A real-time data initiative helped Healthfirst improve follow-up rates for patients visiting emergency rooms for mental health and substance use conditions.
A national challenge for the industry is that relying on claims data alone is not fast enough to ensure members receive time-sensitive follow-up visits, Autumn Kerr, assistant vice president of clinical quality at Healthfirst told Becker’s.
“Recognizing that this is a high-risk, vulnerable population, we wanted to come up with a solution to be able to support our providers and our members in ensuring this care happened timely, as opposed to waiting for a claim to come in,” she said.
Using technology from InterSystems, Healthfirst developed a system to alert providers in real-time when members had been seen in emergency rooms for behavioral health concerns.
The program increased follow-up rates after emergency room visits for patients with mental health and substance use disorders by 34%, according to data from Healthfirst. More than 5,000 members received timely follow-up care due to automated alerts.
The alerts are currently delivered to providers through encrypted email, but HealthFirst hopes to diversify these delivery methods in the future, Kate Beck, assistant vice president of health information exchange at Healthfirst told Becker’s.
“I do think it’s about meeting providers where they are. There are certain providers where getting an encrypted email is perfect for them,” Ms. Beck said. “There are other organizations where we see opportunities to integrate these notifications through their EMR.”
Healthfirst also plans to expand the effort to additional measures, Ms. Kerr said, and increase the number of providers receiving alerts.
The insurer is also looking for ways to alleviate administrative burdens for providers, she added. Currently, providers receive multiple emails with multiple reports, which Healthfirst hopes to consolidate to one email.
“It seems like a simple solution, but it’s going to be a simple solution that has really good outcomes for that administrative burden,” Ms. Kerr said.
For insurers considering similar programs, Ms. Kerr advises confirming receipt of reports to make sure the right providers are getting the right information, and ensure strict regulatory compliance.
Ms. Beck says “measure, and measure often.”
“[Measure] everything about the program. Figure out where you can make improvements,” Ms. Beck said. “Make sure you are getting the right data, timely, and measuring that in order to make this a sustainable and effective program.”
