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Integrating Care: Moving Beyond Interoperability to True Collaboration, Part II


Building the vehicle which will take us beyond interoperability to full integration is a complex task. But, as we saw in the first blog post in this series, there’s ample proof that the need is great – longevity is threatened without integration, quality of life is diminished and costs are needlessly driven higher. So, what does integration look like in practice? Continue reading Integrating Care: Moving Beyond Interoperability to True Collaboration, Part II

Integrating Care: Moving Beyond Interoperability to True Collaboration, Part I

It’s something every traveler knows — you can’t get to where you want to be if you don’t know where you are. For the purposes of this blog series, our collective goal is to arrive at a place of integrated care where behavioral health and human services connect to acute and primary care, providing a single patient/provider view across the entire care continuum. We know we want to arrive at this place because we’ve seen the facts. Let’s refresh them now.

Severe mental illness (SMI) has a direct impact on lifespan. Continue reading Integrating Care: Moving Beyond Interoperability to True Collaboration, Part I

Progress… The Anna Westin Act Passes

tom_h_info-picI want to pause for a moment, to recognize the historical impact of yesterday’s passing of the 21st Century Cures and Mental Health Reform Act of 2016, including key provisions from the Anna Westin Act of 2015. Those of us at Netsmart are fortunate to know Anna’s family and have had the opportunity to help tell their story over the last few years. Anna’s mother, Kitty Westin, spoke at our 2015 Connections and reminded us of the importance of the mission linking us all.

Eating disorders are marked by extreme physical and emotional suffering. Someone with an eating disorder experiences severe disturbances in their behavior while exerting a super human amount of will in an attempt to control their eating. They may eat only small amounts of food, they may eat uncontrollably, or some may alternate between unhealthy periods of fasting followed by bingeing.

The psychological stress they experience related to eating affects every aspect of their lives and the lives of their loved ones. The triggers are different for each person and often unknown, yet reflective of a deep, visceral pain. Eating disorders are indeed illnesses of both the body and the mind. Perhaps nothing describes the internal struggle better than the following journal entry.

“I am scared to death about what’s going on right now. I can’t have any control over my own mind. As much as I know what I need to do it’s so hard to. My moods are very extreme. One minute I’ll be depressed, then another, something will make me happy again.”

Those were the words of Anna Selina Westin. She was a natural beauty of just 19 years when she wrote them. Outwardly, she was a caring young woman, conscientious and generous with her time. She was a joy to be around and by all accounts, she absolutely “sparkled.” Inwardly, however, she struggled mightily. For years she hid the uncontrollable urge to deprive herself of the nutrition her body so desperately needed. There were obstacles that prevented her from receiving the psychological treatment she needed. Kitty Westin, describes the helplessness she felt after being denied by Anna’s insurance.

The insurance company, who had never talked to Anna, had never seen her, didn’t really know anything about her, said that it wasn’t medically necessary, which is obscene. It makes me very, very angry. Anna had a disease they didn’t want to even hear about.

In 2000, after a five-year struggle with the very real medical condition of Anorexia Nervosa, Anna Westin took her own life. She was only 21-years-old.

Fortunately, Anna’s story does not end there. Just as in life, her legacy will be to help others. On Dec. 7, 2016, Congress passed The 21st Century Cures Act. Within that piece of legislation was The Anna Westin Act of 2015.

This bill, introduced by Senator Amy Jean Klobuchar, D-Minn., is the first to address eating disorders specifically. It included the following provisions:

The Office on Women’s Health, a division of the Department of Health and Human Services revise both the BodyWise Handbook and BodyWorks obesity prevention program to include specific information about eating disorders related to both males and females.

– The Substance Abuse and Mental Health Services Administration award the following grants:

  1. To update and merge training on eating disorders into the existing curriculum for health, public health and mental health professionals.
  2. To states, educational institutions and Indian tribal organizations for seminars geared toward school personnel on eating disorders.
  3. To allocate available resources to individuals suffering from eating disorders.
  • The National Institute of Mental Health must make PSAs on eating disorders.
  • Amends the Public Health Service Act, ERISA and IRC –prohibiting them from permanently excluding any particular condition from being deemed eligible for mental health or substance use disorder benefits, including inpatient treatment.

