HealthSource Integrated Solutions is a not-for-profit, shared-service organization owned by the Association of Community Mental Health Centers of Kansas, which supports 26 licensed community mental health centers (CMHCs) across the state with a combined staff of more than 4,500 mental health service providers.
Behavioral health services provided by HealthSource include crisis intervention screenings and assessments, information technology managed services, and a 24/7 crisis call center, which each year receives roughly 75,000 calls. In cases where an individual is in crisis and may require a higher level of care, a licensed clinician will conduct a telehealth screening on behalf of the CMHC to do an assessment and decide about care. Annually, HIS conducts approximately 5,000 of these telehealth screenings.
A major challenge for HealthSource has been the lack of funding available for crisis intervention, despite the urgent demand for these services. This has led to a lack of investment in technology and updated processes, making collaboration and cooperation across the state’s mental health support network difficult if not impossible.
Imagine being a clinician who has identified a person in crisis through a telehealth screening and wants to arrange a higher level of care, such as an inpatient stay. This person requires immediate help, but the clinician now must navigate an archaic bed referral system that forces the clinician to call individual hospitals one by one. The clinician may be put on hold, bounced around, and then told there are no beds available – all while trying to help a person who may be in danger of harming themselves or others.
Once a facility with an open bed is located, the clinician must fax paperwork such as clinical notes and lab results to the facility and await a decision on whether the referred individual will be given a bed and receive inpatient mental health services. If the request is denied, the laborious process starts over. And all as someone in dire need of inpatient mental health services remains boarded for hours or days in an inappropriate care setting such as the emergency department – perhaps one of the most difficult healthcare environments for someone in a mental health crisis.
Meanwhile, the crisis call center may be fielding calls from providers asking questions about a patient or to inform them about what’s happening with one of their patients. These providers frequently would be put on hold as call center clinicians dealt with crises.
Partnership with a purpose
It was clear that a system built on phones and fax machines was inherently inefficient and wasteful, poorly serving both patients seeking mental health services and the CMHCs that provide them.
HealthSource concluded that a closed-loop referral system or portal would enable clinicians to send out referrals and communicate with providers across the state without having to call them. After some research, HealthSource partnered with care orchestration and access solutions provider ABOUT to improve support for crisis care in Kansas.
A big focus of the partnership is ensuring access to care for disadvantaged populations. In a statewide system with limited capacity and technology that hinders care orchestration, access to beds can be difficult for any patient. None are more challenged, however, than patients with socioeconomic or geographic barriers. A system that enables clinicians to instantly view staffed beds and levels of care across a region or the entire state will make it far easier to quickly locate an appropriate and available bed for Kansans in immediate need of acute mental health care, no matter their location or socioeconomic situation.
A long-term need for acute mental health care access is more inpatient beds. But we can immediately improve our ability to orchestrate care for patients seeking mental health services by leveraging technology to eliminate inefficiencies and facilitate coordination.
Going forward, as HealthSource collects data on where resources are most needed in the state, it will help guide decision-makers at the state level. As a contractor for the state, HealthSource works closely with the Kansas Department of Aging and Disability Services and plans to use the care orchestration platform for state programs around inpatient care access. For example, data may show whether there’s a lack of beds in a particular geographic area, or for geriatric patients in a specific county, or adolescent beds across the state – all of which is actionable data.
The vision is for HealthSource to create a statewide hub for behavioral health resources that improves care orchestration and helps patients in need get the care they need when they need it. As more providers embrace value-based care (VBC) and engage in risk-based contracts, there will be increasing pressure on them to control costs, improve resource allocation, and produce better patient outcomes. Accomplishing those goals will require the kinds of increased efficiencies that can come only from investing in technologies that enable care orchestration.
Kenneth (K.C.) Johnson
Kenneth (K.C.) Johnson is chief executive officer of HealthSource Integrated Solutions, a not-for-profit organization which serves the Association of Community Mental Health Centers of Kansas. HIS provides crisis call center services and IT shared services to their partner organizations across Kansas. The company’s mission is to provide value-added services and support to our partners to enhance their services and help their communities prosper.
Dr. Darin Vercillo
Darin Vercillo co-founded ABOUT, drawing upon his expertise in developing and implementing medical information systems specifically designed to manage complex patient needs, medical education, and faculty and staff logistics. A board-certified hospitalist practicing in the Salt Lake City area, Darin also served as a clinical advisor and technical developer at the University of Utah Health Sciences Center. Prior to his work at ABOUT, he served as a physician knowledge engineer and interim Chief Medical Officer at TheraDoc.
