I found myself strongly empathizing with practitioners, administrators, and behavioral health care personnel of all stripes who spend their days trying to provide quality mental health services to their patients…and then spend their nights worrying about what has occurred that day that might get in the way of or assist them in doing their job, but not having the time or the energy to pursue that information. Certainly, the information is readily available on the Internet, but who has time.

There have been numerous discussions of the effects of too much information (TMI) on our functioning. In July, 2008 Nicholas Carr wrote an article in The Atlantic called Is Google Making Us Stupid? This year he has written a book length exposition of that subject called The Shallows: What the Internet is Doing to Our Brain. His thesis is that our brains are literally being changed by the way the Internet is organized. He posits that jumping from one place to another by way of hyperlinks results in shallow pursuit of topics rather than the in-depth exploration of a subject allowed by books. In my brief exploration about his book, I found an extremely articulate review and commentary by Venkatesh Rao who mentioned and hyperlinked to the blog of Jason Kottke, a writer whose name I had heard but had never read. I have demonstrated for you an example of Carr’s thesis. I got distracted from obtaining support for my original thought by the way the Internet presents information and by the ease of pursuing that linked information.

Back to my original thought…here I am adding one more place where there is a bit more information for you to take a look at…or not. You might find this a convenient place to check for information about behavioral health care and its place in the world-at-large, or you might drop in occasionally just to see if there is anything that interests you.

For those of you checking in for something interesting, here are a couple of tidbits.

1. ONC (Office of the National Coordinator for Health Information Technology) has published a final rule in which it establishes a temporary certification program for electronic health records as required under HITECH. As reported by Healthcare & Technology blog, this rule should allow progress toward approval of certifying organizations for EMR products.
2. iHealthBeat reports on release of final rules for “Meaningful Use”. Many observers believe that the easing of requirements for the meaningful use of an electronic health record required to receive stimulus funds made available under HITECH will make it easier for eligible providers to receive funds. Other observers believe that even the easing of the standards will not make it simple for stimulus funds to be acquired, even for those who have already purchased and implemented EMRs.

It appears that life gets more complicated all the time, even if we have information. Since I do believe that knowledge is power, I will keep trying to pass some of what I come across on to you. Thanks for reading. Please let us know what you are thinking about. Just enter your comments below.

HITECH provides for stronger controls. It requires that the provider be able to inform the patient (upon the patient’s request for the information) about all the times that PHI has been released by the organization (disclosures), to whom it was released, and the purpose of the release. This includes release of information for operations and billing. If you send claims to an insurance carrier via a clearinghouse, you would need to be able to document every time a claim was sent and that it went to both the clearinghouse and the insurance company. If you send it to the payer directly on their web site, you would still need to be able to document every time you did that.

HHS has been gathering comments from provider organizations about the burden this will place upon them. How the rules are ultimately written remains to be seen.

At the same time, the HealthIT Policy Committee has been working on a framework for privacy and security of PHI as we move toward EMRs and the electronic exchange of identifiable personal information. An attempt is being made to come up with methods and understandings that will allow a national standard and method of exchanging PHI in spite of different laws and requirements in each of the 50 states. A Privacy and Security white paper series explores these issues.

Part of the current concern is the point in an exchange at which a specific consent should be required from a patient for release of their information. It is believed that patients feel fairly secure when provider #1 releases information to provider #2 whether the provider is a lab or another physician. Trying to determine the point at which comfort in an exchange is lost and the requirement of consent is triggered is part of the challenge. For example, if provider #1 has consent to send information to provider #2 but the only method of doing so is through a third party (like a clearinghouse or directory), does additional consent need to be obtained for that transaction? What kind of situation must exist to trigger a patient’s right to “opt out” of the electronic transaction.

These are important issues that pertain to information electronically exchanged for billing and operations as well as for treatment. Avoiding the use of an EMR will not shield you from addressing these issues if you send claims electronically. . . even at a payer’s web site. 

What do you think about protecting the PHI of the consumer of services?  What are you doing to assure that you meet the requirements of the law? Please share your thoughts and comments below.

1. The National Council Public Policy Update of April 8, 2010 pointed out an important change in timely filing requirements for Medicare claims:

Requirements of the Patient Protection and Affordable Care Act makes (sic) several changes to the Medicare timely filing requirements. Under the new law, all claims from before Jan. 1, 2010 must be filed by Dec. 31, 2010. Beginning on Jan. 1, 2010, all claims must be filed within one year after the date of service in order to be considered timely.

