Heroes Of The Addiction Crisis: How Dr. Nishi Rawat of Appriss Health Is Helping To Battle One of Our Most Serious Epidemics

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Nishi Rawat, M.D., is Chief Medical Officer at Appriss Health and co-founder of OpenBeds. She is a critical care physician, healthcare researcher, and faculty at Johns Hopkins University School of Medicine, where she has received multiple awards for her work in quality improvement. In 2015, Dr. Rawat launched OpenBeds — a technology that facilitates access to behavioral health treatment and is used by hundreds of organizations and nine state governments.

Ispent the first two decades of my career as a critical care physician with a practice in Baltimore. While at Johns Hopkins University School of Medicine, I led quality improvement activities and also spent time as a healthcare services researcher. These days I’m focused on crisis management and behavioral health care coordination — specifically, how community and technology healthcare resources can help people who are experiencing behavioral health crises and ensure connections and transitions in care to support whole person care.

Finally, I’m an entrepreneur. I co-founded OpenBeds, a company that leverages technology to improve care delivery and quality and improve access to mental health and substance use disorder (SUD) treatment. At my core, I truly enjoy building things of value.

Is there a particular story or incident that inspired you to get involved in your work with opioid and drug addiction?

As a clinician, I’ve had firsthand experience with the inefficient manual processes used to locate and refer patients to the appropriate level of care, including for substance use and behavioral health conditions. Time and again I found myself unable to connect patients with the care they needed and felt we were failing an enormous population. I decided to do something about it, so that’s when I started OpenBeds in 2015 with my father, who is a systems and electrical engineer. We created a software platform that provides users — in this case, physicians and other care providers — with a real-time inventory of inpatient and outpatient services. We provide a comprehensive referral network of treatment providers for both mental health and substance use disorder treatment. OpenBeds is live in 9 states and counting.

Can you explain what brought us to this place? Where did this epidemic come from?

The roots of widespread opioid addiction can be traced back to the 1990s, when opioid prescriptions began to increase. According to the CDC, nearly 450,000 people died from opioid overdoses from 1999 to 2018, and the total number of drug overdose deaths in 2018 was four times higher than 1999. A majority of the increase was due to illegal fentanyl use. And when the pandemic hit, overdose deaths accelerated even more. In the 12 months from September 2019 to September 2020, 87,000 people in the U.S. died of a drug overdose according to the CDC. This staggering number exceeds the death toll in any year since the opioid epidemic began in the 90s.

To make matters worse, access to behavioral healthcare treatment is shrinking. More than 50% of community behavioral health organizations have seen an increase in demand for services, yet 39% of those organizations are uncertain due to shortfalls in revenue during the pandemic. With the lack of revenue and pandemic-related restrictions, 65% have had to cancel programs, reschedule, or turn patients away.

Can you describe how your work is making an impact battling this epidemic?

OpenBeds enables people who urgently need mental health or substance use disorder treatment to find and receive assistance. We fill a void in coordinating behavioral healthcare treatment that has left too many people falling through the cracks.

Can you share three things that the community and society can do to help you address the root of this problem? Can you give some examples?

First, it’s really important that we do everything we can to make behavioral health treatment services more accessible and affordable to those who need it. This starts with a continuing investment in reducing the stigma associated with seeking behavioral healthcare.

Second, we need investment in crisis services, specifically the necessary digital infrastructure to help people access care once they’ve called into a crisis line. And third, we need to focus on loosening laws for delivering care remotely. For example, waiving the need for an in-person consultation for buprenorphine treatment, which is a medication used to treat opioid use disorder. That requirement has been waived during the pandemic, but it should be waived permanently to support those working to overcome addiction.

If you had the power to influence legislation, which three laws would you like to see introduced that might help you in your work?

I’m hopeful that the mental health services provisions in President Biden’s stimulus package will be of help. There’s roughly $4 billion in them to support workforce training, community-based organizations and crisis programs, so that’s a step in the right direction.

Beyond that, I’d like to see legislation introduced that supports telehealth services on an ongoing basis. One thing COVID-19 did was force us to democratize access to behavioral healthcare and make it more accessible to anyone who needs it. Data shows telehealth utilization increased more than 3,500% in the 12-month period ending in August 2020. It’s mind boggling. What’s even more mind boggling is that nearly half of those claims are for mental health services, and that’s not something that people talk about.

I know that this is not easy work. What keeps you going?

My commitment to providing the best healthcare possible to every individual, especially those struggling with mental health and substance, keeps me going. Plus, my desire to improve healthcare technology and making it more accessible for everyone — patients and providers.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

We all have the ability to take steps to improve or save lives. If you focus your life’s work on helping others, you will quickly find that you are making a greater impact than ever before.

Wow! Without sharing real names, can you tell us a story about a particular individual who was impacted by your initiative?

Our system has a public-facing portal called Treatment Connection that helps people find trusted treatment resources, determine the right level and type of care that they need and reach out to treatment providers. We receive feedback from users who have had trouble accessing treatment. One woman told us that she had struggled for months to find appropriate residential treatment and was able to connect to three providers via our system. It’s rewarding to know our solutions are helping people find the care they need.

Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?

As a physician, I impact the lives of individuals day in and day out. With OpenBeds and at Appriss Health in general, I have the opportunity to make an impact at scale by working with a talented group of clinicians and technologists.

Do you have hope that one day this leading cause of death can be defeated?

Absolutely. One must have hope. But it will take a village, that is a coordinated effort by the public and private sectors, criminal justice system and medical realm.

How do you define “Leadership”? Can you explain what you mean or give an example?

In, my opinion, good leaders inspire, solve and support. They strive to help their team see the possible in the impossible. They tackle the tough challenges head on and hand in hand. They maximize the performance of individuals by being thoughtful about matching individual skills with team needs to accomplish collective goals.

What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.

I wish that someone had told me the following five things:

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I would inspire the world to be more accepting of people’s differences.

Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂

I would love the opportunity to have a private breakfast with Bill and/or Melinda Gates. They have dedicated their lives and positioned their privilege to solve the world’s most vexing problems. Their ambition, determination and creative approaches have resulted in profound improvements to childhood vaccination, and access to contraception and malnutrition. Their efforts have saved countless lives worldwide.

How can our readers follow you on social media?

Please visit www.apprisshealth.com and follow us at Appriss Health on LinkedIn and Twitter.

This was very meaningful, thank you so much!

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