How Rula Leverages Clinical Note Data to Enhance Quality of Care

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, Director 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:

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:

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.

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.

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:

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:

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.

Conclusion

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