use of ehrs by state

Electronic Health Record adoption in the US

Less than a decade ago, nine out of 10 U.S. doctors updated their patients’ records by hand and stored them in color-coded files. Today, nearly half of all office-based physicians type their clinical notes into computers and maintain electronic files that include patients’ demographic information, complaints, procedures, test results and prescribed drugs.

This greater use of electronic health records is supposed to help doctors and hospitals better coordinate their patients’ care and allow them to meet the cost-containment goals in the Affordable Care Act. Nationwide, 48 percent of office-based doctors used electronic records in 2013, up from 40 percent in 2012 and 11 percent in 2006.

While the doctors and hospitals in some states are forging ahead, in other states they are lagging behind. In North Dakota, 83 percent of physicians have made the switch to electronic records, according to a recent survey by the Centers for Disease Control and Prevention. Minnesota ranked second, at 76 percent, followed by Massachusetts at 70 percent.

But in Maryland, Oklahoma, Vermont, West Virginia and Wyoming, the adoption rate is only 37 percent. Nevada’s rate is 33 percent, and in Washington, D.C. it is 31 percent. Connecticut and New Jersey fare even worse, at 30 percent and 21 percent, respectively.

It’s not clear why there are such disparities among states, though researchers do know a few things about the kinds of doctors who are mostly likely to embrace electronic records.

According to a 2013 report by the Government Accountability Office (GAO), primary care doctors are nearly twice as likely to adopt electronic health records as specialists. Physicians who work alone are less likely to adopt electronic records than those in group practices, and younger doctors are more likely to embrace the change than older ones. Rural and urban doctors are equally apt to use electronic records. And of all health care professionals, dentists have the lowest adoption rate, at less than 1 percent.

Despite recent progress, the U.S. as a whole still lags behind other developing countries in adopting electronic records, according to a survey by The Commonwealth Fund, a health research group.

Ultimately, the Obama administration wants all U.S. doctors and hospitals to share electronic health records.

“Meaningful Use”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the 2009 economic stimulus package, the federal government set aside up to $30 billion to help doctors and hospitals make the transition to electronic records. Under the law, office-based health care professionals can receive up to $44,000 in Medicare grants, in five yearly installments; and $63,750 in Medicaid grants, in six yearly installments. In addition, hospitals are eligible for millions of dollars under both health care programs if they develop and maintain electronic health records. The GAO estimates $15 billion in incentive payments went to individual health care professionals and hospitals in the first two years of the program.

In the first year of the Medicaid incentive program, doctors simply needed to agree to “adopt, implement or upgrade” a federally certified health records system. But in the second year, 2012, they had to demonstrate so-called “meaningful use” of their systems.

That meant doctors who wanted to continue receiving grants had to show that they were, in fact, using their electronic records and sharing them with other providers to improve the quality of patient care. They also had to share the information with patients to help them better manage their own care.

In addition to promoting greater use of electronic records, the administration credits the HITECH law with creating a robust market for health IT products: There are now 941 vendors offering more than 1,700 federally-certified electronic health records products. According to the Bureau of Labor Statistics, more than 50,000 health IT-related jobs have been created since the law was enacted.

If you or your office is interested in how you can qualify for the EHR incentive program Give EHR Funding a call today at 866-203-3260

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Why Patients Prefer Electronic Health Records

Think about the last time you scheduled a doctor appointment. If you’re like most people with health insurance, the process probably involved picking up the phone.

Not necessarily the case with patients of Lakewood physician David Lieuwen, MD, a family medicine practitioner with Kaiser Permanente.

Dr. Lieuwen’s patients have the option of booking appointments with him through Kaiser Permanente’s Web site. They also can use Kaiser Permanente’s online tool, My Health Manager, to access personal health records, send him secure e-mails and order prescription refills.

Policymakers these days talk a lot about digitizing health information. The American Recovery and Reinvestment Act of 2009, signed in February by President Obama (at the Denver Museum of Nature and Science), includes $20 billion to help fund the effort.

