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Why Your Treatment Facility Needs Data, and How to Create a Data-Positive Workplace

As healthcare becomes increasingly digital and moves to value-based care, data is playing a greater role. Behavioral health facilities must use data to demonstrate their value, meet accreditation requirements, and make better treatment decisions.

This can be a challenge for organizations that are not used to collecting, analyzing, and reporting on data. Before you can use data effectively, your behavioral health treatment facility must have a culture that understands the importance of data and how to use it effectively. Here’s how to start creating that culture.

What is data-informed treatment?

First, what do we mean when we talk about data-informed treatment? It means that collecting data becomes part of an organization’s weekly progress monitoring. Data is analyzed and used for individual treatment decisions and to determine how effective those treatments are. Data can also help make decisions about overall programs.

Data can also be used to guide your facility’s financial and operational processes. You might refer to data findings to help find ways to increase revenue and decrease costs. It can help drive innovation, helping to determine which services are the most effective for your clients and stakeholders.

This type of decision-making can be a sticking point for clinicians who may not be convinced that it’s worthwhile to use data alongside their own expertise. However, research shows that data-informed decisions can lead to better client results than those decisions made by the clinician alone.

Creating the data-driven culture

A workplace culture is a set of shared values and beliefs that drive behavior and performance. Note that this is different from work climate, which involves overall attitudes about the organization.

So how do you bring a pro-data attitude into your organization’s culture?

First, you should assess your current organizational culture. Evaluate the quality and performance of the methods you currently use to collect and apply data, if you have them. This assessment may be a one-time event, or you can make it an ongoing process as your organization evolves.

You can conduct assessments in many ways. You might hold a meeting where people offer feedback, or distribute an anonymous survey. You may bring in outside consultants. Once you have completed the assessment, determine what areas need the most attention or change.

Other important elements in creating a data-driven culture include:

Get leadership on board by explaining how data collection supports the organization’s core ideology.
Clearly define, communicate, and practice the appropriate ethics of data collection and use.
Identify the roles, responsibilities, and chain of command for all team members involved in data collection, analysis, storage, and use.
Encourage feedback, including anonymous, from anyone involved in data collection, from frontline staff to clinicians.

The way you implement these changes will depend on your facility’s particular needs. If you have a strict environment where security is important, you may need to use a more managerial, controlled, top-down approach to change. Other organizations may need a more flexible, collaborative approach that evolves over time.

When you move to data-informed treatment, you also need the right tools to help you gather and analyze this data. OutcomeTools by BestNotes is a secure delivery and analysis system that lets behavioral health organizations track their effectiveness through electronic outcome questionnaires.

OutcomeTools helps simplify administration and takes the work out of outcome studies. Get in touch with us today to learn more about how OutcomeTools can help you start making better decisions, sooner.

date:  Sep 01, 2021
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Why Progress Monitoring Is Key to Your Behavioral Health Practice’s Success

Monitoring a patient’s treatment response has become standard practice for physical health conditions. For example, medical providers use regular blood tests to track how a patient responds to their diabetes medication.

Progress monitoring is less common in behavioral health. However, the shift to value-based care has put pressure on many behavioral health providers to monitor client progress and track outcomes. This makes progress monitoring vital for the success of any behavioral health organization.

(Want more information about progress monitoring? Check out our webinar video here!)

What is progress monitoring?

Progress monitoring (PM) uses evidence-based measures to track meaningful changes in a behavioral health client’s life. These changes are measured at regular intervals during the treatment process. Clinicians discuss these results with the client.

Some examples of PM tools used in behavioral health include:

Self-reported questionnaires
Urine tests for substance use
Client attendance in therapy sessions
Neuropsychological tests of brain function

Not every individual will have the same response to a particular treatment, even for the same condition. Monitoring a client’s symptoms over time is one of the best ways to know whether a particular treatment method is working or not.

Barriers to progress monitoring

Although regular PM is important for client progress, there are plenty of obstacles that can prevent behavioral health providers from fully implementing it. Some of these include:

Lack of organizational infrastructure
High staff turnover
Lack of knowledge of how to PM appropriately
Heavy clinician or support staff workloads
Not recognizing the value of PM
Fears of detracting from clinical work

However, evidence suggests that PM can help promote efficiency in a behavioral health organization by helping to guide treatment planning. Clinicians can identify deterioration in clients sooner, and can even become better at predicting client deterioration. PM helps reduce treatment failure and readmissions, which not only is better for the client, but it is also cost-effective for providers and facilities.

