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Curious About Telemedicine for Behavioral Health? Here Are Some Things to Know:

The early adoption of telemedicine, a term often used interchangeably with telehealth, has surpassed the early adoption of electronic health records (EHRs), survey results show. Telehealth is even finding favor with specialists who experience significant burnout.

Telehealth platform company American Well reported at the ATA19 telehealth conference that physician adoption of telehealth increased 340 percent between 2015 and 2018. Even among providers who have not used telehealth, more of them are willing to try it.

Why is Telemedicine Becoming More Appealing?

Telemedicine has already been found to have numerous benefits to behavioral health and addiction treatment providers and their patients.

Closing care gaps: Specialists, including behavioral health clinicians, tend to practice in higher-population areas, creating fewer options for small towns and rural areas. Telemedicine could help bridge some of the care gaps found in behavioral health and addiction treatment.

Reducing care shortages: Although mental health needs are growing across the United States, there is also an increasing shortage of care providers. As addiction, suicide, and other behavioral health concerns increase, telemedicine may mean a difference between life and death.

Improving patient results: Experts note that telemedicine can make counseling and other types of substance abuse treatment more accessible to clients. This expanded accessibility can help individuals get support and make better decisions when faced with the option to use addictive substances.

Improving practice revenue: Telemedicine can be more convenient for patients than in-office visits. It reduces the risk of canceled appointments and no-shows. Faster check-ins can streamline the practice and improve billable hours.

What Are Some Concerns in Implementing Telemedicine?

Telemedicine is a growing technology, and the healthcare field overall is always changing. Researchers, clinicians, and administrators are working to resolve several issues associated with telemedicine. Some of these include:
Fragmented Care: Telemedicine offers a convenient source of care for many patients. At the same time, it could also lead to increased healthcare fragmentation if telemedicine providers do not coordinate with other members of a patient’s healthcare team.

Interoperability: Much like with EHRs, providers have many options for telehealth solutions. Unfortunately, the wide variety of solutions and software may limit interoperability. Behavioral health providers should be aware of this when entering the telemedicine space.

Measuring Value and Effectiveness: As U.S. healthcare moves to a value-based model, efforts to measure value and effectiveness should not exclude telemedicine. Experts at the American Telemedicine Association’s 2019 conference in New Orleans suggest that providers focus on building relationships with patients and asking telehealth users if they feel their needs were met.

Staff Effectiveness: All clinicians and support staff must be thoroughly prepared and trained for the adoption. Take time to address any questions and concerns. Be sure that remote workers have all the information, training, and equipment they need, and are aware of expectations.

Support Your Telemedicine Practice With Specialized EHR

BestNotes EHR was developed specifically to serve behavioral health and addiction treatment practices. Whether you’ve already invested in a telehealth program, you are just starting the process, or simply considering adding it to your practice, BestNotes can help you stay streamlined and cost-effective.

Contact us today to learn more about how BestNotes EHR can help you improve care, track patient outcomes, and increase practice revenue.

date:  Apr 25, 2019
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California Addiction Treatment News

While it has not seen the devastating levels of opioid addiction as other states, California still faces the challenges of opioids and other addictions. Here are the behavioral health issues and solutions making headlines in the state.

California Expands Addiction Treatment Program

The “Hub and Spoke” system of addiction treatment involves regional treatment centers connected to supporting facilities, creating a network that resembles the hub and spokes of a wheel. This helps patients get appropriate help close to home, with individualized treatment plans.
This system was first launched in Vermont in 2012, and since 2017 has been implemented on a larger scale in California. Funded by $90 million in federal grants, California began with 18 hubs and 57 spokes. It has expanded to more than 200 spokes across the state.

San Francisco-Based Insurer Reduces Members’ Opioid Use

Blue Shield of California reports that members with chronic, non-cancer pain have reduced their overall opioid use by 56 percent compared to 2014 levels. The organization in 2015 launched the Narcotic Safety Initiative to reduce members’ opioid use by 50 percent.

