e22ce321-8533-41aa-918f-4c43969d087d/58-0 00:00:04.002 --> 00:00:08.319 <v Jordan Cooper>We're here today with Manish Sapra, the executive director for the Behavioral</v>

e22ce321-8533-41aa-918f-4c43969d087d/58-1 00:00:08.319 --> 00:00:11.585 <v Jordan Cooper>Health Service line at Northwell Health, Northwell Health.</v>

e22ce321-8533-41aa-918f-4c43969d087d/58-2 00:00:11.585 --> 00:00:15.293 <v Jordan Cooper>For those who don't know, is a health system based in Long Island,</v>

e22ce321-8533-41aa-918f-4c43969d087d/58-3 00:00:15.293 --> 00:00:19.002 <v Jordan Cooper>New York with 5200 beds, 17, 000 providers across 20 hospitals and</v>

e22ce321-8533-41aa-918f-4c43969d087d/58-4 00:00:19.002 --> 00:00:19.832 <v Jordan Cooper>other care fac.</v>

e22ce321-8533-41aa-918f-4c43969d087d/65-0 00:00:20.762 --> 00:00:22.602 <v Jordan Cooper>Manish, thank you so much for joining us today.</v>

e22ce321-8533-41aa-918f-4c43969d087d/66-0 00:00:23.302 --> 00:00:23.702 <v Sapra, Manish>Thank you.</v>

e22ce321-8533-41aa-918f-4c43969d087d/68-0 00:00:23.702 --> 00:00:24.502 <v Sapra, Manish>Thank you for having me.</v>

e22ce321-8533-41aa-918f-4c43969d087d/74-0 00:00:25.372 --> 00:00:27.852 <v Jordan Cooper>So let's talk about behavioral health.</v>

e22ce321-8533-41aa-918f-4c43969d087d/106-0 00:00:28.252 --> 00:00:32.453 <v Jordan Cooper>I know there's a lot going on with behavioral health integration and primary</v>

e22ce321-8533-41aa-918f-4c43969d087d/106-1 00:00:32.453 --> 00:00:35.782 <v Jordan Cooper>care settings, schools, colleges, faith-based organizations,</v>

e22ce321-8533-41aa-918f-4c43969d087d/106-2 00:00:35.782 --> 00:00:39.492 <v Jordan Cooper>as well as integrating mental health care into other service lines.</v>

e22ce321-8533-41aa-918f-4c43969d087d/113-0 00:00:39.692 --> 00:00:41.532 <v Jordan Cooper>I know that's core to your strategy.</v>

e22ce321-8533-41aa-918f-4c43969d087d/121-0 00:00:41.612 --> 00:00:44.532 <v Jordan Cooper>I'd like to ask you to elaborate on that strategy.</v>

e22ce321-8533-41aa-918f-4c43969d087d/137-0 00:00:44.532 --> 00:00:48.284 <v Jordan Cooper>What's unique or interesting about it, and specifically what role data</v>

e22ce321-8533-41aa-918f-4c43969d087d/137-1 00:00:48.284 --> 00:00:50.292 <v Jordan Cooper>integration is playing in that effort?</v>

e22ce321-8533-41aa-918f-4c43969d087d/140-0 00:00:50.292 --> 00:00:52.192 <v Jordan Cooper>After all, this is healthy data podcast.</v>

e22ce321-8533-41aa-918f-4c43969d087d/151-0 00:00:53.342 --> 00:00:57.382 <v Sapra, Manish>Sure. Yeah. You know, first of all, thank you for.</v>

e22ce321-8533-41aa-918f-4c43969d087d/200-0 00:00:59.232 --> 00:01:04.711 <v Sapra, Manish>Your giving us an opportunity to talk about behavioral health and bringing the</v>

e22ce321-8533-41aa-918f-4c43969d087d/200-1 00:01:04.711 --> 00:01:09.427 <v Sapra, Manish>discussion about behavior health into the into forefront. You know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/200-2 00:01:09.427 --> 00:01:13.657 <v Sapra, Manish>after the pandemic, we realized that and even prior to that,</v>

e22ce321-8533-41aa-918f-4c43969d087d/200-3 00:01:13.657 --> 00:01:18.304 <v Sapra, Manish>there was a a crisis brewing in behavioral health, access to care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/200-4 00:01:18.304 --> 00:01:19.552 <v Sapra, Manish>And just me being.</v>

e22ce321-8533-41aa-918f-4c43969d087d/211-0 00:01:19.592 --> 00:01:22.432 <v Sapra, Manish>Able to meet the demand, we just skyrocketed.</v>

e22ce321-8533-41aa-918f-4c43969d087d/226-0 00:01:22.982 --> 00:01:27.526 <v Sapra, Manish>After the after the pandemic, we also understood our health care</v>

e22ce321-8533-41aa-918f-4c43969d087d/226-1 00:01:27.526 --> 00:01:30.462 <v Sapra, Manish>disparities in in many of our populations.</v>

e22ce321-8533-41aa-918f-4c43969d087d/232-0 00:01:31.872 --> 00:01:34.352 <v Sapra, Manish>We're we're just not able to provide.</v>

e22ce321-8533-41aa-918f-4c43969d087d/240-0 00:01:36.112 --> 00:01:39.872 <v Sapra, Manish>The the culturally competent access to care and to provide them.</v>

e22ce321-8533-41aa-918f-4c43969d087d/251-0 00:01:41.632 --> 00:01:43.792 <v Sapra, Manish>In, you know, at a time when they need the most.</v>

e22ce321-8533-41aa-918f-4c43969d087d/270-0 00:01:43.792 --> 00:01:47.745 <v Sapra, Manish>So one way to address that is really meeting the patients where they are,</v>

e22ce321-8533-41aa-918f-4c43969d087d/270-1 00:01:47.745 --> 00:01:52.072 <v Sapra, Manish>where they feel comfortable seeing us and. And So what we're doing at Northwell.</v>

e22ce321-8533-41aa-918f-4c43969d087d/301-0 00:01:52.142 --> 00:01:54.904 <v Sapra, Manish>Well, we've been in this journey over last</v>

e22ce321-8533-41aa-918f-4c43969d087d/301-1 00:01:54.904 --> 00:01:59.785 <v Sapra, Manish>several years of integrating behavioral health in our with physical health.</v>

e22ce321-8533-41aa-918f-4c43969d087d/301-2 00:01:59.785 --> 00:02:03.317 <v Sapra, Manish>So in primary care settings, we've set shop, you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/301-3 00:02:03.317 --> 00:02:05.822 <v Sapra, Manish>embedded therapists in in primary care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/323-0 00:02:07.312 --> 00:02:12.660 <v Sapra, Manish>Practices in our pediatric practices. We cover all of our Pediatrics practices</v>

e22ce321-8533-41aa-918f-4c43969d087d/323-1 00:02:12.660 --> 00:02:14.352 <v Sapra, Manish>across the health system.</v>

e22ce321-8533-41aa-918f-4c43969d087d/327-0 00:02:14.352 --> 00:02:16.272 <v Sapra, Manish>Now where we have embedded therapists.</v>

e22ce321-8533-41aa-918f-4c43969d087d/337-0 00:02:18.392 --> 00:02:20.434 <v Sapra, Manish>In the, we'll provide immediate access to</v>

e22ce321-8533-41aa-918f-4c43969d087d/337-1 00:02:20.434 --> 00:02:20.872 <v Sapra, Manish>services.</v>

e22ce321-8533-41aa-918f-4c43969d087d/353-0 00:02:21.382 --> 00:02:24.083 <v Sapra, Manish>As soon as any conditions are are identified,</v>

e22ce321-8533-41aa-918f-4c43969d087d/353-1 00:02:24.083 --> 00:02:28.662 <v Sapra, Manish>so therapists are then supervised by psychiatrists and we're able to provide.</v>

