“Crises, especially the one we are experiencing now, have a significant financial and human toll, stranding assets and human capital and causing significant social and economic dislocation. However, many of these dynamics are ingredients for disruption from which new business models emerge.” – Innovation in a Crisis: Why it is more critical than ever, McKinsey & Company
Many of us read this quote and understand what is being communicated explicitly. There isn’t much to argue in the above statement. But how do these words translate into a reality where data can truly drive innovation for behavioral health providers? Have you considered all that has taken place with COVID-19 and the effects on our industry as innovative ingredients to create a new or revised agency model? A model that can sustain future crises? If not, it is likely due to one of two reasons:
You are currently still operating your agency from a state of crisis due to the effects of COVID-19. You are simply trying to keep your agency afloat, devoting each resource to essential needs of today.
You are uncertain of the first steps to take in becoming an innovative agency. This has impacted your ability to create an adapted and thriving business model.
Then what is the first step in becoming innovative? Without data, innovation will be misplaced and misguided. Efforts, resources, and changes will be applied to unaffected areas of the business. More than ever, right now is the time to look at data. Not tomorrow. Not in a few months. But right now. Because tomorrow may be too late. That over-worked service provider may decide she will submit her two-week notice tomorrow. All of which could be prevented by analyzing billed amount and units by clinician today to reveal potential burnout. To ultimately lead you to ask the right question and reveal the burnout you believe is taking place (likely as a result of overproduction due to COVID-19). Today you could speak to that service provider to create a plan for her sustainability and engagement, and prevent the two-week notice from being submitted in the first place.
So if data is the first step to becoming an innovative agency, what is keeping you from analyzing and utilizing it? Again, two major components are at play here:
You don’t know how to analyze the data. You are unsure of what data to look at and what the data tells you about your current state of business and future decision-making opportunities.
Having the tools to make decisions just as fast as our current environment is changing, is essential. In this upcoming blog series, we will explore the tools needed and points of data to analyze within three major aspects of your agency’s operations:
Behavioral Health Staff Productivity and Utilization: Is overproduction a good thing?
No-Show Rates in Behavioral Health: Can you explain your agency’s no-show rates?
Service Types: Has your response to increased demand in Behavioral Health services actually lost your agency money?
Join us as we take a deep dive into each one over the coming weeks to understand how data can drive innovation in the behavioral health and I/DD fields.
For the entire article of ‘Innovation in a Crisis: Why it is more critical than ever’, click here.
Medicaid managed care for the I/DD population is sweeping across the country, along with other funding changes from grants and fee-for-service, to Medicaid waivers and value-based payments. These new oversight and funding models are putting pressure on I/DD providers, forcing executives to think outside the box in terms of financing, managing performance, and technology. Oftentimes, many providers may be focused more on the features of the software than how they are going to implement it into their workflow. The result is while the software works, it might not be used or used to its fullest because the implementation was lacking.
A lot of what goes into effectively using new technology happens before you make your purchase. So be sure you don’t make these mistakes when selecting and implementing your EHR for your I/DD organization.
You need the buy-in of clinicians and staff in your organization to be successful at choosing and implementing new EHR software. One of the most common mistakes that organizations make is letting one person choose the software without buy-in from everyone else. The result is often resistance to the final choice and providers or staff who fight making the change. We recommend you gather feedback and requirements from you staff through surveys and focus groups before looking for partners and communicate progress to your staff at key milestones in the project. This will help keep staff involved and informed but allow the decision makers to determine best product fit and scope of implementation at a much quicker pace.
Before you select a partner, you have to set clear expectations around what you want in an EHR, what your agency needs, and what resources are available. Because an EHR will sync your entire organization around the client story, this will need to be tailored to each department. This requires input from everyone so that it will work for the whole business and not just the clinicians or agency director.
