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Behavioral Screening and Intervention Training and Software

by Richard Brown, MD, MPH

Our package of training, support and unique software enables proactive, systematic population management for behavioral risks and disorders – major generators of death, disease, disability and costs.

Madison, WI Healthy Living

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About this project

The problem we solve:
Among American adults, the prevalence of smoking is 18%; unhealthy drinking, 23%; drug use, 10%; depression, 8%; and obesity, 30%. These conditions lead to 40% of deaths, most chronic disease, and about $1 trillion in healthcare and workplace costs per year. Although many Americans are screened, few receive the robust interventions and ongoing support known to improve outcomes, reduce emergency department visits and hospital admissions, and reduce costs. A key barrier to behavioral screening and intervention (BSI), physician time constraints, can be overcome by expanding care teams with cost-efficient bachelor’s-level coaches. As payers increasingly base reimbursement on value, incentives will grow to hire such coaches. Our package of training, support and unique software enables coaches to deliver high-quality BSI. Results will be healthier patients, fewer burned out physicians, and more successful accountable care organizations and other managed care organizations.

About our solution:
Wellsys (WELL-siss) provides training, support and unique software for BSI. The software guides coaches in administering, scoring and interpreting behavioral screening and assessment questionnaires; issuing feedback, education and recommendations (including referrals as necessary) tailored to patients’ personal and family medical histories; conducting motivational interviewing to promote commitment to healthier behaviors; helping patients to construct behavior change plans and refine them over time; and administering the IMPACT model collaborative care for depression. It engages patients, prints end-of-session summaries for patients, generates progress notes and billing information, and links with electronic health records. It tracks prevalence, service delivery and changes in behavioral outcomes for all patients and for subsets. It enables complete population health management of behavioral risks and disorders – major generators of poor health outcomes and higher healthcare costs.
Progress to date: Wellsys’ BSI program is a spin-off of a successful university-based program which served 33 healthcare settings, screened over 100,000 patients, documented substantial improvements in behavioral outcomes, and generated $791 two-year healthcare cost savings per patient screened. We initially developed the software for touchscreen laptops. We recently moved it to more portable, user-friendly Android tablets. Thoroughly tested and debugged, it will soon be available in Spanish. A current paying customer – a free clinic and partnering social agencies – is pleased with the training and software. In June 2016 we will launch a new paying customer – 3 FQHCs with 10 coaches. We are expanding marketing to small ACOs, because BSI will improve their performance on 16 CMS quality metrics and generate ample shared savings. We are also marketing to joint replacement programs in Medicare’s bundled payment program, because BSI addresses strong risk factors for complications and repeat surgeries.

About Our Team

Dr. Richard Brown, MD, MPH
Family Medicine , Practicing Physician
Location: Madison, Wisconsin
Medical school: Brown University
Bio: Dr. Brown is a family physician and a tenured professor in the Department of Family Medicine and Community Health at the University of Wisconsin School of Medicine and Public Health. He has published dozens of peer-reviewed articles on the primary care management of behavioral risks and disorders. He was president of the Association for Medical Education and Research in Substance Abuse (AMERSA) from 1997 to 1999 and received AMERSA’s McGovern award for excellence in medical education in 2002.
Practice: University of Wisconsin Department of Family Medicine
Hospital Affiliation: UW Health
Title: Training and Software for Evidence-Based Behavioral Screening and Intervention
Twitter: None
LinkedIn: drrichbrown

About Our Company

Wellsys, LLC
Location: Madison, Wisconsin
Product stage: market
Sales: Less than $250,000
Employees: 3-5

How We Help Patients

Most Americans have at least one unhealthy behavior. Most would like to change – at least sometimes. But change can be difficult. Using motivational interviewing, Wellsys coaches approach patients respectfully and empathically. They help patients learn about the relevance of their risks given their personal and family medical history. They help patients take stock on reasons for and against change, considering what’s important to them. They help interested patients develop, and refine over time, personalized change plans that respect their choices and constraints. No lectures, judgment or scare tactics. Lots of listening, acceptance and support, regardless of patients’ decisions whether or how to change. Software guides coaches and patients, enhancing communication and education. Many patients hang computer-generated session summaries on their refrigerators as a reminder of why and how they’re changing. That’s why our coaches elicit lots of patient satisfaction and change.

How We Help Physicians

Physicians in healthcare settings with BSI have been highly satisfied to have a coach addressing important behavioral issues under their supervision. Most recognize the importance of these issues in determining general health outcomes and lament at their lack of time to address them. Many have marveled that coaches have uncovered issues they hadn’t known about and elicited change in patients who have been “stuck” for years. Many have appreciated the stress reduction that delegating these behavioral issues has brought to their daily routines. As value-based reimbursement expands, practicing physicians will be stressed further as their compensation will increasingly hinge on patients’ behaviors. Physician administrators will be challenged to keep meeting higher expectations on outcomes and cost control. Wellsys’ proactive, systematic, evidence-based, cost-effective approach to identifying and addressing behavioral issues will make many physicians’ lives easier.

Challenge Mission

Mission: Behavioral issues are the most prevalent, modifiable risks for poor health and high healthcare costs. Systematic, high-quality BSI would be a potent way to improve population health and reduce costs.
Use of funds: Wellsys would offer a $25,000 discount to an accountable care organization or managed care organization that agrees to implement Wellsys’ program faithfully with several coaches and to document patient and physician satisfaction, and changes in behavioral outcomes, healthcare utilization and healthcare costs. Such data would likely help Wellsys spread BSI to other ACOs and MCOs and benefit many more patients.
Intellectual Property Status: Dr. Brown’s work at the University of Wisconsin and Wellsys are entirely separate. A letter attests that the University of Wisconsin has relinquished all rights to Wellsys’ software and other materials, which are protected by copyright.
Patent Link: Not applicable
FDA Status: Not applicable
Personal Message: My lifelong professional mission has been to strengthen early intervention for behavioral risks and disorders in general healthcare settings – initially one on one with patients and now through a scalable training and software package. The loss of life, human suffering and economic burden from addressable behavioral issues is staggering. Much is preventable. Please help me spread BSI.


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    04/27/2016 Ken Livesey - Engineer

    Liked the project.

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    04/26/2016 Jacob Petrosky - Resident

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Richard Brown, MD, MPH
Training and Software for Evidence-Based Behavioral Screening and Intervention
Brown University

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