e22ce321-8533-41aa-918f-4c43969d087d/375-0 00:02:30.152 --> 00:02:34.661 <v Sapra, Manish>You know recommendations to the, to the pediatricians in the primary care</v>

e22ce321-8533-41aa-918f-4c43969d087d/375-1 00:02:34.661 --> 00:02:39.352 <v Sapra, Manish>doctors on how to provide services. We've taken this further to our schools.</v>

e22ce321-8533-41aa-918f-4c43969d087d/381-0 00:02:40.912 --> 00:02:41.472 <v Sapra, Manish>You know we cover.</v>

e22ce321-8533-41aa-918f-4c43969d087d/398-0 00:02:41.472 --> 00:02:46.363 <v Sapra, Manish>We have contracts with school districts, so we cover many school districts in in</v>

e22ce321-8533-41aa-918f-4c43969d087d/398-1 00:02:46.363 --> 00:02:51.072 <v Sapra, Manish>Nassau County and Suffolk County and are now starting to go into Westchester.</v>

e22ce321-8533-41aa-918f-4c43969d087d/420-0 00:02:52.462 --> 00:02:56.746 <v Sapra, Manish>In in our New York geography, where we have immediate or same day or</v>

e22ce321-8533-41aa-918f-4c43969d087d/420-1 00:02:56.746 --> 00:03:00.222 <v Sapra, Manish>next day access available to child psychiatry services.</v>

e22ce321-8533-41aa-918f-4c43969d087d/436-0 00:03:01.792 --> 00:03:05.193 <v Sapra, Manish>To students of these school districts, we cover more than 200,</v>

e22ce321-8533-41aa-918f-4c43969d087d/436-1 00:03:05.193 --> 00:03:06.272 <v Sapra, Manish>000 school students.</v>

e22ce321-8533-41aa-918f-4c43969d087d/453-0 00:03:06.272 --> 00:03:09.576 <v Sapra, Manish>Through that program, we have partnership with colleges to</v>

e22ce321-8533-41aa-918f-4c43969d087d/453-1 00:03:09.576 --> 00:03:13.552 <v Sapra, Manish>provide behavioral health services, especially in acute care services.</v>

e22ce321-8533-41aa-918f-4c43969d087d/460-0 00:03:13.552 --> 00:03:17.072 <v Sapra, Manish>We've had soccer, health side and and recently.</v>

e22ce321-8533-41aa-918f-4c43969d087d/469-0 00:03:18.872 --> 00:03:21.632 <v Sapra, Manish>We went into uncharted territory of actually embedding.</v>

e22ce321-8533-41aa-918f-4c43969d087d/482-0 00:03:22.422 --> 00:03:27.622 <v Sapra, Manish>Therapist in in our communities in faith-based organizations.</v>

e22ce321-8533-41aa-918f-4c43969d087d/489-0 00:03:27.622 --> 00:03:32.662 <v Sapra, Manish>So we embedded therapists in a church in Queens.</v>

e22ce321-8533-41aa-918f-4c43969d087d/496-0 00:03:32.862 --> 00:03:34.702 <v Sapra, Manish>What in Harlem and at a mosque?</v>

e22ce321-8533-41aa-918f-4c43969d087d/530-0 00:03:34.702 --> 00:03:38.293 <v Sapra, Manish>In in, in Long Island and we're learning, you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/530-1 00:03:38.293 --> 00:03:42.782 <v Sapra, Manish>as we go to the communities as to how we can use these services,</v>

e22ce321-8533-41aa-918f-4c43969d087d/530-2 00:03:42.782 --> 00:03:48.168 <v Sapra, Manish>not only to provide care but also build those bridges with these communities,</v>

e22ce321-8533-41aa-918f-4c43969d087d/530-3 00:03:48.168 --> 00:03:48.582 <v Sapra, Manish>right.</v>

e22ce321-8533-41aa-918f-4c43969d087d/536-0 00:03:48.582 --> 00:03:51.622 <v Sapra, Manish>We're working with trusted community leaders at these sites.</v>

e22ce321-8533-41aa-918f-4c43969d087d/550-0 00:03:52.142 --> 00:03:55.772 <v Sapra, Manish>And and that is helping us reduce stigma, you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/550-1 00:03:55.772 --> 00:03:59.262 <v Sapra, Manish>build trust in these communities to provide care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/563-0 00:03:59.262 --> 00:04:03.426 <v Sapra, Manish>So that's just, that's a few things about our team of of</v>

e22ce321-8533-41aa-918f-4c43969d087d/563-1 00:04:03.426 --> 00:04:04.302 <v Sapra, Manish>integration.</v>

e22ce321-8533-41aa-918f-4c43969d087d/568-0 00:04:04.302 --> 00:04:06.782 <v Sapra, Manish>We do work with other service lines as you mentioned.</v>

e22ce321-8533-41aa-918f-4c43969d087d/588-0 00:04:08.272 --> 00:04:11.772 <v Sapra, Manish>In in specialty care, so we have programs especially for folks</v>

e22ce321-8533-41aa-918f-4c43969d087d/588-1 00:04:11.772 --> 00:04:14.272 <v Sapra, Manish>who are going through bariatrics procedures.</v>

e22ce321-8533-41aa-918f-4c43969d087d/598-0 00:04:14.272 --> 00:04:19.672 <v Sapra, Manish>We have folks through perinatal care of Women's Health issues.</v>

e22ce321-8533-41aa-918f-4c43969d087d/601-0 00:04:19.712 --> 00:04:21.312 <v Sapra, Manish>We have programs that we have set up.</v>

e22ce321-8533-41aa-918f-4c43969d087d/611-0 00:04:22.062 --> 00:04:25.102 <v Sapra, Manish>Or folks going through transplants at at Northwell.</v>

e22ce321-8533-41aa-918f-4c43969d087d/632-0 00:04:25.102 --> 00:04:29.861 <v Sapra, Manish>So we have a transplant psychiatry program to name a few psycho oncology,</v>

e22ce321-8533-41aa-918f-4c43969d087d/632-1 00:04:29.861 --> 00:04:33.204 <v Sapra, Manish>which is, you know providing behavioral support for</v>

e22ce321-8533-41aa-918f-4c43969d087d/632-2 00:04:33.204 --> 00:04:35.262 <v Sapra, Manish>folks going through cancer care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/636-0 00:04:35.342 --> 00:04:36.582 <v Sapra, Manish>So those are some other.</v>

e22ce321-8533-41aa-918f-4c43969d087d/644-0 00:04:37.952 --> 00:04:39.992 <v Sapra, Manish>Descriptions of integration of care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/654-0 00:04:40.192 --> 00:04:45.709 <v Sapra, Manish>You mentioned how does it all work with integration of data and which is like a</v>

e22ce321-8533-41aa-918f-4c43969d087d/654-1 00:04:45.709 --> 00:04:46.192 <v Sapra, Manish>really.</v>

e22ce321-8533-41aa-918f-4c43969d087d/664-0 00:04:47.952 --> 00:04:50.177 <v Sapra, Manish>You know, it's a, it's a bit of a struggle in behavioral</v>

e22ce321-8533-41aa-918f-4c43969d087d/664-1 00:04:50.177 --> 00:04:51.152 <v Sapra, Manish>health because sometimes.</v>

e22ce321-8533-41aa-918f-4c43969d087d/670-0 00:04:51.462 --> 00:04:53.262 <v Sapra, Manish>We're not allowed to share.</v>

e22ce321-8533-41aa-918f-4c43969d087d/695-0 00:04:54.752 --> 00:04:58.300 <v Sapra, Manish>Data because it's sensitive or it's considered behavioral health,</v>

e22ce321-8533-41aa-918f-4c43969d087d/695-1 00:04:58.300 --> 00:05:01.632 <v Sapra, Manish>though those restrictions are more on the substance use side.</v>

e22ce321-8533-41aa-918f-4c43969d087d/711-0 00:05:02.392 --> 00:05:06.837 <v Sapra, Manish>But we have done as much as we can to improve access to those cares,</v>

