States
Have at least five EHR customer installations in commercial use in the United States

EHRA Developer Code of Conduct

The EHRA launched the EHR Developer Code of Conduct in June 2013. The EHRA developed this code with several stakeholders to promote many of the EHRA’s ideas.

The EHRA’s code of conduct covers numerous aspects of EHR use. A few of these include:

Interoperability: The EHRA believes “that data should follow the patient.” The association encourages clients to exchange clinical information with other parties involved with a patient’s care. Whenever possible, EHR companies should use available, uniform standards for developing software interfaces.

Patient safety: The code recognizes that all stakeholders share responsibility for patient safety. EHR vendors should participate with recognized groups for reviewing and analyzing patient safety events. They should also share safety best practices with clients, and offer processes by which EHR clients can report patient safety-related issues.

Security: Software and business practices should be developed with the goal of securely handling protected health information (PHI). EHR companies should commit to following PHI best practices, recognizing that they are stewards of confidential information.

The EHRA encourages all EHR companies to adopt the code, even if they are not an association member.

Why work with an EHRA member company?
Because of its membership requirements, healthcare managers and providers can expect a high level of quality when partnering with an EHRA member company. EHR vendors with EHRA membership are in good standing, both in business and legally, and are well established in their field.

In addition, you can expect members of the EHRA to value the same principles as the association, including interoperability, patient safety, and meaningful use.

Dedication to quality, safety, and usability

EHRA member BestNotes is committed to creating HIPAA-compliant software applications for behavioral health and addiction treatment providers. Contact us today to ask about a free trial and bring your organization to the next level.

date:  Nov 26, 2018
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News Roundup: Behavioral Health and Addiction Treatment in Idaho

As behavioral health and addiction treatment gets more attention across the nation, Idaho is taking steps to tackle mental health issues. Here’s the latest behavioral-health news across the state.

Idaho Receives “F” Grade for Behavioral Health and Addiction Treatment Coverage

Idaho has received an “F” on compliance with the Mental Health Parity and Addiction Equity Act of 2008, according to a report by the Kennedy-Satcher Center for Mental Health Equity. The advocacy group gave failing grades to 34 U.S. states.

Under this law, insurers must cover mental illness and behavioral health just as they would cover other conditions, such as cardiovascular disease or cancer. In Idaho, one state law references mental-health parity, but applies only to state government employees and their dependents. Idaho’s law also provides equal coverage for only seven behavioral-health conditions, excluding addiction treatment.

New VA Clinic in Idaho Falls Adds Mental Health Expert

The Idaho Falls Outreach Clinic, a new location under the Department of Veterans Affairs (VA), is now accepting patients. The VA will host an official grand opening ceremony on Dec. 6. The new clinic has a capacity of three times its previous location, and also provides new behavioral health benefits for the area’s veterans.

The new VA clinics are being designed to be more streamlined, with shorter wait times and electronic kiosks for walk-ins. The new facility also will have an on-site mental-health expert for patients with conditions such as post-traumatic stress disorder.

Cassia County Pilots Mental-Health Program for Students

Idaho’s Cassia County School District launched a year-long pilot program called CONNECT to offer behavioral health services to students. Students at participating schools have access to free, confidential, in-person counseling for behavioral health issues such as anxiety, depression, grief, addiction, suicidal thoughts, and bullying.

A student or parent must notify a school counselor or teacher about their desire to receive the services. The family then receives contact information to set up an in-person appointment with a licensed clinician. The program is being funded through grants and private donations.

Boise Offers Addiction Treatment for Non-Violent Offenders

The Boise Police Department is launching the Law Enforcement Assisted Diversion (LEAD) program to help curb opioid addiction. The pilot program will provide opioid addiction treatment as an alternative for jail time for non-violent offenders. The program is being funded in part by a new Idaho Department of Health and Welfare grant created to fight the state’s opioid epidemic.

Those who successfully complete the outpatient program, which will include counseling and medication-assisted treatment, could see their original charge reduced or dismissed.

Idaho Counseling Association: 2018 Super Conference

The Idaho Counseling Association (ICA) is holding its 2018 super conference at Boise State University. The “pre-conference” is November 14-15, with the actual conference to be held November 16-17. ICA gathers counseling and human development professionals to encourage human development.

Session topics in this year’s conference include current trends in teen substance abuse, bullying, and preventing burnout.

Meet Current Challenges for Behavioral Health Providers

Improve your behavioral health and addiction treatment services with an EHR created specifically for your practice. Contact BestNotes today to learn more or request a live demo, or stop and see us at the ICA conference!

date:  Nov 14, 2018
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