While Capitol Hill debates the Ps and Qs of health reform, Dr. Lieuwen’s patients and other Jefferson County customers of Kaiser Permanente already experience some of what’s in store. “Patients really like it,” Dr. Lieuwen says about Kaiser Permanente’s electronic health record. “You can show them what’s going on with their labs. You can pull up notes from past visits. You can do a lot of things in real time.”

Hard to argue 
In an age of online banking and ordering dinner by way of iPhone, it’s hard to argue the logic of moving health information into the digital age. Clearly there’s a timesaving and convenience factor. This year in Colorado alone, Kaiser Permanente members will use My Health Manager to send more than 300,000 e-mails to their doctors and view roughly 1 million lab tests.

Dr. Lieuwen estimates he gets an average of five e-mails per day from patients. Sometimes they ask him about symptoms. Sometimes they want his thoughts on a particular treatment option they’ve read about. “If e-mail is not appropriate, I’ll either call them or ask a nurse to look into what’s going on,” Dr. Lieuwen says.

Beyond using Kaisers electronic health record to interact with patients, Dr. Lieuwen uses it to ask opinions of colleagues and track charts of patients he refers to specialists. “I’m not sure of anyone who wouldn’t like to work with a system like this,” he says.

Employer advantage
There’s an advantage here for employers, as well. Studies show health care premiums are less than 50 percent of the total cost of providing health care for employees. In fact, lost productivity due to health conditions and concerns is a much more significant expense.

So if an employee can access her latest lab tests online to confirm the diabetes is in check — rather than worry and wait for a follow up doctor visit — everyone wins.

“It’s not about technology in and of itself,” says Associate Medical Director Mike Chase, MD. “Ultimately it’s about applying the technology to improve patient care. What we’re learning is information now is care, particularly in chronic diseases.”

If you are a practice that is yearning to learn more about Electronic Health Records and how you can receive government funding to implement them. Give HER Funding a call at 866-203-3260 today.

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Use of Patient Portals Takes Hold in Family Practices

“By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems.”

That conclusion was reached by 11 medical researchers whose new report on the success of patient portals – a critical feature of the meaningful use program – was published in the “Annals of Family Medicine.”

The team, led by Alex Krist, M.D., a faculty member at the Fairfax Family Medicine Center in Virginia, found after a three-year study ending in 2013 that practices that pursued thoughtful, pro-active strategies to get patients to use the portal achieved a patient use rate of 25.6%, with the rate increasing 1% a month over 31 months.

Other findings included:

  • That 23.5% of portal users signed up within one day of their office visit
  • Older patients and patients with two or more chronic conditions were more likely to use portals
  • Blacks and Hispanics were less likely to use portals
  • Usage by practice varied from 22.1% to 27.9% depending on how effectively the practices promoted the portals

Eight primary care practices in Virginia participated in the study, with each using a series of learning collaboratives with practice “champions” and redesigning workflow patterns to integrate use of portals in patient care, according to the study abstract.

All used an Allscripts EHR system and two separate patient portal systems, a commercial portal that that only provided secure patient messaging, and one plugging into EHR data.

The noticeable point the researchers discovered was that small and medium-sized primary care practices can engage patients to use portals by incorporating promotion into routine care.

“This approach appears to be more effective than mailing invitations and to match the results of more elaborate promotion efforts by large integrated health systems,” the report says.

If you are a small to medium sized practice who is looking to receive assistance from the government and upgrade to Electronic Health Records then give EHR Funding a call today at 866-203-3260

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A Prototype of EHR Effectiveness

Los Angeles County’s Department of Health Services is installing a new countywide electronic health record system that officials say could end up being a model for other health care organizations across the country.