e22ce321-8533-41aa-918f-4c43969d087d/711-1 00:05:06.837 --> 00:05:09.672 <v Sapra, Manish>at least to the providers within Northwell.</v>

e22ce321-8533-41aa-918f-4c43969d087d/732-0 00:05:09.672 --> 00:05:14.114 <v Sapra, Manish>So when we see a behavioral health provider and we also have a primary care</v>

e22ce321-8533-41aa-918f-4c43969d087d/732-1 00:05:14.114 --> 00:05:16.977 <v Sapra, Manish>provider, the records are shared so they can see</v>

e22ce321-8533-41aa-918f-4c43969d087d/732-2 00:05:16.977 --> 00:05:18.672 <v Sapra, Manish>that information and then we.</v>

e22ce321-8533-41aa-918f-4c43969d087d/737-0 00:05:19.832 --> 00:05:21.352 <v Sapra, Manish>Link to our HIE so.</v>

e22ce321-8533-41aa-918f-4c43969d087d/752-0 00:05:21.542 --> 00:05:27.058 <v Sapra, Manish>That data is available if folks have come into our hospitals or or had a behavioral</v>

e22ce321-8533-41aa-918f-4c43969d087d/752-1 00:05:27.058 --> 00:05:28.502 <v Sapra, Manish>health visit and then.</v>

e22ce321-8533-41aa-918f-4c43969d087d/759-0 00:05:29.952 --> 00:05:31.192 <v Sapra, Manish>We're working now.</v>

e22ce321-8533-41aa-918f-4c43969d087d/763-0 00:05:31.192 --> 00:05:34.672 <v Sapra, Manish>More on the back end of like you know, understanding.</v>

e22ce321-8533-41aa-918f-4c43969d087d/778-0 00:05:36.472 --> 00:05:39.592 <v Sapra, Manish>The How all this is actually really helping our patients, right?</v>

e22ce321-8533-41aa-918f-4c43969d087d/786-0 00:05:39.592 --> 00:05:42.912 <v Sapra, Manish>So we described you the program with primary care integration.</v>

e22ce321-8533-41aa-918f-4c43969d087d/801-0 00:05:43.152 --> 00:05:49.234 <v Sapra, Manish>We wanna study if in providing behavioral treatment along with the medical care it</v>

e22ce321-8533-41aa-918f-4c43969d087d/801-1 00:05:49.234 --> 00:05:50.992 <v Sapra, Manish>in a Co located setting.</v>

e22ce321-8533-41aa-918f-4c43969d087d/819-0 00:05:51.702 --> 00:05:56.036 <v Sapra, Manish>Is that better than treatment as usual than just referring somebody out to a</v>

e22ce321-8533-41aa-918f-4c43969d087d/819-1 00:05:56.036 --> 00:05:56.542 <v Sapra, Manish>practice?</v>

e22ce321-8533-41aa-918f-4c43969d087d/828-0 00:05:56.542 --> 00:06:01.142 <v Sapra, Manish>So we're we're doing that update analytics right now to understand.</v>

e22ce321-8533-41aa-918f-4c43969d087d/835-0 00:06:02.632 --> 00:06:05.112 <v Sapra, Manish>Benefits of behavioral treatment on medical care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/867-0 00:06:06.422 --> 00:06:09.755 <v Jordan Cooper>So many questions I have. After all that, Manish,</v>

e22ce321-8533-41aa-918f-4c43969d087d/844-0 00:06:08.512 --> 00:06:08.832 <v Sapra, Manish>OK.</v>

e22ce321-8533-41aa-918f-4c43969d087d/867-1 00:06:09.755 --> 00:06:14.755 <v Jordan Cooper>on the last thing you just said asking does providing care in a Co located</v>

e22ce321-8533-41aa-918f-4c43969d087d/867-2 00:06:14.755 --> 00:06:17.955 <v Jordan Cooper>setting, meaning some kind of physical care and</v>

e22ce321-8533-41aa-918f-4c43969d087d/867-3 00:06:17.955 --> 00:06:19.222 <v Jordan Cooper>mental health care.</v>

e22ce321-8533-41aa-918f-4c43969d087d/893-0 00:06:19.222 --> 00:06:23.422 <v Jordan Cooper>Is that better? If you didn't know that going into it,</v>

e22ce321-8533-41aa-918f-4c43969d087d/893-1 00:06:23.422 --> 00:06:29.226 <v Jordan Cooper>how did you justify this seemingly expensive investment as an experiment to</v>

e22ce321-8533-41aa-918f-4c43969d087d/893-2 00:06:29.226 --> 00:06:32.662 <v Jordan Cooper>see suite leaders at Northwell? Why did you?</v>

e22ce321-8533-41aa-918f-4c43969d087d/897-0 00:06:33.432 --> 00:06:34.632 <v Jordan Cooper>Say we want to do this.</v>

e22ce321-8533-41aa-918f-4c43969d087d/958-0 00:06:34.742 --> 00:06:39.206 <v Jordan Cooper>Do this and 2nd how did you get, you know, sign off to get permission and do it if</v>

e22ce321-8533-41aa-918f-4c43969d087d/958-1 00:06:39.206 --> 00:06:43.402 <v Jordan Cooper>you don't have the data saying that this actually improves outcomes or reduce</v>

e22ce321-8533-41aa-918f-4c43969d087d/958-2 00:06:43.402 --> 00:06:47.382 <v Jordan Cooper>costs or has some other material benefit to patients or the organization?</v>

e22ce321-8533-41aa-918f-4c43969d087d/941-0 00:06:48.202 --> 00:06:50.733 <v Sapra, Manish>Well, yeah. I mean there are multiple ways to answer</v>

e22ce321-8533-41aa-918f-4c43969d087d/941-1 00:06:50.733 --> 00:06:51.402 <v Sapra, Manish>that question.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1001-0 00:06:51.402 --> 00:06:54.420 <v Sapra, Manish>But first of all, collaborative care which is this model</v>

e22ce321-8533-41aa-918f-4c43969d087d/1001-1 00:06:54.420 --> 00:06:58.656 <v Sapra, Manish>that I described of embedding therapists getting supervision from psychiatrists</v>

e22ce321-8533-41aa-918f-4c43969d087d/1001-2 00:06:58.656 --> 00:07:02.944 <v Sapra, Manish>but working under primary care physicians is a well studied evidence based model</v>

e22ce321-8533-41aa-918f-4c43969d087d/1001-3 00:07:02.944 --> 00:07:07.021 <v Sapra, Manish>that has over 20 years of research and has shown good outcomes and has shown</v>

e22ce321-8533-41aa-918f-4c43969d087d/1001-4 00:07:07.021 --> 00:07:07.762 <v Sapra, Manish>outcomes that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1006-0 00:07:07.762 --> 00:07:10.562 <v Sapra, Manish>Actually saves healthcare.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1011-0 00:07:12.232 --> 00:07:13.432 <v Sapra, Manish>Costs on these individuals.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1016-0 00:07:15.312 --> 00:07:16.472 <v Sapra, Manish>So there is that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1022-0 00:07:16.742 --> 00:07:17.982 <v Sapra, Manish>Background of research.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1035-0 00:07:17.982 --> 00:07:21.766 <v Sapra, Manish>The second piece is we were supported by the system,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1035-1 00:07:21.766 --> 00:07:25.622 <v Sapra, Manish>the redesign project to the previous Medicaid waiver.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1040-0 00:07:25.742 --> 00:07:28.542 <v Sapra, Manish>Or call the dis Rep when within New York.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1089-0 00:07:30.072 --> 00:07:34.325 <v Sapra, Manish>To so which gave a seat funding to get any of these programs going,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1089-1 00:07:34.325 --> 00:07:39.267 <v Sapra, Manish>and I have to show you the program is just so popular amongst the primary care</v>

