Deanne Clark, senior health informatics consultant at Juno Health, recently sat with our editorial team to discuss behavioral health, preserving the Golden Thread, and how Juno EHR empowers healthcare professionals to ensure care continuity.
The following has been edited for length and clarity.
Clark: The Golden Thread is all about keeping a seamless record across a patient’s care journey, from treatment plans to clinical notes to outcomes. Streamlining documentation and care delivery helps drive consistent patient outcomes and care quality.
Electronic health records (EHRs) maintain this Golden Thread documentation by enabling interactive and editable data and ensuring historical data follows each patient. But behavioral health has fallen behind technologically, struggling with paper records and poorly designed systems that create information silos and redundant data entry.
Unlike acute care, which operates with “concept of care” teams, behavioral health developed interdisciplinary teams and treatment plans to drive care from admission to discharge. The treatment plan is a living document that can be updated and accessed by different people—beginning with the patient assessment in the first 24 hours and updated over time. These plans help maintain the Golden Thread because multiple people can access and update them throughout the patient journey. The biggest challenge is follow-through.
Staff must execute interventions to help the patient progress. You may have nurses and others who aren't official members of the treatment team providing support, but everyone bears a responsibility to perform and document actions. If they don’t, it can cause compliance headaches and undermine team trust and accountability.
And just a few years ago, COVID-related staffing disruptions impacted group sessions, making it difficult to rebalance daily workloads. Having that at your fingertips is crucial, from redistributing work to ensuring groups have the right type of therapist.
Clark: When the Golden Thread is broken, everything goes into disarray. For one thing, care breaks down. Not fulfilling your obligations as a team—or not doing so in a timely fashion—can lead to violence or delaying discharge. Maybe you had a great place for a patient but can’t transfer them and close out administratively until everything is documented clinically.
Not to mention the billing and insurance implications of missing the mark—treatment plans enable you to bill for an episode of care, and if the Golden Thread breaks and plans fall apart, this could result in nonpayment or reduced payments. If such issues are looked at through a joint commission, you need to prove you followed your treatment plans to avoid scrutiny or even a shutdown due to noncompliance.
Besides, you don’t want to wonder if someone dropped the ball or if there’s a more efficient way to do something. Older EHRs and technologies for treatment planning were very rigid, and you couldn't adjust the language. But people are all unique, making the case for personalized, editable EHRs for treatment plans. Making treatment plan content your own saves time and helps preserve the Golden Thread.
Clark: Juno EHR streamlines care management and the transfer of Golden Thread documentation in behavioral health settings, whether it’s for group or individual work. The software ensures continuity of care and reduces redundant data entry.
With Juno EHR, users can seamlessly craft individual treatment plans that integrate patient interactions, goals, and interventions to take your team from care delivery to discharge planning. They can also document patient assessments and pull treatment plan interventions into notes and group notes to streamline data entry, shape next steps in treatment, and improve handoffs. And with the powers of session manager and scheduling, your team can further tailor the treatment journey on an individual basis, coordinating and tracking engagement with sessions and activities that align with treatment plans.
But our biggest benefit is personalization. Juno EHR allows you to adjust content to your needs instead of fighting with a cookie-cutter solution or a vendor. Staff can focus on what matters and reduce their frustration without losing care continuity. Personalization streamlines what you can do, from ensuring your notes are complete and accurate to making sure a treatment plan was signed by everybody on the team. Being able to configure and personalize across different patients and programs aligns care across the full spectrum, all the way to compliance and reporting.
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