L.A. DHS Faces Unique Challenges

Los Angeles DHS is the second largest public health system in the U.S. and serves nearly 10 million residents, according to the report. Robert Bart, CMIO of the department, said DHS includes four traditional hospital-based facilities — Harbor-UCLA Medical Center, Los Angeles County-University of Southern California Medical Center, Olive View-UCLA Medical Center and Ranchos Los Amigos National Rehabilitation Center — as well as several offsite clinics.

Data from DHS’ EHR system operating in six primary facilities cannot be shared with other providers.

“The simple task of transporting a patient from a DHS hospital to another hospital can be highly inefficient and cumbersome,” the report noted. “Paper medical records are photocopied while transport ambulances may sit idling” and, “in some instances, the receiving hospital may not have complete medical information about an incoming patient because all the paper records may not have been forwarded,” the report added.

This “silo effect” will be eliminated with the implementation of a countywide EHR system, according to the report.

Fixing a Fragmented System

DHS began work on its EHR system — called the Online Real-time Centralized Health Information Database, or ORCHID — in May 2013. The system is being created by Cerner.

By launching a “uniform, standardized and fully integrated” countywide EHR system, the agency aims to:

  • Comply with requirements to attest to the meaningful use program;
  • Improve patient safety and care quality;
  • Make DHS more competitive in the health care industry;
  • Replace the county’s “fragmented and obsolete” health record system; and
  • Support outpatient care restructuring as part of health care reform.

The new EHR system also will include a master patient index, with unique identifiers for each patient, according to the report.

“The movement to an EHR system is important to DHS for reasons that go beyond the usual factors as to why modern medical groups are adopting EHRs, having one system will bring us together as a single integrated system,” DHS Director Mitchell Katz said.

The new EHR system will be “a single source of truth so that we can have a single medical record for each person that receives health care at DHS,” Bart said. “It will be a huge improvement in patient safety and we hope also in … employee satisfaction and patient satisfaction.”

Making Progress

So far, the first two steps of the design and building of ORCHID — a system review and system validation — have been completed. Cerner now is adding hardware, software and infrastructure to support the system. Unit system integration and user acceptance testing are expected to begin soon and wide-scale training of staff was slated to begin last month. Bart said “a large number of … physicians, nurses, therapists, admission registration staff and other stakeholders have been involved in the building and designing of the solution.”

He said  the “go-live” dates for EHR implementation will be ongoing, with about one launch date every three months — beginning Nov. 1 with Harbor-UCLA Medical Center and a few of the comprehensive health clinics. The department already has begun initial training for staff at Harbor-UCLA and has gotten “encouraging” feedback, Bart added.

The county Sheriff’s Department, Probation Department and the Department of Mental Health also offer patient care and have separate EHR systems. “Currently, these departments have limited ability to share each other’s patient information electronically,” according to the report.

Bart said DHS is “working on a health information exchange to connect these medical records so that there can be appropriate movement of health information so that we can deliver care in a more effective and efficient way.”

A Model for Others

Bart said the department’s new health IT efforts are essential to keeping the county up to date in care delivery methods. “For DHS to be able to transform care delivery and transform the reimbursement for care delivery, we need to move on to this type of modern platform in order to stay current and in order to support the changes that the Affordable Care Act is asking of health care delivery in the U.S.,” he said.

Bart hopes the county’s EHR implementation project “will be a model not just for California, but also for other county, city or state government health care delivery organizations.”

“We want to be able to set an example that being able to have a modern technology infrastructure to support health care and leveraging that — both at the individual level and the level of the population we care for — will result in improved quality of care, improved efficiency of care … and improved efficiency for those who are delivering care,” Bart said.

 

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How Electronic Health Records Give Seniors More Control

Managing senior care programs can provide unique challenges to health care professionals, as elder clients are more likely to have a greater number of concerns than their younger counterparts. As the likelihood of developing many illnesses and requiring a variety of medications increases with age, the task of coordinating care also becomes more difficult. Encouraging electronic health records is one technique that may prove useful to geriatric care managers and others working with senior clients.

