Integrating Digital Apps Into Your Service Lines

Transcription

1 Integrating Digital Apps Into Your Service Lines #OMInnovation The 2018 OPEN MINDS Strategy & Innovation Institute June 5, :30 pm - 3:45 pm Annie Medina, MBA, ACNP-BC, Senior Associate, OPEN MINDS Lincoln Square, Gettysburg, Pennsylvania Phone: info@openminds.com All Rights Reserved.

2 Agenda 1. The Future Of Service Delivery: Digital Apps & Changing Treatment Models 2. Insights a. Stacee DeLisle, LPC, Clinical Director, The Center for Mental Health b. Wayne Easterwood, Chief Information Officer, Centerstone 3. Questions & Discussion All Rights Reserved.

3 The Future Of Service Delivery: Digital Apps & Changing Treatment Models

4 Framing The Field Of Digital Apps Market is about 10 years old a. Apple enabled the mass market in 2008 with the launch of its App Store Hypertension and cardiovascular disease are the largest market in terms of global use cases a. Diabetes and obesity have the greatest potential All Rights Reserved.

5 Digital Apps Continue To Grow ,000 health apps available in 2017 a. 78,000 were added between 2016 and $5.4 billion investment into digital health start-ups fuels the market 3. Estimated 3.6 billion apps downloaded in % of digital health practitioners expect health insurances to be future distribution channel with best market potential Number Of mhealth Apps Displayed In App Stores All Rights Reserved.

6 Landscape Changes Drive Innovation Reimbursement Based On A Fee-For-Service Model Focus On Value Consumerism Integration Market Outcomes Engagement Provider Business Model Limited To Place-Based Transactional Encounters Availability Of Technology All Rights Reserved.

7 Changing Treatment Models Consider that outcomes require a 360-degree approach a. And are impacted by more than just what providers see in a clinic or hospital Focus on engagement and satisfaction a. Consumer, and provider Shift to non-traditional service delivery a. Home and community-based services b. Direct-to-consumer technology Incorporate peer and community support people Consider the consumerism aspect to service delivery All Rights Reserved.

8 Digital Apps: Enabling Autonomy & Engagement Many Types 1. Patient portals 2. Connection 3. Peer support 4. Trackers and reminders 5. Treatment Many Arenas 1. Pain management 2. Addiction treatment 3. Mental health 4. Medication and treatment adherence 5. Chronic disease management All Rights Reserved.

9 Insights The Center For Mental Health Centerstone

10 Stacee DeLisle, LPC, Clinical Director, The Center for Mental Health

11 Today s Agenda Overview of New Client Care Model Impact on Satisfaction, Engagement, Symptoms and Interventions Health Economics of New Client Model Lessons Learned 11

12 Stacee DeLisle, LPC Clinical Director of Montrose, Ouray & San Miguel Counties Licensed Professional Counselor in Colorado Worked with the Center for Mental Health (CMH) since 2007, previously as an Outpatient Clinician and Regional Manager Previously certified as an Incredible Years Parent Facilitator and Youth/Adult Mental Health First Aid Instructor Passionate about suicide education and prevention; involved in creating Open Access and Zero Suicide at the CMH

13 Organizational Background 13

14 Center for Mental Health & mystrength Partnership mystrength partner for 5 years Implemented mystrength at intake and for all new hires at orientation Long-time supporter of mystrength in conjunction with traditional therapy services Collaborated to redesign entire CMH delivery system 14

15 What Is The Business Need? How can we double our capacity without increasing our overhead? Increased consumer demand for organization s services Clinician shortages and over-committed staff Client demand for digital resources Opportunity to use additional CPT codes in recognition of services provided Strong executive support and encouragement around innovative models: We can t be doing business the same way we ve been doing it for the last 20 years 15

16 Value Client Satisfaction Accreditation Competitive Advantage Clinician Efficiency Improved Outcomes Increased Revenues Value = Outcomes Cost 16

17 Traditional Consumer Model New Consumer Model Clinician Consumer Clinician 30 Minutes 50 Minute Sessions Consumer Augmented by consumer access to mystrength. 20 Minutes Peer Specialist supported use of mystrength. 17

18 The Model Clients meet with their clinicians for 30-minutes for faceto-face individual therapy Clinician takes client to mystrength room (clients without appointments also given access to room) Peer-facilitated, guided mystrength session for 20 minutes (or explore individually) Assigned homework, schedule next appointment 18

19 Model Profile 9 Clinicians 1 Full-Time Peer Specialist 362 Consumers (to date) All adults aged 13+; no exclusions Clinician Client Digital Assessment Tool: PHQ9 Assessment used for every client visit New and returning clients Peer Specialist 19

20 Targeted Impact (Goals) Comparable if not better outcomes at lower cost Increased consumer satisfaction and engagement Increased clinical efficiency and increased encounters Expanded revenue Pay-back period for Peer Specialist role: less than 6-months 20

