Electronic Health Records

Brooklyn HIE supports mental health patients, coordinates care

Through text message alerts and secure emails, Maimonides Medical Center and the Brooklyn Health Information Exchange (BHIX) have taken a step forward in coordinating care for thousands of psychiatric patients who suffer from bi-polar disorder and schizophrenia.  Recognizing that such mental health conditions – and the medications taken to treat them – may have an effect on emergency room admissions, Maimonides, BHIX, and six partner hospitals developed a real-time alert system, triggering texts and online messages that alert psychiatrists when their patients are admitted to another facility.

“Beyond the benefits of coordinating care between disparate systems and providers, as an individual physician, I now have a greater sense of where my patients are,” Dr. Kishor Malavade, a psychiatrist with Maimonides, told HealthITBuzz.  “Having that information is incredibly powerful.”  Malavade is able to use the alerts to check in with patients at other facilities and monitor their progress during an illness or crisis.

Participating physicians will receive a text alert if a patient experiences an admission or discharge to an emergency department, inpatient facility, or an admission on psychiatric grounds.  Physicians have so far been very satisfied with the results, although Dr. Malavade notes that receiving an alert isn’t a substitute for face-to-face communication. “Just because I get a text message alert on my phone doesn’t replace the fact that I need to communicate with my colleagues and the patient.  These alerts are great, but they’ll never be as robust as in-person conversation,” he cautioned.

The BHIX infrastructure which provides support for the service is being used as a springboard to launch other care coordination initiatives, including patient education and the addition of different types of facilities.  With a contract from the CMS Center for Innovation, Maimonides plans to expand the service to help monitor chronically ill patients with diabetes and other disorders.

“Now that we have the infrastructure in place, what we are doing with automated alerting is just the tip of the iceberg. As long we have the data and rules set up, we can do things like establish triggers for an entire practice’s patients…for things like abnormal labs…and even a trigger for the absence of data,” said Irene Koch of BHIX.  We are constantly working with our clinicians to determine how they want to use this functionality to improve care coordination.”

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