Mental health professionals agree that training and early recognition by healthcare providers is key to saving lives. Removing the roadblocks that Anna and her family faced in receiving appropriate and timely residential treatment is a huge win for the millions of individuals currently diagnosed with an eating disorder as well as those who are suffering in silence.

The Facts on Eating Disorders – According to the National Eating Disorders Association

– Eating disorders affect around 20 million women and 10 million men in the U.S. currently.

– Struggles with negative body image and body dysmorphic disorder are some of the earliest warnings signs.

– Depression and other mood and personality disorders frequently occur with eating disorders.

– Despite the serious statistics, eating disorders continue to receive inadequate funds for research.

– 42 percent of girls in 1st-3rd grade wish they were thinner.

– 81 percent of 10-year-old girls are afraid of becoming fat.

– In individuals diagnosed with anorexia nervosa, suicide is the second leading cause of death (after cardiac disease) and a major cause of death among people with any other eating disorder

There will never be a moment in which you are not you. Some may try to hide their existence away, pretending they are someone they’re not, but who is this act for? You know the ultimate truth, there is no hiding from yourself. The difficulty of it lies in our societies’ ability to create perfect illusions. – Anna Westin 

To learn more about the life and legacy of Anna Westin, as well as the journey that took her parents Mark and Kitty from grief to advocacy, visit our non-profit advocacy foundation, Every Day Matters and view the documentary A Journey of Love: The Anna Westin Story. 

If you are worried that you may have an eating disorder and need help; or if someone you love is exhibiting signs of an eating disorder — we invite you to visit our Support Resources page to learn more information about eating disorders.

If you are thinking about suicide or just need someone to talk to about your eating disorder or any other mental or physical problem, please do not delay and call the National Suicide prevention Lifeline: 1.800.273.TALK (8255) immediately.

Lastly, I encourage all of us to consider becoming Mental Health First Aid certified. This course both informs and equips around essential fundamentals, providing tools to aid when need arises. Earlier this year I completed my certification, grateful as I was prepared to better assist and offer help in a recent conversation.

If we are willing, intentional in thought and deed, we have the opportunity to ensure Every Day Matters as we serve in pursuit of awareness, assistance, wellness and recovery.

So yes…goodness happened yesterday, progress indeed, but we have more work to do!

#Cures #CuresAct #CuresNow #MentalHealthReform #MHFA #1in1m #CauseConnected #healthcare

Throwing Out the Cookie Cutter: Understanding and Embracing Person-Centered Care


A curious term is increasingly being used in the intellectual and developmental disabilities (IDD) community. It’s person-centered care. I say it’s curious because it naturally prompts the question, “hasn’t care always been centered on the person?” The answer to that question is “well, not exactly.” Allow me to explain. Continue reading Throwing Out the Cookie Cutter: Understanding and Embracing Person-Centered Care

People are the Key to True Care Integration

mary_gannon_info_picThe word integration is so prevalent in healthcare it has become a cliché. Google the term “healthcare integration” and you’ll get more than 76 million results! But integration is typically discussed solely within the context of technology. True integration is a coordination of processes or “a bringing together.” I don’t know about you, but when I think of togetherness I think of people. It’s through togetherness that people create and optimize processes and – at that point – use technology to maximize efficiencies.

On October 23rd I’ll be leading the CONNECTIONS 2016 Nursing Summit. Nurses from across the country will hear from speakers about the intersection of nursing and technology, but, more than that, we’ll be sharing experiences, ideas and, yes, challenges we’re facing. Nurses are among the most engaged groups in the care process and the use of technology to improve outcomes. It’s nurses who spend the majority of time inside electronic health records (EHR). It only makes sense that we come together in a roundtable setting to share insights. That’s integration.