The initiative focused on both preventing patients from being prescribed high levels opioids and reducing the number of patients currently using long-term, high levels of opioids. This includes targeting extended-release opioids, which can contribute to opioid tolerance, and reducing opioid misuse and promoting alternative pain management.

University of California Grad Students Offer Solutions to Persistent Issues

Kate Linker, a grad student in anatomy and neurobiology at UC Irvine, has uncovered data on why adolescents are at such high risk of addiction. Teenage addiction may be connected to the brain’s immune system, Linker suggests. She is currently working with the California-based company Plexxikon to develop a new treatment that suppresses drug motivation without affecting other behaviors.

Many Providers Limited in Treating Opioid Abuse

Research from UC San Francisco has found that at least six states with high rates of opioid abuse also have tighter restrictions on the ability of nurse practitioners (NPs) to prescribe medication that could can help treat addiction. The study, published in JAMA, recommends reforms to relax restrictions and help health providers better address the opioid crisis.

California is one state that more severely restricts NP scopes of practice. However, lawmakers have introduced a bill to eliminate the physician collaboration requirement, a recommendation from the California Future Health Workforce Commission. Study corresponding author Joanne Spetz, Ph.D., suggests that, even without changes in current regulations, states might develop programs that connect NPs with physicians who are willing to supervise them in offering buprenorphine.

Medication May Reduce Arrests in People With Opioid Use Disorder

Research indicates that people with opioid use disorder who are prescribed buprenorphine or methadone may be less likely likely to be arrested and incarcerated compared to those not taking the medication. The study, published in the journal Addiction, included 303 individuals who had entered three opioid treatment programs in California over a period of five years.

Addiction Treatment and Behavioral Health Solutions

BestNotes EHR, created for behavioral health and addiction treatment organizations, can help you improve care, track patient outcomes, and increase practice revenue. Contact us today to learn more.

date:  Apr 18, 2019
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Behavioral Health Practice Management Solutions That Therapists Need

What practice management solutions are essential for behavioral health therapists and addiction treatment professionals? Here are the options that can help streamline your organization, increase your revenue, reduce your workload, and improve your patient care.

Electronic Health Record (EHR)

An EHR is more than just a digital version of a patient’s chart. It also allows you to incorporate data from all clinicians and facilities involved in a patient’s care. With the proper interoperability, all authorized providers and staff should be able to access this information. A behavioral health and addiction treatment EHR can include:

Diagnoses and allergies
Medications and other treatment plans
Immunization dates
Recent hospitalizations
Test results and radiology images
Provider contact information

Therapy Notes

Rather than scribbling paper notes or using a separate program, like Word, to keep additional patient information, behavioral health practice management solutions should include an application for therapy notes. This helps clinicians manage intake forms, create and edit progress notes and goals, develop treatment plans, and create discharge summaries.

Keeping this information in one place saves time and improves communication within a practice and with other providers. This not only streamlines your practice, but it also helps you track patient outcomes, a vital task for value-based care.

Scheduling

Whether you have regular follow-ups with a longtime patient, or new referrals, behavioral health scheduling can become overwhelming fast. The best scheduling software allows therapists and administrative staff to set up appointments and events for patients and schedule staff hours and vacations.

Scheduling solutions also can notify users of upcoming events, including cancellations and no-shows. With a mobile option, therapists and other clinicians can access their calendars anywhere, and create, change, or cancel appointments at any time.

Billing Software

There’s no doubt that billing gets complicated in the healthcare industry, whether physical or behavioral, and can take up a lot of your staff members’ time. The appropriate billing software should allow users to verify insurance, ensure proper claims coding, create invoices, post payments, and generate financial reports. This helps keep staff more efficient and increase practice revenue.

Customer Relationship Management (CRM)

Small or mid-sized behavioral health practices may dismiss the need for a CRM system, but they can provide enormous value to therapists. Your CRM solution should help you understand what emails, ads, website content, and other marketing strategies led new patients to your practice.

Behavioral health CRM can help you set up a system for communicating with both prospective and current patients. The right CRM solution not only offers lead management, but strengthens patient relationships and improves revenue.

