This article is sponsored by WellSky. In this Voices interview, Behavioral Health Business sits down with WellSky’s Carrie O’Connell to learn how the behavioral health industry is leveraging technology to offer effective, accessible care to all. She discusses the regulatory and technological hurdles providers face in the new behavioral health landscape, and she explains how the pandemic has helped eliminate the stigma around seeking behavioral health care.
Carrie, you have been with WellSky, formerly Health Care Software Incorporated, since 2001. What career experiences do you most draw from in your current role?
Carrie O’Connell: Being a clinician in any high-acuity health care setting prepares you for so much. As a nurse or a clinician, you are always anticipating that next event. If you can stay ahead of those events by being nimble and communicative, you can prepare for any scenario.
You also need a strong team that works well together, and the same idea applies to the software world. When we’re all working together with our clients and industry resources, magic can happen.
I have many family members who have been in and out of behavioral institutions for much of my life, so I do have skin in this game. I remember driving up to what were very scary institutions when I was a little girl, and now we have beautiful buildings built with intent and sunlight. The changes in the behavioral health space during my lifetime are so encouraging. Both my clinical and personal experiences keep me passionate about this.
In March and April of 2020, WellSky pivoted quickly to address critical needs caused by COVID-19. How did you and the company act rapidly to understand its long-term impact and the degree to which COVID-19 would transform health care?
O’Connell: Back in February 2020, we knew something unprecedented was happening. Watching the story unfold globally, we did not minimize any information that we learned about COVID-19. WellSky works with a lot of industry leaders, and we’ve developed our own thought leadership content to provide valuable educational resources for our clients, peers and team members.
We were diligent in following industry trends, CDC guidelines and new legislation to anticipate what might come next. Our solutions and engineering teams worked quickly to ensure our solutions were equipped to assist our senior living clients with the 3-Day Stay waiver and the Spell of Illness waiver.
We also ensured that our behavioral health, LTACH (long-term acute care hospital) and rehabilitation clients were able to utilize the latest ICD-10 codes. We made these changes quickly because we knew that our teams were going to need to track and monitor the impact COVID-19 had on their patient populations.
What did WellSky see in terms of COVID-19’s impact on behavioral health?
O’Connell: For the few holdouts who didn’t realize the importance of holistic, integrated care, the pandemic changed everything overnight. We were no longer interacting with friends, coworkers or loved ones, and basic needs were being interrupted. Due to this, alcohol and recreational drug use increased, fueled by a cycle of anxiety, depression, isolation and uncertainty.
WellSky kept a pulse on how those factors affected the industry. From September to August of 2020, there were almost 20,000 more fatal drug overdoses compared to 2019. These staggering numbers jump-started so many studies about the coping mechanisms that increased the need for mental health care.
The stigma around behavioral health is being removed, and people are starting to see that behavioral health care is just everyday care. The industry as a whole did a great job using everything at its disposal to meet that increasing demand.
How is the behavioral health industry delivering its services and ensuring access to care despite COVID-19’s continued challenges?
O’Connell: There have always been issues in behavioral health, such as the 190-day Medicare lifetime, the Medicaid IMD exclusions or the fact that we haven’t exactly realized full parity. The combination of limited access and low payment has left a black cloud over this group for so long.
There has always been a stigma about receiving behavioral health care, and the pandemic has helped normalize seeking help in a comfortable setting. That act of reaching out and utilizing telemedicine has enabled so many people to take that step.
The revised 42 CFR Part 2 was created with the best intentions possible, originally passed to protect people so they could seek help for their alcohol abuse without repercussions. But like all things, there were unforeseen problems. As health care grew to be an integrated environment, focused on comprehensive care, this regulation prevented folks from accessing and sharing their records, and unfortunately, this regulation has hurt us.
Thank goodness the Substance Abuse and Mental Health Services Administration (SAMHSA) is pushing out new regulations to help with collaborative care, as interoperability and data sharing are hugely important.
How are behavioral health organizations using technology to ensure care delivery and continuity of services?
O’Connell: Telehealth has been so important in providing accessible care throughout the pandemic. The other part of that puzzle is the rising staff shortages as more boomers enter this space. Over 80% of the U.S. population lives in an area with a mental health professional shortage. Being able to cross those barriers is critical, and telehealth has made it much easier to realize that vision.
Referral technology is also an important piece of the equation. Regardless of the circumstances, finding the best place for a patient, automating that referral process and sharing the data is essential. This technology is not only appearing in the hospital, but within the communities as well.
Behavioral health care is a revolving door: At the front door is the referral, and at the back door is the data sharing process with our partners. If we get that right, hopefully we can decrease that revolving door. It’s certainly coming with value-based care in the behavioral space, but we also need the technology to document the outcomes and make them easily accessible.
Lastly, when we think about these young, brilliant minds coming into our workforce, they’re all learning on computers and EHRs. They’re used to a system where everything is already talking, so facilities that haven’t adopted technology are going to have a very difficult time competing for talent.
How are behavioral health providers dealing with care delivery challenges resulting from outdated technology?
O’Connell: It’s going to be very difficult for these organizations in general. As we shift to value-based care, behavioral health providers will face more scrutiny on their records from the payers and policymakers. The value-based care play is all about outcomes and quality metrics and standardizing best practices. Providers with the newest and latest technology will be able to rinse and repeat best practices for each diagnosis, giving them a significant advantage over their competition.
Many providers in this industry are still on paper and, though there’s always a fear of not knowing what’s in your records, there will be an emphasis there as audits return. I think we’ve been given a grace period with COVID-19, but we’re going to see an increase in requests for records from a take-back perspective.
We’re also dealing with a crippling clinician shortage across all of health care. Electronic records, machine learning and predictive analytics make us smarter clinicians. With this work shortage, we are going to have to deliver care more efficiently with the resources at hand.
How have behavioral health clients successfully implemented technology to overcome challenges, and how do you see that trend continuing over the next five to 10 years?
O’Connell: Seeing our clients implement and embrace technology has been so rewarding. It truly speaks to the work our team has put into the solution and shows how we have worked collaboratively with experts in the industry to create workflows that are unique to the needs of behavioral health providers.
Overall, I think we’re going to see more EHR adoption among this group due to the increased focus being placed on this industry. We recently surveyed our client base and found that 70% of our behavioral health clients are looking to focus on standardizing clinical best practices. That can’t happen without technology — a point reiterated by our clients. Eighty percent of those surveyed agreed that having an EHR has improved visibility into their patient’s record.
As I said earlier, we’re on a journey to value-based care. To get there, we need to integrate behavioral health with physical healthcare needs. To do this, behavioral health providers need to adopt technology that allows them to standardize processes and share information with other providers in the community.
Entering this year, no one knew fully what to expect. What has been the biggest surprise to you in behavioral health, and what impact will that surprise have for the remainder of the year?
O’Connell: I think that it’s the normalization of seeking treatment. It’s almost becoming a part of self-care. Many providers have capitalized on specialty programs that place people with others who have shared experiences, powering quicker, improved outcomes. Whether it’s for frontline health care workers, veterans or anyone else, there are all sorts of specialty programs.
We still have work to do, but the industry has created customized programs to help people seek care quickly and comfortably. That is amazing to witness.
Editor’s note: This interview has been edited for length and clarity.
WellSky helps behavioral health providers across hospital inpatient and outpatient settings and ambulatory outpatient and residential facilities deliver safer, more effective care with behavioral-specific functionality. To find out how, visit wellsky.com/behavioral-health-systems/
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].