National Council Magazine - Winter 2009 - 59

seamless delivery of services and permits the accurate reporting and tracking of service delivery centers, programs, and providers. The EHR permits patients to be seen at any institute location, because their entire chart can be accessed from any institute center. Providers can use the EHR to review patient records, create and send provider messages, and manage patients from any organization location. Records can also be accessed remotely through a virtual private network, thereby enabling providers who are on call to retrieve records in an emergency. IMPROVING DATA COLLECTION Another valuable use of the EHR for the institute has been the ability to extract data and create reports that have enabled managers to better understand program utilization. Productivity data that can be broken down by center, program, or provider have been a useful tool for individual provider evaluations and understanding program viability. The ability to extract data on a speciﬁc service delivery, medication, or diagnosis has given a comprehensive picture of the patient population and its service utilization. Grant proposals and reports to funders are based on accurate data extracted from the system for speciﬁc time periods and can be sorted to meet the requirements of each proposal. In a time of ﬁscal hardship, the capability to compete for funding is critical; an EHR can provide numerical substantiation and the ability to record and track services provided for a particular initiative. The institute has developed a unique ﬁeld within patient electronic charts for documenting all special grant programs and services; options enable customized reports for funders and management. This ﬁeld enables clinicians to document enrollment and ser- vices provided during a visit. For example, patients seen in a Ryan White HIV program might have a note that states, “RW escort visit.” At the end of a reporting period, a report can be generated that counts all the RW escort visits. This process documents speciﬁc program services without generating paper tracking logs, thereby decreasing the staff time spent gathering data and creating reports. when OTR reports are due or authorizations expire. The EHR can be programmed to ﬂag visits that might be denied by payers for missing or incorrect information, so the paperwork can be corrected prior to being sent out for payment. The institute has been able to dramatically increase payments for mental health services and to provide denial and collection information to managers to better manage service delivery and recoup costs. IMPLEMENTATION CHALLENGES Legitimate concern exists about the future of integrated care models if health organizations transition to EHRs without the inclusion of behavioral health. Instead of resisting integrated charts and the use of a computer to document therapeutic care, behavioral health mangers need to view EHR implementation as an enormous opportunity to promote improved quality of care. Although many analysts view EHRs as the “medicalization” of mental health services, EHRs can actually aid in the success of a mental health program while protecting the sanctity of a mental heath session. The implementation of an EHR is not without difﬁculty, of course. EHRs are in a state of perpetual development and require ongoing attention, provider training, and resources. The ability to master an electronic system and to think the way an EHR system thinks can be difﬁcult for people who do not regularly use computers. The implementation of an EHR system may inﬂuence hiring decisions toward people who are able to adapt to computerized documentation. These difﬁculties, however, can be overcome with proper planning; they should not be used to prevent the investment in and ultimate success of an EHR within an integrated health system. The advancement and tracking of outcomes, along with the expansion of quality improvement, research, and funding opportunities made possible with an EHR, can revolutionize a behavioral healthcare delivery system and mainstream integrated care models. Virna Little, PsyD, LCSW-r, SAP, is Vice President for Psychosocial Services at the Institute for Family Health in New York, New York. She has worked in the ﬁeld of healthcare and behavioral health for more than 20 years. Little has been with the institute for 13 years and assists organizations that are implementing integrated models of care. NATIONAL COUNCIL MAGAZINE • WINTER 2009/ 55 MAXIMIZING REVENUES The EHR can also be a valuable tool for generating revenues. It can help attract new patients who are interested in the beneﬁts of an EHR, and it permits the tracking of referral sources or patient zip codes. These uses can allow for a better understanding of new patient ﬂow and support marketing efforts or strategic planning. EHRs can lead to opportunities to obtain grants for quality improvement projects or research that requires intensive data tracking and monitoring. Most important, the EHR can help decrease payment denials and maximize billing revenue. The Institute for Family Health, like many integrated organizations, struggles with the complexity of billing with multiple state and private payers and the need for authorizations. To obtain behavioral health payments, providers often must complete outpatient treatment reports. An EHR with a ﬁnancial system can remind providers DID YOU KNOW? k A Bazelon Center for Mental Health Law report, “Get it together: how to integrate physical and mental health care for people with serious mental disorders” points out that persons with serious mental illnesses > Have high rates of comorbid medical problems > Are twice as likely to have multiple medical disorders > 42% had at least one chronic physical illness severe enough to limit daily functioning > The detection of physical health problems is poor

National Council Magazine - Winter 2009

Table of Contents for the Digital Edition of National Council Magazine - Winter 2009