Messaging and Communication

The phrase “No man is an island” certainly applies to behavioral health therapists and addiction treatment professionals. Whether you’re sharing data with other providers, sending orders to a pharmacy, or giving updates to patient family members, the right messaging solution is essential for your practice. Communication channels and portals should be fast, easy, and HIPAA-compliant.

An EHR for All Behavioral Health Practice Needs

BestNotes EHR solutions helps streamline your behavioral health practice or addiction treatment organization, saving you time, boosting your revenue, and improving your patients’ lives.

Take advantage of our EHR, CRM, messaging, prescription management, and other features. Contact us today (you can even request a live demo) to learn more about what we can do for you!

date:  Apr 12, 2019
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Selecting Surveys to Measure Treatment Impact

Laura Mills, Ph.D. (QM, Psych) Director, Research & Evaluation, Pine River Institute

When you are about to start measuring the impact of your work, you might first ask, ‘What measurement instrument is the best?’. Asking this question first, however, might result in your measuring factors that don’t resonate with your practice, or omitting factors that are important outcome indicators. The resources and culture shift required to implement evaluation are too costly for this. It’s vital to start right, which means a little bit of ground work. This article outlines some steps to start right, and ultimately, optimize your evaluation efforts.

Step One. Decide Why.

Why are you doing evaluation? Do you want to demonstrate your impact to clients, families, staff, accreditation, state, county or payor? Do you want to validate your treatment approach? Understand where to invest in professional development or make program changes? Engage a university research partner? Maybe you want to do all of this, and evaluation makes that possible, but write down your reasons for evaluation. This will be your guide and will keep you in scope.

Step Two. Get Curious!

‘Success’ is what you want to measure, and ‘success’ means something different for each of your stakeholders. Engage them! Ask clients (lots of them!), ‘if in a year you can say that treatment worked for you, what does that mean?’ Try not to prompt responses; you’ll be surprised with the indicators that are important to your clients. If they really don’t know, you might ask if success means they are working, schooling, medication-free, handling stress, relating to family, social, etc. But keep your input minimal.
Ask your staff what they work on with their clients. In what areas do they foster change? If they see a ‘success’ client in a year, what does that mean? Ask your executive team, ‘why are we here?’ ‘in what ways are we having an impact?’
If you plan to use your evaluation to broaden knowledge, you may want to explore ‘mechanisms of change’- why do you work, or what fosters treatment success. Ask clients ‘what was a moment of change for you?’; ask clinicians ‘what is your magic?’; ask executives ‘where do we expect treatment fidelity?’.

Step Three. List Key Indicators.

Using information from your environmental scan, list the common outcome indicators, and if applicable, process indicators. Outcome indicators are your success markers such as substance use, mental health, criminality, hospitalization, vocation, etc. Process indicators are the mechanisms of change such as treatment completion or progression, therapeutic alliance, family engagement, fidelity to a manualized approach, etc.

Step Four. Be a Journalist.

Who will complete the instrument (client, parent, clinician, referrer)? Where will it be completed (online, on-site)? How will it be administered (paper, device, in a group)? If there is a user cost, do you have the resources? Do you need quantitative responses or qualitative? When will it be administered (before, during, after)? Importantly, if you want to measure change, you measure indicators before and after treatment!

Step Five. Find Your Instruments!

You can explore many sources, such as university libraries and google scholar to see the thousands of measurement tools available. Your ground work will help you narrow the options, thankfully! OutcomeTools has several dozen instruments available to view.
Read every question! Have your stakeholders review different instruments. The tool must align with your language and your purpose. Look for problems such as double-barreled questions (asks two questions in one), hard to remember items (dosage of alcohol or substances), too much jargon, difficult time anchors, assumptive questions (e.g., does your child think about suicide), no ‘other’ or ‘don’t know’ option where it’s needed.

Step Six. Implement!

