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Scaling Behavioral Health While Preserving Clinical Autonomy with Ben Johnson · Becker's Healthcare Behavioral Health

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Welcome to Becker's Behavioral Health Podcast. I'm Ella
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Reuter, your host, and I'm thrilled to be
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introducing our guest today, Ben Johnson,
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director of behavioral health provider practices and operations
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at Lakeland Regional Health in Florida.
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Ben, thank you for joining us today. For
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those in our audience who may not be
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familiar with you and the work that you
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do, could you please introduce yourself and tell
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us a little bit more about Lakeland Regional
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Health?
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Sure. Thanks, Ella. Thanks, for having me on
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today. I'm glad to to be here to
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talk a little bit more about what we
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do at Lakeland Regional.
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My name is Ben Johnson. I have the
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privilege to serve as the director of behavioral
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health providers and practice operations at Lakeland Regional
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Health. Lakeland Regional Health is we're based here
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in Lakeland, Florida. We have the privilege to
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serve the Central Florida community over the last
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a hundred and ten years.
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We started out as a small community hospital
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called Morrell Hospital in 1916,
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and now we're one of the largest hospitals
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in Florida with a physician group of over
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400 providers,
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40 specialties, and 35 locations.
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Over the last five to six years, the
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footprint of behavioral health at Lakeland Regional has
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grown significantly.
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We have a state of the art facility
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of a 96 bed inpatient behavioral health unit.
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We have a thriving outpatient practice with multiple,
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locations.
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Our behavioral health provider group is now over
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50,
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amazing clinicians from psychiatrists,
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child, adolescent psychiatrists,
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psychiatric nurse practitioners,
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addiction medicine physicians,
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psychologists,
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therapists, clinical social workers, and now,
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psychiatry physician residents.
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Besides inpatient outpatient behavioral health, we offer IOP,
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interventional psychiatry services like ECT,
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TMS, ketamine.
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We also have a robust consult liaison
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psychiatry service at our 910
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bed hospital.
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We have a psychiatrist embedded right within our
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emergency department,
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and integrated behavioral health and our primary care
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practices.
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This year, we've also added a walk in
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clinic for psychiatric med management.
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Just a little bit about myself. I've been
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in behavioral health, leadership for over a decade
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and between behavioral health and consulting practices,
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across multiple states.
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I started out as a therapist.
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Marriage and family therapy,
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is my background,
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but I quickly wanted to move into administration,
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which has led me here today.
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Well, wonderful. Thank you so much for that
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brief overview and introduction.
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I'd love to kick us off with our
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first question.
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As Lakeland Regional scales its behavioral health services,
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where have you seen the most operational variation,
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and how are you standardizing
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workflows without losing clinical flexibility?
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A great question.
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The most significant variation in behavioral health is
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usually not the therapeutic work itself.
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It's in the operational
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infrastructure
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infrastructure
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surrounding care,
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including access, intake, pathways,
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referral management, handoffs, documentation, expectations, and scheduling workflows.
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My philosophy,
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is really that behavioral health leaders need to
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be very careful not to over insert themselves
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into
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the the clinical encounters.
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I've seen way too many organizations
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policy themselves into a corner and create
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operational rules that unintentionally
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compromise,
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patient care.
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Behavioral health is,
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difficult to fully manualize.
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It's not a commodity service line, and
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it doesn't respond well to,
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rigid, one size fits all operational models.
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Because of that, I I do not believe
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the the
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goal is to standardize the clinical encounter. The
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goal is actually to
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standardize the infrastructure
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around the encounter.
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At Lakeland Regional, we try to to to
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create an environment where providers can operate as
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closely
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to a private practice model as possible,
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while still benefiting from the strength of an
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integrated health system.
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That means,
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myself, my leadership team, and our support departments
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at Lakeland Regional Health are are really here
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to absorb as much of the administrative burden
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as possible
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so that providers can can stay focused on
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on patient care.
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We're here to solve the operational headaches, not
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to micromanage
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the art of the medicine or the psychotherapy
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itself.
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The way I think about standardizing
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is through guiding principles, not excessive rules.
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You know, we defined
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the the minimum standards necessary for access, for
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safety, coordination,
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and team function, but
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we leave the room for the provider judgment
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and the patient specific nuance.
