Integrated Care Pathways™
AZZLY®’s Integrated Care Pathways™
Insurance payors and accreditation agencies are increasingly requiring a “Integrated Care Pathways™”, connecting the components of patient care, in order to help document “evidence-based treatment” and process payment. It’s a whole patient approach to care that includes medical doctors, nurse practitioners, nurses and psychiatrists working to assess, monitor and maintain the physical health of individuals served so that psychologist, therapists and counselors continue the focus on recovery and daily living activities.
The key is to link all aspects of the treatment process and be able to demonstrate that an individual is getting better, based on “individually” defined goals and objectives being achieved. The Joint Commission, January 2018 Revised Standards requirement is very clear that an evidence-based outcomes measurement tool be used to measure impact of a defined treatment plan to drive client change.
A Bit of History…
Measurement-based care is a routine practice throughout the medical and surgical fields. Today, it is estimated that only 18% of psychiatrists and 11% of psychologists routinely administer simple measurement tools to monitor their patient’s progress. Think about individuals that are diagnosed with high blood pressure. Their provider requests them to daily monitor their blood pressure with a simple blood pressure cuff. When they come in for their next appointment, whether they come with the list of readings or not, the provider takes a new reading, adds to their chart and compares it to their last reading and history of readings recorded. They also compare it to what is considered within a “normal” range, based on evidence-based research and standards. They either keep the medication dose the same, increase it or decrease it, upon discussion of what symptoms have presented since the last visit, to maintain daily living activities and to have a positive outcome for the patient. In most recovery programs, clinicians
have sometimes daily, weekly, monthly interaction with their patients.
Applying an evidence-based outcomes measurement tool frequently to a patient’s care, and tweaking their individual goals based on their input of whether they are getting better or not, should greatly improve clinical outcomes. From the payor perspective, it should also re-align the care treatment plan to reflect greater, less or the same level of service. A “win-win” for all. AZZLY® Rize™ eChart is a chronological list of all services or events in the patient’s history provided by that treatment center. Including Outcome Measurement Tools within the library of forms, simplifies the use, and provides real-time auto scoring and relative risk. A clinician can easily complete the Integrated Care Pathways™ review and adjust a patient’s treatment plan goals for better outcomes.
What makes us different…
Within AZZLY Rize, we display the patients journey in one eChart. Our forms library team creates the personalized assessments, evaluations, treatment plans and notes that support best practices and the gold standard of care culture that you have built with your team. What the accreditation agencies and payor community do not want to see upon a chart audit, is the “one shoe fits all approach” that using a library of thousands of other providers goals, objectives, problems, assignments to create a generic master treatment plan to follow. We don’t expect you to spend your time building templates or to be told “what you see is what you get”.
Expect AZZLY to deliver personalized templates that support your process in an easy to use format.
Medical necessity starts with a provider evaluating a client or patient and authorizing or rendering services that fall within the scope of their license. Medically necessary services are those that prevent the patient from getting worse or developing new problems. Medically necessary services deal not just with the symptoms or signs of an illness but the impact of the illness on the ability of the individual to function. This speaks directly to rehabilitation services, which are primarily focused on maintaining or raising the functional level of the patient. AZZLY medical templates were created by physicians for physicians, by head nurses for the nursing staff, by clinical directors for clinicians and therapists. We contract with a Joint Commission Behavioral Health auditing expert and CARF expert to annually review our master templates for the latest standards and EP additions or modifications. AZZLY is committed to supporting the detailed documentation required with less clicks and fewer scrolls.
Measurement-based care requires an outcomes measurement tool be selected based on your patient population that is used to adjust treatment plans within behavioral health. Based on the low percentage of providers that practice measurement-based care, it may be safe to say that millions of patients seeking help for their behavioral health disorders are missing important opportunities to have their treatments adjusted in a timely manner. This may lead to worsening symptoms that may be going altogether undetected by their providers.
So, what we did at AZZLY is include a selection of copywrite free, research-based outcome measurement tools within the eChart Library of Forms to assist in making this easy. We also auto score the results, display for easy viewing along with the relative risk so any provider of service may visually see this and adjust goals accordingly based on what the individual patient’s responses were. Measurable outcomes are required by The Joint Commission, CARF, Centers for Medicaid and Centers for Medicare, other payors and for compliance in the parity law. We make it easy to comply.
Data informed substance use treatment plans…
Each Episode of Care is memorialized in that patient’s AZZLY eChart. As many treatment centers are offering more programs in support of continuity of care, the ability to document and easily view a patient’s history and speak with knowledge during an UR review can be the difference between receiving more days or being denied on a claim. Weaving the severity of a diagnosis to the medication prescribed (if any) to the amount of services offered individually or in a group, to the outcome measurement score and severity rating, back to the treatment plan goals and objectives and demonstrating the changes made to goals based on the patient’s score, back to services or program changes, supports the new evidence-based standards of care in behavioral health. AZZLY wants you to have stress-free audits.
Questions to consider…
What standardized outcome measurement tool is your center using?
Do the providers of care that are using the measure consider it “helpful” to support initial and updated treatment planning needs?
Can the outcome measurement score and relative risk rating be directly linked to the level of severity for DSM 5 and the fourth digit modifier for ICD-10 (Severity of Impairment)?
Value is determined based on whether you, as the provider, achieve the same or better outcomes with a change of services delivered. The payor is looking for adjustments possibly in cost of services required to provide and the accreditation agency is looking for better outcomes. Both expect the providers of care to use an outcome measurement tool frequently to make changes to the treatment plan. They are looking for proof that a patient is getting better because evidence-based standards of care are being applied. Value gets you patients and payments.
Import most recent (IMR)…
At AZZLY, we understand the value of having the last note that you added or the last note that another provider added to the eChart at your fingertips to review and to make the goal adjustments to treatment plan reviews. A supervisor or outside auditor can quickly filter to see the frequency the treatment plan reviews were done, and outcome measurements scored, and relative risk reviewed and goals adjusted. A review can easily be done for a specific day, week, month, quarter or longer to monitor the personalized Integrated Care Pathways™.