This is where the work gets real! Implementation is a huge undertaking, requiring a working culture shift, huge leadership support, and all-hands-on-deck. For some, evaluation will seem like just another task in their already overburdened day; demonstrate the benefits to them! Show clinicians the scores of one of their clients. Ask them if the scores resonate with their experience. Ask them about the client, the treatment approach, challenges, surprises, successes. Most often, clinicians are so happy to share their experience and see the results of their hard work.
One way to really engage all stakeholders in evaluation is to implement Feedback Informed Treatment, which is periodic measurements of key indicators that are used to inform and guide treatment. This is a powerful way to close the gap between research and practice. Feedback Informed Treatment is also a way to increase your post-treatment survey response rates. When clients see the results of evaluation during treatment, they are more likely to respond to requests for contribution after treatment.
If we can help you get started with these steps or have questions, please reach out to our expert staff at OutcomeTools – team@bestnotes.com or 866-543-6646.

 

For more information on this topic, please see our recent webinar here!

date:  Apr 09, 2019
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Why Behavioral Health and Addiction Treatment Providers Should Track Outcomes (and How to Start)

The Joint Commission, a non-profit organization that accredits nearly 21,000 U.S. healthcare organizations and programs, requires behavioral health organizations to assess patient outcomes with “a standardized tool or instrument.”

This is intended to help “inform goals and objectives identified in individual plans of care, treatment, or services…as well as to evaluate outcomes of care, treatment, or services provided to the population(s) served.”

More than a requirement, measuring patient outcomes has other benefits for behavioral health organizations. While many providers still face barriers to tracking outcomes, the right approach and tools can help organizations succeed.

Benefits to Measuring Behavioral Health Outcomes

Measuring patient outcomes lets providers know if the treatment is working, so they can make adjustments or referrals as needed.
Payer reimbursement is shifting from fee-for-service to value-based care, which involves tracking and measuring outcomes.
Research indicates that behavioral health patients show improvements faster when they can observe their improvements and outcomes over time.
Measuring outcomes helps providers fully utilize their electronic health record (EHR) solutions, improving the return on investment.
Tracking treatment outcomes can help behavioral health providers better coordinate care and improve integration with a patient’s other providers.
Measuring outcomes preserves accountability to regulatory agencies and payers.

Barriers to Behavioral Health Outcome Measurement

Many behavioral health and addiction treatment providers do not use standardized metrics to measure patient outcomes. Unlike with physical health, patient outcomes in behavioral health are usually subjective and tailored to the individual. This makes it more difficult to measure patient outcomes in a meaningful way.

Providers also need a robust EHR solution to help track, store, and manage the data that they create by measuring and tracking treatment outcomes. Many smaller behavioral health organizations, however, are less willing to adopt EHR platforms and technology. Often they are concerned about the expense of an EHR system and the potential workflow disruption, and may not recognize the value of an EHR system.

How to Start Measuring Behavioral Health Outcomes

According to the Joint Commission, behavioral health outcome measurement should involve:

Using a standardized tool
Measuring at regular, frequent intervals
Using the data produced to inform care, treatment, and services
Aggregating data across all clients to improve quality across the organization

Behavioral health and addiction treatment organizations can meet the challenge of defining and measuring treatment outcomes. This process may include the following:
Determine what outcomes need to be addressed, as well as who will receive information about the results.
Determine what measurements are needed.
Develop clear criteria for these measurements, including frequency of measurement and delivering results.
Consider which tools will provide data that shows effectiveness and value.
Train staff on interpreting the results and how to use the results to inform care, treatment, and services.
Document the results in the chosen EHR, such as progress notes, treatment plans, test results, and other clinical documents.
Use performance measurement data to implement changes.

An EHR That Helps Track Outcomes

BestNotes EHR, created specifically for behavioral health and addiction treatment organizations, helps you track your chosen treatment outcomes. Create and manage patient progress notes, track vitals and lab results, and manage intake assessments and discharge summaries.

Contact us today to learn more about how BestNotes EHR can help you improve care, track patient outcomes, and increase practice revenue.

date:  Apr 02, 2019
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