Not Assessing Workflows
It’s important to realize implementing a new EHR may mean you need to change intake, assessment, billing or documentation workflows – just to name a few. It’s important to evaluate your current workflows across the entire client lifecycle before you make a change. The fact is that the workflow will change and those changes will vary depending on how you do things now. To make the most of the EHR, you have to be open to change. By mapping out your current workflow, you can work with your new technology partner to identify areas that will need adjustment. Then, you can prepare for and manage those changes successfully.
Lack of Objectives
Objectives are not the same as expectations. Objectives are specific goals. Setting goals allows you to make sure that the solution you choose and processes you put in place are designed to help you reach certain objectives. You need to ask some basic questions. Do you want to make more money? Provide better client care? Improve documentation costs? Expand your services? For each service, these essential goals are unique. It’s important to make your goals S.M.A.R.T. (specific, measurable, attainable, relevant and time-tracked).
Be sure you have the right infrastructure in place for your EHR. A lack of necessary bandwidth can slow down every process in your agency when you launch. Make sure you have the connectivity and speed to complete all your tasks and choose the right hardware for your needs.
Once you are ready to start your implementation, don’t forget to set some clear milestones for success with your technology partner. Set realistic dates for achieving specific items like training, billing, etc. Then, don’t get derailed by implementation challenges. Stick to your schedule!
If people are not trained adequately it will slow down your transition to an EHR. So don’t skimp on the training! Get as much training as you need for everyone on your staff, and select staff to train as super users to support the rest of the staff after your training is over.
No matter how well trained and prepared your staff are, the change to EHR will slow things down initially. Tell your clients what is going on and ask for their patience and understanding.
Bad Customer Experience
Many providers don’t think about how the EHR will impact their interaction with clients. The fact is that using technology to document while you are with a client does affect that experience. Awareness is the first step to addressing this. Think about what type of device will work best and how you can use it to engage the client instead of letting it come between the provider and the client. Always be thinking of the client – and make sure your workflow and system configuration ensures the interaction provides a positive experience.
Thinking You’re Done
When it comes to managing your agency and improving your business, you are never done. Whether it’s EHR or billing, there is always something new. And you should expect your partner to have a robust plan for ongoing product development. These new tools and features will help you continue to improve the quality of your client care and the management of your business.
The delivery of quality behavioral health services comes with many challenges, especially in terms of portable documentation platforms. In order to assure compliance and billing efficiencies, providers need electronic health record (EHR) technology that can move with their clinicians and synch seamlessly back to the home office—especially when clinicians spend the bulk of their day serving clients in outlying locations.
Pawnee Mental Health Services (PMHS), headquartered in Manhattan, Kansas, serves 10 counties, many of them deeply rural. The not-for-profit organization provides a range of onsite and community-based services for adults and adolescents, including substance abuse and addiction recovery issues and emotional health support.
PMHS began looking for a behavioral health EHR solution in 2016. The organization decided on Remarkable Health’s fully integrated and ONC-certified EHR system, which includes clinical documentation, client engagement tools, billing interfaces and data analytics. The new system gave the agency all the functionality it desired—but only from the home office.
“When we compared other systems, we decided Remarkable Health’s EHR system was the best one for us, but we really needed a mobile application as well,” explains Shelli Schottler, LMSW, Community Services Director at PMHS. “So, in 2018, we agreed to be a beta test site for its new mobile app.”
PMHS began by introducing the CT|One Mobile app to 10 of its technology-savvy clinicians—about 10 percent of its staff. The agency’s clinicians use the app on smartphones, giving them access to client lists, client demographic information, case management documentation, scheduling tools and other features.
As an integral part of the project, the agency’s clinicians provide regular input on ease of use, functionality and the clinical and business improvements gained through the mobile functionality.
“We have weekly meetings with the Remarkable Health product team to provide our user feedback and pass along any issues we find.”
Continuity From the Field
Over the years, EHR systems have matured into great storage tools, but haven’t always been good travel companions. One of the biggest game-changers for PMHS was giving its clinicians the ability to tap into the client demographic information, case notes and appointment lists stored in its Remarkable Health EHR system from anywhere – regardless if they had an internet connection or not.
