Open Technology Leads to Open Collaboration—and Decidedly Better Care Outcomes
The need for better communication and collaboration across the care continuum is clear. Behavioral and developmental disabilities do not exist in a vacuum, as individuals with these conditions tend to also have a co-morbid disorder, such as heart disease, cancers, diabetes and neurological illnesses.
The Institute of Medicine (US) Committee on Crossing the Quality Chasm views this as an important issue, citing four primary separation points in the mental health circle of care: (1) the greater separation of mental and substance-use health care from general health care; (2) the separation of mental and substance-use health care from each other; (3) society’s reliance on the education, child welfare, and other non–health care sectors to secure mental health services for many children and adults; and (4) the location of services needed by individuals with more-severe illnesses in public-sector programs apart from private-sector health care.
Linking technology to improve care
To overcome these challenges, the committee recommends that individual treatment providers create clinically effective linkages among mental, substance-use, general health care and other human service agencies caring for these patients. A cornerstone of these linkages is the seamless sharing of healthcare consumer data though systems such as the electronic health record (EHR), case management and managed care. The imperative is for these systems to not exist in a silo within each individual care provider. The walls must come down in order for an individual to transition from discharge with one provider to admission with another, and yet still enable each provider to have a holistic, comprehensive view of the whole person in front of them.
“In the past, healthcare systems sought to keep their patients’ information and HIT vendors wanted to sell all of their products to a provider,” explains Scott MacLean, deputy CIO and director of IS Operations, at Partners HealthCare in Boston. But he sees the trend moving toward interoperability between healthcare technology systems stating, “Policy and payment models are driving collaboration, which will benefit consumers and save money.”
Federal incentives are driving an interoperability model as well. Two pieces of legislation have been introduced (S. 1685 by Senator Rob Portman R-OH, and S. 1517 by Senator Sheldon Whitehouse D-RI) that both have the same goal: to add psychiatric hospitals, mental health treatment facilities and substance use treatment facilities to the types of entities that may receive incentive payments for meaningful use of electronic health records. With over 20 billion paid out in Medicare and Medicaid incentives to healthcare providers to foster the adoption of a successful EHR platform, this could also become a powerful motivator to increase collaboration and coordination within the mental health community.
Making interoperability a reality
When making interoperability a goal within your own organization, there are some tips to keep in mind: First, when you are considering a technology platform, take into consideration the advantage of a Service Oriented Architecture (SOA). A very popular example of this is Microsoft Dynamics® CRM platform. What this type of approach enables you to do is integrate your existing applications within the architecture, and integrate with the other providers that make up the entire community of care for each individual.
The result is that every investment you make in your IT infrastructure is optimized to deliver maximum value for both your organization and those under your care. Case workers and program managers gain a single, unified 360-degree view of everything that is occurring with an individual at any given moment. That’s the key to meaningful collaboration that drives improved outcomes.
With this type of interconnectivity, you will also have much greater visibility into factors affecting population health and you will be able to share successes with outside agencies in order to secure funding. You will also be able to support the latest mobile technologies, empowering your team to spend more time with clients in the field.
Interoperability will open care providers to exponential knowledge sharing with the individual receiving care at the core. And it is this individual who will gain a much high probability of success in improving their health, both physical and mental, as a result.
 “Institute of Medicine (US) Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the Quality of Health Care for Mental and Substance-Use Conditions,” Quality Chasm Series, National Academies Press, (2006), 5, Coordinating Care for Better Mental, Substance-Use, and General Health.
 Bernie Monegain, Tom Sullivan, “CIOs Gauge Decade of Health IT Headway,” HealthcareITNews, (January, 17th, 2014) , http://www.healthcareitnews.com/news/cios-gauge-decade-health-it-headway?page=1
 Rebecca Farley, “Behavioral Health IT Coordination Act Introduced,” National Council for Behavioral Health, (November 14th, 2013), http://www.thenationalcouncil.org/capitol-connector/2013/11/behavioral-health-coordination-act-introduced/
 Data according to Monthly Payment and Registration Summary Report, Centers for Medicare and Medicaid Services, http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/January2014_SummaryReport.pdf