Mental health providers and the organizations they support have more information at their fingertips than ever before. This information, largely known as population health data, allows provider organizations to examine the overall health of the populations they serve, and to observe any trends among their consumers, particularly those who use services frequently. Officially, population health data is defined as information related to the health outcomes of specific groups of people, communities, or ethnic groups (See Technology & Reporting Requirements For Population Health Management: Preparing For Value-Based Reimbursement).
With the advent of electronic health records (EHR), it is now easy for provider organizations of any size to run reports to glean basic information about their practice using common identifiers such as billing codes, medical diagnoses, medications prescribed, time to referral, and next scheduled appointments. Previously, this information was likely only found on paper and rarely stored in one place – much less stored in a way you could run a report to use the information.
“We were so excited just to have the advanced search feature,” said Bob Puckett, Director of Business Operations for Families, Inc. Counseling Services on their switch to a new EHR in 2010. Headquartered in Jonesboro, Arkansas, Families Inc. has 11 locations in northern Arkansas and has been providing mental health services to children, adolescents, and adults since 2000. “Then we moved to the custom ad hoc feature [in our EHR] where we could actually do a little bit more and thought, ‘Wow. This is awesome.’ And then we moved into business intelligence, and the system keeps taking it up a notch.”
For many providers, the challenge now is not collecting the data, but figuring out what specific data to look at and how to make business sense of all the information collected. In Puckett’s case, they started with an initial focus on compliance and a few key dates (referral date, treatment planning date, and medical evaluation date), narrowing in on about 10 key data points.
“[Our EHR] has all these report functions, but how, as an organization, do I look at that?” Puckett said. Families Inc. staff reached out to analysts with Qualifacts + Credible, their EHR provider, who helped them focus on 10 key indicators, out of more than a 100, to get started. “There’s just so much more [information] than you ever thought you could imagine. How do you narrow it down to what’s important and what’s not?”
Their initial focus on compliance reports gave Families, Inc. a starting point to use with their clinicians and therapists without overwhelming them with stacks of data. Over time, they talked with their providers for feedback on what else could make the report more useful. They found small ways to tweak the formatting, such as replacing a separate column with an icon so that the report was more interesting visually than just a wall of numbers or words. The team also found that using abbreviations for certain data points and pop-up messages helped keep their reports interesting and useful, but not overwhelming.
Families, Inc. was also lucky to have the guidance of an on-staff clinician with a talent in HTML who was able to dig deeper into their health record system and make customizations to benefit the providers and consumers. This staff member was able to help Puckett and his colleagues look at all the information collected and find ways to make it more user friendly. “There are still rows and columns and trying to dig through 60 rows of data trying to find a date that expired [was exhausting]”, said Puckett. To improve the experience, they experimented with highlighting dates in red to show they had expired and yellow to indicate they were going to expire in the next 30 days.
Using these general data points can help providers learn a lot about the people they serve. For example, Anthem used claims data from the 27 million people they serve to create a report on the state of the nation’s mental health (See State of the Nation’s Mental Health). In their analysis, they discovered that more adult Anthem members were diagnosed and treated for anxiety and post-traumatic stress disorder (PTSD) in 2020 compared to 2019. They also found that use of medications to treat depression among this population rose in 2020 (See Anthem Review Of 2020 Claims Data Finds Decline In Mental Health Treatment Rates).
While Anthem has huge patient numbers to analyze, EHR data makes it possible for smaller organizations with fewer patients to look at their patient population, identify trends, and share their results with others—including publishing in medical journals and organizational newsletters. Researchers at the Mayo Clinic in Rochester, Minnesota used their EHR data to identify current e-cigarette users to targets for smoking cessation programs – ultimately identifying 1,000 current e-cigarette users out of their almost 600,000 consumers (See Improved Documentation of Electronic Cigarette Use in an Electronic Health Record). The researchers also identified the needed to adjust their EHR forms to be more specific about tobacco use and include all types of tobacco, including e-cigarettes. Previously, this information was only recorded as “tobacco use” without specifying between cigarettes, cigars, pipes, or e-cigarettes.
“These documentation efforts are not consistent across clinical practices, nor systematically tracked by the health system,” the researchers said. “Reliable population health data could bolster research efforts to generate evidence addressing gaps in our understanding of trends in e-cigarette use by consumers and their overall impact on health.” The researchers add this additional information is critical as many providers had no idea of their consumers’ e-cigarette use and how it may be impacting other areas of a consumer’s health.
OPEN MINDS Senior Associate, Carol Clayton, Ph.D. recommends acquiring an electronic health record as the first, and most important, step to tracking population health data (See Data-Driven Decision-Making For The Post Pandemic Market). For providers who have an EHR, the first step should be examining what fields are already digitized within the EHR, and can be easily sorted (such as numbers, words, or billing codes) — avoiding information that has to be opened and read, such as .pdf copies of consumer records.
“As provider organizations plan for sustainability in the ‘next normal,’ having a data-informed strategy is more important than ever before,” said Monica E. Oss, CEO of OPEN MINDS (See Data, Data Everywhere But Little Action). “Data is critical for two reasons—to demonstrate clinical outcomes and adopt population health approaches that payers are looking for under value-based models, and to grow market share and revenue.”