Webcast 05 – Building an Integrated Behavioral Health Note for Efficiency and Clinical Quality

Summary

Southcentral Foundation (SCF), an Alaska Native customer-owned health care system, has implemented a new electronic note for charting behavioral health care provided in its primary care clinics. SCF had been using electronic charting for some time, but this charting was too difficult and was taking Behavioral Health Consultants (BHCs) too long. SCF also wanted to capture utilization patterns, clinical data, and intervention data from the note. The goal was to identify trends happening with patients, which interventions were being used and why, and if they were making a difference. To do this, SCF’s behavioral health integration leadership spent six months creating the note SCF currently uses. The note is made to prioritize/capture population data in addition to individual symptoms, with the patient-centric data being free text, while the population-based data is entered through discoverable fields. This helps SCF to know at a systems level what percentage of the population has been seen by a BHC and which clinical areas. SCF also wanted to know how many times BHCs were seeing patients, because this allows SCF to look at referrals to behavioral health and determine availability of behavioral health consultants in primary care, and effectiveness of clinical interventions. It also helps providers to stay on top of trends and patterns at the population level, and determine what other behavioral health resources need to be developed. SCF has been using the new note for approximately one year. Since the note has been used, approximately 18% of SCF’s 68,000 patients have been seen by a behavioral health consultant, with approximately 73% of those patients having 3 visits or less in the last calendar year. Charting time for BHCs has decreased from an average of 6 minutes per note to an average of 3.5-4 minutes per note, improving clinical efficiency. Through the data collected in the note, SCF is currently measuring the impact on the number of follow-up visits, symptom reduction, and improved functioning. The note also provides data on which interventions and clinical topics SCF needs to devote training resources and time to.