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Posted: Sunday, February 8, 2015
Richard Carver/Winston-Salem Journal

Better connecting behavioral and physical healthcare for North Carolinians is the goal of another budding partnership between two prominent statewide agencies.

 

The N.C. Health Information Exchange and Daymark Recovery Services Inc. are establishing a network to help Daymark’s behavioral health patients get the physical healthcare they need in a timely manner.

Daymark provides home health, outpatient and inpatient services to individuals with mental health, substance abuse and developmental disabilities to more than 50,000 North Carolinians annually through their 29 facilities, including in the CenterPoint Human Services and Partners Behavioral Health Management territories.

Daymark’s services include outpatient, psychiatric, telepsychiatry and 24/7 mobile crisis. It operates 44 beds of facility-based crisis capacity, 56 beds of residential capacity, and walk-in crisis services at 25 locations.

Along the way, the exchange is hoping to provide physical health providers, specialists, home health agencies, and long-term care facilities with more insight into how to better handle their patients’ mental health issues and treatment options. Another element is sharing patient records through an electronic health records system.

“Connecting mental and physical health providers through the sharing of patient data is crucial to providing whole patient care, said Jayson Caracciolo, director of stakeholder services for the exchange.

“Linked, multi-disciplinary teams can communicate and inform each other in real-time, making more customized care possible.”

Dr. Philip Nofal, medical director for Daymark, said the partnership “will greatly improve the quality and availability of health care by making real-time health information a finger click away for both patients and their providers.”

“This will be especially true for people with co-occurring disorders who have multiple providers.”

The accountable care organization (ACO) initiative is at the heart of what the Obama administration wants to accomplish through the Affordable Care Act.

The goal is for physicians, hospitals, rehabilitation centers and other providers to work together to provide higher-quality coordinated care to patients, while attempting to limit increases in health-care costs. The organizations can share in any savings they generate for Medicare — if they meet specified quality targets.

Another example of the whole body initiative is the regional care organization being formed by Mission Health, a hospital system in Asheville, and Smoky Mountain Center, a managed care organization like CenterPoint and Partners.

Emphasizing a “whole body” approach also is at the center of one element of Medicaid reform championed by Gov. Pat McCrory, state health Secretary Dr. Aldona Wos and state House leaders as the preferred option.

The House has supported having up to 24 ACOs that would offer such care and oversight through expanding an existing nonprofit network.

State Senate leaders prefer a significant privatization role in reform, including pursuing out-of-state, for-profit providers to wring out costs. The track record on for-profit providers is mixed in other states, with some providers pulling out after their profit margins shrank over time.

Jerold Greer, Daymark’s chief information officer, said the partnership has “the potential to significantly overhaul the role of psychiatry and behavioral health care as a whole in the North Carolina health-care continuum with this single advancement that complements our existing electronic health care record.

Billy West, executive director of Daymark, said the partnership will assist CenterPoint and Partners because Daymark officials will have access to their clients’ records so they can be treated for any developing physical issues along with behavioral health.

“Now, this is not yet the tool it needs to be,” West said. “It doesn’t yet have a great impact in indigent patients, and some of our staff use it better than others.

“But it beats having to get two staff from different agencies fax information back and forth or try to talk with one another in the hall, assuming they are under the same roof.

“We hope that as Medicaid expansion is considered, new technology innovations for indigent patients are developed and our staff matures on the system, that overall health care will improve and subsequently cost will be driven down so we can do more preventative care and catch problems early in their life cycle,” West said.

Michael Cottingham, communications manager for Northwest Community Care Network, said he believes the exchange’s “ability to connect and share robust data within a secure environment helps improve patient health outcomes.”

“It exciting that such a large and well-respected behavioral health provider has signed up.

“Since 2010, there has been a tremendous statewide response to the exchange, and Daymark’s support will continue to validate the technology as an effective patient treatment tool.”