Behavioral health systems across the country face the same problem: referrals are slow, care teams don’t know what happens after a patient leaves and coordination often depends on calls, faxes, and guesswork. For individuals seeking care, especially in urgent situations, those gaps can delay access and lead to missed treatment opportunities.
Delaware decided to make a change. In a state with one of the highest overdose mortality rates in the nation, improving coordination was an urgent priority.
From Fragmentation to a Connected Model
Like many states, Delaware’s behavioral health ecosystem relied heavily on phone calls, faxes and personal provider networks to manage referrals. Providers couldn’t see what services or resources were available or whether a referral had been accepted.
To address this, the Delaware Division of Substance Abuse and Mental Health (DSAMH) partnered with Bamboo Health to modernize the process.
What started as an effort to digitize referrals quickly evolved into something broader:
- Electronic referrals replaced manual workflows, reducing delays and uncertainty
- Real-time visibility into referral status improved transparency across providers
- Organizations were connected through a shared system, increasing visibility
What Changed in Practice
The impact of this shift is measurable. Delaware saw real results:
- 200,000+ behavioral health referrals processed
- 70% of referrals closed and tracked from initiation to outcome
- 98% improvement in referral response time (for one psychiatric hospital)
- 80% of follow-up appointments kept
- 180+ organizations participating statewide
Providers finally gained actionable visibility. Instead of piecing together information across disconnected systems, care teams can now see where individuals are in their journey and coordinate accordingly.
7 Lessons from Delaware
Delaware’s experience highlights several principles for organizations looking to strengthen care coordination:
- Fix the real problem, not just the process: Solve coordination breakdowns by focusing on where technology can augment existing efforts and help scale for the next step.
- Think beyond your organization: Align providers and workflows within your network and integrate with external networks to proactively identify gaps in communication and access.
- Make adoption a leadership priority: Lasting change requires engagement from clinicians, administrators, and partner organizations, along with support to ease the transition.
- Invest beyond the platform: Training, operational support and governance are essential for sustained success.
- Make progress visible: Track progress and outcomes in real time to improve coordination.
- Get comfortable with secure data sharing: Maintain clear governance and privacy frameworks.
- Choose partners that can grow with you: Look for partners with proven success across diverse ecosystems and shared goals.
A Broader Shift in Behavioral Health
One key takeaway: Coordination cannot stop at referrals.
Delaware moved from a referral solution to a more robust model, one that supports real-time information sharing, tracks individuals across the system, and enables providers to act with greater speed and clarity.
This shift reflects a broader trend in behavioral health: moving from disconnected interactions to coordinated, accountable systems of care.
Looking Ahead
For states, counties and provider networks, the opportunity is clear. By improving visibility, aligning stakeholders and investing in shared systems, organizations can reduce delays, strengthen follow-through and support better outcomes for individuals seeking care.
Delaware’s experience offers a practical example of what that transformation looks like in action.
Read the full white paper, Lessons From Delaware: Best Practices for Coordinating Behavioral Healthcare, to see how Delaware applied these principles in practice.