How to conduct successful progress monitoring

What does an effective PM plan look like? It should follow these steps:

Choose a tool to help collect, store, organize, and analyze data (this may be part of an existing EHR system)
Review the data that you find
Discuss your findings with the client
Conduct regular clinical staff meetings to discuss data

Of course, this is a general outline. Your organization’s specific PM strategy may vary depending on the tools you use and the data you collect. That will also depend on factors such as your client base, the conditions you treat, and the types of treatment methods you use in your practice.

When discussing results with a client, make sure to discuss not just their current condition, but their progress over time. Clinicians should also discuss strengths as well as setbacks, and take a collaborative approach to interpreting the symptoms and data. (These same approaches also work when discussing PM findings with all clinicians at staff meetings.)

Starting a PM plan can seem daunting. However, the right tools can make the process simple and flexible for your behavioral health organization.

At BestNotes, we’re committed to making life easier for behavioral health clinicians. Our OutcomeTools takes the work out of outcome studies and PM so you can focus on helping your clients and keeping your organization running smoothly. Get in touch with us today to get started on making your behavioral health practice a success.

date:  Aug 17, 2021
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What Providers Should Know About Standards of Behavioral Health Care and Mental Health Parity

Under a series of federal laws, medical insurers must provide equal insurance coverage for behavioral health treatment and for medical and surgical care. Otherwise, payers and insurance policies tend to cover mental health treatment at lower levels than physical illness.

Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008, requiring equal coverage of treatment for mental illness and addiction, known as mental health parity. In November 2013, the federal government released rules for implementing the law.

However, not all insurers have followed this rule for equal coverage. America’s Mental Health 2018, a study of access to mental health care in the United States, found that 42 percent of Americans considered “cost and poor insurance coverage” to be some of the largest hurdles to mental healthcare access.

Lack of insurance coverage for mental health treatment can be devastating for patients with substance misuse and serious mental health disorders. It can also create problems for behavioral health providers when payers deny prior authorization or insurance claims.

Mental Health Parity and the Wit Case

If payers have restrictive guidelines for care, even providers that follow generally accepted standards may have to justify their treatment decisions. This issue came to a head in Wit v. United Behavioral Health, also known as the Wit case.

In March 2019, the U.S. District Court for the Northern District of California found that United Behavioral Health (UBH) wrongfully denied plaintiffs coverage for mental health and substance use services. UBH’s Level of Care Guidelines and Coverage Determination Guidelines were more restrictive than general standards of care.

In its ruling, the court listed eight principles of accepted standards of care. Both patients and providers can refer to these principles when seeking or providing appropriate behavioral healthcare:

Treating the underlying condition, not just current symptoms
Coordinated treatment of co-occurring behavioral and physical health conditions
Treatment should be the least intensive and restrictive while also safe and effective
When uncertain, err on the side of caution and place a patient in a higher level of care
Behavioral health treatment should maintain functioning or prevent deterioration
Duration of treatment has no specific limit
Account for the unique needs of children and adolescents
Appropriate level of care should use a multidimensional assessment

How to Advocate for Behavioral Health Clients and Practices

Drawing from the Wit case, National Council for Mental Wellbeing has developed a toolkit, “A Compelling Argument For Facilitating the Equitable Use of Generally Accepted Standards of Care,” available as a PDF download.

The toolkit aims to help behavioral health clinicians and organizations claim their roles as expert authorities and ensure that clients receive appropriate, medically necessary care. It is meant for providers whose claims have been denied due to misaligned standards of care.

The toolkit includes:

Appropriate steps to take when faced with excessively restrictive claims denials
An infographic highlighting the Wit case
Appeal letter templates for both providers and clients
Talking points to use in phone conversations with reviewers

These resources can help your behavioral health organization better advocate for your clinicians and your clients while demonstrating your expertise and conviction.

Behavioral health billing and reimbursement shouldn’t be complicated. BestNotes EHR solutions were developed specifically for behavioral health and substance use disorder treatment providers to help you operate with less stress and frustration, helping you stay compliant and get reimbursed faster. Contact BestNotes today to learn more.

date:  Aug 09, 2021
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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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