The CT|One mobile app gives clinicians the power of knowledge and efficiency before, during and after a client visit. From an Andriod or iOS smartphone, an agency worker can view client appointments for the next several days, create client notes at each visit and tap into information on the next client. The app saves all documentation and automatically sends the updated data to the agency’s EHR whenever the clinician logs in from a WiFi-capable area.
Being able to document securely from the road erases the distance between the home EHR and the field staff—and eliminates the risk of outdated client record information or not meeting compliance requirements.
Tracking updated appointment data on the mobile platform also saves clinicians from unnecessary travel if a client reschedules an appointment with short notice or changes service locations, a significant time-saver in rural areas where clients can be many miles apart.
PMHS has seen many advantages to using the mobile app, but helping staff work better and smarter is the key workforce impact.
“I think the efficiency is probably the biggest advantage,” Schottler says. “The mobile app helps our staff stay more informed and know what is happening with the client before arriving for a visit. Based on the staff member’s role, the app enables clinicians to pull up notes from other providers quickly, which is helpful when our staff members are meeting with other agencies or individuals. That helps us work efficiently and be professional to others.”
Schottler remembers her own days in the field before electronic documentation tools were common. “Before EHRs, I’d have my client list on paper and would write my notes in my car on the way to my next appointment,” she recalls. Now, clinicians need deep case management tools and the ability to capture documentation at every remote site visit, both for efficiency and accuracy.”
“Clinicians are expected to be billing an eight-hour day, but depending on their jobs, they could be out in the field for anywhere from four to six hours a day,” Schottler says. “So that doesn’t give them a lot of time to sit down and document at their computers like an onsite therapist might be able to do.”
Documentation = Billing
Over the past few years, the expectations of timely billing documentation have condensed greatly. In today’s business environment, being able to document accurately and efficiently is becoming a key attribute of agency success—since it all comes down to how quickly the complete service delivery record moves to the claims processing stage.
Being able to capture and save documentation electronically from the field allows clinicians to complete their service documentation for faster billing—something PMHS says has improved its bottom line. “It used to be you could spend a day out in the field and do your documentation later, but now the expectation is basically 24 hours,” Schottler explains. “So, it’s very important for our staff to be able to document what services were delivered in a much shorter time frame.”
As business expectations increasingly connect timely documentation to revenue cycle management, behavioral health agencies are realizing their needs for EHR technology have shifted from being “paper-replacement tools” to becoming a technology partner in client outcomes management and agency efficiencies.
Next on PMHS’ wish list for app functionality is an easier way to accommodate client handoffs—passing an assigned client list from one clinician to another. And, sooner or later, Schottler says, speech-to-text technology will become every clinician’s next craving. Now that they are incorporating the mobile app into their everyday workflows, they plan to take full advantage of the documentation efficiency features already available, like text-to-speech, tagging, signatures and more.
The ultimate future for EHR mobile apps is to be to be able to do anything a clinician can do in the office, but from anywhere. “Ultimately, we’d love it if the entire EHR was accessible from the mobile app,” Schottler says. “That would allow clinicians to see the full treatment plans and maybe even the deeper conversations between behavioral health and primary care physicians.”
About Remarkable Health
For over 25 years, Remarkable Health has pioneered innovation through technology for behavioral health and DD providers. Our integrated suite of outcomes management, EHR and mobile technology arms providers with the tools they need to improve client outcomes by spending less time on documentation and inefficient workarounds and more time delivering value-based care and engagement. To learn more about the CT|One EHR and the CT|One Mobile app, contact us at (480) 550-8077 or visit our website at www.RemarkableHealth.com.
Community Behavioral Health providers can often face numerous challenges related to the documentation of services. Providers often support large caseloads while needing to maintain productivity, meet documentation requirements and maintain exceptional client care. With the increase in demand for providers to become more efficient, we look to technology for assistance in meeting these needs. After interviewing providers and partnering with them to develop the Remarkable Health EHR application, there were 3 features that stood out as critical to create efficiencies for staff delivering services and documenting care. These features include the ability to assist providers with efficiency and accuracy when documenting, ensuring documentation is signed and up-to-date, and creating and scheduling follow-up appointments.
