Transforming Behavioral Health with APIs

  • Anna Daugherty
    Anna Daugherty
    May 18 2021

Being well over a year into this pandemic, it’s no surprise that there has been a global decline of mental health across the board. In fact, according to this recent report on the implication of COVID-19 and mental health, “during the pandemic, about four in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, up from one in 10 in 2019.”

As we recognize Mental Health Awareness month during May, it’s essential to understand the pivotal role that APIs can play in transforming healthcare programs, especially during the pandemic. We had the opportunity to interview Wes Williams, chief information officer at the Mental Health Center of Denver (MHCD), about how their technology innovation and use of APIs during the pandemic transformed the way they practice healthcare.

Watch our video interview with Wes here, or catch the highlights below.

MHCD is a private, not-for-profit healthcare provider serving people’s behavioral health needs for the city and county of Denver. Spanning 35 locations, they offer child/family services, programs for teens, outpatient, and intensive case management, and a psycho-social rehab program aimed at bringing people back to employment or education post-treatment.

As the CIO of MHCD, Williams ensures they have the platform and data infrastructure to bring all those moving pieces together while juggling the move to Telehealth and iterating on transformative healthcare methods.

“In behavioral healthcare, the biggest problem is access to care; let’s take Denver, for example. From public health information, we know that one in five people have a behavioral health issue. Yet, 60% of those people will never receive help for that problem, which is about 88 thousand people with an untreated mental health condition. If we were to close that gap, we’d have to quintuple our efforts, which is a big lift,” shares Williams.

Closing that gap is where technology can act as a force multiplier, automating previously manual operations and optimizing how providers can connect with patients. MHCD utilizes technology in one of three ways to innovate the mental healthcare process.

Access to care, engagement in-between sessions, and innovating a holistic approach via APIs are the three focus areas.

🔗 Facilitation of Entering Treatment

One of the ways their new architecture makes it easier for patients is to facilitate entering treatment. Many of those in need don’t understand what to ask for or where to look. To combat this, MHCD utilizes technology for local education and community engagement via a self-service model.

“One of the things that have been apparent in our industry is that mental health problems lead to social avoidance. That interferes with people accessing treatment. COVID has forced us to innovate around our telehealth options, which means you can see so many fewer people, but you can get the care you need. The electronic health visit eliminates buses, extra steps, people, waiting rooms…things that are a barrier to care usually. When people get the help they need, they move through treatment faster,” shares Williams.

🔗 Engagement In-Between Sessions

The second component MHCD focused on is engagement with people’s own wellbeing through outreach and connection in-between sessions. When there’s active engagement in-between the full sessions, people are more devoted to their care and progress.

“Technology helps us automate some of that, makes it easier, and ensures sure there’s adherence to best practices. We’ve noticed for many patients, there will be three days of higher engagement and then 11 days of lower engagement. Providing lighter touchers on those lower engaged days helps keep folks activated throughout their wellbeing,” Williams said.

🔗 Revamping the Holistic Healthcare Process via APIs

After a series of trial and error to find their balance and architecture, eventually, MHCD was able to start utilizing APIs.

“My team was sitting down with our board thinking about what we want to accomplish in the next five years and the possibility of growing immensely. We realized technology is an important component of that. We needed a platform that we could innovate on and plug in to multiple different solutions on top of that. And with a variety of APIs, we could do just that. What you’re doing with APIs is exposing a problem to a solution. We realized it would be a little more expensive at first, but the point of the vision wasn’t that we’re trying to do one thing; it was that we were trying to do ten different things, and utilizing APIs was the way to do that,” Williams shared.

Previously, MHCD was on a highly customized legacy electronic health record, which ended up being too difficult to use and train on amidst a shifting healthcare landscape.

“We realized we needed a better information strategy partnering with a solution where we leverage APIs to enforce our own business rules, contracts, and operational business rules. We selected an EHR that allowed for that kind of interface, and we saw the results,” shared Williams.

Their new electronic interface that’s API-friendly has already delivered the success they wanted to see. They were able to configure the system using APIs to make sure that their needs and regulations were met at scale.

🔗 API Innovation During COVID-19

Having been heavily influenced by COVID over the last 14 months set their API-first strategy in place. Previously relying on legacy systems was becoming a drain, and making the shift to relying on Microsoft Azure for FHIR APIs, as well as fast healthcare interoperability resources, was a game-changer for them. However, their new strategy was put to the test when the pandemic hit in March 2020.

Once thrown into a remote-only option due to the pandemic, MHCD quickly noticed that they had to shift from their new API focused on taking vitals in-office during session visits….over to a an API that was focused on enhancing their Telehealth and the in-app experience.The unexpected change in end-users relied heavily on the flexibility and pivotal shift of their API strategy, forcing them to design quickly for a now remote audience.

“By April 2020, we had broken ground on a Telehealth app to connect people with their appointments, and we launched it in July. By September, we released our Docusign integration API to do paperwork remotely, and by December, we released an API plan to handle engagement goals in-between sessions. Our API strategy allows us to innovate quickly because it’s not just this single app but the critical building blocks that can be used for other things on top of that,” shared Williams.

Since then, the adoption of their app is improving, but Williams notes they are also still equally experimenting and building in regular moments for iteration into their technology experience. They have recently released version 2.0 of their Telehealth app, with a focus on adoption.

“We took our API-app based structure, so with V2, we released a browser version of the app so that you don’t need a smartphone to use it. Accessibility is important, and that release also includes new ways to get registered, simplifying that with a registration code. We’re also doing integration with MyColorado, the state of Colorado’s app that includes integration with state-issued IDS such as a driver’s license. That way, someone can match to that instead of needing any new identifiable information. Irritating and finding different ways to make it easier for folks to connect with us the first time is important,” shared Williams.

🔗 Advice for Other API Enthusiasts & Healthcare Technologists

“I think that one of the innovation challenges is that a lot of this hasn’t been done before, except to rework things. One of the key learning methods is human-centered design. So we talk to folks, we test, we learn and we ask how it’s working for people. The takeaway is not just to build things and listen and be expecting to iterate… but instead, to adopt a strategy behind that, one that gives you the technology flexibility where some of that rework doesn’t require you to go back to the beginning. Rethink how you access and share that data across different platforms. APIs can solve a lot of that,” shares Williams.

But when it comes to what type of APIs will help your organization be successful, Williams noted that each approach needs to be specific. He believes more traditional vendors in the API space will run into trouble. For example, read-only APIs no longer cut it, there is a great need for “bidirectional APIs to be able to read the information out, present to the people reading the services, AND the clinicians in their workflow where they need it. We’re getting there, but we still have a way to go for the API industry as a whole.”

In the end, MHCD has seen great success and innovation through its rapid adoption of API technology and a shift away from legacy systems. Their new infrastructure can adapt and expand for their ever-changing needs, and now they are prepared for all situations (remote or otherwise).

🔗 Learn More

All healthcare providers and technologists can take heed of the lessons learned and innovations applied by MHCD to ensure success for their own programs. As you celebrate Mental Health Awareness Month, here are some great resources to check out for facilities, charities, and places to go for more information. If you’d like to learn more about MHCD and its mission, visit their website.

And finally, if you’re looking for some new solutions and tools for your API strategy, visit our blog to learn more.

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