The need has been here for years. Yet despite a heightened urgency for mental health providers and primary care providers to share information, communication between the two parties remains mostly muted.
EHR Communication Could Close Gap Between Providers And Substance Abuse Specialists
The reason for the urgency? It's largely the result of a profound rise of substance abuse disorder (SUD) – more than 20 million Americans a year – in the United States. But many of the communication barriers that existed years ago continue to thwart conversations today.
The biggest barrier? In the case of most mental health providers, it’s a prevailing lack of technology.
“The problem isn’t that physicians don’t know that collaboration influences outcomes,” wrote Charlie Hutchinson, CFO of InSync Healthcare Solutions, in a 2019 article for Healthcare IT Today. “It’s that they don’t always know how to approach collaborative relationships or share information.”
One reason for this, Hutchinson explained, is the profound lack of EHR adoption among mental health providers, especially among substance abuse specialists.
Statistically speaking, the percent of U.S. mental health facilities that have fully adopted EHR (no paper records) is less than 25% - in every single state. That's according a study published in March 2021 by ScienceDirect. Those numbers, it adds, are "significantly less" for Substance Use Disorder (SUD) facilities.
How significant? Consider this from a study reported last year by the Office of the National Coordinator (ONC) regarding SUD treatment centers:
Fewer than 10% of SUD centers use only EHRs to send or receive client health information.
EHR Laws and Regulations A Barrier To Obvious Benefits
And yet, says the Department of Health and Human Services in a 2016 report: "Electronic technologies, such as EHRs, enable individuals and their providers to more easily manage and exchange treatment records to support care coordination. Effective use of these technologies can also improve quality of care, reduce treatment gaps, and provide cost savings to health systems."
To recap: provider collaboration that results in better care and more money.
With all that, why isn't there a mad rush of mental health providers to sign up for EHR software? At least in part it's because of laws that have offered no financial incentive - or have prioritized patient privacy at the expense of collaborative patient care.
Perhaps nothing illustrates or explains the divide between mental health organizations and their medical counterparts than the American Recovery and Reinvestment Act of 2009. It was designed to encourage "meaningful use" of EHR by providers. The incentive was $19 billion in payments, up to $44,000 (Medicare Meaningful Use) or $63,750 (Medicaid Meaningful Use) for qualified healthcare providers - excluding those in mental health.
Until the playing field is leveled, mental health and SUD specialists seem destined to lag behind other healthcare providers in both funding and EHR adoption.
Recent Laws A Step In Right Direction Towards a Collaborative EHR
Fortunately, lawmakers are listening and beginning to swing momentum in the other direction. For example:
Support for collaboration: Title 42 of the U.S. Code of Federal Regulations was launched in 2017 to protect SUD patient records. That law has since been revised (42 CFR Part 2) to facilitate better coordination of care among providers without altering the original basic confidentiality protections.
Revenue incentive: The "Psychiatric Collaborative Care Model" now enables primary care practices that co-manage patients with psychiatrists or other mental health professions to bill for those services using appropriate CPT codes.
"Yet for many PCPs, integrating care with mental health providers is tougher than it sounds," Hutchinson observed. "A 2016 study of provider collaboration published by the International Journal of Integrated Care noted that providers’ collaboration across all contexts is frequently “hampered by organizational and individual factors,” such as differences in professional power, knowledge bases and culture. Because of this, mental health patients often experience inadequate, fragmented care."
This systemic breakdown is particularly concerning at a time when SUD growth across all demographics and income brackets is becoming an increasing burden for PCPs.
"Physicians, especially those in rural and/or underserved parts of the country, who are most affected by the opioid epidemic, have had to step up their engagement with patients to help them physically, mentally and emotionally," Hutchinson said.
But they can't do it alone. It's a job better achieved in tandem with mental health and SUD providers. But how?
Proper Tools Enable Collaboration With Mental Health Partners
What physicians need are better tools and strategies for effective collaboration, Hutchinson suggests. Having the right EHR system and other communications technologies are key to ensuring that all parties are on the same page in pursuit of their patient's care.
As such, PCPs should consider three important characteristics of technology that support collaboration with their mental health provider partners:
Collaboration through Interoperability: In order to collaborate effectively, clinicians need technology that facilitates seamless data exchange. For example, if there are updates to a patient’s medication-assisted therapy protocol or medication adherence issues, a mental health specialist can quickly alert the patient's physician.
Usability. The most effective technology is intuitive and enables providers to quickly scroll through charts, view clinical information, and document care in minutes - allowing them more time to engage with patients, provider partners and other stakeholders on patients’ care teams.
Flexibility. A provider’s workflow is as unique as their patients. Their EHR should be too, whether the provider needs fully customizable group charting templates or one-touch access to telemedicine applications. Having technology that adapts to changing regulations saves time and energy for providers navigating new collaborative partnerships and patient relationships.
If you're looking for a new EHR software that checks these boxes for you, check out InSync Healthcare Solutions' fully integrated, interoperable and mobile-friendly system, and schedule a demo to see how our software can improve your EHR experience.
For a look at how the InSync EHR system can work for your mental health practice watch our 5-minute video preview below. It covers all of the most important facets of the software with relaxing music and graphics rather than a narrator.