Feature #1: Tagging Increases Efficiency and Accuracy When Documenting Care
Writing progress notes can be a time-consuming task. While some providers may write their notes directly after services are provided, there are many instances where notes are not written until several days after the contact with the client, which increases the chances of inaccuracies and/or missing facts. With its simplistic look and feel, Remarkable Health’s EHR mobile application allows providers to enter notes with speed and accuracy, while maintaining the clinical workflow. While decreasing the time it takes to enter clinical notes is a positive step, accuracy and efficiency is the number one goal of the app. To increase the likelihood of clinically sound notes, we added a “tagging” feature to the EHR mobile application. The tagging feature allows the user to select a category in the assessment section of the progress note, which in turn, creates the beginning of a clinically appropriate progress note. During the session with the client, the provider can continue to quickly select key words to develop their assessment. For example, if the client had a flat affect, the provider is simply tagging “flat affect” and the application will provide the following language “The client presents with a flat affect as evidenced by…” allowing the provider to add additional context to create a unified language with a client specific feel.
Feature #2: Simplified Signature Capabilities Makes it Easy to Keep Documentation Up-to-Date
Remarkable Health’s EHR mobile application allows a provider to review the client’s consent form(s) regardless of the location or internet connection. The provider can then discuss the consent form(s) with the client and upon client agreement to the content(s), he or she will confirm the agreement for one or multiple forms. Once confirmed, the client will only need to enter their signature once, which will populate on all accepted forms. Immediately after the form(s) has been successfully reviewed and signed by the client, the updated version will seamlessly sync back to their clinical record.
Features #3: Ad Hoc Scheduling Improves the Client Experience – And Helps Keep Clients Engaged
As the contact with the client wraps up, it is now time to schedule a follow up appointment. Remarkable Health’s EHR mobile application gives the provider the ability to review their schedule, find an opening and schedule their next appointment with the client. This eliminates the need to call the office and speak to the front desk staff to schedule the next appointment, ultimately saving time for both the staff as well as the client. All openings and next 10 consecutive appointments are available at your fingertips in the mobile application, thus creating a seamless workflow and positive experience for the client.
BONUS Feature: A TRULY Offline Mobile Application Improves Coordination and Efficiency
It is important point out one additional bonus feature of Remarkable Health’s EHR mobile application, the ability to work offline. All of the previously mentioned features to increase efficiencies can be completed without a cellular/Wi-Fi connection, resulting in a completely offline experience. Within one client contact, the provider has efficiently reviewed and updated the client’s consent form, scheduled a follow up appointment and completed their progress note in an accurate and timely manner.
Ready to experience the Remarkable Difference? Visit our website to learn more about our mobile application and schedule a demo today.
It is important to deliver high-quality behavioral health and DD services each time a provider encounters a client. These services can range from an initial session with a client to writing full fledge notes that document a client’s progress towards their goals and objectives. But with more services being delivered in the client’s home or community setting, providers are finding it difficult to get their notes done closer to the service delivery time, which can lead to inaccuracies or incomplete documentation for billing. In order to assure compliance and billing efficiencies, it’s critical that their electronic health record (EHR) technology move seamlessly with their clinicians and synch back to the home office—especially when they spend the bulk of their day serving clients in outlying locations. This need for an EHR mobile app roots directly from the crucial ability to work offline in remote areas with weak or no internet connection or access.
But beyond billing efficiencies, what benefits does a mobile EHR bring to providers to ensure improved client outcomes? To help answer this question, Matt Banyai, Product Manager at Remarkable Health, shares 3 ways a mobile-first EHR will not only help providers improve their billing inefficiencies, but also client engagement and outcomes.
