Episode 166 | Blueprint and Values Based Outcomes with Russell DuBois

Maureen Werrbach  

Hey, everyone. Welcome to another episode of The Group Practice Exchange podcast. Today I have Russell Dubois from Blueprint. He’s the director of operations–clinical operations, right? 

Russell DuBois

Yep. Correct. 

Maureen Werrbach

Yeah, Blueprint. And for those of you that don’t know Blueprint, he’s gonna be talking a little bit about what that company does, and how it’s becoming even more relevant as time goes. So today’s episode, we’re gonna be talking about values based outcomes in group practice, and what Blueprint does to help on that. So hi, Russell, thanks for coming on. 

Russell DuBois

Thank you for having me. This is great. 

Maureen Werrbach

Yeah. So why don’t we start off with telling me a little bit about you and a little bit about Blueprint. And then we’ll circle into how Blueprint specifically supports group practices and what values based outcomes are for those that don’t know what it means. And why this is becoming increasingly important in our field.

Russell DuBois

Wonderful. Sounds great. So just a little bit about me. So I’m a psychologist by training. My background is sort of a mixture of research and clinical practice. I’ve always been interested in measurement and this idea of using data in creative ways to understand our clients in a different way than we might be used to. Traditionally, I think our field for a long time has thought of assessment and measurement as something that only psychologists do, like, like either you refer a client out for formal psychological testing. It’s expensive, it’s time consuming, or you just sort of go about your job doing therapy as usual. But the really cool thing is that our fields beginning to change and embrace technology a bit more than we used to. And with that comes opportunities to bring what I believe to be really important changes to the way we provide care. And at the heart of all this change are new ways we can understand our clients through the power of data and technology. So that’s what I do. And that’s what Blueprint is all about. Developing tools and resources to help therapists of all types channel their inner sort of data scientist and provide high quality measurement based care.

Maureen Werrbach  

And why is this starting to become even more important for practices, practice owners, solo or group, to look at this? Because obviously, historically, we are in an industry, at least as outpatient therapists who have private practices, been in the space where we can provide therapy and kind of do it how we see fit, right? With little oversight. You know, if you take insurance, there’s some level of oversight that’s happening, but pretty minimally. And we’re seeing the shift a little bit. So tell us a little on why it’s becoming more prevalent to even be thinking about this in an outpatient setting, and maybe the definition of values based outcomes? 

Russell DuBois

Sure, yeah. Yeah, I think there’s a lot of really good stuff to unpack in there. I think first and foremost, what what I heard you say was this comment around accountability and in the fact that with a lot of our insurance contracts, right now, these are fee for service contracts. And so we basically get a fixed amount of money per service that we provide, you know, it might be $120, per 60 minutes psychotherapy session, or whatever it is. But within that comes, basically like free rein to sort of do what you want. You know, which, which has, generally speaking worked. Okay. I think the interesting thing about this has been that there hasn’t been any financial incentives for producing quality outcomes. So as a therapist, or as a practice, if you pride yourself in being highly effective, and being really great at what you do, other than having that satisfaction, and potentially using that, for marketing purposes, there’s, there’s been no real financial incentive there. And so values based care is this idea of providing financial incentives for quality outcomes. In other words, it’s insurance companies saying, hey, I’m gonna reward you as a therapist, or as a practice for providing high quality care that you can measure and show us so that you have the opportunity to make more money, which is always a good thing. With that comes also potentially penalizes you as a therapist or practice if you show that your care is sort of below the community benchmark. So there is both upside and downside risks. But that’s really, at the heart of what these values based care contracts are, are headed to do. And there’s a number of different ones out there now that are sort of in the exploratory sort of space, right now where they’re optional, and you can choose to go into these contracts. But you know, we certainly feel and we’ve seen all the trends that the future of mental healthcare is measurement based. And, you know, I think we all should be thinking about this now. Because it’s going to be coming up more as a requirement in the not too distant future.

Maureen Werrbach  

What does Blueprint specifically do? For those who haven’t googled and looked Blueprint up? How are you helping practice owners and group practices really get prepared for this kind of shift towards values based reimbursement, values based outcomes? Obviously, I know kind of what you guys do. But for those that don’t know, in layman’s terms, how do you help with that specific issue that’s kind of coming about around the accountability of the out the actual outcomes that we provide in doing therapy with client? 

Russell DuBois

Yeah, definitely. So Blueprint at a high level is a software that was built to help clinicians provide the best possible care, as well as for group practice owners to help scale their business. And we’re particularly focused on making it as easy and simple as possible to collect different types of outcome measures and track progress across time. And then  there’s a lot of sort of value that comes with that at different levels of care. So there’s value around client engagement, client outcomes, client satisfaction, benefits at the clinician level as well. But when it comes to values based care in particular, I think more than anything else, what we’re learning and seeing is that these insurance companies are going to be increasingly requiring some form of objective data as part of these contracts. And so as a practice owner, like you need to find a way to be operationalizing, or measuring outcomes, like whatever that means for you. And traditionally, that’s been pretty hard to actually do at scale. 

