How Rula Leverages Clinical Note Data to Enhance Quality of Care

“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.”

Rula + Brellium Case Study Summary

About Rula

Rula provides nationwide mental health care through a large network of providers, offering therapy and psychiatric services for adults, adolescents, and children.

The Challenge: Limited Visibility and Reliability

• Rula’s internal quality team and external contracted reviewers could only manually review a small sample of clinical notes each month.
• This limited sample made it hard to:
• Identify broader patterns and trends in documentation quality across all patient visits.
• Gain statistically significant insight into network-wide performance.
• Multiple human reviewers introduced inter-rater reliability concerns:
• Behavioral health documentation reviews are inherently subjective.
• Consistently measuring and comparing quality across reviewers was difficult.

Build vs. Buy: Why Rula Chose Brellium

Rula considered building an internal auditing system but chose Brellium for two primary reasons:

1. Engineering focus

Partnering with Brellium allowed Rula’s engineering team to stay focused on core internal priorities instead of building and maintaining a complex auditing platform.

1. Flexible, ready-to-use solution

Brellium provided an out-of-the-box system that was:

• Ready to deploy quickly
• Flexible and easy to tailor to Rula’s specific documentation standards and workflows

Implementation

1. Training the Model

• Rula collaborated closely with Brellium to train the auditing model on Rula’s standards and expectations.
• The goal: achieve equal or better accuracy and reliability compared to a team of human reviewers.

2. Auditing at Scale

• Kat and her team used Brellium to evaluate documentation quality across the entire provider network, not just a small sample.
• This enabled:
• Statistically significant insight into note quality
• Network-wide visibility into trends, strengths, and gaps

3. API Integration

• Rula integrated directly with Brellium’s API.