Vinfen

Advancing Creative and Effective Use of Technology in New England

THE PROBLEM Massachusetts is considered a leader in health care delivery reform in the U.S., as well as a hub for innovations in biotechnology.1,2 As part of the state’s ongoing health reform efforts, public health leaders identified significant gaps in the ability to care for both the physical and psychological health of individuals living with serious mental illness. 3 In Massachusetts and elsewhere in the country, many primary care physicians are not always equipped to address the combined needs of those with serious mental illness, and if conditions are left untreated or undertreated, it can have a profoundly negative impact on the health of these individuals as well as on the utilization of vital community resources, such as public emergency departments.4,5,6

KEY SOLUTION: INNOVATIVE TECHNOLOGY Vinfen is leading the way in identifying and implementing a novel technology solution to connect two critical aspects for people living with serious mental illness – their physical and mental health needs. In 2012, Vinfen – in partnership with three other community behavioral health organizations (Bay Cove Human Services, North Suffolk Mental Health Association and Brookline Mental Health Center) and a non-profit care delivery system (Community Commonwealth Care Alliance) – won a three-year Center for Medicare and Medicaid Innovation Health Care Innovation Award (HCIA) to support the organization’s study on “Community Behavioral Health Homes for Individuals with Serious Mental Illness.” This study uses Bosch Healthcare’s Health Buddy telehealth system along with the Dartmouth-developed Integrated Illness Management and Recovery (IIMR) training curriculum to integrate health care and behavioral health care for individuals with serious mental illness and chronic medical illnesses utilizing real time feedback.  Vinfen was introduced to the Health Buddy by Dr. Steve Bartel and his team at Dartmouth Medical School. Vinfen and Dartmouth have maintained a decade-long partnership anchored in a shared focus on emerging best practices and innovative health solutions for those with serious mental illness. Dartmouth is also a partner in the HCIA study grant.  The Health Buddy is a small device with four buttons and a display screen designed to help individuals manage their physical and mental health needs on a daily basis, identify potential risks and work as a team with providers. Each person utilizing the Heath Buddy is assigned an individualized series of daily questions based on their physical and behavioral conditions. The data from each Health Buddy session is coded by algorithms based on level of urgency and sent to a dedicated nurse practitioner for review and action to ensure proper disease management.  Once enrolled in the study, individuals are given the Health Buddy device to use in their homes at no financial cost, as costs associated with the Health Buddy are covered for study participants under the HCIA.  The Health Buddy and IIMR systems are teaching individuals with serious mental illness to manage their chronic medical conditions and access care sooner to avoid more severe complications.

ADDITIONAL STRATEGIES In addition to the Health Buddy, Vinfen is engaged in a variety of innovative approaches, including:  Integrating Nurse Practitioners and Health Outreach Workers into existing community based psychiatric rehabilitation and recovery teams to merge physical and behavioral health care. Vinfen

 Continuing to develop close relationships with local hospital providers, research institutions and government agencies to better coordinate care among individuals’ various care providers.

ABOUT THE COMMUNITY Administrators at the Massachusetts Mental Health Center and Harvard Medical School, who sought to provide residential services for people with developmental disabilities and mental illness, founded Vinfen in 1977. Vinfen is a non-profit organization that provides a comprehensive array of services to people of all ages with psychiatric, developmental and behavioral disabilities. Vinfen operates more than 300 programs in eastern Massachusetts and northern Connecticut.

References: 1. Commonwealth of Massachusetts Department of Public Health. “Health Care Access.” Health of Massachusetts, 2010. Available at: www.mass.gov/dph/healthofmassachusetts. 2. U.S. Bureau of Labor Statistics. “Quarterly Census of Employment and Wages.” 2011. Available at: http://www.bls.gov/cew/home.htm. 3. National Association of State Mental Health Program Directors. “Fact Sheet on Accelerating Integration of Primary Care, Behavioral Health and Prevention: The SBHA Role.” 2012. Available at: http://www.nasmhpd.org/docs/Policy/Behavioral%20Health%20Primary_Fact %20Sheet%20Accelerating%20Integration%20of%20Primary%20Care.pdf. 4. Health and Human Services: Departments & Divisions. “The History of the Department of Mental Health.” 2013. Available at: http://www.mass.gov/eohhs/gov/departments/dmh/about-the-department-of-mental-health.html. 5. Rosemarie K., et al. “Attitudes Toward Mental Illness.” Centers for Disease Control and Prevention. 2012. Available at: http://www.cdc.gov/hrqol/mental_health_reports/pdf/brfss_report_insidepages.pdf. 6. Centers for Disease Control and Prevention, Office of Information Services. “Mental health.” 2013. Retrieved from website: http://www.cdc.gov/nchs/fastats/mental.htm.

The project described is supported by Funding Opportunity Number VMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. The contents of this publication are solely the responsibility of the authors and have not been approved by the Department of Health and Human Services, Centers for Medicare and Medicaid Services.