It is no secret that data is an integral element of healthcare as a whole, and increasingly, in behavioral healthcare settings. As the movement for measurement-based care continues to gain steam and adoption, the collection of specific data points and how that collection is folded into the behavioral healthcare treatment environment becomes a need and not just a “want.”
Iris Telehealth’s CEO Andy Flanagan and Iris Telehealth’s Chief Solutions Officer David Bartley recently discussed this very evolution as part of a webinar panel hosted by the Scottsdale Institute, a non-profit health system membership organization committed to advancing healthcare’s digital transformation in an equitable, patient-forward way.
Flanagan and Bartley were joined on the panel by Kathi Cox, the chief operating officer of ambulatory and virtual care at Texas Health Resources, a health system that serves the greater Dallas Fort-Worth area with 29 hospitals, 30 urgent care centers, and 469 primary care providers.
Cox, who has spent more than 30 years with Texas Health Resources (THR), provided insight on how data is playing a vital role in the health system’s recent effort to introduce a low-acuity behavioral health service line to the 16 counties it serves across North Texas. For the primary care providers in the THR network who needed to refer patients to behavioral health care, a low-acuity option within the health system network became a crucial missing piece to the overall healthcare puzzle.
“It was a big sticking point for our employed physicians. As they were thinking about how they cared about their patients, it was a gap. So when they identified patients that required some low-acuity care, whether that was counseling, whether that was medication management, they did not have a place to send them except into the community,” Cox said.
In 2023 alone, THR referred nearly 30,000 patients for behavioral healthcare into the community. It wasn’t ideal, from a patient care perspective, from a physician perspective or from a health system perspective. Patients weren’t able to access the care they needed, physicians had no visibility into their behavioral healthcare, and the health system as a whole was carrying higher costs because of it.
“You have wait times of 6 to 8 weeks just for your first appointment. And there is no connectivity back to the physician who referred you out. So what would happen is, those folks would get lost in the process, and they may or may not ever receive that care,” Cox said. “So we identified the need to provide care for our patients in a longitudinal way, in an integrated way.”
Due to a lack of available providers, THR went in search of a partner to provide telepsychiatry services. Not only did that route answer a call from a staffing perspective, but it also meant providers would have the ability to meet patients wherever they are, improving access to care in a way that wasn’t previously available.
Flanagan said THR’s willingness to turn to a tech-enhanced delivery method as a means of improving access to care is representative of the ever-evolving landscape of behavioral health care. A third of patients, he said, prefer a digital-first experience.
“We’re seeing young technology companies, some AI, some digital health trying to come into behavioral health and we should welcome them. And from a service line perspective, view them as just another tool in the toolkit to your goal of continuity of care, being present, and meeting people where they are,” Flanagan said. “I think we’re learning how to have a more expansive view of behavioral health, as well as how to integrate that into whole health.”
To that end, THR partnered with Iris Telehealth to offer its primary care providers a low-acuity treatment option for patients in need of behavioral healthcare. From the beginning, data was a central element of the partnership. THR and Iris Telehealth brought teams together at the start of their partnership to develop an informed roadmap for integration that looked at licensing, credentialing, reimbursement, revenue cycle, employer contracting, payer relationships and the patient journey so that everyone had visibility into what utilization and proper support would look like.
And then they folded in metrics.
Flanagan called the data foundation “key,” while Bartley detailed the importance of data collection at the clinical encounter level so it could be entered into the EMR. Cox said the support, and the dedication to the data from Iris, was pivotal to the success of the partnership and to patient care.
“You have to make it a priority or else you never have a data foundation to build on,” Cox said. “Iris Telehealth has been side-by-side with us all along the way, and in fact, in a lot of cases, they’re the one pushing us.”
Two years after launching the partnership and introducing the new behavioral health service line, Cox said she is able to evaluate the value of the health system’s addition in part because of metrics. Consumer satisfaction measured by an NPS score is over 85%, while consumer effort is measured at over 90%.
Those numbers mean patients are happy and finding care easily.
“Anybody who tries to get behavioral health knows how complex and hard it is, so the fact that people think it’s easy is a really important thing,” Cox said. “We’ve seen enough patients now that we can really start to measure outcomes.”
Over the two years, THR has seen nearly 8,000 unique patients complete 46,000 behavioral health appointments. The average time between a referral and an initial assessment has been measured at between 5 and 7 days. In addition, the health system has seen a reduction in healthcare costs, and patients in treatment have reported a reduction in symptoms of depression and anxiety.
For Bartley, that data supports a critical shift in mindset from behavioral health being a separate part of a care journey for a patient to it being an embedded one.
“How do we have behavioral health just be a natural part of the care journey?” he said. “Especially with measurement-based care, there is no one cadence of data collection, there is no one cadence of messaging and data starts to open the door for how we can lean into what makes each individual unique. The technology is providing the flexibility to engage differently. And again, all of that serves to, not replace the clinical experience, but extend it and enhance it.”
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