#1: Mobile EHRs Will Improve the Client Experience
The last thing a clinician wants to do is stop care to document an event or progress. The right mobile EHR application should help clinicians validate, create, and edit certain areas of interest pertaining to their everyday job duties – without having to rely on internet connectivity. These include reviewing client demographics, clinical documentation, progress notes, and upcoming or historical appointments. With a mobile app, clinicians can easily search and review these areas of interest before, during, and post visits with their clients as desired. This ability is a game-changer in the fast-paced world of a behavioral health and DD clinician or staff member. Simply put: it creates more face-to-face time with the client to focus on their progress and well-being, instead of screen time documenting in the office before or after hours. Ultimately leading to a better experience for the clients receiving care.
#2: Mobile EHRs Reduce Documentation Costs – And Improve Work/Life Balance for Staff
The right mobile EHR application should impact a clinician’s workflow dramatically and work in a rural and offline environment. This capability will enable clinicians providing services in the community to practice most of their normal day-to-day duties at the tips of their fingers. This will not only increase the accuracy of data and clinical performance, but also the ability to schedule a follow-up session while still face-to-face with the client. The power of mobile means clinicians can create a real-time session progress note that is more intuitive and concise to the progress of their client before, during, or immediately after the session. This should then seamlessly sync back to their EHR system of record. This eliminates the need to jot notes down on paper to then later re-create the typed version of the note in the system of record at home or in the office. As for scheduling follow-up sessions, clinicians can now schedule these additional sessions with real-time sync functionality, instantly visible in their agenda. With real-time documentation at their fingertips, clinicians can now spend more time with their clients, document care – and still be home on time for dinner.
#3: Mobile EHRs Give Clinicians More Time to Focus on Goal Progress
Through recent studies and interviews with Remarkable Health partners, providers report that their clients are being positively impacted when clinicians use the Remarkable Health mobile EHR application. This is mostly due to the app giving clinicians increased time with the client to focus on goal progress. Another notable impact is the mobile EHR increases the ability to meet clinician-to-client in the client’s environment of choice; meaning the client’s home, school or business – where they spend most of their time and are comfortable with their surroundings. Our clinicians state that meeting the client’s in their desired environments has allowed them to have clearer insight into the client’s needs and can focus on the progress during real-world situations.
Remarkable Health’s Mobile Companion App
Remarkable’s Mobile EHR app provides clinicians the ability to be more effective, efficient and work in an offline manner to meet the client’s everyday needs. As we continue to enhance the application, we are positively impacting the lives of not only the everyday clinician, but the clients as well – ultimately the why of all we do.
Like many other industries, technology is revolutionizing behavioral health. Ideally, it should support and enhance clinical care for patients while providing real-time behavioral and psychological care for staff providing treatment.
To help you navigate the next year of behavioral health technology trends and changes, our product managers and business analysts share which trends they think will emerge in 2019 – and beyond:
#1: Artificial Intelligence Will Drive Cleaner Data Capture Kyle Woodruff, Sr. Product Manager
Artificial Intelligence (AI) is the next big thing in health IT and it’s ready to make an impact. We are starting to see AI make its mark already; IBM’s Watson is a great example. AI is going to allow more data to be captured faster than ever before, accomplish repetitive tasks, and process predictable outcomes that will help clinicians get time back in their day. With the introduction of AI and its ability to capture data cleanly and more efficiently, it’s quickly becoming something we can’t live without. As time goes on, we are going to see AI get even more up close and personal as newer interfaces for AI emerge. Using AI to capture data and as virtual assistants is only the beginning, wait until you see what tomorrow brings.
#2: Enabling a More Mobile Workforce Will Help Increase Productivity and Efficiency Matt Banyai, Business Systems Analyst
Most employees these days do not need to be “inside” an office to get their work accomplished accurately and efficiently. The mobile era has provided individuals the ability to use mobile devices to accomplish many work activities at a highly productive rate. Bring Your Own Device or “BYOD” is becoming more widespread throughout businesses as it allows employees to use their own devices for all work-related activities, such as meeting with clients at their locations for added convenience. This builds a better community feel and removes barriers of meeting with the client for services. Enabling a more mobile workforce promotes a more flexible, technology-driven and familiar environment to the users. As long as a smartphone, tablet or laptop are available for use, the mobile workforce will continue to grow and outperform desktop usage.
