The behavioral health field is one of the most varied and highly specialized in all of healthcare. At Sigmund, we specialize in building software solutions for behavioral health organizations and understand how powerful an EHR software must be to meet the precise needs of providers in this space.
Intellectual or Developmental Disabilities (IDD) treatment providers have some of the most precise needs within the behavioral health industry. As a result, an IDD EHR must be powerful enough to facilitate the delivery of their unique treatment.
In this blog post, we’ll explore what makes IDD treatment so complex and what providers need out of their IDD software to deliver the best possible care to their patients.
What is IDD?
As mentioned above, IDD stands for Intellectual or Developmental Disability. IDD is an umbrella term for a wide range of conditions caused by mental and/or physical impairments, many of which can be severe and chronic.
These are disorders that typically present at birth or in early childhood and impact an individual’s physical, intellectual, mental, and/or emotional development.
The variety and severity of IDD conditions vary greatly. The U.S. Department of Health and Human Services breaks down the scope of IDD by which aspects of the body they affect, which is a helpful way to organize the spectrum of conditions. Check out the breakdown below:
- Nervous System: Disorders that impact the functions of the brain, spinal cord, and nervous system, which can affect intelligence and learning. These conditions can also cause trouble with movement, speech and/or language difficulties, as well as behavioral disorders. Some examples of these disorders are cerebral palsy, down syndrome, and autism spectrum disorders (ASDs).
- Sensory System: Disorders that impact the senses or how the brain processes and interprets the information received from the senses. Some of these disorders are the result of an illness or infection that causes issues with an individual’s hearing and/or eyesight. Additionally, some people with ASDs may have trouble being touched or held and thus fall under this sensory category.
- Metabolism: Disorders that impact how the body uses food and other resources for energy and development. If the body is unable to break down and digest food, it can lead to an imbalance or insufficiency of the metabolic fuel needed for the body to function properly. Phenylketonuria (PKU) and congenital hypothyroidism are two metabolic disorders that can lead to an IDD.
- Degenerative: Disorders in which symptoms do not present immediately and may not present until adolescence or adulthood. These individuals develop normally for a period of time before losing skills, abilities, and functions due to a degenerative disorder. Some examples are Alzheimer’s and dementia, Huntington’s disease, or Parkinson’s disease.
IDD Software Solutions
Now that we’re clear on what IDD is and what an IDD EHR should be capable of, let’s examine 3 specific software solutions that an IDD provider needs to deliver the best possible care:
- Reporting and Outcomes Software
- Care Coordination Tools
- Engagement Tools
Reporting and Outcomes Software
Providers in this space need an IDD software solution that allows them to easily record behaviors, interventions, and outcomes.
Consider the treatment goals and kind of data an IDD provider needs to track and analyze vs. those of a mental health or addiction treatment organization.
In mental health treatment, providers are tracking relatively straightforward metrics, such as depression symptoms in the form of a scored assessment. In substance abuse treatment, the data can be as straightforward as tracking someone’s sobriety.
IDD providers are tasked with layered and often elusive treatment goals, like getting a nonverbal patient to ask for what they need. There is no exact blueprint for achieving a goal like this because each individual with IDD will respond to treatment differently. Furthermore, a nonverbal patient is unlikely, and often unable, to communicate what is working for them and what isn’t.
As a result, IDD providers must rely on data in a unique and exhaustive manner. There is a need to track virtually every possible behavior a patient could exhibit, as a response to their condition or treatment approach.
You might not even know what will be the most important metrics to track until you start treating someone so you must be able to track them when you find them. And considering how precise or microscopic those metrics can be, you need as much computing power as possible to support that.
To better illustrate this, let’s look at a real-world scenario.
Let’s say a provider is treating a nonverbal child with a moderate to severe IDD. They are unable to express which interventions (treatment methods or actions taken by the provider) are helpful to them and which are not.
In these cases, providers face the challenge of identifying positive interventions and excluding negative interventions largely through trial and error. However, that only works if you’re able to precisely track which specific intervention elicits which response from the patient.
In AURA, Sigmund’s enterprise software solution, we’ve created a tool called Target Behavior Tracking (TBT) specifically for this type of situation.
TBT is designed to track and organize how to get patients to do positive things (make sounds, move their body, attend work, clean their room) and which interventions helped make those things happen. In this way, TBT is used to not only increase a patient’s positive behaviors, but to teach providers how to best treat their patients as well.
Conversely, TBT also helps decrease negative behaviors. Let’s say you’re treating a patient that bangs their head against the wall when they get overwhelmed. That’s a behavior that must be reduced.
As a first attempt, the caretaker puts a hand on the patient’s shoulder when they start hitting the wall with their head. That’s an intervention that is trackable with our TBT tool. When the caretaker puts their hand on the patient’s shoulder, though, it causes them to get more upset and become aggressive towards their caretaker. That’s the subsequent behavior that is trackable with our TBT tool as well.
