Transparency is needed to connect more patients with critical services
By Megan Headley
In addition to a direct death toll of more than 400,000, it’s becoming clear that COVID-19 is also having a significant indirect toll. A July 2020 survey from the Kaiser Family Foundation found four in 10 U.S. adults reporting symptoms of anxiety or depressive disorder, up from one in 10 adults who reported these symptoms at the same time in 2019. In December 2020, the CDC reported that the 12-month period ending May 2020 had the highest recorded number of drug overdose deaths in the United States, more than 81,000. These figures hint at the fact that while overdose deaths were increasing in the months preceding the COVID-19 pandemic, they have dramatically accelerated since the pandemic’s onset, the CDC noted in a news release.
Yet, at the same time, Americans are finding it even more difficult to access behavioral health services. The National Council for Behavioral Health found that 52% of community behavioral health organizations it surveyed have seen an increase in demand for services, while 65% have had to cancel programs, reschedule, or turn patients away due to lack of revenue or pandemic-related restrictions. Nearly 40% of these organizations predict they may not last six months due to this loss in funding.
“This is at a time when demand for their services hasn’t been higher,” points out Dr. Nishi Rawat, critical care physician and cofounder of the addiction treatment connection service OpenBeds. “So how do we go about ensuring that these behavioral health organizations can continue to offer their vital services?”
While funding is no doubt a critical part of the solution, fragmented care remains a major stumbling block when connecting people with behavioral health services. Through her organization, Rawat is seeking to create greater transparency between behavioral health and medical care providers to address the fragmentation in data and care.
OpenBeds does this work through connected provider- and public-facing platforms. On the provider side, OpenBeds offers visibility into outpatient and inpatient treatment capacity as well as decision support tools that help clinicians choose the right level of treatment for their patient. Clinicians can also use the systems to speed communication, with digital referrals and feedback as to whether the client has been accepted into treatment and whether they show up for that treatment. These frequent touch points provide a tremendous amount of data.
“We set up the two-sided network in a given region with a health system, a payer, or a state government as the convener of that network,” Rawat explains. “We provide data analytics, both at the organizational and local level as well as at the regional level, to identify gaps in care delivery as well as what’s working.”
This granular data around capacity or utilization might include the current proportion of inpatient or residential treatment beds that are available, as well as the demographics of the patients who aren’t getting treatment. States and health systems can use this rich data to drive investments around the most appropriate behavioral health solutions, based on a wide range of factors.
For the public, the platform supports a state-deployed Treatment Connection that connects people seeking mental health and substance use disorder (SUD) treatment for themselves or loved ones through a HIPAA-compliant platform. “We’re agnostic as to organizations,” Rawat says, “but we have a decision support tool that we built that helps people figure out the right type and level of treatment based on their needs.”
The platform is currently available in nine states, giving Rawat some insight into areas where there is still a need for improved care coordination between behavioral health and medical providers. “For example,” she notes, “if you are an EMT provider, unless your patient tells you, you may not know that they actually overdosed last week and were seen at a local emergency department. So how do we go about sharing data across different types of providers in order to get better care for the patients?”
While these questions remain to be answered, targeted solutions will be critical to maximize the usefulness of available resources.
Rawat is encouraged by the state and federal government-led initiatives beginning to arise in response to the COVID-19 crisis. Paving the way for this support is $4.25 billion in funding allocated for the Substance Abuse & Mental Health Services Administration by the December 2020 COVID relief package. This includes $1.65 billion for the community mental health block grant; $600 million for Certified Community Behavioral Health Centers; and $50 million for Project AWARE, a school-based mental health program.
“Many say that that is not enough money,” Rawat says, “but in any event, we see states using the money that they’ve been given to date to expand treatment capacity specifically for medication treatment, to build out the necessary SUD and mental health workforce, and to create the necessary data collection infrastructure to identify gaps in care.”
Megan Headley is a freelance writer and owner of ClearStory Publications. She has covered healthcare safety and operations for numerous publications. Headley can be reached at firstname.lastname@example.org.