EHRs don't adequately support integration of primary care, behavioral health

Many electronic health records are a "burden" to the integration of primary care and behavioral health, requiring providers to resort to workarounds, according to a study in the Journal of the American Board of Family Medicine.

The researchers, from University of Colorado School of Medicine, Oregon Health and Science University and elsewhere, suggested that integrating primary care and behavioral health could improve care and lower costs. They noted that while almost half of the U.S. population will at some point meet the criteria for a mental health disorder, less than two thirds of those needing such care will receive it.  

The researchers studied eight primary care clinics and three community mental health centers in Colorado for three years that received funding to integrate primary care and behavioral health. They found that EHRs created obstacles to integrating the care.

Other studies have demonstrated the benefits of including mental health records in EHRs even though behavioral health providers are not part of the Meaningful Use program. There have been efforts to integrate this treatment with other medical services, including the recent introduction of legislation.

While EHRs helped somewhat in increasing communication among clinical team members, the systems lacked standard templates to document the additional inputs of data not previously recorded and tracked, lacked templates that supported shared care plans and lacked interoperability. As a result, the providers created workarounds in order to integrate the care, such as double documentation and duplicative data entry. It was only over time that the providers moved to customized templates, upgrades and unified EHRs.

"Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability," the researchers said. "This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators."

To learn more:
- here's the study

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