Why Brief Care Management?

A growing body of evidence shows that telephonic care management  for chronic mental illness as an adjunct to usual care, has a favorable impact on treatment compliance, outcomes and cost. PsychCoverage call data indicates that the overwhelming majority of after-hours clinical calls fit into one or more categories of the Chronic Care Model i.e. safety, education, treatment compliance and care coordination. This has led to an awareness that these usually brief interactions with patients can be seen in an entirely new and innovative way. The safety of patients posing a danger to themselves or others will always be our highest priority, but we have come to realize that we can also have a significant impact on the majority of patients calling in with less emergent concerns.

This much larger group of patients, when seen through the lens of a chronic disease risk stratification, often meet the definition of an acuity 1 or high risk/high priority patient. Typically, they are patients presenting with an unmanaged symptom or side effect which poses a risk to treatment adherence or patient safety, that in the absence of an immediate intervention can lead to an adverse event or an otherwise avoidable ER visit or hospitalization. A rapid response and supportive prn follow up on these calls can make a great deal of difference in both short and long term outcomes as well as patient satisfaction scores. We certainly don’t see our model of after-hours support as a substitute for a fully implemented Care Management program involving proactive outbound calls. It clearly is not. It is, however, an innovative way to engage the most at risk patients at the moment they are most receptive to intervention. A welcome occasion in the world of chronic disease management. In addition to addressing the issue that prompted the call, we view after hours calls as opportunities to have a longer lasting impact by identifying and addressing deficits in mental health literacy, improving treatment adherence through medication teaching and coordinating care with a feedback loop to you as the treating provider for continuity.

In addition to the obvious benefit to your patients, the addition of PsychCoverage services can also enhance the image of your practice and help to support the boundaries you’ve established, while preserving your downtime as a work free zone. The positive feedback you’ll receive from your patients and their family members will give you the confidence you need to fully unwind during your hours of free time, knowing that your patients are in good hands with PsychCoverage.

How Phone Calls From Nurses Reduce Patient Readmissions

A recent study published in Health Affairs found that quick phone calls from a nurse can reduce patient readmissions and cut $1,225 in costs per patient. The researchers tracked a low-resource veteran’s program that uses registered nurses for quality transitional care, who call high risk patients once a week for four weeks (or until the patient transferred to a primary care doctor) for an open-ended discussion. In these phone calls, nurses answered questions about medication and symptoms and side effects, often explaining the importance of medication adherence. Patients that are considered “high risk” have dementia, are 65 years or older, and live alone or have had a previous hospitalization in the year.

Almost all of the patients participate in the nurse phone call program because the goal is to “more seamlessly bridge the patient’s journey from the hospital to the home and to primary care,” according to Amy Kind, assistant professor of medicine (geriatrics) at the University of Wisconsin School of Medicine and Public Health, the university behind the study. She adds, “Patients don’t mind a phone call.”

The simple act of calling patients to follow up after a visit has saved the hospital almost $750,000 in a year and a half. Patients saw 11% fewer 30-day readmissions  Nurses can reach a lot more patients by phone call than by home visits and can provide their patients with the reassurance they may be looking for during that crucial one-month period after a hospital admission. While patients will typically receive medication descriptions and instructions at the time of the prescription, they may have questions, may be worried, or may be experiencing unexpected side effects and need someone to talk to. These phone calls keep patients on their medication, explain symptoms, and reduce the need for readmission.

The end result is a more cost effective hospital, but also a less stressed hospital staff and healthier patients, a win-win-win situation. The hope is that the same program can be used in larger patient populations and significantly help resource strained hospitals around the country.

Behavioral Health Training Program at UMass Medical School

We are thrilled to announce that Jack Coughlin, RN, founder of PsychCoverage, Inc. has recently been accepted into the Certificate Program in Primary Behavioral Health Care at UMass Medical School. Congratulations, Jack!

The program is designed to “prepare mental health professionals for success as primary care behavioral health clinicians.” Over a period of three months, certificate participants will meet at the University of Massachusetts Medical School (or through their Adobe Connect distance based learning program) for six full-day workshops. The program is taught by primary care behavioral health clinicians and primary care physicians from the Department of Family Medicine and Community health at UMass Medical School and provides actual or virtual discussion and role play for enhanced learning. At the completion of the program, mental health professionals will be better able to provide their services in a primary medical care setting, an achievement that will surely help mental health patients who do not have access to specialized psychiatric professionals.

One of the goals of PsychCoverage is to be able to better prepare primary care doctors to handle the intricacies of mental health patients, and to be a resource for primary care physicians in the same way that they are a resource for psychiatrists. Primary care doctors experience the same types of professional burnout that psychiatrists do, and as general practitioners many physicians and clinicians are less able to diagnose and treat patients with mental illness. At the very least, many mental health patients seeing a GP do not receive the same level of care that they would with a psychiatrist or other mental health specialist. For both the patients’ and physicians’ sakes, PsychCoverage feels it’s important to work on this type of integration between the two medical fields.