From intuition to quantification: Using the power of data to expand access to care and improve clinical outcomes in behavioral health

By now, no one should be unfamiliar with today’s behavioral health crisis. The topic of behavioral health has been catapulted into the global spotlight over the past eighteen months:  the impact of the ongoing pandemic, world class athletes publicizing their own mental health struggles, and headlines of the expected explosive growth of the mental health and substance use disorder services market have all contributed to the long overdue de-stigmatization of these ever-present conditions.

This de-stigmatization has finally helped place mental health in closer parity to physical health, ultimately leading more people to recognize their symptoms and seek help when needed. Per CNBC, it’s estimated that 1 in 5 Americans have some type of a mental health condition, and that the number of Americans experiencing anxiety and depression is up significantly — 42% of U.S. adults reported symptoms in 2020, up from 11% in previous years.  Yet, according to US News & World Report, about 37% of the U.S. population, or 122 million Americans, live in areas experiencing behavioral health professional shortages.  Psychiatric Times reports that 43 of 50 states have a severe shortage in psychiatrists specializing in child and adolescent care.

The bottom line is that demand exceeds supply, and we need to find a way for behavioral health organizations to efficiently meet today’s heightened needs for their services.

What now?

Essentially, behavioral health organizations must focus on two critical priorities in order to overcome today’s behavioral health crisis: 1) expanding access to care for those in need and 2) improving clinical outcomes for those that are suffering. After all, providing more people with access to care and implementing the most efficient and effective treatments will lead to quicker improvement for people — and isn’t that the main goal?

But we can only achieve these two goals with actionable data insights that come from measurement-based care.

EXPANDING ACCESS TO CARE

People quickly associate the idea of expanding access to care with training more psychiatrists and psychologists; basically, throwing more expensive resources at the problem.  However, the real opportunity is to efficiently use the resources one has. For organizations that have a range of behavioral health services and staff, how do they decide how to utilize them most efficiently? Are your psychiatrists caring for low acuity patients? Are people scheduled for inpatient programs that would do better with outpatient programs? These are the questions to ask to ensure that you are freeing up resources by using the ones you have most efficiently. Of course, the most critical information you need to answer these questions is data.

Let’s break it down further and articulate precisely how behavioral health organizations can improve efficiency through the use of data.

Risk stratification and triage

Behavioral health organizations need to better understand incoming patient levels of severity and the level of acuity so that they can match them to the right treatment and the appropriate clinician.  For example, someone with severe depression who would benefit from a SSRI should see a psychiatrist and not spend several weeks speaking to a therapist that isn’t equipped to prescribe medication. The better informed organizations are to make these decisions, the quicker patients receive treatment and improve, thereby freeing up a slot for a new patient.

With measurement-based care, organizations can collect valuable patient data – such as  evidence-based assessments (ie. PHQ-9), intake forms, social determinants of health data, and past history of behavioral and physical conditions. All of this rich data provides the necessary and actionable insights to understand patient and population risk levels and quickly match patients to the right level of care, program and clinician for efficient use of resources, and therapeutic course of action including digital health tools for low acuity patients.

Monitor and Guide Care

Once someone starts the correct treatment pathway, how can behavioral health organizations best guide and identify any needed changes in their care? It’s important for clinicians to continuously monitor their patients through patient reported outcome measures (PROMs) in order  to monitor for notable changes that warrant a change in treatment. For example, if a patient’s  severity level increases, they might need to switch their care from a psychotherapist to a psychiatrist and receive transcranial magnetic stimulation.   This longitudinal monitoring of progress captured by a measurement-based care platform is critical in ensuring that people are receiving the right level of treatment throughout their care journey.

Again, it’s the data that will support a clinician’s decision-making. Without this data, how would a clinician know if their treatment is working, or if they need to change course to improve patient outcomes? Behavioral health organizations need measurement-based care tools that provide progress monitoring throughout the course of treatment to inform decision making and to guide care and support a stepped care model.

Telehealth

Telehealth has come of age quickly during the pandemic as a way to effectively serve patients. Many providers view telehealth as a strategic way to efficiently expand access to care for their patients in need. It’s been particularly helpful for those living in rural areas, where few, if any, behavioral health clinicians practice nearby. But, regardless of where one lives, we need to monitor the quality of telehealth delivery via clinical outcomes. So the question remains: How can we ensure the quality of telehealth services in an objective way?

We need measurement-based care seamlessly integrated into the remote delivery of behavioral health services to monitor the quality of care and meet the expected requirements from payers.

IMPROVING CLINICAL OUTCOMES

The big question about improving clinical outcomes in behavioral health is this: how can we improve what we aren’t measuring? The answer is simple: we can’t.

We need outcomes measurement and data to both understand and improve clinical outcomes. Measurement-based care is the only way to do this.

Patient engagement & clinical decision support

High patient engagement means there will be more patient-reported outcomes data for clinicians to use to make effective decisions to guide individualized care throughout the course of treatment.  In addition, patients who are engaged in their care, are more empowered, experience a stronger therapeutic alliance with their clinician, and show improved outcomes more quickly than those that don’t engage. Put simply: measurement based care solutions that drive high patient engagement and provide real-time data will help inform care and improve outcomes. It is a fact!

Care quality

There is often a lack of standardization of care that leads to a high degree of inconsistency across clinician practices.  But armed with evidence-based measurements, a behavioral health organization can, with confidence, objectively evaluate a patient’s progress because they can determine how the patient is doing throughout treatment. This is true from both a clinician and management perspective. An objective measurement system enables organizations to identify outliers and gaps in care, take proactive action, and provide a more consistent care delivery model across its organization.

Moving Forward

Expanding access to care and improving clinical outcomes are the critical priorities in overcoming the behavioral health crises that we are all now facing.  Let’s start treating behavioral health patients the same way we treat patients with diabetes, cancer or obesity: by gathering critical data to understand patient needs so we can use our resources more efficiently throughout treatment,  and  better manage the business of behavioral health care.  It’s the data from measurement-based care solutions that will get us where we need to be, on a pathway to break through this crisis once and for all…with confidence.

Photo: metamorworks, Getty Images

 

 

 

 

 

 

 

 

 

 

 

 

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