So measurement based care is not a new concept. It’s been around for, you know, a long time in many areas of health. But with behavioral health, in particular, it’s traditionally been really hard to collect these outcome measures at regular intervals. People tend to start through paper and pencil forms where you’re giving your clients you know, pH, q nines or Gad sevens or whatever it might be. And then you have to score those enter those into a spreadsheet and make sense of that data. It’s really not sort of possible at scale. And because of that, we haven’t seen measurement based care really sort of expand within our field. 

But the really cool thing about technology and what Blueprints all about is both helping scale measurement based care in a really easy way. So as a practice, or as a therapist, you can use Blueprint to collect information from your clients, this is objective information in about progress, about symptoms, about pretty much anything that’s connected to the type of work that that you do. And then Blueprint will automatically score, interpret that and show you that back both at the client level as well as the population level. So just a really easy way to actually implement measurement based care. 

But the other really important thing that we do alongside the actual product, is we provide a lot of advocacy and education for how to actually go about doing this. Like there’s a lot of people out there who’ve never thought about tracking outcomes and like what measures to use and how to use them. There’s so much uncertainty. And so a lot of what we do with Blueprint is help people begin to sort of approach this space and just understand what they need to be doing. And so I think what we do, you know, really well with our sort of secret sauces, is this combination of this really easy to use friendly platform that just makes sense for everyone, together with the education and the training around, you know how to start thinking about these things.

Maureen Werrbach  

I know you and I spoke a few weeks ago, and one of the things that I really liked as a group practice owner, and one who has a fairly larger practice, is we’ve always had difficulty consistently collecting data across all of our locations, and across all of our staff. And one of the things that you were talking about before is how you can set Blueprint up in a way where there are almost like triggers for certain data, for certain pieces of data to be collected, whether it’s like, you know, after an initial session, two days later sending out a specific client satisfaction survey or a specific–because you guys have like, a couple of 100 different types of measures, right? 

Russell DuBois

Yeah. 

Maureen Werrbach

So you can search as a practice owner, essentially, say like, this is the data specifically, like a baseline we want to collect after an initial session or every eight sessions. And it happens automatically, then because you can set that trigger up so that your clinicians don’t actually have to send that to clients. Because I feel like that’s where the issues really come about, is really holding every single individual therapist accountable to actually giving their client that survey or data, right. And so they happen automatically. But then on top of that clinicians are able to based off of the type of therapy they provide, there are different things like what’s it called, like a mood diary or whatever, that they can grab and use if you know if their style of therapy uses mood diaries, or if they’re DBT. And they have other sort of measures that they want to collect, that they can then do that on an individual case by case basis to also strengthen the work that they’re doing. Am I saying that all right?

Russell DuBois

That is that is exactly right. Yeah. What’s what’s really nice about Blueprint is part of our partnership model starts with just understanding all these nuances around how the different practices want to be using Blueprint. So everything like, what is meaningful change mean to you like what types of measures do you want to be used, that you think are most connected to the type of care that you provide. So we have, as you said, over I want to say, 200 measures at this point that span everything from, you know, pathology based ones to relationship measures, couple satisfaction, family based measures. I mean, we offer a whole bunch of different stuff. And we really pride ourselves on on connecting these different measures to the unique aspects of care that all of our partners have. 

And then second is, is creating those sort of automated workflows and protocols where it, it might be, you know, we’re going to assign a certain screener at baseline, and then these other measures to go out every other week. And sort of everything is turnkey, such that when clients get enrolled on a Blueprint, everything kind of happens automatically. Clinicians have have access to this information, but there’s really not much that they have to actually do to keep everything running. 

And then I think the last point I mentioned as well, as is, you know, we’re really big on providing different types of tools and resources to keep clients engaged in between session. And so above and beyond the outcome measures that we have on the platform, we have a range of different therapeutic worksheets and symptom tracker. So things like DBT diary cards, CBT thought records, TICES log for EMDR is a big one that we’ve been seeing recently. Pretty much anything that you give your client to do that’s on paper, we’ve sort of built it into Blueprints in a really accessible way. And so, you know, as as, as a therapist, it’s easy to keep your clients engaged. And it provides a sense of accountability when you’re giving your clients tasks outside of session.

Maureen Werrbach  

Yeah, that I feel like has so much usefulness in it. Even looking outside of this whole shift that’s happening with insurance companies to values based reimbursements. And such is just at which I feel like is something that a lot of therapists are going to be resistant to because it’s a change. But it also has this undertone of feeling like there’s more control that insurance companies are having, and that’s an issue that providers have as it is, right? 