e22ce321-8533-41aa-918f-4c43969d087d/1089-2 00:07:39.267 --> 00:07:44.020 <v Sapra, Manish>doctors and pediatricians that even though we barely break even at times or</v>

e22ce321-8533-41aa-918f-4c43969d087d/1089-3 00:07:44.020 --> 00:07:46.272 <v Sapra, Manish>sometimes we honestly do not on the.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1113-0 00:07:46.272 --> 00:07:49.002 <v Sapra, Manish>Revenue side, it is just so popular amongst our</v>

e22ce321-8533-41aa-918f-4c43969d087d/1113-1 00:07:49.002 --> 00:07:51.959 <v Sapra, Manish>providers in primary care and pediatrician offices,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1113-2 00:07:51.959 --> 00:07:54.632 <v Sapra, Manish>but that is one thing they want to hold on to.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1121-0 00:07:55.592 --> 00:07:57.992 <v Sapra, Manish>And this will be the last thing for them to give it up.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1144-0 00:07:58.412 --> 00:08:02.293 <v Jordan Cooper>So in Healthy Data podcast, we often like to be very concrete to</v>

e22ce321-8533-41aa-918f-4c43969d087d/1144-1 00:08:02.293 --> 00:08:06.652 <v Jordan Cooper>provide the most material benefit to listeners across the United States.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1157-0 00:08:06.772 --> 00:08:11.123 <v Jordan Cooper>You mentioned that you integrate behavioral healthcare with a variety of</v>

e22ce321-8533-41aa-918f-4c43969d087d/1157-1 00:08:11.123 --> 00:08:12.852 <v Jordan Cooper>specialty care service lines.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1171-0 00:08:12.852 --> 00:08:18.516 <v Jordan Cooper>Bariatrics Women's Health transplants oncology was just for the sake of getting</v>

e22ce321-8533-41aa-918f-4c43969d087d/1171-1 00:08:18.516 --> 00:08:20.852 <v Jordan Cooper>concrete. Look at Women's Health.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1175-0 00:08:21.252 --> 00:08:22.812 <v Jordan Cooper>There's a woman, Jane.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1181-0 00:08:22.812 --> 00:08:24.772 <v Jordan Cooper>Jane lives in Long Island.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1183-0 00:08:24.812 --> 00:08:27.152 <v Jordan Cooper>She gave birth three months ago.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1192-0 00:08:27.542 --> 00:08:29.862 <v Jordan Cooper>And now has postpartum depression.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1197-0 00:08:29.862 --> 00:08:31.982 <v Jordan Cooper>That's a behavioral health condition.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1241-0 00:08:33.752 --> 00:08:39.273 <v Jordan Cooper>Please walk us through not only what James experience of care is in terms of</v>

e22ce321-8533-41aa-918f-4c43969d087d/1241-1 00:08:39.273 --> 00:08:43.001 <v Jordan Cooper>accessing mental health care while also doing well,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1241-2 00:08:43.001 --> 00:08:46.801 <v Jordan Cooper>baby check ups or doing her own OB/GYN appointments,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1241-3 00:08:46.801 --> 00:08:52.895 <v Jordan Cooper>but also how is the data being integrated? Because clearly postpartum depression has</v>

e22ce321-8533-41aa-918f-4c43969d087d/1241-4 00:08:52.895 --> 00:08:54.472 <v Jordan Cooper>an impact on the baby.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1249-0 00:08:54.472 --> 00:08:57.032 <v Jordan Cooper>'S well-being and needs to be viewed by the pediatrician.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1292-0 00:08:57.382 --> 00:09:02.532 <v Jordan Cooper>Caring for the infant but also in the EHR, but also needs to be viewed by the</v>

e22ce321-8533-41aa-918f-4c43969d087d/1292-1 00:09:02.532 --> 00:09:07.814 <v Jordan Cooper>obstetrician gynecologist caring for Jane, who has a depression and needs to be</v>

e22ce321-8533-41aa-918f-4c43969d087d/1292-2 00:09:07.814 --> 00:09:13.293 <v Jordan Cooper>aware that she is being treated for this. And that's gonna have an effect on blood</v>

e22ce321-8533-41aa-918f-4c43969d087d/1292-3 00:09:13.293 --> 00:09:15.472 <v Jordan Cooper>pressure, other comorbidities so.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1306-0 00:09:15.502 --> 00:09:20.222 <v Jordan Cooper>Please the patient's journey and also the data's journey for Jane.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1341-0 00:09:19.882 --> 00:09:23.494 <v Sapra, Manish>Sure, sure. And by the great question. So, so, Jane,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1341-1 00:09:23.494 --> 00:09:28.468 <v Sapra, Manish>if she came to a visit and provided Northwell or even if she brought her</v>

e22ce321-8533-41aa-918f-4c43969d087d/1341-2 00:09:28.468 --> 00:09:31.602 <v Sapra, Manish>three month old to a pediatric office, right,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1341-3 00:09:31.602 --> 00:09:35.282 <v Sapra, Manish>she'll get a screening instrument and for depression.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1375-0 00:09:36.712 --> 00:09:39.513 <v Sapra, Manish>And and for postpartum depression specifically,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1375-1 00:09:39.513 --> 00:09:43.482 <v Sapra, Manish>and if she if there is a screen, a positive Screener or maybe it is</v>

e22ce321-8533-41aa-918f-4c43969d087d/1375-2 00:09:43.482 --> 00:09:48.209 <v Sapra, Manish>because there was a conversation with her provider or the pediatrician where she</v>

e22ce321-8533-41aa-918f-4c43969d087d/1375-3 00:09:48.209 --> 00:09:48.792 <v Sapra, Manish>mentioned.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1406-0 00:09:49.142 --> 00:09:54.380 <v Sapra, Manish>State that needing some help or support that will be quantified using these</v>

e22ce321-8533-41aa-918f-4c43969d087d/1406-1 00:09:54.380 --> 00:09:59.962 <v Sapra, Manish>standardized scales and a referral will be made to an embedded therapist in that</v>

e22ce321-8533-41aa-918f-4c43969d087d/1406-2 00:09:59.962 --> 00:10:00.582 <v Sapra, Manish>practice.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1411-0 00:10:02.032 --> 00:10:03.552 <v Sapra, Manish>The therapist can do a few things.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1435-0 00:10:05.272 --> 00:10:07.704 <v Sapra, Manish>They can. First of all, they do an assessment, right,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1435-1 00:10:07.704 --> 00:10:10.135 <v Sapra, Manish>their license, mental health providers as to what the</v>

e22ce321-8533-41aa-918f-4c43969d087d/1435-2 00:10:10.135 --> 00:10:13.512 <v Sapra, Manish>situation is and based on what the situation is, they can do a few things.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1447-0 00:10:13.632 --> 00:10:17.485 <v Sapra, Manish>They can provide care coordination to a provider in the community or within</v>

e22ce321-8533-41aa-918f-4c43969d087d/1447-1 00:10:17.485 --> 00:10:17.992 <v Sapra, Manish>Northwell.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1452-0 00:10:18.502 --> 00:10:20.102 <v Sapra, Manish>Be here for health services.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1457-0 00:10:20.302 --> 00:10:22.502 <v Sapra, Manish>They can actually provide treatment.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1496-0 00:10:22.502 --> 00:10:28.175 <v Sapra, Manish>They can do time limited 8 to 10 therapy sessions right there with the patient on</v>

e22ce321-8533-41aa-918f-4c43969d087d/1496-1 00:10:28.175 --> 00:10:33.363 <v Sapra, Manish>on, on, on, on a frequent basis, they can refer the patient to a perinatal</v>

e22ce321-8533-41aa-918f-4c43969d087d/1496-2 00:10:33.363 --> 00:10:38.137 <v Sapra, Manish>psychiatry program which we, which is a specialized programs that if</v>

