Mental and behavioral health EHR buyers' guide
Mental and behavioral health practitioners face a number of complex challenges while dealing with patients, including high risk of non-compliance, confidentiality, complex long-term treatment plans and comorbidity with other conditions.
This means it is often hard to know where to begin when selecting a mental and behavioral health EHR. Making the wrong choice isn’t just costly - in the worst cases, it can throw your practice’s ability to provide the best possible care for your patients into jeopardy.
That’s why we’ve put together this buyers’ guide for mental health EHRs. We’ll discuss:
- What features you should look for in an EHR for your behavioral and mental health practice
- How much mental and behavioral health EHR should cost
- Which vendors you should consider when choosing a behavioral and mental health EHR
Whilst needs will vary between size and type of practice - multi-specialty practices will have a different set of requirements to a clinic specifically dealing with substance abuse, for example - this guide will give you a good grounding in how to find the right system for you.
The answer to this question will largely depend on what requirements your practice has.
That’s why it is essential to carry out a suitable requirements gathering exercise before diving into the search for new EHR software. You’ll need to have a good handle on where your current system is letting you down, key stakeholder interests, and how you hope a new EHR will make things better for your clinicians.
Nevertheless, there are a few challenges that all behavioral and mental health practices need to address. These include:
- Supporting patients on complex treatment plans: mental health recovery plans frequently need to accommodate talking therapies, medication, socio-economic factors and input from other providers
- The need to accommodate multiple facility types: clinicians treat mental health patients as inpatients, outpatients and everything in between
- Patient confidentiality and data protection: this is crucial for mental health practices; any new software should help meet compliance needs surrounding this.
To meet these challenges head-on and ensure the best possible outcomes for your patients, there are several EHR features you should be considering.
We’ll start with the basics:
- Your EHR should meet all compliance requirements. Ideally, you’ll want to be Meaningful Use certified to at least level two, and it goes without saying that HIPAA compliance is a must-have
- An e-prescribing module allows you to keep on top of patient prescriptions and reduce unnecessary paperwork. It’ll need to be equipped to deal with controlled substance prescriptions too
- Lab integration is useful for getting test results back quickly and efficient results sharing with other healthcare providers
- Flexible charting styles are a must-have; behavioral and mental health is a broad church, and patients present in a variety of ways. You need to enable your clinicians to deal with this.
- Patient portal is a challenge for mental health practitioners due to the nature of the illnesses they treat. Any software you choose should offer an easy-to-use patient portal at the very least, and ideally be able to remind patients of any upcoming appointments.
To enhance your clinicians’ experience with the software and to get the maximum benefit out of your mental health EHR, consider some of these more advanced options:
- Specialty-specific menus and intake forms can make all the difference to your clinicians workflow, particularly when a patient has a long or complicated treatment history. In a psychiatric environment, documentation tools should include the Sadness Scale and suicidal/violent risk factors assessments, for example.
- Hands-free notes - whether through dictation or pre-programmed buttons, this allows better patient engagement. In environments where a lot rests on how the patient describes their illness, this is extremely useful
ICANotes’ interface. Note the buttons down the side to simplify note taking and minimize need for typing
- Medication management - as mental health conditions are often comorbid with physical disorders, your physicians need to keep on top of other prescriptions patients might be taking. Medication management helps to do this and can provide alerts if there’s risk of a harmful drug interaction.
Among all these factors one of the most important things to consider when choosing a behavioral health EHR rests in the needs of a practice’s patient population. Features should be tailored to best meet your practice’s patient population’s needs.
Patients receiving behavioral health services present unique challenges regarding the scope and type of services required. For example, patients receiving behavioral health services require a unique array of screening tools and a higher level of care coordination when compared to patients presenting at other ambulatory clinics. Further, the type of care behavioral health patients require can run a broad gamut from traditional behavioral health services to more intensive forms of treatment such as addiction treatment. Given the considerations, mentioned above behavioral health practices must pay careful attention when selecting an EHR to be certain it has the right features that can enhance a behavioral health practice’s service mission.
The following are examples of features that behavioral health practices should consider essential when selecting an EHR.
Patient engagement - Patients suffering from serious mental illness have increased rates of preventable co-occurring conditions. Common co-occurring conditions for behavioral health patients include cardiovascular disease, diabetes, and respiratory disease. Given the high rates of co-occurring conditions in this patient population, behavioral health practices can benefit from deploying patient engagement features usually found in patient portal features. Features that encourage patient engagement can benefit behavioral health patients by putting in place conditions which can improve the likelihood a patient will comply with treatment and receive educational material on preventative treatment.