Sec. 6404 of the law details the requirements. This is a change from the former allowance of 3 calendar years to file a claim. Be clear about this: you now have 1 calendar year after the date of service to file a timely claim for payment for those services.  Now might be a good time to use your billing software to learn which old Medicare claims have not been paid (the claims may have been lost) and if there are any Medicare services that have not been billed. If these are not already three years old, you have only until the end of 2010 to file them, and with services that are new in 2010, you have one calendar year to file a claim for the services.

2. Seth recently posted a message on our User Group about the potential privacy and security problems that can be caused by data left on newer copiers and multifunction machines. NJAMHAA Newswire of May 3, 2010 also commented on the possibility of HIPAA violations that can result from careless use of these machines. Seth’s comments follow:

Now that you finally got all your computer hard drives encrypted and you are feeling pretty smug, here comes another headache — thousands of images containing PHI stored on a hard drive hidden inside other office machines. Take a peek at this investigative report by CBS news:

http://www.youtube.com/watch?v=6pIFUOav2xE

This is a pretty big vulnerability. If you have one of these higher end digital copiers, printers, or multifunction machines and it is stolen — or you neglect to remove or wipe the hard drive before selling or trading it in, you have a reportable security breach. Nobody would be likely to have a list of the patient documents that had been copied over the years, so you
would have to assume that EVERYONE’s protected information was at risk. That means reporting to the Feds, taking out the newspaper ad announcing your negligence, and the rest of the breach notification nightmare!

Apparently all major manufacturers offer security add-ons of some sort. Now would be a good time to inventory your document devices to determine if they contain hard drives and whether you can retrofit appropriate security add-ons to avoid a potentially disastrous situation in the future.

3. The National Council on April 23 published a review of Parity Act implementation that will allow you to determine whether your insurer or the payer with which you are dealing is in compliance with the Parity Act. Is your insurer in compliance with the Parity Act? will help you ask the right questions and provides resources to help you answer the question.

4. On April 22, FierceEMR and other sources reported that hospital-based doctors are now eligible for ARRA incentive payments for meaningful use of certified EHR technology, and that a bill has been introduced by Rep. Patrick Kennedy (D-RI) and Rep. Tim Murphy (R-PA) seeking to include mental health professionals, Community Behavioral Health Organizations (CBHOs), psychiatric hospitals and chemical dependency programs in the ARRA incentives. Time will tell what will fly.

5. And finally, the Mercom Capital HIT Report of May 3 indicated that HHS is seeking comment on the anticipated impact the stricter disclosure reporting requirements included in the HITECH Act will have on providers.

To help guide the Health and Human Services Department in tightening rules for health information privacy, HHS has asked providers, payers and consumers to comment on the benefits and burdens of accounting for the disclosure of protected health information, even if the data is intended for treatment and billing purposes. The HITECH Act called for HHS to strengthen the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA). With the changes, providers, plans and their business partners will have to account for disclosures of patient information contained in an electronic health record, even if the data is for healthcare provision and payment. 

HHS’ Office of Civil Rights (OCR), which oversees health information privacy, published a request for comments in the May 3 Federal Register 
“to inform our regulations under the HITECH Act,” according to the announcement. Under HIPAA, providers and plans currently do not have to report releases of protected data when the disclosures are related to patient treatment, payment and healthcare operations. HHS said in the notice that it will remove the exemption for those disclosures when it involves an electronic health record (EHR).

Needless to say, there is a great deal going on in the world of behavioral health care and health care in general. Please feel free to share news items you discover that might be useful to other readers.

Don’t forget, your comments are always welcome. Please share them below.

The biggest difficulty Spring provides for me is that it is hard for me to stay task-focused. This has been the case since I was a child. I just don’t much feel like being indoors, so working on indoor responsibilities comes much harder. As an adult, work is no exception. It is hard for me to focus on tasks that need to be accomplished. I would much rather be playing….or at least doing different work.

As a result of this year’s Spring fever, it was not difficult to decide that the celebration of Synergistic Office Solutions‘ 25th anniversary should happen at home rather than in a restaurant. It may cost me a bit more work, but it is not my usual work. I get to have a party instead of focusing on the changes I need to make to our web site or some other such task.

Yes, our software company has now been around for 25 years. Seth started doing consulting to other psychologists in 1985. Our billing software for mental health and medical practitioners followed in the next year. Florida psychologists were our first customers, but we started selling nationally in 1988 or 1989. Our electronic clinical record product was released in 1990. We made the transition from full-time practice of psychology to full-time software business in 1992-1993. Sometimes I am sure we jumped from the frying pan into the fire!