As a second intervention attempt, the caretaker plays a specific song when the patient bangs their head against the wall, which results in the patient calming down. That intervention is then recorded as one that yields a positive behavior.
In AURA, these are all separate data points that can be captured automatically using the TBT tool, which can then be visualized in a graph for easy review. That way, providers can systematically track every single intervention and how they either increase positive behaviors or decrease negative ones.
The way TBT synthesizes and digitizes this complex, tangible trial and error process is a huge plus for IDD providers. The biggest benefit here is how precisely AURA can track and differentiate between specific pieces of data. It takes dynamic, cutting-edge data capture technology to be able to leverage the data that truly makes a difference in IDD treatment.
To deliver the best treatment possible, IDD software must empower providers to precisely and comprehensively track behaviors of patients, interventions attempted by providers, and the subsequent outcomes.
Care Coordination Tools
There can be a lot of moving parts in an IDD patient’s overall care.
For example, a patient’s care may involve:
- Working with a social worker at an IDD organization
- Working with a psychiatrist who prescribes or evaluates medications
- A therapist who primarily works/communicates with the patient’s family/guardian
- An employment counselor who coordinates the patient’s employment
- A specialist, such as a music therapist, that comes to the patient’s house to provide care
That’s where an IDD EHR comes in, to tie all those treatment threads together. To compile and record a comprehensive picture of the patient’s care. That way, each professional has the necessary information and context to not only treat their patient individually, but to do so in accordance with all the other care the patient is getting.
Perhaps the most important care coordination tool in an IDD EHR is the care plan, which incorporates both workflow and documentation solutions to serve as the central hub for a patient’s treatment.
This is the feature that establishes and organizes the patient’s care strategy so that each provider and caretaker is working toward one common treatment goal. By automatically and intuitively collecting relevant data from every treatment setting, all parties can refer to that information to ensure their efforts are aligned and complement all other treatment approaches.
Because there are so many moving parts in a patient’s treatment, an EHR should offer a dynamic IDD scheduling tool as well.
Though this may seem obvious, it’s a critical feature that makes a patient’s care consistent and streamlined.
Providers should make sure that their IDD scheduling tool contains an automated conflict checker to avoid double-booking the patient across all levels of care.
Guardians or caretakers are typically the primary communicator and advocate for IDD patients.
An individual with an IDD can’t always use the phone or navigate digital technology. They may need a guardian to set up and confirm appointments, submit payments, review documents, provide signatures, and communicate with the care providers.
Because a third party is largely responsible for the patient’s treatment management, IDD software must offer a mobile, user-friendly patient portal. From there, a guardian can leverage all the tools of a modern patient portal to manage and coordinate the patient’s care.
In some cases, the guardian or caretaker isn’t the only one who needs access to a patient’s record in the portal.
For example, it’s common for certain specialists (like a music or speech therapist) to not be on an IDD organization’s staff and thus not be able to access the EHR. However, with access to the patient portal, a specialist could administer helpful assessments and record treatment progress.
An IDD EHR should have the ability to incorporate the efforts of care providers outside their practice. That way, they can always offer the patient a comprehensive treatment experience. It’s important to be able to track that those services were provided, and the outcomes of those services, to preserve a complete picture of the patient’s health.
These engagement tools play an integral role in keeping a patient’s care comprehensive, coordinated, and progressive.
Finding Your IDD Software Solution
One of the driving philosophies for treating IDD populations is having patients do difficult things to help and support their development. Those things are often frustrating to the patients. They don’t necessarily know how to deal with those frustrations and commonly respond with negative behaviors.
The mission, and challenge, for providers is to figure out how to best support their development and navigate those frustrations simultaneously.
An effective IDD EHR offers the tools to deliver that treatment and support. Through features such as dynamic data tracking, a powerful workflow engine, and a robust virtual care environment, providers are empowered to deliver precise, individualized care to each patient.
As you treat a patient and compile treatment data, your IDD software should be able to leverage that information into a treatment “blueprint” – one that presents which interventions are effective and therapeutic, and which ones are counterproductive. As a result, treatment approaches can be consistently refined and optimized for the patient’s unique needs and preferences.
If you’d like to learn more about what your IDD software solution should look like, or where to find one, feel free to reach out to one of Sigmund’s knowledgeable professionals today!
We also mentioned that engagement tools and the virtual care environment play an integral role in an IDD patient’s care.
Matthew Prete, Sigmund’s VP of Software Development and Information Technology, recently presented a webinar that examined the true potential of the virtual care environment. He explores a variety of crucial patient engagement solutions that allow providers to deliver thorough and patient-centered care, even under the constraints of the pandemic.
Matthew examines the cutting-edge engagement features AURA offers, many of which are extremely helpful to a guardian or caretaker who is managing the care of an IDD patient. To get an even better idea of how an IDD EHR should support IDD treatment, click the button below to view the full presentation!