BrightView Health, a behavioral health facility that specializes in addiction treatment and substance abuse, already was using telehealth when the COVID-19 pandemic and associated response happened. The organization mostly was using telehealth between its various locations.

THE PROBLEM

However, BrightView did not have a secure communications platform to engage with patients either synchronously or asynchronously.

"So, the pandemic and the lockdowns created some potential gaps in access to care that we needed to predict and fill," said Navdeep S. Kang, chief clinical officer at BrightView Health and a fellow with the Obama Foundation. "We looked at several platforms to implement secure communications.

"We were specifically interested in technology that would allow us to do one-to-one visits that we could sequence with a 'waiting room' functionality that enables members of the care team to go in and out of patient visits and allows for group services," he continued. "And we needed something that would be easy for patients to use. So, technology that would work on everyone's phones, including staff and patients."

Because of the pandemic, some patients had problems finding transportation options, because the response to COVID-19 resulted in a reduction in other services – such as Uber rides or taxis – that had often facilitated patients' access to transportation.

This further reduced their ability to access care and hampered achievement of their treatment plans.

"We needed to do something new, something we hadn't done before, which would enable secure and seamless telehealth while ensuring access to and retention of care, while reducing risk to patient engagement," Kang explained. "In behavioral health and addiction treatment, duration matters, so we needed to maintain the connections."

PROPOSAL

BrightView had used a telehealth technology for two or three months. It had limited functionality, and was more of a survival tactic to get things up and running. The organization pushed it out to the team and got them to reach out to the patients who couldn't leave the house.

But the organization kept testing a variety of platforms and opted for a more thoughtful and thorough approach, Kang said. He said they particularly needed a system that was HIPPA-compliant and easy for any patient to use.

"We needed to do something new, something we hadn't done before, which would enable secure and seamless telehealth while ensuring access to and retention of care, while reducing risk to patient engagement."

Navdeep S. Kang, PsyD, BrightView Health

"What was unique about DrFirst's Backline was the combination of ways to communicate – how it enables the team to interact with the patients and with each other; plus, its ability to integrate with our Meditech EHR." he noted of the vendor they decided to run with.

"The admission-discharge-transfer feed has been essential to freeing licensed clinical resources who are usually tasked with pulling a patient's clinical information – allowing them to focus on patient care," he added.

Kang referred to the new technology set-up as magical, but added staff should expect this level of sophistication in behavioral health, which is still not where the rest of healthcare is with regard to technology.

"Technology that does all the functional ADT processes and is integrated with our EHR allows us to pull patient information directly in," he added.

MEETING THE CHALLENGE

The counseling and nursing teams use Backline more than medical staff because the medical staff tends to see patients mostly in person. But both teams can use the technology to communicate with the patient either outside of their typical medical visit cadence, or in between for counseling. If the patient is seeing the medical staff once every two weeks, they're seeing their counselor every week.

"The patient can use the platform outside of their in-office medical visits," Kang said. "That way, they don't need to use a ride share or their insurance benefit or ask their neighbor to watch their kids if their counselor can still provide them with the service virtually.

"We also have an opioid treatment program where we provide medication to the patient," he continued. "And the nursing team does patient education – how to properly store and use medication, how to keep it safe. They also provide infectious disease education and other counseling through the technology, which, again, also happens in person but can be easily done as needed through the technology."

RESULTS

BrightView has not cut its data to reflect only the results of those who have used Backline versus those who have not. But it does have a robust outcomes dashboard through which it tracks patient progress longitudinally over time.

"Our telehealth visit and chat metrics do reflect the increased level of interaction between care teams and patients since we started using Backline in 2020," Kang reported. "For example, we had more than 1,300 telehealth visits as of November 2022, more than twice the number for all of 2021. And we are logging more than 150,000 chat feeds in 2021 and 2022.

"Backline has allowed us to increase patient access to outpatient care and extend our reach into as many communities as possible," he added.

ADVICE FOR OTHERS

"You must be mindful of the intended goal," Kang advised. "What are you trying to achieve by adopting the technology? Without intentionality, a few things can happen. One, you have a bunch of technology that you throw at your staff and at your patients, and that just leads to inadequate adoption, and wastes a lot of energy and money.

"You need to be clear on your needs and what you want to accomplish," he continued. "You then need to thoroughly understand the distinct capabilities of different technologies and match your needs to correct technology. What are you trying to accomplish? Be clear with that."

And then, whether one goes through a formal RFP or other process, make sure one's team has an opportunity to fully evaluate functionality, and determine who delivers it best.

"Recruit volunteers to do testing and use that opportunity to gain feedback from folks who are the end users," Kang said. "Also, when you're training staff on the new technology, whether you're talking to the staff or to the patients, make sure the value proposition is clear.

"Why should we use this?" he concluded. "How will it impact care? Clinicians care about the patients getting better, and they care about value and quality. Patients obviously care about the same. So be clear on what the new technology does and its value to their role."

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Email the writer: bsiwicki@himss.org
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