Health Home Technology
The guy living on the street, the hopeless alcoholic/drug addict with other diagnosed problems like depression, schizophrenia, bi-polar disorder and whatever else you can throw into the mix, is about to get better.
New York is closing applications for agencies to become Health Homes, which means a bundle of improved treatment solutions to focus on our guy mentioned above are about to hit the field. Health Homes at the base level coordinate care for high-usage consumers. The goal is more focused, knowledgeable team treatment.
Our guy needs help from a number of professionals...His addictions need to be dealt with by special professionals in that treatment field. Additionally, medications need to be prescribed by a psychiatrist for his mental disorders. While we're treating our high-maintenance consumer, let's add in a psychologist and perhaps an MSW or two to help him overcome Post Traumatic Stress Disorder (PTSD) and find a place to live.
Since this population of consumers seems to continue on the same loop of treatment, people say "None of it works, so why bother?"
That's the attitude that propagates the growth of this group of folks who have lost hope. They use a ton of services, and don't get better. Studies have shown that if concerted efforts to coordinate care are implemented, our guy probably will start to recover from all these problems. OK. Fine. So what's the problem? We have a community of professionals out there who deal with this sort of thing, Medicaid and Medicare likely will pay for the care, so why aren't these folks getting better.
The answer may be in communication. Assign a case manager to coordinate care in the treatment community and communicate with professionals involved with the consumer, and you deliver the tools so all the professionals know what else is going on with that consumer. Coordinate and communicate to overcome problems with unknown diagnosis and treatment that can lead to drug interaction problems, conflicting therapies, and so on. If a search of a database of Medicare and Medicaid patients numbers (without names) was performed at every intake, and existing treatment was identified, our guy has a chance of recovering through coordinated, effective treatment. This is of great value to Health Homes in coordinating treatment among professionals.
It took me a while, but this is where Information Technology comes in. Any consumer controls outside access to their health information. I envision a checkbox for each provider in the health home the professional belongs to. The consumer agrees or declines sharing the information. Not perfect, because sometimes we're dealing with consumer paranoia that keeps those things secret, but hey, we're trying to help.
Here's what sorts of information would be available to the professionals' fingertips once an electronic Health Home network of some sort was settled upon:
There are a lot of technological details involved, and IT professionals like me enter the picture to help design and implement the details, but this is as decent a solution. It sure beats faxing paper all over the Health Home network. Regional Health Information Networks (RHIOs) and products like Netsmart's ConnectCare have a head start on delivering secure access to information like this with consumer approval. The difficulty in IT is not the availability of solutions, it's modifying professional processes and deploying the solutions, integrating these solutions into existing Electronic Health Records (EHRs).
The advice is the same as it was when we were kids: don't do this in your home without supervision.