#3 Development Disability Programs Will Move off Paper and to EHRs Tom Liccardi, Product Manager
Changing from a paper-based world to a digital infrastructure can be an agency culture change and will require champions. Paper charts and paper tracking has been the medium of choice for documenting client information in the I/DD world. Searching paper records can be an impossible task and the writing is often illegible causing inaccuracy and confusion. The primary goal is to both serve the client and reduce the staff’s burden of collecting data. Switching to an EHR will reduce this burden and allow for the ability to search, understand, and trend those data elements important to you and your business.
#4 Client Engagement Will be Key to Fighting the Opioid Crisis Tom Liccardi, Product Manager
The opioid crisis is a widespread epidemic impacting all forms of human classifications. The early stages of a client’s recovery are critical. Because there is a high demand for services, clients often have to wait to be admitted into treatment. During this waiting period, it’s not uncommon for a client to disengage in the path of treatment. Another contributor to early client disengagement in treatment is the lack of connection and staff being unavailable. It has been found that clients who participate in some form of engagement tool, such as a patient portal, will have high levels of treatment satisfaction. By engaging with clients outside of the traditional treatment model and teaching critical engagement strategies, agencies will develop better communication and trust with clients. Clients who are more engaged with their treatment tend to manage their condition better. Lastly, agencies who improve client engagement through extra therapeutic factors have better treatment outcomes.
#5 Taking a Data-Driven Approach to Value-Based Care Sheri Brown, Business Systems Analyst
Value-based healthcare strives to improve population health, increase patient satisfaction and reduce cost. Value-based programs, in turn, reward healthcare providers with incentive payments when they demonstrate the quality of the care they give. The question is, how can you demonstrate something as nebulous as ‘quality’? The best way to demonstrate this is with solid data. Good data shows you what is currently happening, exposes gaps, helps you predict what is likely to happen in the future based on that information, and then take action. As time passes and you continue gathering data on those actions you take, you will see the direct impact (positive or negative) of those actions and can continuously recalibrate and improve quality of care.
The electronic prescribing of controlled substances (EPCS) has been a topic of discussion surrounding the ways we can take preventive measures and utilize technology. The use of EPCS can make a difference by streamlining clinical workflows and providing critical security measures that are designed to help prescribers prevent prescription drug abuse. Using this as a management tool would also help with drug-drug interactions, inappropriate dosing, and dosage reminders, which could help reduce errors as well as enhance the safety of patients.
Remarkable Health recently partnered with Kevin Hines to help produce “Suicide the Ripple Effect”, a feature length documentary film, currently in production. The film focuses on the devastating effects of suicide and the tremendous positive ripple effects of advocacy, inspiration and action that are helping millions of people find the hope needed to stay alive.
The film takes you on a journey with Kevin, who at age 19, attempted to take his life by jumping from the Golden Gate Bridge. Kevin is now one of the Golden Gate Bridge survivors. Today, Kevin still battles many extreme symptoms of bipolar disorder, but that hasn’t stopped him from becoming a world-renowned mental health advocate, motivational speaker and author who has helped thousands of people choose life. We are excited to help Kevin spread a message of hope, recovery, and wellness as he visits some of the people who have been impacted by his suicide attempt.
Please join us in this mission to help insure this film and its inspirational message of hope reaches its full potential and is seen around the globe by those who need hope the most. You can help by sharing this post with your social networks.
Between implementing health and wellness initiatives and building fun cultures that promote flexibility, several stellar organizations among the 100 Best Arizona Companies work extra hard to keep their people happy. Meet some of the best companies for work-life balance — including American Express, Remarkable Health, Henry+Horne, meltmedia, Ryan, Longboard Asset Management, Shutterfly, USAA, Vanguard, and Workiva.