Features Technology
Speaking the same language

You’ve probably been hearing about the HealthIM and interRAI’s Brief Mental Health Screener (BMHS) program, the brainchild of two ambitious University of Waterloo graduates, for a handful of years now.

Blue Line last reported on the digital mental health assessment tool for law enforcement back in 2016, noting it had been field tested with the Niagara Regional and Brantford police services since 2013. We wanted to check in with the technology and see what has happened since.

The system is currently deployed in 19 communities in Ontario, Manitoba and Saskatchewan, says Brendan Sheehan, the director of operations at HealthIM. Outside of these communities, there are an additional 21 communities in all these three provinces plus in British Columbia currently undergoing implementation and will be operational within the next 12 months.

One of those communities is Belleville, Ont., and it’s a standout case because here the Local Health Integration Network (LHIN) is the one funding the program for the local police service.

Belleville Police Insp. Sheri Meeks has been in the field of crisis negotiation since 2002. She says she had been aware of HealthIM for quite a while and actively brainstorming on how to fit it into her municipal police budget.

For more than 10 years, Meeks has sat on her local (Hastings-Prince Edward County) Human Services and Justice Coordinating Committee (HSJCC) as well as the police/hospital committee, which meets quarterly to discuss specific cases.

She began liaisoning with Addictions and Mental Health Services – Hastings Prince Edward, and proposed pitching the HealthIM business case to the LHIN.

Thanks to her passion for better, patient-centered transitions of care as well as some steely perseverance, and an advocate at Addictions and Mental Health Services, Meeks finally had her funding request approved for a three-year contract with HealthIM in February 2019.

“I was told I was the first municipality to receive this kind of financial aid from a LHIN for the technology,” she says. “As soon as I got the word, I called HealthIM and we started. We’re well underway right now, with implementation starting in July. I’ve also met with our healthcare partners and the community agencies that will be involved in the referral process —when we don’t apprehend and take people to the hospital.”

Implementation will take around 14 weeks of test runs and training, according to Meeks, and everything should be ready to go live by Oct. 29.

“What stands out about using HealthIM is we’re all speaking the same language… We aren’t psychiatrists and nor do we claim to be but with this tool and the drop-down menu options, we’re using the clinical language the hospital is using. The officers are already doing such a good job out there. This just provides them with an extra tool that can make their decisions more evidence-based. It’s recorded and tangible in a document form as opposed to us having a conversation with healthcare staff afterwards, where things can get lost in translation.”

Additionally, it is so user friendly, Meeks adds.

“Officers are inundated with admin tasks now more than ever and with this in-your-hand-fill-out tool, you can complete the assessment in three to five minutes,” she says. “It’s not anything cumbersome.”

Secure and mobile

HealthIM will be accessed solely via a mobile app for Belleville Police Service (BSP). It’s a shift Sheehan says the company has noticed in a broader context, too.

“The biggest shifts we have observed over the past three years would be a move from a member using the system with a person in crisis on the in-car MDT to mobile devices,” Sheehan says. “That and a bigger demand for the performance reporting and analytics. The most positive outcomes we hear continue to be around safety (member and the individual) and improved collaboration with healthcare.”

The reporting process has evolved since the technology’s inception, he adds, to include automated monthly reports, reporting at the command level as well as platoon, and reporting that compares operating units and then individual members.

HealthIM says it utilizes a combination of encryption protocols and transport layer security to protect data at rest and in transit. After the report is written on the mobile device, the system sends the data to HealthIM’s servers. Sensitive fields (identifiable data) are separated from the remainder of the data. If the report is being transmitted to another organization (such as a hospital or community mental health agency), the sensitive fields are encrypted specifically for each organization.

“For Belleville Police Service, we will be receiving the electronic reports from the HealthIM servers in PDF format and uploading the documents into our records management system (RMS),” adds Joe Myderwyk, the systems network administrator with BPS.

Better transfer of care, wait times

Over the past two years Meeks tried to capture the data on the call volume for mental health calls involving police in Belleville by tasking someone internally with a Microsoft Excel spreadsheet.
“Our records management system was capturing some of the data, but not all of it,” she explains. “For example, the time the individual cleared the hospital was not being tracked. We were trying to do that so we could get an accurate picture of the overall situation. It was very difficult.”

Implementing HealthIM takes care of all that. However, it is only a piece of a three-stage project for Meeks. The next step is to establish a mobile crisis response unit, as found in many other services.

Part of the overall goal of this multi-pronged project is to reduce the wait times officers are sitting in hospitals as well.

“Average wait times are around 2.5 hours,” Meeks says. “The target goal is 60-90 minutes.”

In consultation with her Ontario Provincial Police (OPP) partners, Meeks has also brought about a Memorandum of Agreement (MOA) between the Chief of BPS, Ron Gignac, and the CEO of Quinte Health Care regarding these wait times.

Furthermore, in April 2019, a new “Transfer of Care form” went live at Belleville General Hospital, completed by Meeks and the OPP.

“This is a one-page document filled out by every police officer and kept at the hospital,” Meeks says. “We’re already seeing a change in wait times from this alone. Frontline members are coming up and telling me it’s getting so much better.”

HealthIM notes it will digitize BPS’s Transfer of Care form.

“Where these existed prior to a jurisdiction adopting the system, we just try and move the process off of paper for the frontline members,” Sheehan says.

It’s these types of protocols that you’ll find in the freshly released Police-Hospital Transitions Framework and Toolkit. These resources, endorsed and recommended by Ontario’s Ministry of the Solicitor General and the Ministry of Health and Long-Term Care on June 3, 2019, are “meant to help police, hospitals and others comply with legal requirements (e.g. as found in Ontario’s mental health, human rights, policing and privacy legislation) and support the adoption of best practices.”

The hope for the future, with shared protocols like the above and technology like HealthIM, is improved communication between police and healthcare, Meeks says.

“My number one priority is that we become better at serving these individuals through increased collaboration with our community mental health partners… So maybe an officer can link an individual with a support agency in the community instead of taking them to the hospital in order to better serve them versus that revolving door of going in and out of hospitals.”

Visit hsjcc.on.ca/our-work/projects/policehospital-transition-framework/ for more on the Police-Hospital Transitions Framework and Toolkit.