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How EHR tech eases behavioral health workflows
KVC Health Systems turned to WellSky's EHR platform to gain more flexibility documenting high acuity patients and gathering data to help monitor warning signs of safety threats, the organization's CIO said.
When behavioral health systems use electronic health records, privacy is even more important due to sensitive patient information, and HIPAA compliance is also crucial.
"Health information is sensitive. Period. But when you get into behavioral health care, there are more stigmas associated with that information, which makes it even more sensitive to the patient," explained Lonnie Johnson, chief information officer at KVC Health Systems, a child welfare and behavioral health organization based in Olathe, Kansas, in the greater Kansas City area. "They require and expect more privacy with their information."
A nationwide network of 10 private nonprofit organizations specializing in behavioral health services, KVC has a dedicated HIPAA committee that ensures that all information is HIPAA compliant. The health system also performs HIPAA walk-throughs to check for information at risk of exposure.
KVC, which operates both in person (often in patients' homes) as well as through telemedicine, uses WellSky Specialty Care for Behavioral Health, which incorporates EHRs, revenue cycle management and business intelligence. The platform encompasses all aspects of child welfare or behavioral healthcare for children and adults, including preventative care, foster care and psychiatric treatment.
An extensible EHR platform
KVC's first EHR platform was Netsmart Technologies' myAvatar. Then KVC realized it needed more robust medication management and the ability to scale over time, according to Johnson, who has been at KVC for 25 years and is the organization's first CIO.
A key concern for Johnson was finding an EHR platform that could meet KVC's needs for the complex workflows that come with psychiatric residential treatment. KVC needs a robust, seamless documentation system to accommodate patients with a high acuity, he said.
Johnson realized the organizations' IT systems couldn't keep up with clinical workflows. EHR platforms must be able to accommodate multiple documentation types and flow seamlessly, he said.
When KVC's previous EHR platform was unable to adjust to their needs, Johnson's team began speaking with WellSky, a global health and community care technology and services company.
A key consideration when choosing an EHR platform was interoperability, Johnson noted. WellSky offered connectors that are integrated with KVC's other systems.
"When you have an EHR, you have to connect with a lot of other systems, medication management, pharmacy ... and maybe even other provider systems," Johnson said.
WellSky is smaller than other platforms such as Epic, and Johnson noted that larger EHR vendors may not be willing to work with smaller health systems with less beds.
KVC needed a flexible EHR system that could adjust to its needs, and the health provider was able to fit the WellSky EHR platform to its own work culture and environment.
"There are a lot of nuances, especially in behavioral health care and within child welfare for children, and so by them having that very extensible and agile system, we're able to then modify it easily," Johnson said.
EHR innovation with AI
KVC has been implementing artificial intelligence as part of its AI road map and uses ambient AI to integrate with EHRs to help with documentation.
"It will pull up the appropriate forms based on what type of intervention or interaction you're having with the client, if it's your initial one, and then it pulls up the assessment form or the intake form," Johnson explained. "It starts filling in the appropriate fields with information about the client."
The AI tools can recommend treatment plans, which a clinician can accept or reject.
KVC is also using analytics to collect information from EHRs, like if a physician needs a report on children that fall within a set of specifications.
"They say, give me a listing of all the kids with this diagnosis that came from this county who may have been admitted within this time frame," Johnson explained. WellSky constructs the list using the SQL programming language, submits it to the database and then a report is created.
This allows clinicians to access data reports without tech experts, according to Johnson.
"They don't have to wait for a technologist to be available. They don't have to wait for their request for the report to come into queue," Johnson said. "They can create it right there, on the spot, on their phone while in the field, wherever they are. It's completely mobile."
The bottom line for Johnson: "EHRs just can't be a product or commodity. The EHR itself is a tool by which we document, track and do diagnoses. It's really a fundamental piece of how we provide care, because the information that's in there is valuable to us in solving problems, in future trainings and things of that nature."
Next steps for EHRs at KVC
Johnson and his team will enhance data visualization so frontline workers or the executive staff don't have to wait for more "data-literate" experts to make decisions. He would also like the team to pursue data education and integrate the platform further with its workflows.
Going forward, Johnson plans to focus on the data in WellSky and explore predictive and prescriptive analytics as part of the organization's analytics road map. That includes being able to predict when patients are suicidal by drawing on EHR data to monitor behavioral patterns in advance, Johnson said.
"If we're able to de-escalate situations in advance, then I think overall we've improved the quality of care, the safety of the child, the overall impact that child has on life within their family," Johnson explained. "If families are in better shape, we have better communities, so I think those are the things that we're going after, those critical behaviors."
Brian T. Horowitz started covering health IT news in 2010 and the tech beat overall in 1996.
