News: Patients Shouldn’t Wait – Improving Access to Canadian Mental Health & Addictions Services

If you had to guess, what illness would you say is more prevalent in developed countries — cancer or maybe heart disease? Believe it or not, it’s mental illness.  1 in 5 people in Canada lives with a mental illness, representing more than 6.7 million Canadians.  By comparison 2.2 million people in Canada have type 2 diabetes.

The mental health and addiction treatment system have struggled to provide the most compassionate and responsive treatment possible, but both have been dogged by the problem of stigma that has had a negative impact on their development. Arising out of widespread misunderstanding and broad misconceptions, individuals with mental illness were often inappropriately judged and labeled while addiction problems were perceived as a sign of personal weakness. In some cases, a punitive attitude, exemplified by a desire to remove individuals with mental illness and addiction from public sight, has hampered the delivery of appropriate services. Despite many advances in models of care, policies and legislation, negative perception and stigma still persist today.

There is also the challenge for these individuals to find the most appropriate care. Mental health is one of the most frequently miss diagnosed or ignored ailments by many general practitioners. While many GP’s may have taken a rotation during their residency, they are not equipped to handle these patients in the manner that is needed. Furthermore, acute care settings often are ill equipped to manage patients with Mental Health and Addiction issues presenting in the Emergency Department with other acute ailments. These patients are often treated medically for their acute episodes and discharged into the community without the appropriate linkages to Mental Health and Addiction programs.

Undertaken as a partnership between Vancouver Island Health Authority (VIHA), Canada Health Infoway, Strata Health Solutions Inc. and Cerner Canada, the BRIDGES project involved developing and implementing EHR-based clinical decisions support tools to optimize care within the network of Mental Health & Addictions Services (MHAS). (Read more about this initiative here)

The web-based Mental Health & Addictions eReferral tool powered by Strata Health Pathways accelerates the matching and placement of at-risk mental health clients to clinical and community resources. In real time, clinicians can see service availability and wait times and the tool intelligently matches assessed client needs with the complete array of MHAS resources and programs.

The Bridge project was spread across 114 programs and 125 care facilities. The three key components of this initiative were to increase quality and access of care while delivering maximum productivity. In order to achieve this the BRIDGES project consisted of the following elements:

Quality

• Promotes clinical interoperability with greater continuity and coordination of care through access to a shared body of information across service.
• More effective management of client safety-risk issues through shifting to synoptic reporting from largely free,text based documentation
• Better capacity to judge appropriateness of clients referred for services

Access

• More appropriate timing around the initiation of care Reduced likelihood that referrals will be declined
• Better capacity to judge appropriateness of clients referred for services
• Increased likelihood that a client will transition effectively to required follow-up services

Productivity

• Complete synoptic reports reduce the time to process incoming referrals as clinicians spend less time seeking out information from different locations
• Optimization of flow between services results in shortened length of stays

A fully articulated end-to-end view of the project was developed very early to ensure required resourcing and planning for the full scope of implementation. There was also a Change Management approach of inviting clinicians to critique the whole solution design of the project and demonstrating a commitment to developing a solution that works for the clinicians. Key members of the project team had strong clinical backgrounds and extensive knowledge of most service delivery areas within MHA

The Results

• 1000 MHAS Clinicians using the Bridges tool across all VIHA community sectors
• 50% Clinicians and programs engaged
• 2000- 3000 Synoptic reports generated/ month
• 600+ Referral events managed/month

“We finally have a single collaborative tool that replaces countless referral forms and processes and integrates the entire continuum of services on a single computer screen.” – Kenneth Moselle, PhD., Manager, MHAS VIHA

To find out how you can partner with Strata Health to develop and implement EHR-based clinical decisions support tools to optimize care within the network of Mental Health & Addictions Services (MHAS) click here.