21 Implementation Process 12-Month Development Cycle: Strategy, organizational alignment, model definition, business case, workflow design, training, peer selection Clinician/Staff Buy-in: Staff meetings (clinicians, front-desk, intake) Multiple communications Giving space to ask questions, acknowledge change, talk through concerns Pilot Site: Montrose Clinic Highest volume of clients (new intakes); targeted substantial population size to demonstrate impact mystrength Collaboration: Joint mystrength and Clinic staff training session Integration into new workflow design/model 21

22 Preliminary Results Other Center for Mental Health clinic locations expressing strong interest: When do we get to start?! Clinician Clients enjoy having the resources mystrength provides at the tip of their finger. Both myself and many of my clients appreciate the focus on skills. The clients are responding really well to mystrength and being able to utilize it at home especially the daily trackers. Peer Specialist I ve seen a difference in people s lives. Surprised at how engaged our clients are in this new model. 22

23 Preliminary Results I love being able to do mystrength anytime. Having the support of my therapist is great I m very thankful I have both. Client Having both [help from a therapist and a peer/mystrength session] was helpful to me. I have different learning styles depending on area of material. I was/am struggling with suicidal thoughts and depression and working with my therapist is supplemented at home with mystrength. I know I can use the crisis line but I also have mystrength at my fingertips to help balance me. I was walked to the mystrength room and introduced to the lady there. She helped me set up my account and got me started. It was great. They both [help from a therapist and a peer/mystrength session] really help me in all areas! 23

24 mystrength Satisfaction Survey Among CMH Population 95% of users found mystrength easy to use. 75% of users report mystrength makes getting care when they need it easier. 88% find mystrength is helpful when they use it on their own. 80% report mystrength makes them more confident to handle life situations. 24

25 New Model Maximizes Interactions & Billable Hours Encounters 51% YoY increase for same month in Montrose services mystrength Utilization Pilot Other CMH Clinics TCMH Pre-pilot Complete mystrength Registration 97% 86% 87% Avg Time Per mystrength Session 0:27:05 0:13:19 0:12:13 Avg Daily New mystrength Registrants Billable hours 306% YoY increase for same month Clinicians are able to bill for 2/30 minute sessions per hour instead of 1/50 minute session Opportunity to bill with new CPT Code: Peer Delivered Assessment 25

26 lth CMH Pilot Model Compared to Diverse mystrength User Base New model comparison to mystrength Book of Business supports the conclusion that quality of care is maintained for the most severe symptoms, while those with moderate clinical depression are showing greater improvement in the new model. PHQ9 Outcomes Report PHQ9 Outcomes PHQ9 Outcomes - BoB Minimal Depression Mild Moderate Moderately Severe Extremely Severe 24 Minimal Depression Mild Moderate Moderately Severe Extremely Severe Pilot Results Book of Business Value Value % -39% -16% -6% -18% -19% Users with Baseline Minimal Depression Mild Moderate Moderately Severe Extremely Severe Avg. 8 Baseline PHQ9 15 Score 14 Grand Total 239 Users with A Follow Up 66 Avg. Baseline Score Measure Names Avg. Last Score Avg. Last PHQ9 Score Details Details BoB Users with Baseline 239 Users with Baseline 2,791 26

27 Strong Gains Resulting From New Model mystrength Peer Model Traditional Model Clients per Day 6-7 Clients per Day % Change 66%-83% Increase in Clients Seen 60 min Equivalent Value = $ min Equivalent Value = $ % Increase in Value of Service 60 min $ min $ % Increase in Revenue During the Same 60 min Period Peer Salary Current Rate in < 6 Months n/a n/a 27

28 Lessons Learned Are there any changes you are making after starting this? Created handoff card from clinician to peer to improve experience and efficiency Opened up populations that can self-opt into the new model mandated clients really like the new model (wasn t expecting that level of enthusiasm) Some clinicians struggling with 30-minute model Will add an option for 40-minute sessions instead Any constructive feedback? Change can be challenging a couple of clinicians had more difficult time making adjustments Technology needed to make some modifications Learning: Would have included the clinics in decision making of where to start pilot vs. executive selection of clinic 28

29 The mystrength Room 29

30 mystrength: Personalized Emotional Health Resources At Scale Interactive Applications Stress Substance Abuse Depression Chronic Pain Anxiety Insomnia Mind + Body + Spirit Resources Wellness Spiritual Social and Community Cognitive Behavioral Therapy Behavioral Activation Mindfulness Motivational Interviewing Positive Psychology 30

31 Wayne Easterwood, Chief Information Officer, Centerstone

32 A Journey: Digital Apps In Care Wayne Easterwood, Chief Administrative Officer, Centerstone

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34 Centerstone At A Glance

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36 Agenda Centerstone Back in 2014 Investment Thinking 2018 Multi-Point Strategy Take Away & Questions

37 Back In 2014 Can we use these tools? Can our clients use these tools? Ginger.io

38 Technologies We Learned Worked Smartphones Mobile Apps Mood Tracking Activity Monitors Chat Instant Messaging Telehealth Tools (e.g., video calling, etc.) Web-based Portals/Resources

