Top 5 Reasons Why Established EMRs won't Cut it in Behavioral Healthcare

The federal government is considering extending the Meaningful Use Incentive program to eligible behavioral healthcare providers. The bill, called the “Behavioral Health Information Technology Act of 2012,” would redefine the term “eligible hospitals” to include residential or outpatient mental health or substance abuse treatment facilities. (Read the full text of the bill here.)

The bill is another step in the direction of the integration between primary healthcare and behavioral healthcare.

As with the originally defined eligible facilities, behavioral healthcare facilities would have to attest to the meaningful use of a certified EMR. This may prove to be harder than expected, as many established EMRs tend to focus predominantly on primary care.

With the introduction of this bill, the time has come to begin examining the gap between what established EMRs provide and what the behavioral healthcare industry needs in an EMR. Below are the top five areas where established EMRs may not currently meet the needs of behavioral healthcare providers.

1.)  Treatment plans. The concept of the treatment plan is relatively new in the primary care arena, however it is a practice that has been used for some time in the behavioral healthcare setting. Treatment plans are complex documents that reflect the prescribed treatment for the management of the patient’s disease. They are referred to as “living” documents because of the need to frequently update the document and because they are a reflection of the complexity of each individual patient and their diagnosis. Not only will a successful EMR application capture this complexity in electronic format, but also, the EMR will be able to preserve and present historical treatment plan data.
 

2.)  Social and behavioral data collection. Most state mental health and substance abuse agencies require large amounts of social and behavioral data to be collected during a behavioral health assessment. This data is used to determine if the services provided are appropriate for the patient. This data may include the patient’s current living situation, current and past family situation, social supports, sexual history, and past medical and behavioral health treatment history. Established EMRs may not allow for the complete capture of this information, nor provide for the analysis of this data. Successful EMRs will allow behavioral healthcare providers to collect the appropriate data. Furthermore, successful EMRs will be robust enough to facilitate analytics on this data, which tends to be highly varied and individualized.

3.)  Security and privacy. Although the protection of all health information is covered under several federal and state regulations, behavioral health data is “given heightened protection under the law” (HealthIT.gov, 2012). Successful EMRs will be agile enough to provide restricted access to behavioral health PHI based on federal and state laws as well as on the needs of the facility or provider.
 

4.)  Data exchange. A lawyer friend of mine recently told me that the future of healthcare is not in our hospitals – it’s in our communities. From long-term care facilities to stand alone behavioral health clinics, the importance of providing care along the entire continuum has never been more evident. For many behavioral health care patients, community clinics are the primary point of contact for treatment. An EMR that facilitates the exchange of data between larger health systems and community providers will be the EMR of choice as our healthcare systems move toward integration.
 

5.)  Documenting and measuring outcomes. Outcomes are king in the behavioral healthcare industry. It is by measuring the outcomes of prescribed treatments during and after episodes of care that the industry can make the case for increased funding. Successful EMRs will not only facilitate the capture and reporting of outcomes, but will also provide the ability to analyze outcome data.