As alarm bells sound around behavioral health needs, Oregon Health & Science University and partners have launched the first phase of an information coordination effort that will make the most of existing resources.
The Oregon Behavioral Health Coordination Center, or OBCC, will be a hub for information about bed capacity among 11 facilities that provide inpatient mental health care. The tool is based on the COVID Capacity Center that OHSU and partners launched three years ago, at the height of the pandemic. Just as that tool provided essential information about bed availability for COVID-19 patients in hospitals across the state, the new OBCC tool will assist in coordinating which beds with what care are available for behavioral health patients.
OBCC has launched amid limited inpatient resources and increasing need for both adult and pediatric patients.
“We have very few available pediatric behavioral health beds anywhere in our state, while our children’s psychiatric needs are escalating,” said Ajit Jetmalani, M.D., a child psychiatrist at OHSU Doernbecher Children’s Hospital. OHSU does not have an inpatient behavioral health unit for children. So once a child in mental health crisis is stabilized in the emergency department but they are not safe to go home, they need to be transferred elsewhere for in patient care.
“This is an often daunting, impossible task for providers, and a further traumatizing experience for the youth and their loved-ones,” Jetmalani said.
“Without centralized information, we are calling around to colleagues with inpatient care, sometimes asking for favors — even as other providers are, as well,” he continued. “This is an incredibly disheartening and stressful time, full of medical and moral conundrums. Without adequate resources, it is absolutely essential that we make the most of what we do have by efficiently coordinating among providers.”
The coordination effort is another remarkable show of health systems cooperating for the benefit of patients, said Matthias Merkel, M.D., Ph.D., OHSU senior associate chief medical officer for capacity management and patient flow. Behavioral health care providers across the region — including OHSU Health, Unity Center for Behavioral Health, PeaceHealth, Kaiser Permanente, Trillium Family Services and Oregon State Hospital — participated in developing the tool from the early stages, providing real-time data and feedback to ensure the most valuable information is shared most effectively.
“We are working with unprecedented collaboration in order to better connect Oregon’s fragmented and under-resourced behavioral health services, improve access for Oregonians, and support providers at every level of care,” Merkel said. “OBCC will ensure clinicians have a full picture of available resources as they work to help someone in mental health crisis. These coordination efforts are an important investment for the health of Oregonians.”
After receiving state funding to launch the effort, as well as additional federal support, OHSU worked with health systems, community partners and Oregon Health Authority to build the prototype of a real-time capacity visibility tool, developed in partnership with GE Healthcare and Blackbox Healthcare Solutions.
The phase 1 launch is largely proof-of-concept among a subset of health systems and community partners, demonstrating that OBCC can provide the information essential to better utilizing and coordinating behavioral health resources. OBCC dashboards now provide real-time regional data about behavioral health patient populations in emergency departments; total inpatient and behavioral health inpatient capacity; capacity among community partners; and referral demand.
“Already, OBCC is improving our collective understanding of Oregon’s behavioral health utilization and, most importantly, maximizing the impact of our infrastructure for Oregonians,” Merkel said.
Partners are working to expand OBCC, with the ultimate goal of tracking behavioral health capacity across the state. OHSU and partners aim to fund dedicated OBCC staff who will assist in coordinating placement of both adult and pediatric patients. Data dashboards that are updated in real-time will improve efficiency in getting patients the services they need, and the data collected will help health systems quantify demand for services in order to continually optimize available resources.
The model that OBCC partners envision has already proven effective in the Oregon Medical Coordination Center, or OMCC.
In 2021, OHSU initiated the creation of the OMCC, which works with OHA and other health systems in the Portland metro area to better serve Oregonians who need a higher level of critical care than is available in their communities. The OMCC team uses real-time data about hospital bed availability and available critical care services to efficiently place patients in facilities where they can be treated.
The value of this coordination was on full display during the winter’s respiratory illness public health emergency: OMCC teams coordinated among children’s hospitals to find treatment for children critically ill with RSV, even as pediatric intensive care units were overflowing. As RSV, flu and COVID-19 struck adults, OMCC helped find available beds for patients in rural Oregon, where treatment resources were especially limited.
Just like the phased expansion of OBCC, the center initially coordinated among Portland’s larger health systems and it now coordinates across the entire state — proving particularly valuable for hospitals in rural areas, allowing them to access the state’s highest level of critical care services.
OHSU’s leadership in empowering information sharing across health systems dates back to 2020: At the start of the global coronavirus pandemic, OHSU partnered with OHA, hospitals and health systems statewide to create a capacity tracking tool that provides real-time hospital census data to inform hospitals about inter-hospital transfer options for patients. The system centralized information-sharing efforts and improved coordination of critical care resources available across the state, as the number of critically ill patients, including those with COVID-19, surged.