Technology, Care, and Mental Health

Healthcare Information Technology (HIT) has taken a driver’s seat in the rapidly accelerating transformation of healthcare. Investments are being made in HIT by the industry providers, hospitals, and Accountable Care Organizations (ACO) at an unprecedented rate. Pharmaceutical companies are shifting gears and investing in care model records systems with predictive analytics and IoT (internet of things) medical devices and monitors. A seemingly infinite outpouring of wearables is hitting the market everyday with more ways to metricize our active lifestyles. Forbes had to update its 2017 Best Wearable Tech and Fitness Gadget collage, as the list was outmoded before the holiday purchasing season rolled around (Forbes Article – WCMHS not responsible for advertising). If you read the article, you will notice that the “wearables” concept has spread to a much wider range of gadgets than just smart watches; how about smart pants??? Beyond that is a ceaseless explosion of products, articles, and businesses targeted for healthy lifestyle maximization. All of which are powered by technology, from automated home delivery of healthy foods to 24-hour electronic access to the gym! These evidentiary factors point to a healthcare renaissance fueled by technology and Washington County Mental Health is gearing up for the festivities! But what does this look like and why should we commit

Technology, in its own right, has always been intended to augment and empower the human beings that wield it. The first analog computers emerged in the mid-19th Century and were completely mechanical arithmetic devices, much like automated abacuses for calculating against navigational charts – Charles Babbages “Analytical Engine” is considered to have been the first programmable computer. Modern era computers emerged in the 70’s, rapidly evolving from calculators and word processors to smart phones in 37 short years, every advancement in technology has attempted to improve human input and increase human output (e.g. moving from handwriting and copy-set to typing with spell-check, and so forth). So, at its very core, technology is meant to improve and empower the work that we do. The most recent wave of technology moving into the healthcare space is no different.

As an example, wearable technologies engage the wearer by turning day-to-day activities, such as walking, into engrossing challenges with community building. Many conversations now begin with, “I have to get my steps in.” The online forums and dashboards that host the data from these devices take those same activities to new levels with visualizations, historical activity level comparisons, and community challenges with millions of other users across the globe. Healthcare is looking to this same technology to tell the health story through metrics of daily living such as average and recovery heart rate, activity levels, sleep cycles, blood sugar, and the list goes on! Technology has a place in our lives and can be harnessed toward a healthier lifestyle when used responsibly. So, how do we get to a point where all of this is possible and useful to us?

First and foremost, technology needs heroes! While it is true that technology wizards appear to have super-powers, the technology trade requires skills, aptitude, but more importantly, it requires time and dedication. WCMHS has joined forces with Lamoille County Mental Health Services (LCMHS), and Laraway Youth and Family Services (Laraway), to form a rock star team of tech gurus to build a new era of technology for these three agencies along with Collaborative Solutions Corporation (CSC or Second Spring). This team, along with other partners throughout Vermont, is coming together on two major tech initiatives.

The Unified Electronic Medical Record (UEMR) Project is the first. This is a statewide initiative in collaboration with all of the Designated Agencies (DA’s) in Vermont. A unified request for proposal (RFP) launched in January 2017 with the intention of creating a multi-tenant, or multi-agency, architecture and a unified EMR for all of the DA’s. Well over 100 staff members from WCMHS, LCMHS, CSC, and Laraway have participated, so far, in demonstrations alongside their peers throughout all of the other DA’s across the state.

WCMHS and LCMHS, again fostering collaboration, have assembled a cross-agency steering board of subject matter experts, to guide the project, whose disciplines and expertise span the complete spectrum of services provided by both agencies. A much larger Project Working Board includes sixty participants from all four agencies, including Laraway and CSC. Beyond the primary goal of replacing our legacy EMRs, the shorter-term high-level strategic goals of the project are to create a technology platform that will foster physical and mental health integration, and to create strategic and economic resource sharing. The longer-term goals of the UEMR project are to explore a roadmap to data-enhanced care, and to create a technology platform for operational agility to enable the Agencies to pivot, easily, with market pressures and payment reforms. What that really means for WCMHS is that we want an EMR that is easy to use, accessible, and will help us grow as a company and a care provider.

The UEMR project will take at least two years, from now, for full completion. However, it will generate incremental improvement, all along the way, through the ancillary work of process improvement with an aim toward the unified platform and approach. The UEMR is one component of the larger picture, which brings us to the other major tech initiative, the Infrastructure Project.

For car enthusiasts, it is all about engine, for Star Wars enthusiasts it is all about the story of a galaxy far far away, for antiques enthusiasts it is all about the patina, and for tech gurus it’s all about the infrastructure! What infrastructure really means in this context is the combination of servers, networks, internet connectivity, telecommunication systems, and cloud services all running in the unseen background to get the staff the computing services they need, when they need it, where they need it. Embracing the future of HIT and data-informed healthcare, WCMHS is embarking on a complete overhaul of its networks, communication systems, and server systems by building a hyper-converged virtualization data center and fiber-rich wide area network with cloud-hybridization. Roughly translated from the original tech-speak, that last sentence means “awesome.” Basically, if we are moving to a modern electronic records system, we need a modern way to get to it, and the new infrastructure is that way. The result will be a robust, fast, and reliable system to keep up with the dedicated work of the staffs of our agencies. Additionally, there is a heavy focus for the new infrastructure to support a mobile workforce and reduce the need for staff, who work out in the Vermont communities, to return to office space in order to complete their work.

These large-scale projects do not happen overnight, but the project timeline should have these agencies migrating into the virtualized data center inside a year.

The need for big tech has arrived, the dedicated tech-star team has been mobilized, and data-informed care is around the corner. WCMHS is ready. We have teamed up in a whole new way with our partners at LCMHS, CSC, and Laraway to deliver the future of tech for mental health care in Vermont.

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