With the right platform, behavioral health practice successfully adapts through disruption

By Jennifer Lewy | April 2, 2021


Dr. Sanjay Nigam’s five-provider behavioral health practice, located in suburban St. Louis, Missouri, quickly adjusted to new ways of working during the pandemic. Southern Illinois Associates, LLC, adopted a telehealth solution to stabilize volume and maintain contact with the patients who needed it most virtually. They easily leveraged athenahealth’s Marketplace for third-party applications that nimbly adapted communication and workflows. In fact, the changes they implemented have been so successful that Dr. Nigam and his team are building a brand-new facility and plan on adding a provider to the group. They have delivered conveniences like virtual check-ins, conducted successful patient messaging campaigns, and kept providers up to date with documentation. Best of all, they have created even more meaningful relationships with their patients.

[Click below to hear Dr. Nigam speak about thriving in change.]

As a practice, how have you developed resiliency?

It’s important for a behavioral health practice like ours to handle disruptions like the COVID-19 pandemic while providing uninterrupted care to our patients. In a typical day we deliver psychiatric services like medication management, counseling services, ongoing therapy and long-term care management. We go into several nursing homes and group homes. We also provide opioid addiction treatment. We need a platform that sustains our financial and clinical processes as things around us change. We partnered with athenahealth to deliver that kind of foundation — and now that’s what has allowed us to adapt and grow.

How has offering telehealth affected your practice?

We developed virtual care during the pandemic. Our athenahealth customer success manager helped us to establish telehealth services over the course of a few hours.

Offering virtual care has made it possible to see more patients. It’s been a major factor in our ability to grow as a practice. We’ve been encountering more patients with anxiety, especially since the pandemic started. Telehealth is convenient for them. They are glad they don’t have to go out for an appointment. It’s also kept our clinic running despite unexpected office closures. For example, in a recent storm, we previously would have cancelled the clinic. But with telehealth services we could run the full clinic remotely.

Having telehealth has also made it easier to adapt to changing treatment guidelines. We can now start a patient via telemedicine for opioid addiction treatment. We were not able to do that before COVID-19. Our nurse practitioners and social workers have adapted quickly to using telehealth to protect the comfort and health of our patients and staff while continuing to deliver care.

What are the most important factors in sustaining your practice during times of uncertainty?

Having telehealth in place helped us do much better during the pandemic compared to previous years when we would have to totally shut down for unexpected interruptions. Besides virtual care, athenaCommunicator is a very effective tool. It allows us to send messaging to our entire patient population to educate them about things like changing office policies and our new telehealth services.

We worked to make payment policies more flexible. That eased some of our patients’ anxieties during the pandemic about paying their bill and allows them to keep up with their care. We regularly utilize athenahealth’s Marketplace apps like Qure4U and CallMyDoc to communicate with patients in real time. And we are now developing virtual check-ins, which will be another welcome service for our patients.

How do you balance providing patient care with running the business side of things?

Our number one priority is maintaining relationships with our patients. We need to do that effectively without getting bogged down by things like billing and documentation. It’s important for our providers to be able to send secure messages and referrals to other providers. It was very difficult to do that with our previous EHR. Now it is very easy. I can make a primary care referral, neurology referral, sleep study referral, and I can choose and add the right document. It takes less than a minute to take care of it right there with the patient. Those things are really valuable to me and I think other practices would enjoy that kind of functionality, too.

What I appreciate the most is the time I get to spend with my patients. I’m able to look into a person’s eyes when we’re talking. I’m not missing what the patient is trying to say because I’m too busy with notes. I can put my pen down. I can take my hands off the keyboard and still complete the documentation.

I always ask about a patient’s goals and expectations of me and my practice. athenahealth provides the tools to record all that in the assessment and plan. At our practice, we finish our notes 99 percent of the time on the same day. And the rest will be done the next day.

What advice do you have for other behavioral health and psychiatric practices considering their technology options?

Look at your current capabilities and consider how they can be improved upon. Our previous EHR had no integrations or apps available which made it very difficult to use. athenahealth’s interface is much easier to work with. It integrates all our different labs and services into a single interface.

With our former billing company, it could take months to hear about errors that needed to be fixed. Having full control of the billing through athenaOne has helped because now we can see the entire revenue cycle. It’s easy to run different reports in real time so we can catch any issues and track our revenue. That has improved the overall performance of the practice.

I would definitely recommend athenahealth to other behavioral health practices. In my opinion, the steps to migrate to athenahealth were simple. The training athenahealth provided was very effective. During implementation, we started with a 50 percent schedule for the week. I was thinking we’d have to do that for about two weeks. But we were running 100 percent in athenahealth by the end of the first week. All my providers learned athenahealth very quickly.

The key for us is adaptation. I am confident that we have the capacity to stay flexible and maintain patient relationships, and continue to grow our patient base, no matter what comes our way.

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