e22ce321-8533-41aa-918f-4c43969d087d/1496-3 00:10:38.137 --> 00:10:41.042 <v Sapra, Manish>the condition is such that it requires to.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1502-0 00:10:41.032 --> 00:10:42.542 <v Sapra, Manish>Be seen by a reproductive psychiatrist.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1505-0 00:10:43.312 --> 00:10:43.632 <v Sapra, Manish>They can.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1530-0 00:10:43.632 --> 00:10:46.884 <v Sapra, Manish>They can be seen by that individual or they can just be seen by a general</v>

e22ce321-8533-41aa-918f-4c43969d087d/1530-1 00:10:46.884 --> 00:10:50.312 <v Sapra, Manish>psychiatrist who may have interest in women's behavioral health or expertise.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1532-0 00:10:50.662 --> 00:10:51.222 <v Sapra, Manish>That area.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1534-0 00:10:51.962 --> 00:10:52.162 <v Jordan Cooper>Mm hmm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1570-0 00:10:52.992 --> 00:10:57.775 <v Sapra, Manish>At times they can also recommend, after discussing it with psychiatrist</v>

e22ce321-8533-41aa-918f-4c43969d087d/1570-1 00:10:57.775 --> 00:11:01.096 <v Sapra, Manish>medication, set up OB GYN or can prescribe to the</v>

e22ce321-8533-41aa-918f-4c43969d087d/1570-2 00:11:01.096 --> 00:11:05.812 <v Sapra, Manish>patient if that is the person who's holding the care of that person or</v>

e22ce321-8533-41aa-918f-4c43969d087d/1570-3 00:11:05.812 --> 00:11:07.472 <v Sapra, Manish>patient during that time.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1589-0 00:11:07.472 --> 00:11:12.737 <v Sapra, Manish>So that's sort of the the patient journey. And if they do receive treatment with</v>

e22ce321-8533-41aa-918f-4c43969d087d/1589-1 00:11:12.737 --> 00:11:16.312 <v Sapra, Manish>this care manager who we have embedded, there will be.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1598-0 00:11:17.792 --> 00:11:21.032 <v Sapra, Manish>Monthly, you know, assessments on what is their.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1603-0 00:11:21.422 --> 00:11:22.942 <v Sapra, Manish>Depression scores, if you will.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1612-0 00:11:24.592 --> 00:11:28.232 <v Sapra, Manish>Using standardized instruments to measure that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1653-0 00:11:29.912 --> 00:11:32.811 <v Sapra, Manish>And that way we can at a on a population basis,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1653-1 00:11:32.811 --> 00:11:37.764 <v Sapra, Manish>maintain a registry of all the patients that we are treating and also measure the</v>

e22ce321-8533-41aa-918f-4c43969d087d/1653-2 00:11:37.764 --> 00:11:41.387 <v Sapra, Manish>clinical outcomes. You know if people are getting better or</v>

e22ce321-8533-41aa-918f-4c43969d087d/1653-3 00:11:41.387 --> 00:11:45.192 <v Sapra, Manish>not and as I mentioned we we do have, we do follow that track.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1671-0 00:11:45.192 --> 00:11:49.241 <v Sapra, Manish>That at this time, but we're we are trying to analyze now is,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1671-1 00:11:49.241 --> 00:11:51.592 <v Sapra, Manish>is that what are the effects on the?</v>

e22ce321-8533-41aa-918f-4c43969d087d/1678-0 00:11:52.422 --> 00:11:55.022 <v Sapra, Manish>Physical health outcomes, yeah, but you help.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1708-0 00:11:56.112 --> 00:12:01.166 <v Jordan Cooper>So and the the data journey, how are you integrating the behavioral</v>

e22ce321-8533-41aa-918f-4c43969d087d/1708-1 00:12:01.166 --> 00:12:07.408 <v Jordan Cooper>health with the traditional clinical EHR, especially when there's such overlap with</v>

e22ce321-8533-41aa-918f-4c43969d087d/1708-2 00:12:07.408 --> 00:12:09.192 <v Jordan Cooper>one affecting the other?</v>

e22ce321-8533-41aa-918f-4c43969d087d/1750-0 00:12:10.032 --> 00:12:14.164 <v Sapra, Manish>So one of the things that all documentation that that happens is is</v>

e22ce321-8533-41aa-918f-4c43969d087d/1750-1 00:12:14.164 --> 00:12:18.903 <v Sapra, Manish>happening in right in the medical EHR, there is no separate behavioral health</v>

e22ce321-8533-41aa-918f-4c43969d087d/1750-2 00:12:18.903 --> 00:12:23.886 <v Sapra, Manish>EHR in this condition except if they get went to the to the specialized perinatal</v>

e22ce321-8533-41aa-918f-4c43969d087d/1737-0 00:12:19.622 --> 00:12:19.742 <v Jordan Cooper>Hmm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1750-3 00:12:23.886 --> 00:12:26.802 <v Sapra, Manish>program that they would have that that sort of.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1767-0 00:12:26.792 --> 00:12:32.303 <v Sapra, Manish>You know a separate EMR cause because we are embedding these providers in the in</v>

e22ce321-8533-41aa-918f-4c43969d087d/1767-1 00:12:32.303 --> 00:12:34.072 <v Sapra, Manish>the physical host setting.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1784-0 00:12:34.872 --> 00:12:37.801 <v Sapra, Manish>They're using the same Emrs, so the they're provide referring</v>

e22ce321-8533-41aa-918f-4c43969d087d/1784-1 00:12:37.801 --> 00:12:40.872 <v Sapra, Manish>providers are getting access to all the behavioral health nodes.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1801-0 00:12:41.462 --> 00:12:45.938 <v Sapra, Manish>And in the standardized instruments, they can graph out the depression scores</v>

e22ce321-8533-41aa-918f-4c43969d087d/1801-1 00:12:45.938 --> 00:12:49.782 <v Sapra, Manish>and they can follow all that right there in their radical records.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1827-0 00:12:50.742 --> 00:12:55.648 <v Jordan Cooper>So just to be clear, the epic electronic health record as a</v>

e22ce321-8533-41aa-918f-4c43969d087d/1827-1 00:12:55.648 --> 00:13:02.352 <v Jordan Cooper>portal is either available to providers on a phone or in a desktop at schools and</v>

e22ce321-8533-41aa-918f-4c43969d087d/1827-2 00:13:02.352 --> 00:13:03.742 <v Jordan Cooper>churches as well.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1835-0 00:13:04.612 --> 00:13:06.932 <v Sapra, Manish>Well, when I've yet on epic, but we will.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1842-0 00:13:07.622 --> 00:13:09.942 <v Jordan Cooper>Right, all scripts.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1846-0 00:13:08.872 --> 00:13:10.832 <v Sapra, Manish>Be a journey over the next two years.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1891-0 00:13:10.832 --> 00:13:13.668 <v Sapra, Manish>Yes, but the all scripts program is is</v>

e22ce321-8533-41aa-918f-4c43969d087d/1891-1 00:13:13.668 --> 00:13:19.050 <v Sapra, Manish>available to all the providers in who are coming in the medical settings.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1891-2 00:13:19.050 --> 00:13:22.250 <v Sapra, Manish>Also in in the school and colleges program,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1891-3 00:13:22.250 --> 00:13:28.214 <v Sapra, Manish>we do have a separate way of documenting for the faith-based program just because</v>

e22ce321-8533-41aa-918f-4c43969d087d/1891-4 00:13:28.214 --> 00:13:30.832 <v Sapra, Manish>of the community based setting that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1893-0 00:13:30.832 --> 00:13:31.192 <v Sapra, Manish>We are in.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1900-0 00:13:31.982 --> 00:13:33.782 <v Jordan Cooper>And so how does that data?</v>

e22ce321-8533-41aa-918f-4c43969d087d/1930-0 00:13:34.622 --> 00:13:38.802 <v Jordan Cooper>I'm really trying to hone in on data since that's the focus of this, this,</v>