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That's a is is, especially important in behavioral
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health where
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trust, the therapeutic alliance, with the patient,
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and the individualized care planning,
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are central to outcomes.
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So the balance is is really this, the
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standardized what protects
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the patient
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and supports the team, but
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do not,
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overstandardize
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in ways that intrude on clinical judgment.
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Yeah. That's really incredible.
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Thank you so much for for giving that
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overview there. And I'm really curious about how
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technology is playing a role in this.
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If you could kind of dive into
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where it's driven consistency
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versus where it's kind of fallen short.
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Great question.
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Technology has played an an important role in
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helping us create consistency
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in the administrative and operational aspects of care.
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It can support
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the the standard referral pathways, documentation,
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templates, the order sets,
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the communication workflows,
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the tracking tools, and
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performance visibility across our practices. It's especially helpful
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in creating a a shared infrastructure
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so that teams are are are not solely
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relying on their memory,
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their tribal knowledge, or even, like, the the
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local workarounds. That said,
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technology has its clear limits in behavioral health.
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It can support a workflow,
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but it really shouldn't define the entirety of
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of the of the care model.
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Where technology really falls short is when organizations
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try to force behavioral health
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into a rigid system
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that doesn't always reflect the nuance of the
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work.
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An EHR
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can
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standardize
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the the fields and the steps, but it
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really can't replace the clinical judgment,
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the therapeutic align alliance,
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or the reality that behavioral health is often
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nonlinear.
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Technology,
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it it can fall short when it becomes
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another layer of an administrative burden rather than
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a tool that actually removes the burden.
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In behavioral health,
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that is a real risk if the system
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creates more clicks, more duplicative
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documentation,
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or,
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more operational policying
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than
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of the actual clinical encounter.
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Clinicians will will feel it immediately.
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So I view, technology as more of a
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enabler,
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not the solution itself.
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It should support support,
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consistency
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in the administrative scaffolding
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around care,
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but it should never become,
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yeah, a mechanism
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through which,
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administration
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overreaches
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into the into the clinical encounter.
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When technology is
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is well designed,
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it creates
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clarity,
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it reduces friction.
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But then
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on the opposite side, when it's poorly designed,
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it it amplifies both frustration
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and fragmentation
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in the system.
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One of our big wins for our team
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this past year has been adding AI,
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to help our providers
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document their sessions.
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It's been a huge patient satisfier,
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or a huge provider satisfier rather
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that they can spend more patient facing time
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and not have to worry about getting to
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the the next session. And it also helps
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our providers get home quicker to their families
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and move on, so they're not having all
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of that, extra documentation at the end of
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the day.
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Yeah. That's really incredible. I know I've talked
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to a lot of leaders about kind of
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that workforce strategy there with
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the AI,
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listening tools and documentation tools. So thank you
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so much for for talking more about how
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AI is is, you know, affecting,
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Lakeland Regional Health. I'd also love to dive
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more into I know you mentioned standardizing versus
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clinician autonomy.
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And I was kind of wondering if you
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could dive more into the challenges there and
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kind of how
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you're navigating that so that you are balancing
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the two in the in your system?
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First,
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I I do assume that a a more
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standardized process is automatically
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a better one.
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In behavioral health,
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a a process can look more efficient
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on,
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on paper
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and still create friction,
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that damages patient care or clinician and, engagement.
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I look at whether the the process
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is actually helping patients,
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enter care more smoothly or move through the
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continuum more effectively
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and connect with the right provider with less
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confusion and less duplication.
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I also look at,
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at whether it is protecting clinicians,
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from unnecessary administrative burden.
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One of my core leadership principles is that
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providers should be doing
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the,
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provider work and not spending
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their day fighting avoidable
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operational barriers.
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If a process
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improve,
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improves throughput by pushing,
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work back onto clinicians
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or
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by creating,
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an impersonal patient experience. I I really don't
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consider those to be a successful design.
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We try to build systems that reduce administrative
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drag,
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and create real clarity,
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for the entire support around the provider.
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That means having schedulers,
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MAs, operational leaders,
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and support teams really carry that administrative load,
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that they're meant to carry. So
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the provider can,
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remain focused on care delivery. You may hear
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me say that, multiple times because, it's it's
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really important to me. It also means being
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honest that,
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not every access metric tells the full story.
