Innovation in behavioral health is often seen as a story about new technology. But according to two healthcare leaders, transformation comes when technology and process improvement work hand in hand, helping patients access care, supporting providers and making systems more sustainable.
Nikita Duke, DNP, RN, vice president of operations for behavioral health at Franklin, Tenn.-based Fast Pace Health, and Becky Stoll, senior vice president for crisis services at Nashville, Tenn.-based Centerstone, shared how their organizations are blending tech adoption with workflow redesign.
“Innovation for us is really us using our creativity, trying to come up with new ways that we can improve, whether it’s patient care, patient satisfaction, improving our staff, their operations, their workflow, making sure that they’re happy and they’re hearing from patients good feedback on the operations. Also making sure that my providers are supported,” Dr. Duke said.
Ms. Stoll added: “Being innovative is thinking about process, [turning] over all of the rocks and looking at, ‘Can you do this thing better?’ And if you can do it better, how do you go about doing that? What lipstick and jewelry can you put on it to make it better, more effective for the patient, more effective for the staff? Sometimes that involves tech, and sometimes it doesn’t.”
Technology driving change
At Fast Pace Health, the pandemic accelerated adoption of telehealth and electronic registration.
“In 2020, we had to quickly adapt and create telehealth options — more so e-registration,” Dr. Duke said. “So how are patients going to be able to sign their consents, do their paperwork and register online for an appointment if we’re going to start allowing home visits? How are they going to do this and not have to run to the clinic? We quickly had to find a vendor or program that would allow us to adapt.”
For Centerstone, one of the most impactful recent adoptions has been AI scribes.
“Sixty-five percent of the time, [clinicians] don’t edit the note at all,” Ms. Stoll said. “It was an exact capture of what the therapy session was about. And the other 35% they’re editing a little bit. But that’s transformative for a clinician who has to sit and write a whole lot of notes.”
The system is also preparing to pilot virtual reality peer support.
“We’re going to pilot — if they are awarded — these virtual reality headsets where they can interact with … real peers, and it was really interesting. … You answer a few questions, and you get assigned to a peer. I could walk with them on the beach while we’re talking. I can sit in a cafe like I’m having coffee while I’m talking to them.”
Process innovation as a force multiplier
With respect to growth, Fast Pace Health has leaned on standardization.
“Because we’re growing so much and continuing to hire, we need more things on paper,” Dr. Duke said. “We need more standardized procedures so that it’s the same thing. Everybody [has] the same expectation from how you answer the phone, to how you schedule a patient, to how you see the patients, send the medications, do their follow-up care.”
At Centerstone, safety planning in suicide prevention has been strengthened with microvideos for patients and staff.
“[The system’s research team] developed a tool that goes along with the safety planning,” Ms. Stoll said. “Now every single section of the Stanley-Brown [safety plan] has a microvideo, and that microvideo explains to the person with whom you’re completing the plan what that section is about.”
Fast Pace Health has also embedded screening into everyday care.
“Starting March 1 of 2023 they slowly began to pilot and integrate out the concept that every patient over the age 12 or older that comes in that door — no matter if you’re there for flu, strep, urinary tract infection — that you get a PHQ-9 and a GAD-7 scale,” Dr. Duke said.
Supporting the workforce
Both leaders underscored that provider well-being is inseparable from innovation.
“I have said a lot of times, we should not ask people to be well, working in our crappy systems,” Ms. Stoll said. “If we were to be running one, we shouldn’t ask people to do that.”
Dr. Duke described restructuring teams to make sure providers have closer support.
“We’ve been keeping smaller pods at 10 … trying to make sure it’s not where one manager is over so many [patients] that they can’t be supportive or offer one-on-one time for their people,” she said.
