A modular, extendable ambulatory electronic medical record software platform has enabled a mental healthcare provider to quickly innovate to integrate psychiatry into its offerings.
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UpLift, which started operations at the end of 2021, is using technology from Canvas Medical, a San Francisco-based EMR and payments company, to deliver faster, more targeted psychiatric referrals, even allowing therapists to schedule follow-up psychiatric care during their own patient encounters.
UpLift’s service delivery model is based around the patient-therapist relationship and is delivered 85% virtually and 15% via in-person encounters.
“While in a video session, the therapist is able to actually look at the psychiatrist schedule, understand their profile, and actually book that encounter, send them a note, and be able to do that at the point of care,” says Kyle Talcott, the organization’s co-founder and chief executive officer.
This convenience replaces the traditional therapy practice of steering patients undergoing mental health treatment to directories of psychiatrists so that they can book their own follow-up appointments, and it helps pre-quality patients for the referral by matching patients with the insurance accepted by the psychiatrists.
The in-network referrals currently connect the patients to psychiatrists employed by UpLift, but could be expanded to other psychiatrists that also accept the patient’s insurance, Talcott says.
As a result of the follow-up appointment being made by UpLift-contracted therapists, “we have very low no-show rates, especially compared to [other] mental health providers,” he says.
The key technology enablers are application program interfaces (APIs) included in the Canvas EMR that permit UpLift’s technology team to orchestrate desired features, such as the in-session psychiatric referrals.
At a time when America faces a crisis of demand for mental health services and a shortage of qualified therapists, the UpLift playbook is to innovate in nimble ways to fill this need. The platform allows the company to reach out to the growing number of therapists who have opted out of working for large healthcare systems and networks.
“We started out really focused around solving the pain point of finding an in-network therapist,” Talcott says. “So we work on both sides, both bringing therapists into our virtual group practice, and then helping them actually enroll, get credentialed with and contract with the large health plans in a given area.”
UpLift contracts with close to 500 therapists, and its growth strategy is regional in nature. It now offers services in the District of Columbia, Virginia, and Maryland, Talcott says, and in March will expand into Florida.
The company also reaches out directly to consumers, working with local providers to help patients find in-network therapists.
The integration of psychiatric services adds some core capabilities that psychiatrists require beyond what therapists can do, such as e-prescribing and some EMR components.. Canvas APIs made that integration work more smoothly than any other alternatives evaluated by UpLift, Talcott says
Talcott says his history with digital health startups left him with the impression that many keep rebuilding the same components, thus slowing down innovation. The Canvas platform, he says, enabled UpLift to achieve the needed data integration and automation more quickly.
“For us, the ability to bring in some of these components, which are very complex, you could do individual integrations, but it would take a long, long time,” he says. “To be able to bring them in through somewhat standardized APIs that are prepared has allowed us to speed up. We were able to launch psychiatry in close to a month.”
The use cases for therapists and psychiatrists are different enough that UpLift had to optimize each use case. For example, psychiatrists need to be enrolled and credentialed into each health plan UpLift supports.
“Some take longer than others, so when somebody is looking at a schedule, it’s actually the right psychiatrist for them,” Talcott says.
The technology also helps match patients to the right therapist, he adds.
“As that patient journey continues, the information is shared between the two providers, which historically has not really happened in mental health,” he says.
Traditionally, a patient sees a psychiatrist, who may prescribe a medication. Patients may return to see the psychiatrist as little as once a quarter, while they continue to see their therapists weekly, Talcott says.
If the therapist senses some issue or side effects with the medication prescribed by the psychiatrist, the UpLift platform is able to send that information to the psychiatrist, who may adjust the medication or dosage between psychiatric appointments, Talcott says.
Although initially offered as a fee-for-service, UpLift’s model anticipates the move to value-based care.
“Our goal is to move towards shared risk over time,” Talcott says. “The health plan landscape is very early, especially in broader-based mental health. We’re in conversations now with various health plans around how we build a bridge towards shared risk.”
The company is also considering integrating pharmacists into its care team, he says.
“Having pharmacy be able to understand the impact of all those medications is really critical,” Talcott says. Such a model, he notes, may become more practical as the service moves from fee-for-service to value-based care contracts.