You’ll notice I’m using the word “we.” I, too, am a nurse (who happens to be an EHR product manager). Many of my colleagues at Netsmart, including Dr. Dennis Morrison and Dr. Ian Chuang, also have clinical backgrounds. That’s not a coincidence – it’s by design. Our goal is to help improve outcomes, so it’s important to have an immersive understanding of what’s happening on the front lines of care. Likewise, it’s key that those on the front lines of care have a full view of the technological options to optimize care. That’s integration.

I can’t wait for our Nursing Summit at CONNECTIONS 2016. We’ll examine everything from value-based payment models to innovations to the future of care management. But I think the biggest breakthroughs will come from engaging with each other, sharing our successes and struggles face-to-face. Through those transparent discussions we can coordinate processes and come together to improve outcomes. That’s integration.

Bringing Home the Value of Health IT


Begin a conversation with, “I’d like to talk to you about machinery and equipment developed from the application of scientific knowledge” and you can expect the listener to act like they’ve just been given the cure for insomnia. Let’s begin the conversation about National Health IT Week with concepts such as equal access to care, treatment of the whole person, research support and reduced documentation time. That’s the value of health IT. This value is being realized by organizations like KVC Health Systems, Henderson Behavioral Health and Cohen Veterans network.

“The biggest fear about someone out there is that they don’t have equal access, whether it’s behavioral or physical, to the care and services that they need,” says James Roberson, LMSW, vice president of program services for KVC Hospitals. “Thirty or 40 years ago there were people who never even went to the doctor. Now the connectivity gives them immediate access.” Obstacles ranging from distance to even inconvenience can be surmounted because care comes to them.

Henderson Behavioral Health CEO, Dr. Steven Ronik echoes that point and shares a tangible example of how they’re able to provide whole person care utilizing a computer tablet, an app and the myAvatar® CareRecord™ electronic health record. The advantage: People receiving mental health services can now have physical healthcare more easily brought to them.

Cohen Veterans Network (CVN) was launched in April of this year with an ambitious plan to provide free, comprehensive mental healthcare to post-911 veterans and their families.

Anthony M. Hassan, Ed.D., LCSW, is the CEO of Cohen Veterans Network and he’s intent on making the organization a “learning mental health system” using data analytics. CVN will adapt and innovate by monitoring treatments and outcomes in their CareRecord.

“We can run randomized control trials because we’ll have data that really helps us understand the benefits of complementary and alternative treatments,” says Hassan. “It’s a game changer.”

And since National Health IT Week is all about having conversations about technology, let’s examine a solution that captures conversation and turns it into usable data. KVC is an early-adopter of integrated speech recognition technology (M*Modal Fluency Direct®) which initially allowed doctors, therapists and caseworkers to dictate their progress notes in a way that’s much more efficient and consistent than traditional dictation. But Roberson says speech recognition technology has also given them “a level of confidence about the electronic health record that’s hard to put a value on.”  What about the time savings? 

National Health IT Week is much more than a discussion about technology and equipment. Here’s to continued conversations about the many values of health IT and the promises it holds for the future.

Impossible – Amazing Stories of Recovery

Bill_C_Info-Pic.fwIt’s been rejuvenating to read all the stories being shared as part of Recovery Month, the Substance Abuse and Mental Health Services Administration’s (SAMHSA) annual effort to increase awareness and understanding of mental and substance use disorders and celebrate the people who recover. Being reminded of others successes is integral to creating an authentic atmosphere of hope for clinicians and their patients alike. We all feed off each other. That’s what community is about. In my 15-plus years as a licensed, clinical social worker I had the pleasure of seeing countless individuals find a way forward.

As my Netsmart colleagues (also former social workers) and I talked, we discovered that each of us had similar experiences. In the interest of stoking the flames of hope, we’ve chosen to share those stories here. One involves my interactions with a man battling schizophrenia.

A second comes from my co-worker Andrew Mersman, who counseled a young girl who was abused.

And finally, we’ll hear from my colleague Joe Kocsis who walked alongside a man who had turned to substance use to cope with a family tragedy.

Please feel free to share these stories individually or the blog as a whole. And remember, impossible is just a word.