The American Recovery and Reinvestment Act of 2009 (ARRA) contains provisions for spending approximately $19 billion in health IT infrastructure and Medicare and Medicaid incentives to press providers to use health IT, according the NJAMHA Newswire , a publication of the NJ Association of Mental Health Associations. The National eHealth Collaborative, the replacement for AHIC (the American Health Information Community), is clearly relieved that this funding has been approved, assuring their continued existence. They tout the law’s determination to solicit “broad stakeholder input” and “full participation of stakeholders” in the process of recommending how to accelerate adoption of use of health IT. The National Council for Community Behavioral Healthcare cheers their successful work to include community mental health centers as eligible entities for the available funding.
As a small company that provides mental health EHR software, mental health billing software and medical office billing software to small provider organizations, we are very concerned that the voices of those small providers will get lost in the shuffle. There is no question that hospital systems and the physicians who are part of those systems will adopt medical EMR software as well as other IT tools that will facilitate the deployment of health IT in the general medical arena. The size of those organizations will also make it easier for them to apply for some of the funding that will be available. But what about the solo mental health practitioner or the small group practice or even the large group practice?
While SOS Software has been involved to some extent in the development of a standard for a behavioral health EHR, we have been concerned from the start that the standard will make software too costly for the small provider to acquire. While our current product is very affordable, we do not yet know what the effect of requiring certification for EHRs will be on the cost of our products. We expect to raise this issue repeatedly in this space and other forums in which we participate over the next couple of years in hopes that some of you will be stimulated to get involved and to express your opinions about how far-reaching the requirements should be and what assistance you will need to adopt a mental health EHR in your practice.
Please let us know what you think and how you would like to be involved.
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Carolyn Stimel says:
I just got back from APA State Leadership Conference where I went to several presentations on the move to have all patients have an EHR by 2015. Minnesota has passed a statute that requires all their providers to have moved to EHRs by 2015. However, at this time there is no mechanism for the required intercommunication that is envisioned, nor is there much thought about how to incorporate our stuff. There will be privacy issues and APA is looking at continuing to work out different handling of psychotherapy notes. I suspect that we will have to rethinking how we do notes, and spending considerable sums to upgrade our technology in our offices.
Kathy says:
Thanks for your note, Carolyn. I hope you will be able to keep us apprised of APA’s work on these issues. SOS is working toward new versions of our software that will be CCHIT certifiable and we will do everything possible to keep prices as reasonable as possible. But, yes, I think you are correct that providers will need to be prepared for additional expense for EHR software.
Nancy says:
I can’t even get my providers to use the scheduler on the computer for appts. They don’t want anybody to have access to their psychotherapy notes. We are a small mental health facility and just renewing the support contract each year is like pulling teeth. I don’t think they will ever comply. None of them have computers to do notes in Case Manager and they don’t do OTRs on line either.
Tasha Elder says:
Kathy, You had posted a blog about this a while ago and I was thinking about it yesterday. I’m currently helping a provider establish herself as a new MH provider. She had worked for another provider I worked for and she wanted to branch out on her own. So we set up all her forms to be electronic. We then took it a step farther b/c she was still using paper to scan the papers into a file on the server.
And honestly, this is such a hard thing for her and her secretary to grasp. I’m working with another provider to go “electronic” and they are having such trouble with it also. We just set up an internet fax and she wsa worried about HIPPA and violations and this and that.
“Older” providers are having such a hard time with technology. While I tell them, it’s really easy, you just have to push a button, blah, blah, blah. They make it such a big deal that I just want to throw my hands up and say, nevermind, keep doing what your doing! Although, at the same time, they are open to the electronic records.
I say all this to say, I have no idea how they’re going to adapt.
Kathy says:
Thanks for your comment, Tasha.
Some providers have an easier time if the records are all in one program rather than scattered in various documents and locations. You might try reviewing and having Trish show you Case Manager. It is a way for a provider to do their entire clinical record (EHR) in one place.
But I have to agree with you. I think we will see lots of folks my age (almost 60!) trying to retire before they are required to deal with going electronic. The economy is not making that easy since so many folks have had their retirement savings reduced by 30% or more. The next few years will be very interesting.
Kathy
Kent Eichenauer says:
I have noticed that EHR seems to gaining more steam. My mother had recently been hospitalized and her PCP was part of the hospital’s network allowing his records to be readily available to the hospitalist. My father, who was with my mother during all this time, was impressed and it brought the issue front and center for me of the quality of care this can provide.
Yes, I do wonder what effect this will have on small psychological practices like ours. We do not use Case Manager at this point, but have considered dipping a toe into this pool but are not sure that a piecemeal approach is even workable.
Cost, as always, is a major consideration.
Thanks, Kathy, for putting this out here.