e22ce321-8533-41aa-918f-4c43969d087d/1911-0 00:13:36.812 --> 00:13:37.372 <v Sapra, Manish>Sure, sure.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1930-1 00:13:38.802 --> 00:13:41.142 <v Jordan Cooper>this, the audience expects that with this</v>

e22ce321-8533-41aa-918f-4c43969d087d/1930-2 00:13:41.142 --> 00:13:44.375 <v Jordan Cooper>episode is is, you know, how are you integrating whatever</v>

e22ce321-8533-41aa-918f-4c43969d087d/1930-3 00:13:44.375 --> 00:13:46.102 <v Jordan Cooper>electronic data is being input?</v>

e22ce321-8533-41aa-918f-4c43969d087d/1946-0 00:13:48.392 --> 00:13:53.912 <v Jordan Cooper>In kind of a remote community based location into the organizational</v>

e22ce321-8533-41aa-918f-4c43969d087d/1946-1 00:13:53.912 --> 00:13:55.112 <v Jordan Cooper>enterprise EHR.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1951-0 00:13:56.242 --> 00:13:57.522 <v Sapra, Manish>Yeah. So it is not different.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1973-0 00:13:57.522 --> 00:14:02.015 <v Sapra, Manish>Right. It is in the organizational EHR, it is not a separate behavioral health</v>

e22ce321-8533-41aa-918f-4c43969d087d/1957-0 00:13:59.582 --> 00:13:59.942 <v Jordan Cooper>OK.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1965-0 00:13:59.942 --> 00:14:00.302 <v Jordan Cooper>Got it.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1973-1 00:14:02.015 --> 00:14:02.242 <v Sapra, Manish>EMR.</v>

e22ce321-8533-41aa-918f-4c43969d087d/1980-0 00:14:02.242 --> 00:14:05.082 <v Sapra, Manish>So anything that's getting integrated is getting integrated there.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2026-0 00:14:05.582 --> 00:14:09.676 <v Sapra, Manish>And we're running dashboards on depression screening across the system.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2026-1 00:14:09.676 --> 00:14:14.167 <v Sapra, Manish>We have a initiative to do depression screening, not just in OB/GYN practices,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2026-2 00:14:14.167 --> 00:14:18.147 <v Sapra, Manish>but across all our specialties. Whether you went to a dental visit to</v>

e22ce321-8533-41aa-918f-4c43969d087d/2009-0 00:14:16.252 --> 00:14:16.452 <v Jordan Cooper>Mm hmm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2026-3 00:14:18.147 --> 00:14:22.752 <v Sapra, Manish>your rheumatologist or dermatologist, they're also screening you for depression.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2026-4 00:14:22.752 --> 00:14:23.662 <v Sapra, Manish>And all that is.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2041-0 00:14:23.662 --> 00:14:28.793 <v Sapra, Manish>Being monitored for all the service lines across the system in data that sits with</v>

e22ce321-8533-41aa-918f-4c43969d087d/2041-1 00:14:28.793 --> 00:14:30.462 <v Sapra, Manish>just a General Medical ENR.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2075-0 00:14:30.982 --> 00:14:36.564 <v Jordan Cooper>And So what are some of the obstacles to providing care in these settings if one</v>

e22ce321-8533-41aa-918f-4c43969d087d/2075-1 00:14:36.564 --> 00:14:41.181 <v Jordan Cooper>of our listeners says, hey, I'm in Minnesota and I would love this</v>

e22ce321-8533-41aa-918f-4c43969d087d/2075-2 00:14:41.181 --> 00:14:44.902 <v Jordan Cooper>program to begin to be rolled out at my organization.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2089-0 00:14:44.942 --> 00:14:48.939 <v Jordan Cooper>You know what are some of the challenges that I need to be aware of going into</v>

e22ce321-8533-41aa-918f-4c43969d087d/2089-1 00:14:48.939 --> 00:14:50.862 <v Jordan Cooper>trying to set up this kind of program?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2098-0 00:14:51.862 --> 00:14:54.622 <v Sapra, Manish>Yeah, there, there are a few challenges for sure.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2109-0 00:14:54.622 --> 00:14:59.502 <v Sapra, Manish>One, you know the medical community, the non behavioral health, right?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2132-0 00:14:59.502 --> 00:15:04.141 <v Sapra, Manish>They have to to really want this and adopt this and be be friendly to it and</v>

e22ce321-8533-41aa-918f-4c43969d087d/2132-1 00:15:04.141 --> 00:15:08.841 <v Sapra, Manish>and you know they suddenly see a lot of behavioral health in their day-to-day</v>

e22ce321-8533-41aa-918f-4c43969d087d/2132-2 00:15:08.841 --> 00:15:09.142 <v Sapra, Manish>work.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2136-0 00:15:09.422 --> 00:15:10.582 <v Sapra, Manish>But do they really?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2146-0 00:15:10.582 --> 00:15:13.387 <v Sapra, Manish>What? What are they gonna do to to bring in a</v>

e22ce321-8533-41aa-918f-4c43969d087d/2146-1 00:15:13.387 --> 00:15:14.302 <v Sapra, Manish>new discipline?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2150-0 00:15:14.582 --> 00:15:15.102 <v Sapra, Manish>Excuse me.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2161-0 00:15:15.102 --> 00:15:19.221 <v Sapra, Manish>Into their practice and integrate them well and endorse them. So Andre,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2161-1 00:15:19.221 --> 00:15:20.822 <v Sapra, Manish>for patients to them, right.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2189-0 00:15:20.942 --> 00:15:27.205 <v Sapra, Manish>So I think the 11 challenge is to to just working with our medical community to to</v>

e22ce321-8533-41aa-918f-4c43969d087d/2189-1 00:15:27.205 --> 00:15:30.902 <v Sapra, Manish>be adapters of of behavioral health integration.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2223-0 00:15:31.502 --> 00:15:35.879 <v Sapra, Manish>The second challenge is which is I think is much better now than it used to be</v>

e22ce321-8533-41aa-918f-4c43969d087d/2223-1 00:15:35.879 --> 00:15:38.815 <v Sapra, Manish>when when we started in this journey 1520 years ago,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2223-2 00:15:38.815 --> 00:15:42.638 <v Sapra, Manish>just having behavioral health providers who worked in that settings,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2223-3 00:15:42.638 --> 00:15:45.242 <v Sapra, Manish>you know it used to be we we had, you know, a.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2240-0 00:15:45.232 --> 00:15:47.631 <v Sapra, Manish>Therapy offices on our couches and and, you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2240-1 00:15:47.631 --> 00:15:50.942 <v Sapra, Manish>do not disturb signs of the door. When we were in a therapy session.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2277-0 00:15:51.062 --> 00:15:55.746 <v Sapra, Manish>You cannot work like that in a medical setting where you're where the you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2244-0 00:15:51.482 --> 00:15:51.682 <v Jordan Cooper>Mm hmm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2253-0 00:15:54.352 --> 00:15:54.552 <v Jordan Cooper>Mm hmm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2277-1 00:15:55.746 --> 00:16:00.079 <v Sapra, Manish>the primary care physician or knock on your door and introduce a patient,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2277-2 00:16:00.079 --> 00:16:02.831 <v Sapra, Manish>you know, to you right then at that spot time,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2277-3 00:16:02.831 --> 00:16:03.182 <v Sapra, Manish>right.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2302-0 00:16:03.182 --> 00:16:05.675 <v Sapra, Manish>So, so having behavioral health providers who</v>

e22ce321-8533-41aa-918f-4c43969d087d/2302-1 00:16:05.675 --> 00:16:10.011 <v Sapra, Manish>want to work in medical settings and do time limited treatment do a lot of care</v>

