New system alerts Bridgeway Center when mental health patients show up at the ER

Sep 9, 2021 | In the news

FORT WALTON BEACH — When a patient shows up at an emergency room during a mental health crisis, Bridgeway Center Clinical Officer Larry McFarland said the behavioral health center often never knows about it.

“You see that especially with our substance-using individuals,” McFarland said. “It denies us that opportunity to reach out and try to engage someone, because clearly if either a loved one or themselves presented them to an ED (emergency department), at least they’re thinking about getting help.”

Bridgeway Center will join the Florida Health Information Exchange’s Encounter Notification Service (ENS) next month, and McFarland said the new alert system could help the behavioral health center reach out to some people who might otherwise fall through the cracks.

The system has already been connecting several health care providers throughout the state with real-time notifications about their patients’ hospital encounters, but Florida HIE outreach specialist Ashely Wells said in a Tuesday video conference that they are starting to see more behavioral health organizations participating.

“We’re excited to be reaching more of the behavioral health community and getting more behavioral health facilities sharing data,” Wells said. “They’ve really used it a lot for that seven-day post discharge follow-up measure, which I believe is relatively new for mental health facilities.”

The Encounter Notification Service receives admit, discharge and transfer notifications from over 400 health care facilities that have signed up across the state.

Many local hospitals are already participating including, Fort Walton Beach Medical Center, Ascension Sacred Heart Hospital, Baptist Hospital and more. That information is then matched with patient lists provided by other subscribed organizations.

“What happens is we get the permission from our clients and patients, and what we do is we say ‘Look, we want to be able to know when some adverse situation happens where you wind up in the doctor’s office, emergency department or a hospital,’” McFarland said.

Organizations like Bridgeway Center will receive an alert if a patient who has agreed to be put on their list receives care at any number of health care facilities in the network.

“It’s really quite neat because it’s minimally intrusive. It’s minimal information. It’s only patients that have agreed and it’s instantaneous,” McFarland said. “The alerts, as soon as they’re processed, the alert goes out and our people see it every day.”

The alert will tell behavioral health providers the time and place the patient showed up, their chief complaint, what services were rendered and when they were discharged.

“It’s not meant to be extensive. It is not meant to be everything that might appear in a patients’ medical record,” Wells said. “It’s meant to be just enough information for you to assess the nature and severity of the encounter so you can base your follow-up accordingly.”

McFarland said case managers with Bridgeway Center will monitor the alerts and reach out to patients within seven days of discharge to link them with various services. Case managers currently do that with patients who have been admitted to psychiatric hospitals.

“They get that alert and what will happen is they’re going to send a case manager out to you and say, ‘Hey are you OK? What’s happening?’ and just touch base with you,” McFarland said. “If it was behavioral health, then we’re going to make sure you get linked to the services you need.”

The system is also expected to help providers lend “emotional support” to patients with physical health problems. McFarland said they “can’t fix broken bones,” but can help provide transportation and other services needed for patients to continue receiving mental health care.

Although taking part in the Encounter Notification Service is optional for patients, McFarland said he expects it to be highly beneficial. Behavioral health providers plan to educate current clients on how it may help them.

Last month, a woman said her husband who was experiencing severe mental health issues sought help at a hospital in Pensacola but was not admitted. The 39-year-old man was arrested two days later for murder. McFarland said the Encounter Notification Service may help prevent situations like that in the future.

The Baker Act allows a person to be involuntarily committed to a mental health treatment center for up to 72 hours if they display certain violent or suicidal signs.

But McFarland said many people who show up at an emergency room are not admitted for inpatient care, and Bridgeway Center previously would not have any knowledge of those encounters. The Encounter Notification Service will change that.

“For cases where people are visiting emergency departments, it’s really going to be nice,” McFarland said. “We already have that happen with full-on psych admits. But so much of the time it is not — more people are not Baker acted than are that present to an emergency department.”

McFarland said the Marchman Act is also rarely invoked. Florida Statutes allow family members and other people to address serious situations in which a person is over-using drugs or alcohol and refuses or is unable to seek help by petitioning for court-ordered evaluation and treatment.

“If we can get to them while they still have that thought in their mind, all the better. So that’s what this system is designed to do,” McFarland said of ENS. “Get that early alert out so people can reach out while the person is still thinking about getting help. People that are already involved in the system, it will absolutely be a help.”