How outpatient and inpatient mental health providers can work better together

Patients in a hospital waiting room
Behavioral health clinics and hospitals could stand to improve communication, experts say. (Getty/SuwanPhoto)

Teamwork between outpatient behavioral health clinics and hospitals has been a perennial problem in healthcare—but it doesn't have to be that way.

There are some simple changes that behavioral health providers can make and, in some states, those efforts are already paying off.

What's the secret? There are key priorities during a patient handoff where providers should focus on improving their communication, said Lisa Patton, Ph.D., director of behavioral health at Truven Health Analytics, an IBM Watson Health subsidiary.

Those priorities include discharge planning, medication reconciliation, advance directives and safety plans, said Patton, who was speaking at the National Council for Behavioral Health's annual conference this week.  

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Communication between providers was improved in Missouri after the state's Coalition for Community Behavioral Healthcare launched a web tool to allows providers to share data with hospitals and primary care physicians. 

Since the state has begun to harness available data, it reduced emergency room visit rates from 45% in 2012 to 31% in 2015. It also saw a drop in inpatient admission rates from 34% to 25% during that same time period. The state also saved about $98 million in healthcare costs.

The process wasn't easy, said Natalie Fornelli-Cook, manager of integrated care for the Missouri Department of Mental Health. They had to continually adjust the tool they used and address gaps in the data to provide a more complete picture. That required getting hospitals to share more information, such as hospitalization alerts, while also needing to align with electronic technology for different providers.

Behavioral health providers who are serious about improving their relationship with hospitals will need to step back and re-evaluate frequently through the process. 

"You use what you can and improve as you go," Fornelli-Cook said. 

RELATED: Care coordination key to low readmission rates by geriatricians 

In New York, officials also found behavioral health providers needed to monitor their patients' needs to avoid readmission, said Julie Gutowski, managing director of clinical operations for adult mental health at Buffalo, New York-based Spectrum Human Services. 

At Spectrum, patients who are hospitalized are required to come in for a visit during a short window after discharge. If they're no-shows, Spectrum will send its "community team" to a patient's home and conduct the follow-up there. 

Spectrum will also bundle certain services if a patient needs additional care to avoid hospitalizations, Gutowski said. Having a multidisciplinary team of engaged individuals is crucial, she said. 

"The magic is in the team," Gutowski said.