Even by the standards of an addiction treatment provider community that has been relatively cautious in embracing information technology, the Valley Hope Association arrived slowly on the path to automation. It was not even 10 years ago that the nationally known treatment organization hired its first programmer, who was just approaching age 20 at the time. No one would have foreseen then that Valley Hope today would be entering a realm few other behavioral health provider organizations have even stopped to consider: marketing its homegrown technology products and services to other provider agencies.
As a nonprofit that has staked its national reputation on treatment grounded in 12-Step principles and emphasizing family involvement and continuing care, the Kansas-based Valley Hope by definition does not see the technology business as an avenue to riches. Rather, its leaders describe the uncommon move as a logical extension of ideals the organization has held since it first leased space on the campus of a Kansas state hospital in 1967.
"We believe our product is good enough to share commercially, and we see this as allowing us to pursue our mission, which is to help addicts wherever we can," says John Leipold, Valley Hope's executive vice-president and chief operating officer.
Now that effort has the potential to extend beyond the seven states where Valley Hope operates its own treatment facilities (Arizona, Colorado, Kansas, Missouri, Nebraska, Oklahoma, and Texas). In its effort to market its technology solutions to other providers, Valley Hope will emphasize that with treatment having become more individualized and with clinical and insurance requirements now more burdensome for staff, sound clinical and administrative technology is essential for maintaining counselor productivity with sufficient caseloads.
"The pressures on productivity are massive today. If you can't keep up, you'll fall by the wayside," Leipold says.
Leipold says he wouldn't describe Valley Hope as embarking on a full-fledged, head-to-head competition with the well-performing software vendors in the behavioral health market. Nevertheless, it is clear that the agency can distinguish itself to a degree from that group because of its firsthand experience in clinical addiction care, which has informed the design of its technology solutions from the start.
When the organization began to consider automating systems in the early 1990s, it essentially was starting from scratch because its only computer support was located in accounts receivable. Because of a relatively limited number of off-the-shelf products at the time, and because Leipold believed the combination of Valley Hope's size and his own background in writing program code made an in-house system design possible, the agency proceeded without an outside vendor. Leipold says Valley Hope staff exhibited surprisingly little resistance to automation at that time, and that openness remained consistent over the years.
"Managers prior to 1992 had done a nice job of hiring decent people who were on a mission to help the chemically dependent. Whatever tools were available to help, they were willing to embrace them," Leipold says. "Also, most other organizations had already started this process, so there was a sense that we were behind the times."
Valley Hope's first foray into technology consisted of a series of stand-alone workstations that were not networked. But even from that small step, changes were immediately noticeable: Managers now could readily compose their own documents, which in turn changed the nature of support staff's work. Eventually Leipold spearheaded an effort to automate patient demographic information, and the makings of a patient database appeared.
About five years into the process, executives realized they needed a more standardized network approach, and began to investigate development tools for working in a Windows environment. At that time Valley Hope hired George Boutwell as a programmer. Today he is the organization's software development manager and supervises four programmers—with a larger staff likely on the way as the agency begins to work on contracts with other treatment providers. But in some ways, Boutwell's job has remained remarkably consistent, as the writing of code continues to be the focus of his job.
"It's really hard to manage a team of people who do something as technical as programming if you don't know how to do it yourself," Boutwell says. In fact, even the organization's information systems director, an MBA-trained manager, has proficiency in programming.
The foundation of Valley Hope's tools for improving its clinicians' performance has been the Electronic Clinical Record (ECR), a consolidated group of applications that among its features allows multiple clinicians at different locations to view a clinical record simultaneously. "The computer provides fundamental change in how we handle clients," Leipold says.
The ECR includes modules for electronic progress notes, treatment plans, admissions assessments, and discharge summaries. For treatment planning, Valley Hope's software allows clinicians to create problem statements and interventions, generate multidisciplinary case conference review forms, and research various intervention options through an online treatment planning library. (A full description of the programs and services Valley Hope is making available to others can be found at http://www.vhaimcss.com.)