Using traditional paper records, staying on top of older adults’ medical needs can present many problems. Records kept by one doctor may not find their way to another if seniors don’t keep track of their health providers, and there is plenty of information that may never make it into the record at all. Seniors using family caregiving could have incomplete records if they don’t supplement that care with doctor’s visits, while the daily minutiae of elders’ health complaints and solutions to minor issues are unlikely to make it into writing at all.

Securing records 
Electronic health records can help solve these problems by centralizing and automating many aspects of record-keeping. Storing information electronically can help keep records more secure and more thorough, according to Senior Housing News. Records stored on modern cloud-based platforms may be more up to the task of complying with HIPAA regulations than those kept in older networks, since new systems offer more security options. For instance, two computers or two wireless access points using the same infrastructure could have different restrictions on who can use them or what data they make available. That makes it harder for any unauthorized person to access the information without putting up barriers between the data and authorized users.

Power in users’ hands 
Another major benefit that electronic records can provide is the ability to capture data with limited input from users. With traditional records, it’s mostly up to health care providers to ensure that information is entered accurately. Few clients keep precise track of their own health when they’re responsible for writing down every medication they take and every change that they go through in nutrition or fitness. Electronic records can put a lot more power into the hands of people receiving care by allowing easy or automatic data capture.

The newest generation of health tracking software could go a step further, not only taking the burden of data collection from doctors, but removing it from people almost entirely. At a recent press conference, Apple announced its new product offerings, one of which came out of a partnership with the Mayo Clinic, the Star Tribune reported. The two organizations collaborated on an application called Health that may represent the easiest way yet for people to monitor their own health. Building on existing platforms that can track information such as exercise levels and calorie intake, often based on user input, Health allows for more robust data collection with less effort needed from users. The app could take measurements such as heart rate and body temperature and use changes in these metrics to determine – or even predict – when a user may be in danger of a health emergency or a less urgent change.

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Electronic Health Record Adoption Up Significantly

Substantial increases in the use of Electronic Health Records (EHRs) among the nation’s physicians and hospitals are detailed in two new studies published earlier by the HHS Office of the National Coordinator for Health Information Technology (ONC).

The studies, published in the journal Health Affairs, found that in 2013, almost eight in ten (78 percent) of office-based physicians reported they adopted an EHR system. About half of all physicians (48 percent) had an EHR system with advanced functionalities in 2013; a doubling of the adoption rate from 2009. About six in ten (59 percent) of hospitals had adopted an EHR system with certain advanced functionalities in 2013; quadruple the percentage for 2010.

“Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of Electronic Health Records,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.”

The information in the studies was collected by the Centers for Disease Control and Prevention’s National Center for Health Statistics and the American Hospital Association in 2013.

The case for Electronic Health Records cannot be understated. Electronic Health Records (EHRs) are the first step to transformed health care. The benefits of electronic health records include:

  • Better health care by improving all aspects of patient care, including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity.
  • Better health by encouraging healthier lifestyles in the entire population, including increased physical activity, better nutrition, avoidance of behavioral risks, and wider use of preventative care.
  • Improved efficiencies and lower health care costs by promoting preventative medicine and improved coordination of health care services, as well as by reducing waste and redundant tests.
  • Better clinical decision making by integrating patient information from multiple sources.

Don’t be left out in the cold with your paper records. Let EHR Funding help you qualify for funding from the government to start the process of converting your office to Electronic Health Records. Call today at 866-203-3260

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Paper Records VS EHR’S

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The Change From ICD-9 To ICD-10 and How Adopting an EHR Will Help

While most of the world is using the International Statistical Classification of Diseases and Related Health Problems, 10th Edition, or ICD-10, to classify diseases and diagnoses,  the United States continues to use ICD-9, which was published more than three decades ago. The U.S. remains the only developed nation in the world still using ICD-9.

The ICD-10 is mandated to be implemented in the US by HIPPA and there are many benefits to upgrading the 30-year-old ICD-9 code set that is no longer viable. Use of ICD-10 will pave the way for innovations in diagnosis and treatment options as well as improved coordination of benefits and care for healthcare consumers. The opportunities it offers, such as coding and documentation improvements, quality measurement, and fraud and abuse prevention—will change how the health care industry operates.

