Tag: Behavioral health EMR

Wal-Mart and Mental Health EMR: Unlikely

Posted on | by SOS Blog | Leave a Comment on Wal-Mart and Mental Health EMR: Unlikely

For the past week the health IT news world (NYTimes; Chicago Sun Times; MSN; ) and blogosphere (FierceHealthIT; Healthcare Informatics) have been abuzz with Wal-Mart’s announcement that they will begin selling electronic health record (EHR) software to doctor’s offices starting this Spring. They will do so in partnership with eClinicalWorks and Dell through their Sam’s Club stores.  

Our initial reaction was panic. After all, if the world’s largest retailer decides to get into our market space, how can we possibly survive? And what does this mean for our customers?

Then we started reading the fine print. The cost for the first physician in the practice will be $25,000 plus $10,000 for each additional physician. The first year’s price includes hardware, installation, some training, technical support, and a variety of other odds and ends. And that is for software as a service. That means you do not own a license for the software; rather you connect into the company’s system and maintain your records there.  (This is the model that some people believe is the only viable one for a broad national system, but many dispute that.) After the first year, the cost per doctor is $500 per month.

John D. Halamka, M.D., CIO of the CareGroup Health System and Harvard Medical School among many other posts, is convinced that this pricing is fair and that Wal-Mart’s expertise in supply chain management and their own experience with IT systems inhouse will make their coordination of this project a success. In fact, he says that its a “good deal“. 

While this sort of price point might be cost effective and competitive for general and speciality medical physician practices, it is certainly not so for those in behavioral health practices. Most community based behavioral health organizations are also not likely to find this pricing structure something they can build into their budget.

If this is the Sam’s Club bargain software, where does that leave mental health providers? While there are currently a few companies with very reasonably priced electronic medical records (EMRs) aimed at the behavioral health community, time will tell whether meeting the requirements for CCHIT certification and paying to acquire that certification will allow the products of this small cadre of companies to remain affordable.

What’s your take on the Wal-Mart announcement? Where do you see this search for the EMR going for you? 

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Behavioral Health EHR: Dream or Reality, Obstacle or Asset

Posted on | by SOS Blog | 11 Comments on Behavioral Health EHR: Dream or Reality, Obstacle or Asset

Last month I wrote an article about movement toward Electronic Health Records (EHR) in the behavioral health community. I was stunned by your silence on the issue. So much of my energy for the past two years has been focused on EHRs, their use in general medicine and in mental health, that I was very surprised that our readers were not interested in discussing EHRs. I am not sure whether the booming silence was a reflection of denial about movement toward these products, lack of information about them, or some other factors. So let’s start with some information.

In May, 2003 the President’s New Freedom Commission on Mental Health reported that the mental health community has been much slower to adopt Electronic Medical Records than the general medical community in spite of the potential benefit for consumers being just as great. The Commission concluded that a substantial effort should be made to develop the infrastructure to support interoperable electronic medical records and personal health records, and that the behavioral health community should move forward with adoption of appropriate products.

Early in 2006, a SAMHSA (Substance Abuse and Mental Health Services Administration)-funded Behavioral Health EHR Profile Workgroup, a multi-stakeholder effort to develop an EHR Conformance Profile for behavioral health began work. I joined that workgroup early in 2007 and participated through the adoption of a standard for Behavioral Health EHRs by HL7 this past summer. The Certification Commission for Healthcare Information Technology (CCHIT) has formed the necessary workgroup to develop testing and certification standards for Behavioral Health EHRs and plans to begin such certification by summer 2010.

The thinking about EHRs and their benefit are multiple. Primarily, they are believed to improve the quality of care by minimizing errors and duplication, by providing decision support for the provider, by offering evidence-based practice options, and by making all that information available rapidly to other providers. Adding Personal Health Records (PHRs) into the mix and connecting everything by way of a National Health Information Network (NHIN) or Health Information Exchanges (HIEs) will provide real-time information access for both consumers and providers of health care services.

The election of Barack Obama has spurred lots of discussion about the direction that healthcare reform will take. He mentioned electronic medical records in speeches and debates, but there is not yet much information about how he will pursue policy in that arena. The current financial crisis and recession will undoubtedly take priority over healthcare reform, but the cost of healthcare makes it a pressing issue for everyone.

I have heard providers talk about EHRs in widely varied ways. Some (including some of our customers) have used software products to maintain their clinical records for years and would not want to practice without one. Some clinicians believe that such a product would create obstacles to best care of their clients. Others are concerned about workflow interruption and the amount of time it might take to utilize an EHR. And those of us who work in the industry and are clinicians by training have major concern about privacy and security of health records generally and EHRs in particular.

What are your thoughts about EHRs? Do you see them becoming a part of the picture for your organization? Do you have a plan for purchase of such a product? Do you already use an EHR? How well does it do the job for you? Please let us know your thoughts. What providers think and how they plan to behave will control how this all unfolds.

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Thanks for your thoughts.