39 Outcomes 60% Decrease in Days Experiencing Depression 47% Decrease in Days Experiencing Anxiety 39% Decrease in Days of Illegal Drug Consumption 50% Decrease in Hospital Days 30% Decrease in Emergency Department Visits Increased Recovery Capital Decreased Dependence on High Intensity Care Steady Utilization of Low Intensity Care

40 Technology In Practice Everyday it was an inspiration to me to keep going -Client It helps me be in places that I can t be -Wellness Coach It gave them access to doctors [and] online resources -Nurse Care Manager

41 Left Turn & Right Turns Disjointed Staying Aligned Finding the Value Treading Lightly

42 Desired Outcome At Acceptable Costs Value Outcom e Cost

43 Sustainable?

44 Think Investment

45 Centerstone Grants Service Enhancements/Expansions Integrated Care Electronic Recovery Oriented System of Care Addictions Treatment Veterans Services Employment Services Systems of Care Suicide Prevention Drug Court Services Recovery Engagement Center Prevention Services

46 Leveraging Funding For Innovation Innovation at Centerstone

47 What It Takes To Leverage Funding Leveraging Funding Across the Health System: Shared Vision Common Goals Openness to Change Commitment to Clients and Colleagues Innovation at Centerstone

48 Grants, Stakeholders, & Collaborations EROSC & I-Recover REALives ACF Fatherhood Health Home IL, IN, & TN National Strategy Suicide Prevention Grant Center for Clinical Excellence Technology Finance Grants Office Marketing Payer Contracting Research & Evaluation

49 Empowering Clients To Manage Their Health & Recovery Mobile Application Treatment Plan Home Work Assessments Medications Reminders Daily Mood Tracker Journaling 24/7 Care, connections, & Resources Clinician Portal Client & Clinician Interaction Between Sessions Analytics Clients Engagement / Use of the App Individualized Resources Clients Technology Supported Clinical Models EHR Integration Standardized Assessments More Detailed Clinical Record & Analytics Ongoing Refinement Based on Advances in Research Client & Clinician Engagement Strategies Design & Develop With Clinicians Design to Reduce Time in Front of the Screen Client & Clinician Feedback Loops/Individualized Care Makes a Difference

50 Proof Points Today Centerstone Cares App Clinician Dashboards Clients Technology Supported Clinical Models Sage SCID, Owl Insights Zero Suicide Mozzaz LifeTiles

51 Proof Points Today Centerstone Cares App Clinician Dashboards Clients Technology Supported Clinical Models Sage SCID, Owl Insights Zero Suicide Mozzaz LifeTiles

52 Centerstone TN ZERO Suicide Client Engagement Program Realtime Warning Alerts Engagement Level Monitoring Monitoring Care Plan Adherence Video Consults / e-coaching Mood Thoughts Sleep Medication Activity Self-Help Resources Hotline Support Monitored Interventions Telehealth Remote Care

53 The Mozzaz Solution PAYER PATIENT PROVIDER Person-Centered Care Management Compliancy and outcomes Reporting Risk stratification to impact Level of Care Gaps in service/utilization reviews Individualized Patient Engagement Personalized Care Plans Connecting with Care Team Remote Care / Monitoring Tech-enabled Services E-Coaching / E-Consults Digital Therapeutics Mobile Case Management

54 Client App: Self-Help Resources & Support Easy Access Information at Your Fingertips Available Anywhere, Anytime. Self-Help Resources One-Tap Hotlines Healthy Interventions Recommended Social Media

55 Scheduled Check-Ins 6 Self-reporting Forms Scheduled Throughout the Week Automatic Reminders

56 Proof Points Today Centerstone Care App Clients Technology Supported Clinical Models Sage SCID, Owl Insights Clinician Dashboards Zero Suicide Mozzaz LifeTiles

57 Centerstone Care App

58 Centerstone Care App Care Plan

59 Centerstone Care App - Assessments

60 Centerstone Care App - Medications

61 Centerstone Care App - Resources

62 Centerstone Care App - Activity

63 Centerstone Care App Mood Tracker

64 Centerstone Care App - 24/7 Help via 911 & Centerstone Crisis

65 Clinician Portal Overview

66 Clinician Portal App Engagement

67 Clinician Portal Analytics Snapshot

68 Additional Features Televideo Secure Chat & Instant Messaging GPS Tracking - for Clients That Want Trigger Points (i.e. Liquor Stores, etc.) Alert Systems Emergency Room Tracking via GPS Public Connection to Indeed.com Employment for Clients Enhanced Features Mood Tracker, More Robust Videos/Resources

69 Pilots Launched October 2017 I-Recover Clinicians 5 Clients 30 Anticipated 75 POPs Fatherhood Clinicians 4 Clients 45 Anticipated 50 Re-entry Clinicians Clients Anticipated 40

70 Additional Pilots 2018 HealthHome IN Clinicians 10 Clients Anticipated 200 HealthHome IL Clinicians 35 Clients Anticipated 275

71 Take Away EHR (broader system) Integrat ion Think Venture Capital Partner Strategy Alignment Focus is Improved Care

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73 All Rights Reserved.

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