The primary benefit of the change from providing services to mental health clients to providing products and services to mental health providers has been that we have met so many wonderful folks who embody in their work their mission to care for others. Behavioral health providers and service organizations are the BEST! We are grateful for the opportunity we have had over the past 25 years to work with so many talented and caring people. Thanks to each and every one of you!

As you can see, my Spring Fever is so bad this year that I could not even write a blog article that would have the usual links to information you could use. It contains nothing about behavioral health electronic medical records or HIPAA or HITECH. Oh well, maybe next week will allow a return to those serious issues.

How do you respond to the appearance of Spring? Are you one of those wonderfully responsible people who can just put your head down and keep on taking care of business? Will you share with me how you do that? Or maybe you are just like me and want to have a party!

Please enter your comment in the box at the bottom of this article. If you don’t see one, double click on the title of the article, then scroll down to the box to make your comment.

• The 10th annual meeting of the Health Information Management Systems Society (HIMSS) in Atlanta took top billing. One of my favorite bloggers [EMR (EHR) and HIPAA] attended and posted frequently during the conference. John has been writing about EMRs since December 2005 and his knowledge is considerable. In fact, he just published his own e-book on how to choose an EMR. He is sincerely interested in the best ways for a facility or practice to choose the best EMR for their organization. John’s Sunday post referenced an article by Didier Thizy from macadamian titled “Electronic Medical Records – 3 Key Differentiators“.The three most interesting and possibly most important differentiators Mr. Thizy heard being promoted by EMR vendors at HIMSS about their systems were:

The EMR has excellent UI (user interface) and usability.
The EMR is designed for a specific speciality.
The EMR’s technology makes the user’s life easier.

Obviously, when it comes to electronic medical records, one size does not fit all. Making sure that you take usability, specialty specificity, and life simplification into consideration is likely to make your selection a better fit for your organization.

• FierceHealthIT reported a number of interesting items on March 8.

1. The Veterans Administration and the Department of Defense have been working diligently through a contractor to connect their respective EMRs so they can communicate with one another. After incorrect communication of patient information (providing information about the wrong patient in response to a user query), the VA decided to shut down access to the DoD system. Hopefully, this is a very temporary glitch and does not mean a complete return to the drawing board.
2. The Medical Group Management Association (MGMA) expressed concern about results of a survey they completed recently. They found that practice executives are not as optimistic about productivity gains as software and information management executives. Over two-thirds of those surveyed believe that physician productivity will decrease because of the proposed meaningful use criteria. The other third of practice executives felt productivity would increase. This split resulted in MGMA’s chief Dr. William F. Jessee’s statement: “For the incentive program to succeed, the meaningful use criteria must be practical and achievable. If the final rule mirrors those outlined in the current proposal, there is significant risk that the program will fail to meet the intent of the legislation, and that a historic opportunity to transform the nation’s health care system will be missed.”The survey results indicated which criteria will be most difficult to meet:

The proposed requirement that 80 percent of all patient requests for an electronic copy of their health information be fulfilled within 48 hours (45.9 percent) and

The proposed requirement that 10 percent of all patients be given electronic access to their health information within 96 hours of the information being available (53.5 percent).

Those of you who like to closely follow news in the health care IT space might consider following these two excellent sources yourselves:

EMR (EHR) and HIPAA and FierceHealthIT

Since the passage of ARRA last year, there has been rampant speculation about whether the Certification Commission for Health Information Technology (CCHIT) would be the only certifying body approved by HHS. Many who have felt that CCHIT is too closely tied to the large players in the medical EMR community have believed that diversification in the certification community should be a given.

Currently, CCHIT is the only organization designed to certify EMRs. Prior to ARRA, the certification was to a particular set of standards, features and functionalities decided upon by CCHIT as necessary for any electronic medical record program to call itself a player. In the past few months, CCHIT has added an ARRA certification to meet the requirements of “meaningful use” so that providers could qualify for ARRA funds. Unfortunately, the “meaningful use” definition is not yet finalized…and the cost of the ARRA certification is significant.

This cost of certification by CCHIT has been the primary concern for small software vendors. Those of us who have limited financial resources and small development staff have been worried that the fees and methodology of CCHIT would prevent us from obtaining certification for our products. Dr. David Kibbe, senior advisor to the American Academy of Family Physicians Center for Health IT is one of the critics. As reported by Neil Versel at FierceEMR, Dr. Kibbe believes that the cost and complicated nature of the CCHIT certification method stifles innovation and the development of new technologies.

