Samepage Healthcare – Software for remote and collaborative care 

Medicine is changing rapidly. The times when a doctor’s visit meant a face-to-face interaction between one patient and one doctor seem to rapidly go away. Nowadays, we are observing online clinical consultations increasingly replacing in-person appointments. The COVID-19 pandemic has had an enormous influence on the speed at which this change is taking place. However, the changes started much earlier. 

With virtual appointments, it has become possible to create a team of doctors with different specialties to provide better care in a highly cost-effective way. This aligns with a greater appreciation that optimal healthcare is rarely about one provider treating one patient in an isolated environment. In order to optimize the health of an individual or a population of patients, the evidence-based model of collaborative care is deployed. Simply put, collaborative care allows multiple providers to efficiently communicate with each other about a patient’s diagnosis and treatment. Thanks to the timely sharing of clinical notes and results from patients’ visits, healthcare providers can collaborate and treat the patients or patient populations in the most effective way possible. 

About Collaborative Care Model

From a clinical point of view, the collaborative care model facilitates the integration of behavioral health and general medical services and allows health systems to treat the whole individual. It has proven to improve patient outcomes, save money, and get rid of administrative burdens, such as emailing referrals, requesting records, or chasing down lab results. In addition, the use of virtual and integrated services helps to reduce the stigma related to mental health.  

A collaborative care team includes a primary care provider (PCP) as well as behavioral health care managers, psychiatrists, and other mental health professionals. All of them collaborate effectively using shared care plans that incorporate patient goals. It is especially important for patients with chronic or complex conditions, who receive collaborative care to ensure that their healthcare treatment plan is properly coordinated between clinicians, laboratories, pharmacies, and healthcare facilities. The collaborative care team implements a measurement-guided care plan based on evidence-based practice guidelines and focuses on all patients in a caseload, but particularly those who are not meeting their clinical goals. Practices track and reach out to those patients who are not improving. In their case, mental health specialists provide caseload-focused consultation, instead of just delivering ad-hoc advice.

Integrated care in and the Samepage Healthcare solution 

In addition to improving outcomes and quality of care, collaborative care increases access to care, including the opportunity for patients to get both physical and mental health care through a familiar location or source. The experience of those who receive collaborative care is that it is comfortable to patients and reduces duplicate assessments. Increased patient engagement leads to a better health care experience and improved treatment outcomes.

The Samepage Healthcare system facilitates the provision of collaborative care to ensure that health systems can effectively treat individuals with multiple behavioral health and medical conditions. Samepage Health is a patented, reimbursable, highly-scalable, evidence-based software and services platform for patients best served by behaviorally integrated collaborative care. 

How does it work?

Samepage Healthcare helps healthcare organizations to integrate behavioral health into chronic care management programs and primary care settings. The solution optimizes clinicians’ performance and improves outcomes and revenue generation through team-based behavioral and medical care. Based on clinical trials and experience with hundreds of providers and multiple settings, Samepage Healthcare software facilitates systematic case review (a virtual team of providers efficiently coordinating care during a weekly review of a patient), behavioral brief interventions, and simplifies documentation for clinical and reimbursement purposes. 

Samepage Healthcare case review provides a flexible registry for psychiatric and medical caseload supervision. Patient information is accessible in one consolidated record, including demographic information and contact notes. The platform streamlines this process through presentation templates, team tasks management, and outcomes tracking. It is possible to set personal notifications to be triggered if patient-reported data indicates high-risk factors. The software guides care managers in training and skill maintenance of proven behavioral strategies, such as problem-solving treatment or motivational interviewing techniques. The system ensures care managers can easily follow evidence-based methods in a HIPAA-secure and standardized way.  All forms, surveys and questionnaires can be exported securely to PDF and converted into a print-friendly format, and clinical notes are automatically generated. 

Samepage Healthcare software not only documents patient contact to the minute but also provides a record of goal setting and shared decision making. Treatment plans can be customized as needed and communication between clinicians is facilitated through secure messaging. 

Real-life results

The Samepage Method was implemented in 11 clinics of a large Health Delivery Network. Patients enrolled in the Samepage pilot program had out-of-target diabetes and out-of-target hypertension and clinical depression. Afterwards, they experienced a 56% reduction in emergency room visits, and within 17-24 weeks, they achieved target goals for A1c (glucose control), PHQ-9 depression scores, and blood pressure. 

How does the Samepage Healthcare solution facilitate the achievement of such outcomes?

The Samepage Healthcare Systematic Case Review module is utilized by integrated collaborative care teams (consisting of psychiatrists, social workers, nurses and physician assistants) who thoroughly a population 50-60 cases in under 2 hours on a weekly basis. The software supports value-based payments and reimbursable services and integrates with most electronic medical records (EMR) and case management platforms (the latter thanks to the fact of being HIPAA-compliant SaaS software with robust APIs).  In this way, it enhances current care offerings without disrupting existing workflow.