What Exactly is the ICD?

The International Statistical Classification of Diseases and Related Health Problems, published by the World Health Organization (WHO), uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, the ICD helps store and retrieve diagnosis information and compile national mortality and morbidity statistics.

Considerations for EHR Implementations

The changes in documentation and coding that ICD-10 requires makes transitioning to a certified EHR system a strategic business move. For practices that decide to do so, there are incentive programs to assist in switching to a compatible system, such as the EHR Incentive Stimulus Program for Medicaid providers, that will allow practices to adopt an EHR which is compatible with the new standards set in place by HIPPA, WHO and the US.

Practices should consider the following questions when implementing a new or upgrading to a certified EHR system:

  • Is the EHR certified? If the practice’s physicians want to participate in the meaningful use EHR incentive program, the EHR must be certified specifically for use in the program.
  • Has your state already mandated the use of a certified EHR? All Minnesota providers are mandated to adopt a certified EHR system by Jan 2015, with many other states arguing to pass this mandate as well.

What are the advantages of using ICD-10 instead of ICD-9?

While ICD-9-CM contains about 13,000 diagnosis codes, which for the most part are three- to five-digit numbers, ICD-10-CM has more than 68,000 codes made up of three to seven alphanumeric characters (ICD-10 in its entirety contains more than 140,000 codes). In this manner, the American Association of Professional Coders (AAPC) noted in its ICD-10 FAQ, a single code can refer to a disease and its current manifestation. A single code also can express laterality, noting that a condition is on the left or right side of the body.

The United States’ move to ICD-10 is expected to streamline the process by which health care providers submit medical claims resulting in fewer coding mistakes, less need for supporting documentation and as a result, fewer requests for additional information after a claim has been submitted. Other benefits include better sensitivity in refining grouping and reimbursement methods, and improvements to public health surveillance, according to an ICD-10 implementation overview presentation by CMS.

The additional characters in the ICD-10 codes provide many types of key information — for example, the body system, root operation, body part and device involved in a particular procedure — but they also make it necessary to expand the data fields in all applications that use the ICD codes.

Because ICD-10 codes must be used on all transactions containing HIPAA-protected patient data — including outpatient claims with dates of service, and inpatient claims with dates of discharge — they are integrated in numerous applications; Electronic Health Record (EHR) technology, including medical billing software, practice management software and revenue cycle management systems.

As the deadline draws near, demand for hardware, software, implementation, and training support will quickly exceed supply, and costs for consultants and talent will sky rocket.

Strategic thinking and a clearly mapped transition plan that involves cost analyses and effective communication with vendors and payers will prepare practices to implement the changes and gain the benefits that the robust ICD-10 code set brings.

If your practice has not yet transitioned over to the use of Electronic Health Records then now is the time. Give EHR Funding a call today and let us help you qualify for the government incentives that are out there.  866-203-3260

 

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Will The Government Mandate EHR Use?

As the federal government is encouraging EHR adoption through incentives. A few states are developing their own programs to apply extra pressure on physicians.

In Maryland, there isn’t an EHR mandate, but the state is turning the screws on doctors who don’t have clinical information systems. Under legislation that was signed May 19 2010, Maryland required all private health insurers to build EHR incentives and penalties into their payment structures. Minnesota was the first state to mandate EHRs for all of their physicians and required all physicians to prescribe electronically by 2011.

The two direct EHR mandates, which along with Maryland’s initiative are the only state programs passed at this time, were approved in states that are already way ahead of the national curve in health IT adoption. More than 40 percent of Massachusetts doctors already used EHRs in their offices, and 68 percent of primary-care physicians in Minnesota had electronic records. The evolution of health care organizations in both states has had a major impact on their EHR penetration rates.

