“Now we can go to our payer partners with confidence that we are taking the extra step to ensure our providers are supported and our patients are getting high quality care. And that's really powerful."

— Kat Hebard, Senior Manager of Clinical Operations, Rula

About Rula

Rula is on a mission to make mental healthcare work for everyone. With a nationwide network of thousands of providers, Rula offers comprehensive therapy and psychiatric services for adults, adolescents, and children.

We recently spoke with Kat Hebard, Senior Manager of Clinical Operations at Rula, to explore how Rula enhanced patient care and improved provider quality by using AI to audit their notes at scale.

The Challenge: Limited Visibility & Reliability

Before partnering with Brellium, Rula's internal quality team and external contracted reviewers could only review a small sample of notes each month. While this manual approach ensured high standards for the notes that were reviewed, it was challenging to spot broader patterns across patient visits. As Kat put it:

“We wanted to be able to proactively understand what was happening in our visits so we could be better prepared for payor audits. With our manual method, we couldn't get a good pulse on our note quality.”

Moreover, having multiple reviewers raised concerns about inter-rater reliability. Manual audits of behavioral health documentation inherently involve some level of subjectivity by the reviewer, making it difficult to consistently measure quality. 

Recognizing the need for greater visibility into the quality of documentation and care, Rula sought a scalable solution.

Build vs. Buy: Why Rula Chose Brellium

Rula initially considered building their own auditing system but ultimately chose to partner with Brellium for two main reasons:

First, working with Brellium let Rula’s engineering team stay focused on high-priority internal projects, such as their provider portal.

Second, Brellium offered a flexible solution that was ready to go and easy to tailor. Kat shared:

“When we looked at Brellium, we saw a well-developed, customer-focused solution. Brellium had so much out-of-the-box functionality, and what made it even more valuable was the team’s flexibility and willingness to adapt it to our operational needs.” 

Partnering with Brellium allowed Rula to rapidly upgrade their auditing capabilities without diverting internal engineering resources.

Implementation: How Rula went from auditing hundreds of notes per week to thousands. 

Training the model: During implementation, the Rula team worked closely with Brellium to train the model, ensuring that Brellium audited their notes with equal accuracy and greater reliability than a team of human reviewers. 

“The model was trained by our clinicians using a custom-built scoring rubric, ensuring that note audits align with Rula’s specific standards of quality”

Auditing at scale: Kat and her team wanted to deeply understand quality across their entire provider network to let them get a statistically significant reading on note quality across their network.

“We scaled slowly to ensure that anytime we found a quality issue that needed one-on-one intervention, we had the team ready to intervene immediately.” 

API Integration: Rula leveraged Brellium’s robust API to quickly send data back and forth between Brellium and Rula’s internal database.

“[The API] was quick to stand up and Brellium was really great with adding new endpoints that we were hoping to use in our database.”

Results: Leveraging Clinical Note Data to Enhance Quality of Care

Today, Rula uses Brellium to assess documentation quality across their entire network and identify areas for improvement, such as optimizing note templates. On a more granular level, Brellium flags individual notes for quality concerns that require closer attention, such as professionalism, safety, and coding compliance. 

Brellium’s automation makes this detailed auditing scalable, enabling Rula to efficiently pinpoint and address specific notes and providers needing support, even within a large network.

Provider support: Rula is able to quickly identify providers who need support with documentation best practices, helping their providers minimize risk while focusing on delivering fantastic care. 

Improved reliability: After training the model, Brellium proved equally and in some cases more consistent as compared to human reviewers:

“We still manually review a small sample of notes each week to ensure the model stays accurate. In the process, our human reviewers sometimes noticed Brellium would catch nuances in the note that they missed – resulting in closer adherence to rubric standards than human reviewers. This goes to show that catching every detail in a manual review is challenging, and using a tool like Brellium can lead to better reliability than human reviewers.”

Driving quality improvements with data: With this wealth of patient and provider data available to them in Brellium, Rula analyzed thousands of clinical notes. The team is now using this data to make quality improvements across the board by targeting specific factors correlated with better patient outcomes: 

“We saw that providers with higher quality notes had better patient outcomes. And then when diving a little bit deeper, we also saw that they had better retention. So what we're hoping to do as we learn more about our data is drive better note quality, drive better outcomes, and support providers in making that happen.”

A better payer partner: Implementing Brellium has enhanced clinical quality transparency at Rula, allowing them to improve patient care and ensure provider quality across their network. This empowers Rula to be a stronger partner to payers by ensuring consistent, high-quality care and compliance throughout their network.

"Now we can go to our payer partners with confidence that we are taking the extra step to ensure our providers are supported and our patients are getting high quality care. And that's really powerful"

Conclusion

Through its partnership with Brellium, Rula has strengthened its clinical quality oversight, improved operational efficiency, and better supported patient care.

"Brellium allows us to truly have a pulse on the care provided, enabling continuous improvement and proactive quality management."

About Brellium

Brellium is an AI-powered clinical compliance platform. Organizations like Grow Therapy, Headspace, Lightfully Behavioral Health, Talkiatry, and more trust Brellium to streamline compliance across millions of patient visits. With Brellium, you can rest assured knowing your organization remains compliant, documentation standards are consistently met, and your patients receive the quality care they deserve.