How To Choose an EHR

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Integrated Products for Mental Health: Save Time, Money, Errors

Mental health therapists are beginning to talk about wanting “integrated products” to help manage their practice tasks. But what do they mean by “integrated product?” More importantly, if you wanted to look at some, how would you go about finding them? Googling “integrated product” isn’t likely to produce the results you want.

One of the problems is that these types of products go by more than one name, which may be why people have begun referring to them as “integrated products.” Common names are Electronic Health Record (EHR), Electronic Medical Record (EMR) or Practice Management System. To complicate matters, just being called one of those titles doesn’t automatically mean the product is well-integrated.

All Patient Notes in ONE Place – You Don’t Have to Go Looking

Recently, a top journal in the field of Electronic Health Record (EHR) development posted this quote from an anonymous doctor who was dissatisfied with his EHR:

“I firmly believe this EHR makes important information difficult to find and interpret, and it is very inefficient.” He went on to say, “It creates superfluous and difficult-to-navigate notes and information that are not centralized. That makes it easy for care providers to disregard notes, and they often do. That affects patient safety. . . . It is difficult and arduous to document in the EHR, and providers’ efforts to do so still yield subpar results with erroneous, irrelevant information.”

This doctor is pointing out a very real problem inherent in some EHRs. However, he was referring to one of the "ONC Certified" EHRs which we've discussed previously. Those types of EHRS are inherently much more difficult to use than most EHRs that have been specifically created for the mental health professions, such as PSYBooks.

Why Do People Hate Electronic Health Records (EHRs)?

Actually, most patients don't. A recent study conducted by Catalyst Healthcare Research found that 93% of adults would prefer to go to a doctor that offers email communication, even if there was a $25 fee (Pai, 2014). Encrypted email is incorporated into most, if not all present-day EHRs that also have patient portals. By being integrated with the entire medical record, it's relatively easy for doctors to correspond with patients right from their electronic chart. Leaders in prominent health care groups in Houston, encouraged patient enrollment in their EHR system and have found similar results. Dr. Robert Dickinson, Kelsey-Seybold's medical director for executive health and wellness says, "They think it's the coolest thing they've ever seen. It's like online banking. People love this kind of access. Before, it was kind of mysterious" (Hines, 2014).

However, when you ask doctors if they like EHRs, you often get an entirely different story. You mostly hear dislike, frustration and irritability. There are actually excellent reasons for this.

Doing Telehealth? You Need a Portal.

Think you're not doing telehealth? Think again. Although there's no one-size-fits-all definition that cuts across state and/or discipline lines, most agree that telehealth basically involves any electronic method you use to communicate with or about your clients. This can include common things like phones, email and electronic file storage, in addition to video sessions, which is what we typically think of with the term telehealth.

Business Associate Agreements:
Do We Really Need Them?

I sometimes hear therapists mention specific software programs they’re using in their practices for tasks like notes, calendar/schedulers, online file storage, billing, video sessions or email and then add something like, “They’re HIPAA compliant. They just don’t – you know – have Business Associate Agreements.”

Behavioral Health Portal

The portal is the web-based interface between you and your clients. In a sense, it allows your clients (or anyone else you designate) to have their own “mini” version of PSYBooks that contains just their own data – no one else’s. You can view data they enter on your side and interact with the client about their data, all through the portal.

Types of EHRs: Introduction

Let’s face it. There are LOTS of EHRs on the market and most of us simply don’t have the time, energy, or frankly – interest – to put a lot of effort into researching them. Some therapists have told me that although they’d sort of like to explore EHRs, they begin looking at all the options, get overwhelmed, and decide to put the whole thing off. Although it doesn’t have to be overwhelming, it IS an important decision. An EHR that’s designed well, with attention paid to usability issues so it’s easy to use, can simplify your life enormously and save you a lot of time and money. On the other hand, an EHR that’s poorly designed will have you pulling your hair out and cursing EHRs in general – possibly not realizing that not all EHRs are the same and that there might be better options.

What is an EHR Anyway?

The acronym EHR stands for Electronic Health Record. Originally the term EHR was supposed to mean a very specific thing. It was to be a type of digital (i.e., computerized) practice management system for health care professionals that could “talk to” (i.e., share data with) EHRs of other health care providers and organizations, such as laboratories, specialists, school and workplace clinics, medical imaging facilities, pharmacies, emergency facilities – essentially anyone that might be involved in a patient’s care. Similar products that did NOT automatically have the “talk to everyone” feature were to be referred to by other names, such as EMR (Electronic Medical Record) or simply, practice management system.

Types of EHRs: Scope

To begin this series of posts, let’s look at a concept I’m calling “scope”. In reference to EHRs, scope doesn’t refer to the number of users a particular EHR has, but rather, to the number of different roles for which it’s designed. For example, a large scale medical EHR needs different roles or tracks for each of the various personnel that might need to add something to a patient’s chart. That could mean, for example, different tracks for scheduling, billing, intake, nurses and other mid-levels, doctors, lab technicians, social workers, etc. Additionally, such EHRs are designed primarily for hospital settings. Doctors who are affiliated with the hospital can typically access the EHR from their office, but the EHR itself was developed with hospitals in mind.

Types of EHRs: The Shared Chart Model

At it’s simplest, digital record-keeping could simply mean a Word doc, Excel sheet or PDF that you’ve saved on your computer, tablet, phone, thumb drive or other type of digital storage device. There are advantages to digital record-keeping even at this elementary level. For example, with digital records, you no longer have to contend with bulging filing cabinets, finding adequate long-term storage, or shredding – all of which are factors with paper health records. Additionally, it’s relatively easy to make backup copies of digital files to guard against some type of disaster, whereas making copies of paper records is costly, both in terms of time and money and also, effectively doubles the number of filing cabinets or other physical storage space you need.