How one health system moved 85% of its services via telehealth

Preferred Behavioral Health Group, based in Lakewood, New Jersey, is a multi-site outpatient behavioral health organization providing adult mental health services, youth and family services, and substance use services. Its mission is to deliver quality and compassionate behavioral health services to individuals and families through a trauma-informed care philosophy and approach.

PBHG's vision is to be a center of excellence that focuses on innovative and integrated wellness through compassionate care, and its promise is to change lives and save lives through a strengths-based approach, partnering with individuals to help achieve their full potential and enhancing their quality of life.

The group has provided services to more than 30,000 clients operating the majority of services in Monmouth and Ocean counties in New Jersey. PBHG employs more than 450 certified and professional staff.

The state closes

On March 16, 2020, New Jersey was shut down by the COVID-19 pandemic. PBHG was facing not only the pandemic, but how it would continue to provide healthcare services to its clients without having the ability to meet face to face.

New Jersey at that time did not allow telehealth services for healthcare. The state and federal governments approved telehealth services because of the pandemic, and PBHG reacted quickly, led by its management information systems director, Jenni Pollen.

She put together a team including individuals from billing, corporate compliance and clinical service areas to revamp the electronic health record system, Qualifacts, to be able to transition to telehealth services.

"Training ended up being the most important factor leading to a positive transition."

Jenni Pollen, Preferred Behavioral Health Group

"As we moved forward, we faced multiple issues outside of the EHR," Pollen said. "We had to train all clinical staff on how to interpret and use the revised clinical system. We were faced with an aging fleet of laptops along with an extreme shortage of laptops and phones which were required for clients with no computer access."

Almost half a million from the FCC

Pollen led the team, which included IT and finance, that applied for an FCC telehealth grant. PBHG was awarded $420,675 for laptops, phones and remote access software to offer video and voice consultations and to conduct remote monitoring of patients under treatment for mental health and substance use issues during the COVID-19 pandemic.

"The funds allowed us to provide all clinicians with new equipment, and more importantly clients were now reconnected with their clinicians," Pollen said.

As PBHG evolved using telehealth, reports were developed that identified improper use of the EHR. Clinicians had to identify the service as telehealth or telephonic. Minimum times were required to be able to bill for the service.

"Training ended up being the most important factor leading to a positive transition," Pollen said. "The team developed training documents, which were sourced to all clinicians. The IT and corporate compliance departments provided help desk services for clinicians who required immediate assistance."

Extremely susceptible patients

Individuals with preexisting mental illness or addictions were extremely susceptible to exacerbation of their conditions or possible relapses during the pandemic. Many with underlying medical conditions were not able to leave their homes for group therapy or counseling. They were experiencing isolation and despair.

"The loneliness intensified their underlying mental illness and addiction issues," Pollen explained. "With telehealth, staff could stay connected with their clients and the community. We were able to use all our resources to provide the critical therapy and support virtually. During the past year, we provided 100,000 services to children, teens and adults; and 85% of those services were done through telehealth."

PBHG now is into year two of operating in "pandemic mode" and has recovered to pre-pandemic volumes in most areas.

"During the year, we developed reports that compared volumes and revenue by service area pre- and post-pandemic," Pollen said. "Other reports track billing compliance by service area. Reflecting on the last year, the two most important success factors would be training and teamwork. Our organization received strong support from our management team and board. Difficult times require strong, dedicated individuals, which we found to be our strength at PBHG.

"PBHG is committed and driven to supporting our mission, vision and promise so that no one who comes to us ever feels isolated, lost or alone," she concluded. "Technology has kept us connected to the most vulnerable during these challenging times. Recovery is possible, and we will always be there to save lives and change lives."

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