Treating the Person and Not the Illness: Why Behavioral Health Needs Interoperability

As published in PsychCentral, August 16, 2016.

According to SAMHSA[1], approximately 7.9 million adults in the United States had co-occurring disorders in 2014. In fact, individuals who have mental health disorders are more likely than individuals without mental health disorders to experience Substance Use Disorder.

The likelihood that an individual receives behavioral health care for just one illness or medical condition is slight. The need for interoperability has been widely accepted by the medical community, and perhaps nowhere more than in the field of behavioral health is this model so critically important.

Providers in the field of behavioral health juggle a variety of proverbial balls related to the presentations of biological, psychological and socio-economical symptomology.

Take, for example, the fact that behavioral health care providers routinely treat individuals for one or more drug dependencies – often a result of a patient’s attempt to self-medicate.

Oftentimes, an individual receives treatment for one illness while the other illnesses remain undiagnosed and/or untreated.

It can be a lot to ask of any provider to treat a patient with multiple diagnoses or illnesses and when those conditions cross our system’s self-imposed barrier between ‘general medicine’ and ‘behavioral medicine,’ it complicates things even more.

Silo Effect

We have effectively created a health care system of compartmentalized illnesses and conditions that fall under one clinical umbrella, which has resulted in silos of patient information.

Each silo typically includes well-documented patient information; however, it is difficult for any provider to have a complete grasp of a patient’s entire record because of this silo-effect.

Every individual, whether or not they have one medical condition or multiple, is best served with integrative medicine. Simply stated, integrative medicine disrupts the silo effect by providing care across the continuum and addresses the whole person.

Interoperability affords providers the ability to address medical, mental and substance use disorders concomitantly, often lowering costs and improving outcomes. To presume that the silo effect is in the patient’s best interest greatly compromises care and prevents the ability to deliver holistic, effective treatment.

Because of the specialized, yet comprehensive, nature of treating patients in the behavioral health care arena, it is important, as in other areas of health care, to collect, measure and demonstrate treatment outcomes.

Data Collection

Partly because of the silo effect and partly because of a variety of other factors, the field of behavioral health has fallen woefully behind other medical specialties when it comes to data collection.

Empirical data, a common tool to help inform best practices for a myriad of measures such as cancer treatment, is lacking when it comes to treating substance use disorder. This lack of outcomes data has contributed to laying the groundwork for some bad press, particularly in the addiction treatment industry.

Consumers and health insurance payers have extreme confidence issues in current treatment models because providers have not been able to effectively demonstrate treatment outcomes, something that would not be acceptable in other aspects of health care. Consumers aren’t sure what they are paying for.

Interoperability is a clear solution to at least part of the challenge, however implementing integrated care delivery systems while maintaining compliance with mental health regulations has the potential to create obstacles. Disclosure requirements regarding patient data must be acknowledged when sharing patient data. Of equal importance is the proper identification of a specific list of providers to which disclosures may be made in order to remain compliant with patient protection measures.

Integrative Medicine

Involving multiple providers, professionals, treatment plans and health care teams may seem, on the surface, to complicate an individual’s care. In fact, this setup actually simplifies the process as every treatment team member has access to the entire patient picture. When efficacy and productivity is maximized, duplicate services will be minimized. As such, preventable medical errors (currently the third-leading cause of death in the United States) will likely decrease with an across-the-board integration of health care systems.

It is incumbent upon the field of behavioral health to take on practices and methodologies that are in the best interest of the patient. Behavioral health interoperability offers the ability for providers to break down barriers and obstacles to deliver the best-suited treatment to the patient. It is time for the field to meet the patient where they are and treat them accordingly: the practice of treating the patient rather than the illness.

The future of successful, integrative medicine requires a commitment to fully collecting, measuring and demonstrating treatment outcomes. When consumers and payers are able to discern quality treatment and the solutions best suited for their particular illness, confidence will grow and outcomes will improve.

Additionally, embracing and adopting the appropriate standards in order to communicate and collaborate with a patient’s entire treatment team, essentially disavowing the silo effect, will have a positive influence on the consumer, the payer and our communities at large.

Increasing awareness and building the capacity within differing medical delivery systems are important in helping to identify and treat co-occurring disorders. Early detection and treatment can improve treatment outcomes and the quality of life for those who need these services and by employing integrated services through interoperability, the field will take a giant leap forward.

References

[1] 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB)

Avi Mukherjee, Chief Technology Officer at MAP Health Management, LLC, excels in numerous leadership positions in the areas of product management, clinical interoperability, mobile health, clinical analytics, and risk mitigation strategies. Avi oversees MAP’s product management, technology engineering, and managed services teams tasked to build the market-leading behavioral health platform with care coordination, interoperability, analytics, and telehealth capabilities. His role also entails identifying opportunities and risks for delivering the technology platform, including identification of competitive services, rtunities for innovation, and assessment of data security, marketplace obstacles and potential technical hurdles.

Kasia Bialasiewicz/Bigstock

---