Integrated systems dominate Minnesota

In Minnesota, large, integrated delivery systems dominate the healthcare market, says Becky Schierman, manager of quality improvement for the Minnesota Medical Association (MMA). A large percentage of Minnesota physicians work for or are affiliated with one of these healthcare systems, which have the resources and the technical know-how to help practices implement EHRs.

In addition, the longtime emphasis on quality improvement in Minnesota has helped persuade many physician groups to move to EHRs. “We have a culture for high quality performance, and we have public reporting on quality measures,” says Susan Severson, director of health IT for Stratis Health, a Minneapolis research and consulting organization. “The physician groups recognize that to perform well on quality measures, they need more data than they can abstract out of medical records manually. The [EHR] is a tool for improving quality of patient care and safety if it’s orchestrated correctly.”

This was also the view of the Minnesota and Massachusetts lawmakers when they adopted EHR mandates in 2008. But the Massachusetts market is a bit different than that of Minnesota.

In the Bay State, about 60 percent of physicians practice in solo or two-doctor practices. While large healthcare organizations prevail in the Boston metropolitan area, small, independent practices unaffiliated with hospitals are common in the rest of the state. In eastern Massachusetts, many small and medium-sized practices are bound together in contracting networks that center around hospital systems. Some of these systems are actively promoting EHRs. Partners Healthcare in Boston, for example, required all of its network physicians to get EHRs by 2008 as a condition of participating in Partners’ insurance contracts.

Minnesota providers move together

In Minnesota, says Severson, a consensus is forming that everyone will soon have EHRs. “That, plus the incentives from Medicare and Medicaid, will continue to propel us forward,” she says. Severson also heads a federally funded health IT regional extension center that will help primary-care practices choose and implement EHRs. This assistance will be especially important in rural areas of the state, she notes.

The Raiter Clinic in Cloquet, a small town in northern Minnesota, has stepped up to the plate. The independent practice, which includes 12 family physicians as well as three surgeons who share space at Raiter’s offices but work for the local hospital, implemented an EHR. Family physician David Luehr, a former president of the MMA, says the EHR is going to helps improve care, especially after they hooked it up with an electronic disease registry. Luehr predicts that practices of his group’s size and very small practices will get computerized by 2015. Luehr states” I think [universal EHR adoption] will happen. There’s a lot of support in the state to get it done.”

If you are in need of help and are looking to receive more information on how your office can qualify for incentives from the Affordable Care Act please give us a call at 866-203-3260

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Behavioral Health and Electronic Health Records

Behavioral healthcare (BHC) is one of the most varied healthcare settings, encompassing a wide range of services from outpatient substance abuse treatment to full-time, residential psychiatric care. Within these services, the type of care provided also differs. For instance, a single organization may offer group therapy, one-on-one counseling, crisis stabilization and community outreach. Compounding the diversity is the fact that each area has significant sensitivities in terms of both treatment approach and client privacy.

Historically, behavioral health organizations have shied away from implementing an electronic health record (EHR), feeling that the complexity of the care setting prevents technology use. Plus, EHRs have traditionally focused on capturing information about physical medical conditions, and the content for the BHC field has been limited. The expense of an EHR has presented additional roadblocks, as organizations are sometimes hesitant or unable to expend capital for technology. However, there are challenges for healthcare organizations – providers, facilities and the greater industry – if EHRs are not implemented, especially as behavioral health information becomes a more critical piece of a patient’s long-term patient record.

The reality is that selecting and implementing an EHR that meets the diverse needs of the behavioral health segment can be complicated, but the challenges are not insurmountable. With the right system and a careful, well-considered implementation strategy, BHC organizations can reap the benefits of a tool that efficiently facilitates comprehensive patient care and improved outcomes. As Congress once again debates whether to extend Meaningful Use to behavioral health facilities, the time is right for providers to consider implementing an EHR.

