By Cori McMahon, PsyD, NCCD, Vice President for Clinical Services
As we move toward a post-pandemic world, virtual care has become an essential avenue for health. Patients and providers alike have embraced connections via telehealth platforms and have taken a close and thoughtful look at how healthcare is delivered. Now, clinicians are interested in maintaining and improving efficiency, while zeroing in on patient-centered care.
As a hybrid virtual and in-person model begins to emerge, taking a digital approach to behavioral health screening can allow for minimal interruption to clinical workflows as well as maximum benefits in terms of efficiency and ability to analyze data.
What are the benefits of digital behavioral healthcare screening?
Routine behavioral health screening has become essential in primary and other specialty care settings. Leaders in those settings should weigh practical factors (i.e. available resources, desired benefits (i.e. improved outcomes), impact on value-based contracting, and total cost of care. When considering a tech-based approach to behavioral health screening, leaders should consider the following.
- Efficiency and effectiveness
Behavioral health screening should be quick enough that it does not create a burden for
patients while covering a breadth of domain areas to inform the best course of care.
- No more than five minutes for screening duration to improve patient engagement
- Immediate surfacing of behavioral health risk and link to appropriate level of care, including crisis response
- Little to no impact on workflow
- Use of standardized measures
Employing gold-standard measures for routine behavioral health screening ensures psychometric integrity and provides common data points for all providers and payors to leverage.
- Well-validated measures might include PHQ, GAD, or US AUDIT
- Tracking symptoms and progress informs the need for change in treatment plans or referral to different levels of care
- Consistent data collection supports outcomes analysis
- Focused visits and decreased time in discovery
With screening results available prior to the visit, valuable clinical time can be spent on intervention and improving efficiency in care.
- Surfacing behavioral health issues and critical alerts in real time most accurately reflects current functioning
- Pre-appointment preparation leads to less time spent in discovery and increased focus on the presenting problem
- Decreased time to discover underlying behavioral health concerns aids primary care and other specialty care settings where visit time is limited
- Availability of data analytics for population health understanding
A view into the behavioral health profile at the population level (i.e. filtering data by provider, patient demographics, time frame, and location) provides valuable insights that will drive systemwide decisions.
- Supports data reporting, clinical oversight, outcomes monitoring, and research
- Informs resource allocation decisions and identifies “hot spots” of higher acuity by uncovering needs across the population
- Bolsters patient programming and education with an understanding of specific clinical challenges
- Enhanced practice revenue
Consider whether routine behavioral health assessment can be established as a new standard of care and create a new line of revenue.
- Look at specific CPT codes that might be added to payor contracts (CPT 96127 for brief emotional/behavioral assessment) and explore impact on value-based care contracts
- Consider what is accepted by Medicare, Medicaid, and the commercial carriers you partner with (reimbursement and allowable instances may vary)
- Determine desired level of care integration and whether technology alone and referral to behavioral healthcare works best or integration of a behavioral healthcare manager into the practice is preferred (i.e. integration supported by CMS, like Psychiatric Collaborative Care Management and Chronic Care Management).
- Ability to integrate with EHR
Behavioral health screening results are most useful when they are both immediately available to providers and integrated into the patient record. In clinical care, it’s important to ensure that the appropriate information is documented in clinical notes and supports accurate billing practices.
- Should employ a seamless workflow, including single sign-on for providers
- Data/results should be easy to locate on patient chart and promote visibility for all care team members
- Progress over time should be charted to compare symptom presentation/severity over time to inform treatment plan
- Focus on increased patient engagement and satisfaction
When behavioral health assessment is part of a larger measurement-based care initiative and is established as standard and results are discussed/acted upon with patients, patients become more engaged in their own care.
- Improves patient outcomes and therapeutic alliance
- Enhances patient health literacy and leverages their own voice
- Identifies patients at-risk for treatment non-adherence or drop out
Digital behavioral health screenings offer a number benefits to the practice, the clinician, and the patient. As virtual care use increases, these digital tools will become a standard of care that patients expect.