ECRI, EHR Association put forth safety practices for behavioral health IT
ECRI's Partnership for Health IT Patient Safety is working with the HIMSS Electronic Health Record Association to chart some of the common challenges involved in integrating behavioral health systems with primary care EHRs.
WHY IT MATTERS
In a recent white paper, Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care, the two groups outline some recommendations to help support and improve such IT integrations.
Among the EHR challenges explored in the report, ECRI and EHRA focus on use of consistent terminology standards for documentation; incorporation and integration of screening tools; segregation of behavioral health records from other medical records (due, for instance, to regulatory requirements or privacy considerations); and barriers to information sharing between primary care and behavioral health providers.
A joint ECRI-EHRA workgroup developed five recommendations – with practical strategies for achieving them – focused across three areas: screening, documentation and information sharing.
- Ensure integration and easy accessibility of validated and clinically accepted behavioral health screening tools in the EHR
- Enable decision support triggers associated with those screening tools to link behavioral health and primary care
- Optimize clinical documentation for behavioral health and primary care integration
- Enable easier data sharing across care settings, via patient portals, secure messaging and HIEs
- Enable EHRs to segment patient data consistent with organizational policies, patient requests and state and federal laws and regulations
"While technology cannot solve every issue, its development and implementation has the potential to better facilitate the integration of behavioral health and primary care," said workgroup co-chair Patricia Giuffrida, RN, senior patient safety and health IT safety analyst at ECRI, in a statement.
THE LARGER TREND
With perhaps half of behavioral health conditions going undiagnosed, better treatment for conditions such as depression, substance abuse disorder and anxiety depends on integration with primary care, since that's typically where patients present first.
As ECRI and EHRA note, studies have shown that when tools for screening for behavioral health issues are embedded in the EHR, screening rates increase – enabling earlier identification of patients with behavioral health needs.
Especially as the pandemic-era telehealth boom has broadened the reach of behavioral health services (just as the pandemic and its quarantines have exacerbated behavioral health challenges), these questions are more important than ever.
ON THE RECORD
"The integrated health care model recognizes that both medical and behavioral health factors are important parts of a person's overall health," said David Bucciferro, vice chair of EHRA, in a statement. "Our workgroup's focus was ensuring that all clinicians have the information they need to make informed decisions in the treatment of the individuals they serve.
"Our recommendations identify where developers can enhance technology in the near term – one to three years – to address the bifurcation of health information into primary care and behavioral health," he added. "By creating technology to allow for the real-time exchange and integration of data, we can ensure that clinicians of all disciplines have a complete picture of their patients."
"The uncertainties of COVID-19, limited patient and provider resources, and the increased use of telehealth visits during the current pandemic highlight the urgency of integrating behavioral health treatment with primary care," said Dr. Marcus Schabacker, president and CEO of ECRI. "It is important to ensure that patients with behavioral health needs do not fall through the cracks."