Delivering crisis care with the best IT

IT partnerships lead the way to growth and clinical outcome

Connections Health Solutions is a psychiatric urgent care provider, operating two of the nation’s largest crisis response centers in Phoenix and Tucson, Arizona. Last year, the organization served 30,000 people, using community partnerships with law enforcement, first responders and local behavioral health providers to divert mental health emergencies from the ER. This forward-looking crisis model is supported by several studies and reflected in the latest CCBHC guidelines, as well as the creation of 988.

Connections’ mission is to accept anyone in crisis, regardless of ability to pay. Services include a 24/7 walk-in mental health clinic, crisis stabilization, extended stabilization services, and recovery support and coaching. Because this approach has been so effective, Connections is experiencing rapid growth. Recently, they opened a court-ordered evaluation unit in Phoenix, and a new mobile crisis facility is underway in Bozeman, Montana.

So, what’s the secret to Connections’ success delivering crisis care and leveraging data? It’s not just the efforts of the Board or their talented team. Connections’ secret weapon is a top-tier IT department with a sophisticated understanding of data and clinical technology. Connections IT also values partnership and collaboration, and they’ve introduced several innovations by working closely with both clinical teams and their technology vendor. The result is both growth and sustainability––including more efficiency, happier employees, and the ability to offer the best possible crisis outcomes.

In just three years, Connections has adopted one platform approach for all locations, built a real-time data repository, enhanced workflows for clinicians, created operational KPIs that allow them to succeed, and developed a strong behind-the-scenes partnership with their IT vendor to assist in the technology side of operations.

Our #1 goal is to look for ways we can improve patient outcomes. We’re not patient facing, but we always support the clinical folks. We do that by ensuring the system is there for them where they need it.

- Keith Knutson, Connections Health Solutions VP, IT Services

Becoming data-driven

Keith Knutson, VP of IT services, is all about data. Since joining Connections three years ago, he’s led something of a data revolution. Now, the entire team considers themselves data-driven––and the results go far beyond technology or even clinical care.

Originally, technology at Connections was highly decentralized. The Phoenix and Tucson locations had separate EHRs that didn’t communicate with each other. The IT team itself was scattered throughout the organization, supporting different departments. One of Knutson’s first steps was to bring everyone together in one department. Then, he tasked them with a major initiative: to build a centralized data analytics function. In other words, he asked his team to help transform Connections into a data-driven culture.

“Access to any and all data within the EHR is vital,” Knutson explained. “It’s vital to patient care, operations, efficiency–– we’re always looking for ways to leverage that data more.” The IT brigade got to work, with the help of myAvatar, the single-platform EHR that Connections had just invested in. They created a daily data refresh from their EHR and the backend database into an automated repository, with access to live data and real-time reporting capabilities. This was hugely beneficial for the clinical staff who needed medical information right away when dealing with people in crisis or short-term care.

That was all it took for the clinical team to see the value of a data-driven culture. They approached the IT team to collaborate on a massive operational project using their data repository. Together, providers and IT dug into the numbers and created 30+ clinical model KPIs––some of which, Knutson reported, are not typically measured in the industry. These became Connections’ new benchmarks for driving clinical performance, and soon that included operational and financial KPIs––all of which could be communicated back to leadership in an automated report.

“The biggest catalyst was being able to access data in a way that was meaningful,” Knutson pointed out. Without this data, it’s doubtful that Connections would have succeeded so rapidly as an organization, much less added more locations.

Clinically-informed workflows

With a partnership firmly established, IT and clinical staff decided to collaborate on EHR workflows. Thanks to new tools and features of myAvatar, Connections has even more tools to expand extreme usability for not just clinicians but for all staff. When discussing eMAR NX, a solution that optimizes medication administration workflows, Knutson observed, "they clearly put a lot of effort and time fine tuning it... The level of quality assurance was very high. We love it." With these solutions, they were able to standardize processes between the two locations, such as meeting responsibilities to payers and states, while adding seven new forms created by the provider team. This increased efficiency and allowed staff to spend less time navigating the EHR and more time doing their jobs. Most important, these enhancements have allowed Connections to meet the growing demand for crisis service.

They clearly put a lot of effort and time fine tuning it... The level of quality assurance was very high. We love it.

- Knutson

The Connections team was thrilled to have a workflow built for point-of-service care that also captured the patient’s journey with one platform. Clinicians were able to see an integrated, holistic view of every person they served––up to 60 days post-discharge. Once again, the power of data led to more powerful care.

Partnership pays off

If there’s one piece of advice Knutson has for other organizations, it’s that infrastructure matters. The systems you use to support your business matter. Connections has succeeded precisely because they’ve given technology a seat at the table––and leadership over clinical projects. After all, clinicians are more effective when they can focus on care, not the technology they’re using. “If we’re doing our job right, providing care will go smoothly,” Knutson observed.

He also acknowledges the importance of a different partnership: the IT department and their technology vendor. Connections has forged a relationship with Netsmart that’s closer to a partnership with a trusted advisor, according to Knutson and his team. They describe Netsmart as “responsive to the needs of your end users,” which is exactly the job of every IT team.

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“If other organizations are serious about expanding services and helping the larger community, they need to partner with the right vendors who share their vision,” Knutson advised. He added that, if you can express where you’re trying to go, the right vendor can help show you what that can look like.

In addition to providing a configurable EHR, Netsmart has supplied Connections with the technology they needed for innovation many times. One example is the data repository and KPI function, which helped create a data-driven partnership between technology and clinical care. Connections also uses a Netsmart solution that integrates data from Sonora Labs, a clinical laboratory across Arizona, and Conjecture, the Arizona state health information exchange (HIE). They’ve implemented PMP so providers can easily check myAvatar for controlled substances prescribed elsewhere––instead of opening up another browser. Connections is also implementing a patient engagement solution from Netsmart that includes two-way messaging and telehealth services.

“Especially when our expansion was becoming a reality, [Netsmart] did a great job helping us navigate that and the costs,” said Natalie Bruer, Director of Business Systems and a member of Knutson’s team. “Who knows what opportunities lie ahead in our industry––areas there’s a need that we’d be perfect to fill. We feel really comfortable that Netsmart can meet all of those business needs, known today and unknown in the future.”

“We’re comfortable bringing issues up, and we get the attention and results we need. There’s a good relationship there with that feedback loop,” Knutson agreed.

Looking to the future

Connections Health Solutions is guided by their mission to help the most vulnerable on the worst days of their life with compassion and the right resources. Their shining beacon is their success rate––according to all their data, Connections has highly positive outcomes with low readmission rates. And then, there are the successes that can’t be measured, such as a patient experience where people are treated with dignity and feel heard. Or a reputation as a trusted community partner.

If there’s one word that keeps appearing in the Connections story, it’s partnership. The collaboration between clinical and IT staff doesn’t always happen in the behavioral health industry, but that’s what makes Connections special and has allowed them to grow while retaining efficiencies, staff satisfaction and profitability in their current locations.

But none of those technical innovations would have happened if Connections hadn’t formed an equally valuable partnership with their technology vendor. Netsmart helped them consolidate everything to one platform, which in turn led to the cross-team collaboration and data-driven culture they thrive on today. And Connections was able to call on Netsmart for a customizable EHR, plus help with the technology side of their expansion.

If anyone understands the importance of someone to have your back, it’s a crisis care provider. And if anyone exemplifies the value of cooperation, selfless caring, and community support, it’s Connections.