Getting behavioral health online with EHRs

Wediko Children’s Services implemented its first electronic health record (EHR) system last year, going live on July 1, 2015.

The EHR quickly proved invaluable, allowing its cadre of therapists and counselors to capture more information more frequently, even while out in the field – a particularly important achievement as most services happen in schools and clients’ homes, said Michael J. Clontz, LICSW, a director at the Boston-based behavioral health provider.

Clontz said he and his colleagues knew an EHR would deliver strong returns, but he also acknowledged that his organization was late switching over to the new system from their old process of using a billing system that let them take notes electronically.

That lag in adoption is typical for many in the behavioral health space, he said, in large part because the financial incentives offered under the federal Meaningful Use program did not extend to this class of providers.

Studies show the extent of the lag. For example, a 2014 healthcare IT research study from the nonprofit Massachusetts eHealth Institute (MeHI) found that adoption of health IT among the state’s primary care and specialty care providers exceeded 90%, while other sectors, including behavioral health, had only a 55% adoption rate.

Policymakers, medical leaders and healthcare IT advocates are working to increase adoption and use of EHRs and other technologies among behavioral health providers, several officials with the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and Office of the National Coordinator for Health Information Technology (ONC) said during a recent conference call on the topic.

Samantha Meklir, director of the ONC Division of Strategic Policy, said increasing EHR adoption and use among behavioral health providers is critical not only to improve patient care and generate efficiencies in that sector but to help ensure that such data eventually flows back to each patient’s primary care physician through data exchanges.

“There’s increasing awareness around the need to integrate behavioral and physical care and a greater understanding that you have to treat the whole person,” Meklir said, noting that sharing behavioral health information will become more critical as reimbursement models increasingly move toward outcome- and value-based payments.

Laurance Stuntz, director of MeHI, said he agrees with the need to have higher adoption of EHRs, and more mature uses of those systems, from behavioral health providers. The need is great enough, in fact, that in 2015 MeHI awarded more than $1.3 million in grants to 25 behavioral health providers in the state to help fund their technology adoption efforts. Wediko Children’s Services received nearly $50,000 to help fund training and other initiatives around its recent adoption of a new EHR system.

Stuntz said increasing behavioral health providers’ use of EHRs and supporting their ability to share data through exchanges can help the entire healthcare system, including PCPs, deliver better, more efficient medical care overall.

He pointed out that the Health Policy Commission’s 2014 Cost Trends shows that healthcare spending for medical conditions is several times higher for patients with behavioral health needs, with research suggesting that digitizing behavioral health records and better integrating them could help bring down costs and improve care. 

“For a primary care physician, having access to a patient’s behavioral health care [data] is key to understanding everything that might be going on with that patient,” Stuntz added.

Clontz said adopting an EHR is moving his organization in that direction, as its clinicians are following new workflow processes to gather, store and analyze data about patients – information that can now be more easily shared.

As Clontz said: “We have gained ability to quickly communicate across clinicians.”