Having worked with patients for more than 20 years, I have a good sense of which clinical interventions help individuals with behavioral health issues and substance use disorders. The right combination of one-on-one counseling, group therapy and ongoing care through community re-engagement strategies are essential to improving overall health and wellness.
While personalized care and regular human interaction form the foundation of success, technology offers promise as an enabler of care—even though the behavioral health sector has been slower to adopt health IT than our medical counterparts. Notably, the power of the right technological framework came into full view almost overnight last winter when our state shut down over COVID-19.
If our practice hadn’t implemented an EHR in the nick of time, six weeks before COVID began to spread in Rochester, N.Y., more than 400 patients would have suffered. In truth, they might have gone weeks without access to the essential services they need to stay healthy and address complex behavioral health issues.
The impact of the COVID-19 crisis on behavioral health cannot be overstated. At least 40 states have reported an increase in opioid overdoses since the onset of the pandemic, likely due to a convergence of triggers: social isolation, job loss, fear of seeking emergency medical care, and more.
There are no studies to quantify how many patients we’ve saved. But we are certain that implementing the right EHR and accompanying telehealth platform made a huge difference in our ability to engage with patients and provide support and ongoing care.
Finding the right technology counterparts
COVID wasn’t even on my radar when I was hired to oversee practice management at Westfall Associates. I was struggling with how to balance federal privacy regulations—such as the Confidentiality of Substance Use Disorder Patients (or 42 CFR)—with the need to be more efficient.
Early in my employment, we were seeking better ways to not only address compliance but also handle clinical documentation, billing and e-prescribing for the practice’s patients with one or more substance use and mental health diagnoses.
The healthcare industry is saturated with EHRs designed to address the needs of primary care physicians. But behavioral health is not traditional medicine. We needed an EHR that understood mental health diagnoses and treatment goals, and could support other aspects of care specific to our practice.
We also wanted a system that offered the perfect balance of out-of-the-box functionality and customizable templates — tailored to the workflows of behavioral-health professionals.
The EHR we chose met all these requirements and was equipped with the right workflows that supported clinicians’ needs. It also featured advanced reporting capabilities that would enable the practice to send data to state and federal registries, while allowing the practice to benchmark its progress for key metrics.
But after the pandemic went into effect, our mindset shifted: Would our newly installed EHR and accompanying telehealth platform work as well as in-person contact with clinicians and social workers? And would patients still actively participate and engage in their treatment?
Supporting patients, virtually and in person
Fast forward to a little over a year later, and we’ve learned behavioral health practices can no longer survive without a digital presence.
Today, Westfall uses a hybrid model of in-person and (mostly) virtual care – which is night and day from how we operated a year ago, when we only offered in-person care and documented everything by hand.
Having an EHR made it possible for Westfall Associates to sustain its operations over the last year and provide medication-assisted treatment (MAT), outpatient counseling and urgent care services. Our telehealth platform works seamlessly, and has saved staff the hassle of going into the office after a day of patient visits.
We see the positive impact of our digital practice on patients every day. In fact, a patient called one of our clinicians recently when he felt lonely and isolated and wanted to indulge in his addictive behavior. The clinician was able to schedule a virtual one-on-one consultation and talk him through his panicked state.
This experience was tough but helped us lay the groundwork for a successful hybrid program. For the foreseeable future, Westfall will offer a combination of in-person and video conference meetings—an option that wouldn’t have been conceivable with the EHR we have in place. Clinicians, too, appreciate the continued flexibility to see patients in the way that fits their safety needs.
And for the first time I can stay on top of our productivity. I know exactly how many sessions we’re doing in a given week and can easily scan records and give clinicians access to all of the files and information they need, so they can work from virtually any location.
Sherry Nau, EdD, LCSW, is clinical director for Westfall Associates.