GRAND RAPIDS – Behavoral health patients benefit from better care coordination when their health providers leverage a reversed shared care approach supported by Great Lakes Health Connect’s referrals application.
Closing the gap in communication between behavioral health and primary care providers was the foundation of Lara Dengerink-VanTil’s doctoral dissertation as part of her Doctorate in Nursing Practice program at Grand Valley State University Kirkhof College of Nursing. Her project focused on integrating physical health data into the behavioral health setting to facilitate better decision making and better care coordination for behavioral health patients.
Throughout implementation of the project, Dengerink-VanTil recognized several practical examples of how enhanced communication had a direct and positive impact on quality of care. In one instance, Dengerink-VanTil recalls receiving records for a patient who presented for a behavioral health consult. She recognized the individual had been prescribed Haldol, a powerful antipsychotic medication, by a physician outside of the behavioral health care setting. This medication is most often prescribed to treat a severe mental illness under the close supervision of a behavioral health clinician.
“Finding Haldol listed among medications prescribed by a primary care physician in an outpatient environment is unusual and raised questions,” said Lara. “Having access to this information at the outset of the patient’s behavioral care consultation was significant. The discovery initiated a follow-up with the patient’s primary physician and ultimately led to a better-informed approach to treatment and better overall quality care.”
According to Dengerink-VanTil, “Prior to the integration of the GLHC referrals application, the process and protocols for requesting primary care assessment information at the behavioral health site were inefficient and inconsistent. Support staff and RNs faxed record requests and made repeated phone calls with varying degrees of success.”
Dengerink-VanTil’s DNP project set out to answer two questions. First, would implementation of a communications tool facilitated through a community-based health information exchange (HIE) improve the efficiency and effectiveness of integration, and enhance collaboration between behavioral and primary care clinicians for patients with persistent mental illness? Second, would the HIE tool be effective in requesting and retrieving primary health care data for use in holistic behavioral health medication review and psychiatric assessment?
The project took place at InterAct of Michigan, a private, non-profit, Kalamazoo-based behavioral health and substance abuse treatment provider. Cherry Health, the state’s largest Federally Qualified Health Center, was chosen as the primary care partner because of their existing relationship with both InterAct and Great Lakes Health Connect.
Using GLHC’s referral application provides health systems, physicians, payers and behavioral health providers a secure repository for sending, receiving, and tracking patient referrals across the state. InterAct began requesting primary care assessment data from Cherry Health, including laboratory results, medication lists, and relevant assessment information. Upon receipt from the GLHC repository, the information was used to coordinate behavioral health care, medication review, and psychiatric evaluation.
Project Outcomes
The pilot produced a renewed interest in integrated care among InterAct’s staff, prompting a review of existing workflows in order to make process improvements.
Jenifer VanWyngarden, Director of Operations at InterAct, shared this assessment of the project: “The implementation of Lara’s project, using GLHC to facilitate care coordination, has had and will continue to have significant impacts on the quality of care for our clients. It also has the potential to impact the larger behavioral health care system.”
