Five essential EHR features for behavioral & mental health practices

Behavioral and mental health practices require unique EHR features compared to other specialties or general medical practices.

Specifically, behavioral, and mental health practices have different requirements regarding how they use clinical data.

As noted in this article from the Journal of the American Board of Family Medicine, the primary differences between each practice’s EHR requirements rest in the type of data they use:

"behavioral health and primary care differ in their language, classifications, codes, data reporting requirements and regulations."

Behavioral and mental health practices collect more intensive data resulting from screening tools and from ongoing treatment. Further, these practices largely depend on effective care coordination across clinical settings and patient engagement to achieve positive clinical outcomes, but are also subject to more data privacy laws that go above and beyond HIPAA’s requirements.    

When considering the type of wide scope of care, clinical settings and patient populations mental health practitioners engage the mental health EHR requirements will vary. Despite these diverse needs, one can point to two levels of features, and functionalities mental health practices should consider when selecting an EHR: core requirements and advanced requirements.  

The American Psychiatric Association’s Committee on Mental Health Information Technology has developed guidelines which offer mental health practitioners guidance on selecting an EHR. The user and system requirements compiled by the organization provided a thorough overview of the core and advanced the EHR requirements mental health practices should consider.

Core requirements

The organizations instruct mental health practices first to consider basic functionality which including the ability to create bills, write basic progress notes, track patient medications and appointment scheduling.  When moving beyond this core functionality mental health practices’ mental health EHR requirements will depend on whether services are delivered through a solo practice setting or in a group practice. For the former type of practice, basic functionality may be sufficient whereas in the case of the latter more advanced features may be needed such as perhaps the ability to send claims electronically or order and send prescriptions electronically.  

Advanced features

The organization also notes that outpatient mental health clinics or those offering inpatient services will require a full-featured EHR containing much of the functionality described in this document.  Lastly, for those organizations who accept Medicare/Medicaid, it is important to consider the quality measures issued by CMS as part of their value-based reimbursement program. As such a practice should make certain, their EHR features allow for quality tracking and reporting.

Organizing mental health EHR requirements

The APA offers a straightforward method for selection teams to organize mental health EHR requirements. The organization identifies 2 sets of requirements:  User and Systems. User requirements involve functionality that an EHR user will require during daily work.

User requirements are divided into 7 major functions:  

• Appointments
• Billing
• Clinical charting
• Order entry
• Patient access
• General documentation
• Reporting

Systems requirements involve EHR functionality that can be best described as the portion which keeps the system running and protects clinical data from being lost or compromised by third parties.

5 mental health EHR requirements

Given the recommended core and advanced features and user and system requirements, behavioral and mental health practices should look for EHR systems aligned with these unique needs. When selecting an EHR, the following five EHR features should be viewed as essential to providing quality care:   

Care coordination

The care behavioral and mental health practices provide on coordinating with other providers. Therefore, the ability to share records is vital to this mission.

Mental illness is often a comorbid condition with other types of chronic illnesses, particularly patients suffering from obesity, diabetes, or cardiovascular disease. As such, a mental and behavioral health practice should be able to seamlessly share EHR records with other providers.

Billing coordination

According to a survey conducted by EHR vendor Valant, “the most common survey response (40% of survey respondents) was that collaborating with external resources for billing or care was the biggest organizational challenge.”

Just as coordinating care is an important aspect of behavioral and mental health services, an EHR with practice management capabilities can eliminate some of the administrative problems these practices face.

Clinical decision support tools

One of the foundations of behavioral and mental health practice involves the use of behavioral health screening and assessment tools and the close monitoring of patient progress in other care settings.

As such, practices can benefit from clinical decision support tools which take clinical data and provide alerts and reminders, diagnostic support, clinical guidelines, focused patient data reports and summaries and reference information.

Medication management and monitoring

As mental illness often occurs comorbid with physical illness, behavioral and mental health practices must rely on EHR features which allow them to monitor the medications patients are taking and be alerted if the risk of a harmful drug interaction is present.

Patient engagement

In the behavioral and mental health setting, patient engagement is vital in achieving clinical goals.

An EHR that allows a free flow of information between patient and provider communication can facilitate greater compliance with treatment, particularly with medication adherence and can play a vital role in facilitating patients’ ability to take an active role in their care.

Patient engagement features should also allow for a way for patients to take an active role in appointment scheduling and offer a user-friendly messaging system.

At their core, EHRs are generally comparable, however, when moving beyond core features, specialty practices, such as behavioral and mental health practices should consider their patient base and how an EHR can facilitate providing care in a way that enhances the mission of providing behavioral and mental health treatment. In addition to practical considerations such as the type of practice and the type of patients, it is also crucial for mental health practices to view their EHR requirements in light of their strategic goals. From this perspective, the requirements needed should satisfy an immediate need but should also build towards where a practice aspires to be in the short term and the long-term. These considerations can include improving services, expanding into new markets or adding new service lines.