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I'm very cautious about those workflows that technically
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satisfy
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payer timeline standards so that,
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that in a way, it fragments the patient
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experience.
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For me, true access is not just about
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getting a patient seen quickly.
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It's about getting them meaningfully connected to the
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right
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level of care, ideally,
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with the right long term provider
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relationship too. So
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so we evaluate,
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the process design
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through both an operational lens and a care
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experience lens.
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If it improves
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throughput but weakens trust,
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continuity or the provider sustainability,
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then it's truly not optimized.
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Yes. And I'm really curious too about
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how you're connecting with providers to making to
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make sure there isn't an added friction.
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I was kinda curious about how you're receiving
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that feedback and maybe closing those loops.
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So I really think it's important that
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you have an open line of communication
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between your provider group, your support teams,
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and your leaders,
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and that really does require
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open door policies
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and frequent meetings,
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particularly within within our department. We
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have
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one large department meeting, and then we have,
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smaller meetings within, behavioral health. Like, our outpatient
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team, we meet, once a month
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where we,
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discuss those,
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friction points. And,
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what I ask of my team is that,
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if they've identified,
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a friction point, that they're also, you know,
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helping us try to find solutions as well
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because, we're we're a team here. And,
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on my team, they know that,
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I like to volunteer us for lots of
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different pilot opportunities. So it's not turning away
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turning down a an idea just because we
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want to continue. Well, this is this is
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the way we've always done it. You know,
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if there's some if there's a different way
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for us to
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find a find a solution for a problem,
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then let's try it and then,
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monitor and adjust from there. So it's having
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those open discussions about those friction points
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and,
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being willing to to trial things to,
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to make it better.
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Yeah. That's great to have that feedback from
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your team,
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and really be in in, close communication there.
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And for our last question, I'm really curious.
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If you could standardize one thing across behavioral
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health programs in the country, what would it
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be,
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if any, and what kind of impact would
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it have?
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That's another great question.
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You know, I I've thought about this,
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a lot, and it just it's just what
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kind of one of those things that
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I think
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we as, behavioral health operators, we've,
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would love to have across
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the nation. And that is one thing that,
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you know, if we could standardize one thing
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nationally, it would be,
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a true health information exchange across
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community agencies, behavioral health providers, addiction treatment centers,
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hospitals,
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other care settings.
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One of the biggest barriers in behavioral health
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today, is fragmentation.
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Many of the patients that we serve have
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interacted with multiple systems over time across different
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organizations,
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different levels of care, and sometimes different states.
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Particularly, you know, in in our location in
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Florida, we hit quite transient. We have people
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that,
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you know, snowbirds that'll come down.
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But yet, providers are still often,
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forced to
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piece together the story,
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from incomplete
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records and patient recollection.
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This is a major problem, especially in behavioral
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health,
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where patients
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may have, you know, complex treatment histories,
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multiple diagnoses,
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prior medication trials, prior hospitalizations,
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substance use treatment episodes,
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and, you know, and trauma histories that are
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are
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are are highly relevant to the current care,
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it would be enormously
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valuable
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if our providers could see the full picture
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and pick up where the last provider left
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off rather than having to start over from
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scratch. That would really improve continuity, reduce duplication,
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reduce reliance on,
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on patients perfect you know, being perfect,
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historians
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and help clinicians
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avoid repeating interventions that have already failed.
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For a large hospital system like ours, that
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would that would be particularly important because,
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we serve patients from across the state. We
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also
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care for seasonal residents that that may only
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be here for part of the year.
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A robust a robust
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information exchange would create
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a better coordination across a full continuum
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and across geographies.
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The impact would
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be improved safety,
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better treatment planning,
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more efficient care transitions,
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less fragmented care,
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and much more intelligent use of the system
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as a whole. If behavior health is ever
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going to function truly,
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like a truly integrated continuum, then the information
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has to move with the patient.
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Well, wonderful. Thank you so much, Ben, for
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sharing more about Lakeland Regional Health and your
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perspective as, director of behavioral health provider practices
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and operations.
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Thanks to our listeners for tuning in to
16:56
Becker's Behavioral Health Podcast, and we'll see you
16:58
next time. Thank you. Thank you very much.