Support for telehealth - Delivering care through telehealth technology supplies a promising way to offer services for hard to reach populations and provide services in underserved areas. Among behavioral health practitioners surveyed in a study conducted by the University of Michigan’s Behavioral Health Workforce Center a majority of respondents believe telehealth is important to the success of their organization and a valuable tool for improving access to services and quality of care. In light of these findings and the value telehealth features can bring to a practice, EHR selection teams searching for a mental health EMR should consider telehealth an important feature to consider.
Seamless integration of care with other providers - Patients requiring behavioral health services often require integrated treatment for multiple disorders and other cooccurring health conditions. In these situations, behavioral health providers, as part of providing care that takes into consideration, both the mental health of their patients, but also their physical health will need to coordinate with other providers. Under these circumstances, providers should be able to share information with other providers to better coordinate care. As such, the ideal EHR for behavioral health should be widely interoperable and allow patients and other outside providers to request records and stay up to date in on a patient’s treatment history and treatment plans moving forward.
This is a big question - perhaps bigger than you might initially think.
It’s difficult to give any sort of useful average here, as the baseline price offered by vendors is really just the start of it. The overall cost of an EHR system will depend on a number of factors, each of which will be different for each practice. These include:
- Deployment method
- Whether you need to update your hardware (for on-premise systems)
- The support package you choose
- Implementation services offered by vendor - e.g training, consultancy, data migration
- Reduced practice throughput during implementation
- Overtime worked by staff during implementation (whether to make up for lost efficiency or to implement the system itself)
That said, baseline prices can be useful in creating your budget, as long as you forecast for hidden costs as well.
Vendors can be a bit cloak and dagger about how much a system will cost. Sometimes this is because they’ll need a better idea of what you’re after (modules, customization etc) before they can give you a reliable quote. Sometimes it’s simply a case of selling first, talking price later.
We’ve taken a snapshot of some mental and behavioral health vendors’ prices from our EHR pricing guide to start you off - though do check out the whole thing if you need some broader data.
Cloud-based behavioral health EHR (prices per provider/per month):
- Practice Fusion - free
- ICANotes - $149 for prescribing clinicians. $69 for non-prescribing clinicians.
ICANotes tiered pricing structure. Why it’s essential to nail down your user requirements before budgeting.
- drchrono - $199
drchrono’s pricing progression is a perfect example of how much prices can vary depending on the features you need
- CureMD EHR - $295
- McKesson - $349
On-premise behavioral health EHRs (prices are a one-off fee per provider):
- Amazing Charts - $1200
Amazing Charts’ breakdown of license fees and annual maintenance and support costs
Which mental health EHR vendors should I consider?
There are a few approaches you could take here.
The first is searching for a specialty-specific EHR. These are systems that have been built around the needs of behavioral and mental health clinicians.
These are generally more likely to contain the ‘advanced’ features outlined above and will probably require less customization to suit your workflow. On the other hand, interoperability could be an issue, as larger, more well-known systems are often better designed to integrate with other software.
Specialty-specific EHRs suit specialty-specific practices best. If you do mental and behavioral health and nothing else, here are a few good options to consider:
- Carelogic EHR: provided by Qualifacts, Carelogic is designed for use in a range of mental and behavioral health settings, including psychiatry, therapy, substance abuse and more. Deployments tend to be in practices with 20 clinicians or more.
- ICANotes EHR: ICANotes is a web-based psychiatry EHR used by a wide range of mental health professionals. It allows users to take mental health progress notes and reports without typing or transcription expenses by using a range of pre-formatted buttons.
ICANotes’ calendar and scheduling tool
- Valant EHR: Valant is a cloud EHR designed for both behavioral and mental health-focused private practices. It works well on smartphones and tablets, and the UX is based on a mobile app design for familiarity and ease of use.
Recording a patient encounter in Valant.
Another option would be to look at a multi-specialty vendors offering mental and behavioral health workflows and pre-customized templates. This is a sort of ‘halfway house’ solution which could suit multi-specialty practices who need more than just mental health EHR, but lack the time and resources for heavy customization.
Finally, you could choose a general EHR and customize it to suit your workflow. This could be a good idea if you’re part of a multi-specialty practice looking for a solution that can be adapted to all your needs. If you choose to go down this route, make sure you have the resources available to customize your software well.