Addiction treatment providers seem to be several steps behind their medical counterparts in adopting technology, in a health care community that is generally seen as a late arriver to technological innovation. Addiction professionals have long embraced the intuitive, non-technological aspects of the field. I continue to witness how content many have become with paper-based systems, even when they result in inefficient processes and workflows. Yet in recent years many addiction treatment professionals have elected to adopt more sophisticated health care management systems. Clinicians have a great deal to do with this gradual shift.
No matter what they believed in the past, clinicians today believe in information technology. They are going online in record numbers, and their organizations are beginning to get on board, too. E-mail usage across facilities is soaring, investment in electronic medical records is rising, and the phrase “clinical information systems” soon might become as familiar to the field as “treatment planning.”
In recent years, more health organizations have found themselves under significant pressure to invest in clinical information systems to improve quality of care and increase clinician productivity. Many large chemical dependency facilities already have them, with many medium-sized and small facilities planning to implement them soon. And while few observers have the false impression that the presence of a completely wired, flawlessly interconnected health care industry is imminent, recent converts are getting more of what they want and need. These brave pioneers are going to see the kinds of profit gains associated with any type of efficiency improvement.
Serving as executive director of a small startup facility in Malibu, California about five years ago, I was asked to evaluate an information management system for which the decision to install already had been made. The organization had invested about $10,000 into the system and still did not understand fully how it operated.
Facility officials explained that they wanted a way to ensure quality charting and treatment planning. The sales team had promised that the system indeed would provide a framework for charting, treatment planning, and other administrative functions that would be compliant with licensing and accreditation requirements. The software came from a respected treatment center with the same type of accreditation my facility sought, so installing this software appeared to be a straightforward proposition.
Unfortunately, upon evaluation I found the customer service for the system to be lacking and the system not very intuitive for the user. Worse still, a significant future cost was looming if we ever were to have a fully operational system. I could foresee the system consuming much more time and money, without a clear return on investment. Overall, the most important deficit was our inability to tailor the system to our treatment plan and unique provision of services. It was clear that if we continued with this system and managed to navigate these shortcomings, we still would be confined to another facility's vision of treatment.
I advised that this system should stay on the shelf. This would be a costly move, as we could not recoup the down payment that had been made, but still my advice was to cut our losses.
Fortunately, the following years were good to us, as we successfully managed to expand from a 6-bed facility to a thriving 30-bed treatment center. We managed the old-fashioned way: We rolled up our sleeves and used a lot of paper. I developed simple systems on a centralized server to keep us all connected. This served to improve communication among clinicians and within administration. This relatively unsophisticated approach gave us the results we needed with little training. We never looked back with regret on our decision.
Fortunately, solutions that were not present even a short time ago have since become available. A few years after the aforementioned experience, I had changed jobs and found myself advising Perry Litchfield, CEO of the Bayside Marin facility, that he needed to consider an information management system for his small center.
While Bayside Marin and the facility where I previously worked had some similarities, external variables had changed significantly. After spending time researching the many new options available, I ironically chose to adopt a system that, like the one my former facility had acquired, was developed in a treatment center. The strengths of this system, however, directly overlap the weaknesses of the other.
Bayside Marin has successfully navigated the first phases of a process toward the goal of implementing a comprehensive treatment, billing, and administrative system across the entire continuum of care. We have found a new partner, the nationally known treatment organization Valley Hope Association, and a software product with the support necessary to make the idea a reality. We ultimately chose Valley Hope's homegrown technology solutions, now being marketed to other providers, because of their strengths in the areas most important to us: user ease, ability to adapt to our treatment program without complication or added cost, and superior customer and tech support.
In addition, with this system we do not have to purchase expensive equipment. All of these factors will keep our overall costs in line with our short- and long-term operational budget.