e22ce321-8533-41aa-918f-4c43969d087d/2302-2 00:16:10.011 --> 00:16:12.450 <v Sapra, Manish>coordination. I think we have done a lot in,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2302-3 00:16:12.450 --> 00:16:14.022 <v Sapra, Manish>in developing that workforce.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2313-0 00:16:15.472 --> 00:16:20.512 <v Sapra, Manish>I think many of these EMR related integration over the years.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2352-0 00:16:20.862 --> 00:16:24.471 <v Sapra, Manish>It is much better now, but that is certainly a thing to make</v>

e22ce321-8533-41aa-918f-4c43969d087d/2352-1 00:16:24.471 --> 00:16:29.263 <v Sapra, Manish>sure that you know the electronic medical records are integrated and are part of</v>

e22ce321-8533-41aa-918f-4c43969d087d/2352-2 00:16:29.263 --> 00:16:32.044 <v Sapra, Manish>that. And if I need a big one is the financial</v>

e22ce321-8533-41aa-918f-4c43969d087d/2352-3 00:16:32.044 --> 00:16:36.422 <v Sapra, Manish>reimbursement right that that always lacks all the innovation that we do.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2362-0 00:16:36.422 --> 00:16:38.582 <v Sapra, Manish>In in in the medical community.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2371-0 00:16:38.582 --> 00:16:41.622 <v Sapra, Manish>So you know, we just need a reimbursement models.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2372-0 00:16:41.622 --> 00:16:43.102 <v Sapra, Manish>That's that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2388-0 00:16:43.102 --> 00:16:47.440 <v Sapra, Manish>Do reimburse well for non reimbursable activities of care coordination of</v>

e22ce321-8533-41aa-918f-4c43969d087d/2388-1 00:16:47.440 --> 00:16:49.902 <v Sapra, Manish>reaching out to patients and helping them.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2399-0 00:16:50.532 --> 00:16:56.252 <v Sapra, Manish>Through these behavioural journeys, and I think that that's only lagging area.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2406-0 00:16:57.242 --> 00:16:58.802 <v Jordan Cooper>I appreciate that, Manish.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2416-0 00:16:58.802 --> 00:17:01.350 <v Jordan Cooper>We are approaching the end of this podcast episode.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2416-1 00:17:01.350 --> 00:17:02.722 <v Jordan Cooper>A few more questions though.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2436-0 00:17:02.922 --> 00:17:06.886 <v Jordan Cooper>I just asked about some of the obstacles to providing care with this integrated</v>

e22ce321-8533-41aa-918f-4c43969d087d/2436-1 00:17:06.886 --> 00:17:09.562 <v Jordan Cooper>model of behavioral health in multiple service lines.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2443-0 00:17:09.802 --> 00:17:12.482 <v Jordan Cooper>I like to ask the converse, which is what are the benefits?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2455-0 00:17:12.482 --> 00:17:15.654 <v Jordan Cooper>Why do and? You already spoke improved outcomes</v>

e22ce321-8533-41aa-918f-4c43969d087d/2455-1 00:17:15.654 --> 00:17:17.042 <v Jordan Cooper>reduce cost, but why?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2462-0 00:17:17.082 --> 00:17:21.004 <v Jordan Cooper>More specifically, why is there such high engagement among</v>

e22ce321-8533-41aa-918f-4c43969d087d/2462-1 00:17:21.004 --> 00:17:21.602 <v Jordan Cooper>patients?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2470-0 00:17:21.602 --> 00:17:24.262 <v Jordan Cooper>Why do the patients love this integration and behavioral health?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2485-0 00:17:24.492 --> 00:17:28.599 <v Jordan Cooper>In traditional physical, physical clinical care and why do</v>

e22ce321-8533-41aa-918f-4c43969d087d/2485-1 00:17:28.599 --> 00:17:29.852 <v Jordan Cooper>providers love it?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2492-0 00:17:29.852 --> 00:17:32.972 <v Jordan Cooper>Why would a primary care provider love this delivery model?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2495-0 00:17:33.012 --> 00:17:34.012 <v Jordan Cooper>Why would a patient love it?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2521-0 00:17:34.902 --> 00:17:38.688 <v Sapra, Manish>So I think the patients like it because it is done in a medical setting,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2521-1 00:17:38.688 --> 00:17:42.422 <v Sapra, Manish>it's destigmatized and it also meets the patient where they are, right.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2546-0 00:17:42.422 --> 00:17:47.034 <v Sapra, Manish>So so they don't have to like now be labeled as a behavioral health patient,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2546-1 00:17:47.034 --> 00:17:50.089 <v Sapra, Manish>mental health patient and go to a separate clinic.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2546-2 00:17:50.089 --> 00:17:54.342 <v Sapra, Manish>They're getting the treatment in a very destigmatized medical setting.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2549-0 00:17:54.942 --> 00:17:57.022 <v Sapra, Manish>There is great communication between.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2568-0 00:17:58.462 --> 00:18:01.557 <v Sapra, Manish>Their medical provider and behavioral health provider, which you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2568-1 00:18:01.557 --> 00:18:04.346 <v Sapra, Manish>benefits the patient, but that's it's a good segue into why the</v>

e22ce321-8533-41aa-918f-4c43969d087d/2568-2 00:18:04.346 --> 00:18:04.782 <v Sapra, Manish>providers.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2593-0 00:18:05.132 --> 00:18:08.963 <v Sapra, Manish>Like if they're not sending these patients into some behavioral black hole</v>

e22ce321-8533-41aa-918f-4c43969d087d/2593-1 00:18:08.963 --> 00:18:13.202 <v Sapra, Manish>out there where they will never hear back from the psychiatrist or therapist is to</v>

e22ce321-8533-41aa-918f-4c43969d087d/2593-2 00:18:13.202 --> 00:18:15.092 <v Sapra, Manish>go how that treatment is progressing.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2613-0 00:18:15.132 --> 00:18:19.638 <v Sapra, Manish>Everything that is being done every every wizard is documented right there with</v>

e22ce321-8533-41aa-918f-4c43969d087d/2613-1 00:18:19.638 --> 00:18:22.962 <v Sapra, Manish>with their own notes, and they can see the progress of the</v>

e22ce321-8533-41aa-918f-4c43969d087d/2613-2 00:18:22.962 --> 00:18:23.412 <v Sapra, Manish>patient.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2625-0 00:18:23.852 --> 00:18:29.012 <v Sapra, Manish>They like it that they can do curbsides with actually actual experts,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2625-1 00:18:29.012 --> 00:18:30.412 <v Sapra, Manish>like psychiatrists.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2637-0 00:18:31.342 --> 00:18:35.742 <v Sapra, Manish>When things get tough and they also like the fact the providers that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2669-0 00:18:36.052 --> 00:18:39.741 <v Sapra, Manish>If there are some care coordination available, because honestly,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2669-1 00:18:39.741 --> 00:18:43.429 <v Sapra, Manish>like navigating the mental health space, it's hard for patients.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2669-2 00:18:43.429 --> 00:18:47.685 <v Sapra, Manish>But it's also hard for for providers as to where do they send this person,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2669-3 00:18:47.685 --> 00:18:51.657 <v Sapra, Manish>who has? You know, there's depression, anxiety. They started a treat.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2669-4 00:18:51.657 --> 00:18:52.792 <v Sapra, Manish>But I don't know if.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2677-0 00:18:52.782 --> 00:18:54.012 <v Sapra, Manish>They're looking like a bipolar disorder.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2681-0 00:18:54.012 --> 00:18:55.212 <v Sapra, Manish>Or is it looking like OCD?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2688-0 00:18:55.732 --> 00:18:57.252 <v Sapra, Manish>Who's an expert in what?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2699-0 00:18:57.572 --> 00:19:01.410 <v Sapra, Manish>Which place we send them and they're they have somebody in their practice who can</v>