But there’s this other element that I am really trying to focus on more, which is really being able to provide more benefit to clients and like visually show, because as we know, like, it’s really it’s not super common that clients are, you know, leaving treatment and being like, this was so impactful. Like, right therapists really hold on to those few clients that throughout their years really like let them know that the work that they’ve done with them has been really good quality work and has been really helpful. And I really can see, regularly measuring things, in a more intentional way like this is going to provide an opportunity for therapists and clients to see progress that’s really being made, when that might not be being communicated, which is a whole other issue in and of itself to talk about is like how there can be you know, checking in with clients, how the treatment is actually going versus just having session after session. But I also feel like something that you had brought up last time we chatted was that you’re seeing clinicians actually using the app itself with the data for that client as like a starting point at each session, to really help the client see visually what that progress is looking like and using that as a starting point for each session.

Russell DuBois

Definitely, yeah, and now I’ll preface that by saying too, so we’ve, you know, spent a lot of our time talking about values based care and, you know, these new contracts that we are, you know, at the heart of what we do, is helping to enhance and sort of facilitate the growth of the relationship between clients and clinicians. Like that’s really what we’re all about. The sort of secondary gain here is that as a practice owner, you can set yourself up well for the future of these values based care contracts. But you know, there’s a lot of misconceptions out there that that measurement and outcome tracking can feel cold, it can feel you know, disconnected from the work that you do and the empathy that you bring as a therapist, but it very much doesn’t need to be that way. And that you know, as a client, you want to feel understood and you want to feel connected to your clinician. And through these these tools like like Blueprint it’s a wonderful way to go about doing that, where you can understand your clients in a in a new and unique way that really does enhance the therapeutic relationship. And just one example of that is, you know, what, what you were saying how, you know, therapists will oftentimes use Blueprint as sort of a temperature check to start a session when a client comes in, right? So, so if you are using data, you tend to ask the client, like, how was your week? You know, how have things been going, and you sort of go from there. What’s really exciting and unique about Blueprint is as a therapist, you have access to this rich and meaningful information about your clients in between session. And so when they come in, you can already have sort of a benchmark for how you think they’ve been, what’s been going on, and you can start sessions and much more of a targeted way. And so we definitely see that quite a bit.

Maureen Werrbach  

Yeah, I think that’s gonna be really, the most beneficial piece of it, like you said, is less so because, you know, there’s movement with insurance companies, and more. So just refocusing on actual care we’re providing, and I think, sometimes we get away from that as therapists because we can get into this routine of how we, you know, engage in sessions. And so having a tool like this could be really helpful in holding ourselves accountable, whether insurance companies do or not, and, you know, helping the client and therapist relationship. I think, as just we’re circling to the end here, the only thing that I think is maybe I want to say unique to group practices, because I can envision well, as a solo provider, if you’re using it, you’re kind of making the choice to use it. And it could, you know, depending on the quality of the work that we’re doing with our clients that can show some data that maybe helps us realize we need to do more work on a clinical side to, to, you know, do better work, but I’m envisioning that there’s going to be this extra little bit of consideration that group practice owners will have to have, because they are kind of making that decision to implement this. And it tends to anything that’s new, or that changes, tends to be anxiety provoking for employees who really aren’t the ones making the decision to like, implement something like this. And it can also feel like, initially, like it’s either micromanaging, or that employers, group owners just want to, you know, see how they’re doing, you know, what I’m saying? And so I think that’s just one thing in our group practice owners world that we’ll have to think about how we have this discussion, and really focus it not on, you know, we want to implement this thing that’s gonna show if you’re a good therapist or not, which is, I think, what the will initially thing and more from a relationship space perspective. 

Russell DuBois

Yeah, yeah, definitely. And I, I’ll say to, you know, we’ve been doing this for quite some time, we’re, you know, we’re now and I want to say, almost 40 states. You know, we’ve done a lot of these different implementations across the span of practices, all the way from solo clinicians to, you know, multi state group practices. And, you know, having done all of that, I would certainly agree that it’s really important as a practice owner to be mindful and to think about how you’re going to implement a solution like Blueprint, because it can certainly be implemented in a way that feels compassionate and connected to your values as an organization, it doesn’t need to feel like this top down thing where, you know, therapists are just being mandated to do this, and they don’t understand why and they’re all angry, like, it doesn’t need to be that way. And so there’s a lot of sort of tips and tricks along the way to, you know, make sure that you’re setting yourself up for success.

Maureen Werrbach  

Yeah, and I know, you mentioned you guys offer a lot of support, especially initially with getting, you know, actually implementing Blueprint in a practice, which is, I think, really helpful for, you know, group practices to have employees that will, you know, need to be using this service. So, I think that’ll, that’s also a real benefit. Yep. All right. If people want to reach out and learn more about Blueprint, how can they do that?

Russell DuBois

Yeah, so pretty simple. You can visit us at our website, it’s www dot blueprint dash health dot com. Don’t forget the dash in there. Some people do. So it’s blueprint dash health dot com, and that’s where you can go to find more information about Blueprint. We have a range of different webinars and training activities as well. So that will also be up on the website.

Maureen Werrbach  

Awesome. Well, I appreciate you coming on to chat about values based treatment and what blueprint does for practices. Thank you so much. It’s been great.