e )
Action Area : Improve System Efficiency
Respondents indicate that there is an opportunity to improve system efficiency by having an integrated , longer-term approach to service provision .
Research participants discussed system-level issues in two categories : ( 1 ) crisis or short-term needs ; and ( 2 ) longer-term or chronic needs . Crisis or short-term needs benefit from immediate access to critical patient and situational information and care . Participants indicate that siloed operations among health systems , public safety , and other entities ( though instituted to secure patient privacy – which all agree is important ) can reduce ability of providers and first responders to have access to timely , helpful information .
Longer-term or chronic needs require coordination between and among service providers . Participants say that a centralized organization or other type of entity that could better coordinate system level activities would be helpful . For example , they say that in many cases , grants temporarily assist certain populations , but when the grant money runs out , programs end , and the patients are left without services . Additional coordination of care between organizations would help alleviate some of these issues . Others shared that excessive administrative burdens , duplicative / redundant paperwork , and other specific grant requirements are time-absorbing and consume limit resources that could otherwise be used to enhance patient care . Additional comments are included in the “ Breaking Down Silos ” theme narrative below .
• “ We need a centralized grant management system that shortcuts a lot of the administrative work required of us [ i . e ., grant recipients ]. Believe me , I would much rather spend an additional 20 % of the grant money on direct care than on admin !”
• “ The region needs a recovery community center – one centralized location , one phone number that can provide peer support , a robust longer-term care network , and a clearing house for services . Having ‘ trusted resources ’ takes a long time , as it requires a longer timeline for patients – especially mental health and SUD patients – to build trust . A more efficient system can be built by linking services .”
• “ Getting the initial intake is a big challenge . If you need to be seen by a psychiatrist , you ’ ll need to be patient – and not in crisis ! Many times , the doctor is overbooked , so it takes time .”
• “ PCPs [ primary care physicians ] are not fully educated on behavioral health issues and DO NOT have access to Care Coordination services .”
• “ Managing entity structure seems very finance-driven , rather than outcomes-driven because of working with managed care .”
• “ Many different organizations share the same patients ; all have different processes , and the systems don ' t talk with each other . There are a lot of demands on patients , made even worse when they ' re in the criminal justice system . It seems that many organizations don ’ t see the situation from the patient ' s perspective . Many others do , but they are limited in their ability to tear down silos . Also , in many places , there is a culture of protectionism due to variety of limited financing ( County health plans , grants , Medicaid ). I understand that some aspects of the system-level , finance-related thing are unavoidable , but I think that something as simple as a grants management or coordination system would help .”
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