e22ce321-8533-41aa-918f-4c43969d087d/2699-1 00:19:01.410 --> 00:19:01.972 <v Sapra, Manish>handle that.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2709-0 00:19:01.972 --> 00:19:05.852 <v Sapra, Manish>So I think that's great for them. And I'll lastly I'll say why for the.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2745-0 00:19:06.292 --> 00:19:10.714 <v Sapra, Manish>Or the senior leadership or large health systems. You know you want everybody.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2745-1 00:19:10.714 --> 00:19:15.080 <v Sapra, Manish>We're working in this world of narrower and narrower networks and and and and</v>

e22ce321-8533-41aa-918f-4c43969d087d/2745-2 00:19:15.080 --> 00:19:18.606 <v Sapra, Manish>large health systems. Wanna make sure that their patients have</v>

e22ce321-8533-41aa-918f-4c43969d087d/2745-3 00:19:18.606 --> 00:19:21.572 <v Sapra, Manish>access to all care within that health system. Right.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2755-0 00:19:23.102 --> 00:19:26.222 <v Sapra, Manish>And what better way of expanding behavioral health care?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2779-0 00:19:27.822 --> 00:19:31.566 <v Sapra, Manish>Then you know the integrating care in medical settings because it costs much</v>

e22ce321-8533-41aa-918f-4c43969d087d/2779-1 00:19:31.566 --> 00:19:35.262 <v Sapra, Manish>less. And even if you lose money, you're losing much less than if you work.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2794-0 00:19:35.772 --> 00:19:42.182 <v Sapra, Manish>You know, just opening our, you know, dozens of outpatient practices out there</v>

e22ce321-8533-41aa-918f-4c43969d087d/2794-1 00:19:42.182 --> 00:19:44.292 <v Sapra, Manish>and it's a real, you know.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2823-0 00:19:45.782 --> 00:19:51.045 <v Sapra, Manish>Booster for patient experience in in A and if if any systems get ready for value</v>

e22ce321-8533-41aa-918f-4c43969d087d/2823-1 00:19:51.045 --> 00:19:54.943 <v Sapra, Manish>based care or population health that really sets them well.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2815-0 00:19:54.042 --> 00:19:54.122 <v Jordan Cooper>Mm.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2823-2 00:19:54.943 --> 00:19:57.542 <v Sapra, Manish>You know if there's a program like this.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2837-0 00:19:58.662 --> 00:20:02.982 <v Jordan Cooper>So the last question I'll ask you, Manish, before we wrap up this episode.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2851-0 00:20:02.982 --> 00:20:06.782 <v Jordan Cooper>Someone's listening to this episode and they love everything that you're saying.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2855-0 00:20:06.782 --> 00:20:10.142 <v Jordan Cooper>Again, the Minnesota example I want to do this.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2861-0 00:20:10.222 --> 00:20:13.382 <v Jordan Cooper>What's 1 word of advice that you'd give to them?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2876-0 00:20:13.382 --> 00:20:18.277 <v Jordan Cooper>Or perhaps a word of advice that you'd give to yourself five years ago before</v>

e22ce321-8533-41aa-918f-4c43969d087d/2876-1 00:20:18.277 --> 00:20:20.222 <v Jordan Cooper>you start this kind of journey?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2882-0 00:20:20.502 --> 00:20:23.902 <v Jordan Cooper>What would should someone do or keep in mind as?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2887-0 00:20:24.622 --> 00:20:26.142 <v Jordan Cooper>A begin to move in this direction.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2910-0 00:20:27.642 --> 00:20:31.001 <v Sapra, Manish>Yeah. I mean, I think especially in a large health</v>

e22ce321-8533-41aa-918f-4c43969d087d/2910-1 00:20:31.001 --> 00:20:34.162 <v Sapra, Manish>system where I work, it's it's a constant work.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2919-0 00:20:34.162 --> 00:20:37.522 <v Sapra, Manish>It's as I said, you're introducing new discipline in in</v>

e22ce321-8533-41aa-918f-4c43969d087d/2919-1 00:20:37.522 --> 00:20:38.242 <v Sapra, Manish>an existing.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2929-0 00:20:39.742 --> 00:20:44.142 <v Sapra, Manish>Space that has honestly been been the same for decades, right? So.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2954-0 00:20:45.742 --> 00:20:48.192 <v Sapra, Manish>You know, getting as senior an executive</v>

e22ce321-8533-41aa-918f-4c43969d087d/2954-1 00:20:48.192 --> 00:20:51.001 <v Sapra, Manish>sponsorship, you can get you know a a top down</v>

e22ce321-8533-41aa-918f-4c43969d087d/2954-2 00:20:51.001 --> 00:20:55.542 <v Sapra, Manish>approach on saying that this is the strategy of where the system is moving.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2957-0 00:20:55.702 --> 00:20:57.502 <v Sapra, Manish>You know, why is it important to treat?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2964-0 00:20:58.492 --> 00:21:00.372 <v Sapra, Manish>Depression and primary care setting.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2967-0 00:21:00.412 --> 00:21:01.852 <v Sapra, Manish>You know why?</v>

e22ce321-8533-41aa-918f-4c43969d087d/2976-0 00:21:01.852 --> 00:21:04.741 <v Sapra, Manish>It's it's, it's, it's actually your job to, you know,</v>

e22ce321-8533-41aa-918f-4c43969d087d/2976-1 00:21:04.741 --> 00:21:06.132 <v Sapra, Manish>screening for suicide and.</v>

e22ce321-8533-41aa-918f-4c43969d087d/2986-0 00:21:06.212 --> 00:21:09.932 <v Sapra, Manish>And having those discussions were in a busy medical office.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3004-0 00:21:10.052 --> 00:21:14.445 <v Sapra, Manish>That message really needs to come from a senior leadership in the organization,</v>

e22ce321-8533-41aa-918f-4c43969d087d/3004-1 00:21:14.445 --> 00:21:16.532 <v Sapra, Manish>so getting that in is the first thing.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3039-0 00:21:16.532 --> 00:21:19.569 <v Sapra, Manish>Then, of course, analyzing what are the resources are</v>

e22ce321-8533-41aa-918f-4c43969d087d/3039-1 00:21:19.569 --> 00:21:23.956 <v Sapra, Manish>available in the Community and and just doing a very good analysis of of that</v>

e22ce321-8533-41aa-918f-4c43969d087d/3039-2 00:21:23.956 --> 00:21:28.399 <v Sapra, Manish>primary care setting or medical setting where we want to integrate services is</v>

e22ce321-8533-41aa-918f-4c43969d087d/3039-3 00:21:28.399 --> 00:21:31.942 <v Sapra, Manish>done prior to moving in. I think those will be two big things.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3041-0 00:21:31.942 --> 00:21:32.372 <v Sapra, Manish>There.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3043-0 00:21:33.242 --> 00:21:33.922 <v Jordan Cooper>Well.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3051-0 00:21:35.342 --> 00:21:37.062 <v Jordan Cooper>Manish, thank you very much for joining us today.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3058-0 00:21:37.402 --> 00:21:39.322 <v Sapra, Manish>Sure. Thank you for having me.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3056-0 00:21:38.772 --> 00:21:39.332 <v Jordan Cooper>For those.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3077-0 00:21:39.332 --> 00:21:43.164 <v Jordan Cooper>For those who've been listening, this has been Manish Sapra,</v>

e22ce321-8533-41aa-918f-4c43969d087d/3077-1 00:21:43.164 --> 00:21:47.812 <v Jordan Cooper>executive director of Behavioral Health service line at Northwell Health.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3088-0 00:21:47.892 --> 00:21:51.532 <v Jordan Cooper>And again, very glad to have you on today Manish.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3087-0 00:21:51.712 --> 00:21:52.232 <v Sapra, Manish>Thank you.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3090-0 00:21:52.232 --> 00:21:52.792 <v Sapra, Manish>Thank you.</v>

e22ce321-8533-41aa-918f-4c43969d087d/3091-0 00:21:52.792 --> 00:21:53.352 <v Sapra, Manish>Talk to you later.</v>