 

Existing Opportunities

There are many advantages to using an EHR in the BHC setting. For instance, a EHR charting system will support better information capture, allowing clinicians to fully document care in a format that empowers patient and family interactions, enables robust reporting and data aggregation, as well as enhances clinician-clinician communication. EHRs are designed so that if all substance abuse counselors were to an EHR certified charting system, there will be greater care continuity and a more consistent patient experience.

An EHR is also designed to be interoperable. When organizations use an EHR, their system would be capable of exchanging information with outside entities, such as hospitals and primary care physicians, they can build a more unbiased and detailed picture of the patient, supporting more informed decisions that take the patient’s entire care context into account and limit situations in which a provider is completely dependent on the patient and family for health history. As the trend toward integration between primary care and behavioral health becomes more prevalent, it is critical for providers to implement forward-thinking technologies that allow integration and collaboration to support quality care goals.

 

Key Characteristics of a BHC-Centered EHR

Not all EHRs are ideal for BHC organizations. When screening potential options, here are some key thoughts to keep in mind:

  • Offers robust BHC content. EHRs have historically focused on capturing patient data about physical conditions (i.e., the patient has a laceration on the right side, is having trouble breathing or is running a fever). To be effective in the BHC setting, an EHR must have in-depth behavioral health content, such as targeted protocols for psychological diseases and drug treatment. The tool must also accommodate the different types of care found in BHC facilities. For example, a residential program may require an EHR to capture information from patient appointments as well as group therapy sessions, offsite field trips and/or general rounds.

 

  • Captures free text and more. A chief characteristic of BHC treatment is that clinicians often document information about the patient in free text, writing down what they observe and what the patient and family shares. A BHC-focused EHR should be able to capture discrete data from the content mentioned above and also be able to seamlessly capture free text, integrating it into the clinical record in a useable way. Systems that capture both discrete information and free text allow clinicians to manipulate and examine the information they enter, and use it to add value to the patient’s treatment and achieve better outcomes. They also allow the organization to more easily meet the myriad reporting requirements imposed by funding sources, payers and governmental entities. The efficiencies gained in this manner can allow organizations make better use of limited human and capital resources. Some EHRs include a tool that functions like a pen on paper, so that patient perceptions of the care experience don’t change once technology is introduced into the environment—the provider appears to be taking notes like usual and is not turning away from the patient to use a computer.

 

  • Delivers interoperability. Sharing information with outside entities is key to creating a comprehensive health record. EHRs enable these exchanges in a private and secure fashion.

 

  • Allows for configuration. Organizations should choose a tool that is configurable to the unique needs of the care site but still fosters consistency to maintain a high standard of care.

 

Getting Started

To get the most benefit from an EHR, behavioral health organizations should take a concerted approach to implementation. Clinicians need to be directly involved in the process—both in selecting the tool and configuring the system. This is even more important than in other care settings because of the variety of sensitivities and nuances involved in addressing behavioral health.

It is also important to keep an eye on the big picture. Will the technology be used predominantly for data aggregation or to improve treatment planning and enhance communication between providers? Will it drive better reporting and encourage interoperability? Is some combination of these goals appropriate? Taking time to develop an overarching strategy and then framing the technology to support that strategy is a best practice.

Organizations should also have a full appreciation of their workflows, including the steps and people involved as well as the timing. As with other kinds of technology, an EHR will not fix ineffective or inefficient workflows. Organizations should use it to enable well-designed processes to support optimal care. When revising workflows, look for any unintended consequences that may emerge. For example, if the organization streamlines the method for gathering information about substance abuse at registration, how will that affect other areas of care? This is where pulling the clinical staff together and mapping processes becomes most critical.

Moving Forward

While implementing an EHR in a BHC organization may seem intimidating, the advantages far outweigh the challenges. Organizations that commit to thoughtful vendor selection and planned system implementation can successfully navigate the effort and reap the benefits. If you are in need of help and are looking to receive more information on how your office can qualify for incentive money to help acquire an EHR certified software from the Affordable Care Act, please give us a call at 866-203-3260.