This announcement by ONC may well open the playing field significantly. Whether the stimulus funds are worth the cost to achieve “meaningful use” is a separate issue that eligible providers will need to determine for themselves. Since these incentives are largely aimed at primary care providers, not many behavioral health organizations are likely to be impacted or even eligible for funds. But we must assume that the move toward EMRs in the general medical world will increase the pressure upon behavioral health providers to follow suit.

I first heard the term “continuity of care” in a healthcare seminar I took back in graduate school in the early ‘70s. It was an obvious, common sense concept that patients could receive better care at lower cost if providers were able to continue care already started by another provider, rather than starting over, duplicating care already rendered by the previous provider. Continuity of care requires that meaningful, usable information pass from provider to provider. Almost 30 years later, every patient in the US is familiar with the challenges of getting even simple demographic data, much less meaningful health records, transferred from one doctor to another. Well, the CCD might just be a solution to that problem.

Our meeting started with a demonstration of the creation of a CCD by the system of one SATVA member, and the display and subsequent import of that CCD by the system of another SATVA member. These are the exact capabilities that are mandated by 45 CFR, Part 170, HHS’s recently published Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology (Interim Final Rule).

Required or not, systems that are actually doing CCD interchange today are few and far between. To our knowledge, there are NO behavioral health EMR systems that do. Nevertheless, the technical proof of concept was convincingly demonstrated at our meeting — a valid CCD was created, and the generic medical information contained therein was displayed and “consumed” by another system.

In many respects, the technology is the easy part. The challenge that faced our group was to define a standardized way that behavioral health providers can represent their unique domain information within the CCD to allow accurate import by a receiving system. Think, for example, of the five-axis DSM diagnosis — something that exists only in our family of behavioral/mental health specialties. Ultimately, the DSM five axis profile turned out to be the focus of our group’s efforts.

The standard CCD contains sections for identifying information (technically called the Header section), Problems, Procedures, Family History, Social History, Payers, Advance Directives, Alerts, Medications, Immunizations, Medical Equipment, Vital Signs, Results, Encounters, Functional Status, and Plan of Care. A given CCD can contain one or more of these sections, in any order. In this context, the Problems section is normally intended to contain a list of diagnoses, but it is flexible enough to include other information including findings and observations, which means that “problems” in the behavioral health sense could be included when necessary to convey significant information that diagnosis alone could not.

One of the most important aspects of the CCD and related electronic documents is that they must rigidly adhere to standardized sets of coded descriptions that are included in the specification of these documents. For example, when diagnosis codes and descriptions are included in the Problems section, they must be either ICD-9 (until supplanted by ICD-10) or, better, the more universally used SNOMED-CT. The latter includes everything in the ICD, plus a great deal more, and is preferred. Before you get too worried, all the vendors present agreed that it would not be difficult to modify our products to take the sting out of SNOMED for you. Likewise, in Medications, drugs should be listed with their RxNorm codes, and in Results, labs should include LOINC codes. The use of these specific coding systems avoids ambiguity that could potentially result in misunderstandings and serious harm to patients.

The CCD is rendered in XML, a cousin of the HTML code that sits behind the content and presentation of the typical web page. As a result, the CCD can be displayed by any modern web browser. Without getting too technical, the CCD uses a related style sheet that determines the way the CCD data is displayed on screen. As a result, any CCD that you receive can easily be formatted to display in any way you like! Let’s say that you want the Alerts section (which contains important information such as allergies, adverse drug reactions, and perhaps such information as dangerousness) displayed in a bold red font in the top right corner of the page. You can modify your organization’s CCD style sheet to make it so. Thereafter, EVERY CCD you display will have the desired information in the desired font and position. It doesn’t matter who sends it. Compare that to searching through several inches of paper records that bear no resemblance to anything you do in your own organization. See what a breakthrough this would be? Below is the very same CCD, but displayed with two different style sheets. The fancier one is courtesy of Brett Marquard of Alschuler Associates, LLC.

Returning to the meeting, after considerable discussion the group determined that we could, in fact, communicate our beloved DSM axes within the existing CCD specification, with no need for extension or new templates (another component of the document specification). This conclusion was nothing short of huge! The fact that we can get what we need without having to go hat-in-hand to the standards bodies to plead for inclusion of something new means that implementation can go forward on a much faster schedule. Our goal now is much more modest – just an Implementation Guide that describes how and where to put our unique stuff.

If you are still with me, and are curious, we determined that Axes I, II, and III diagnoses will go into Problems, along with additional specific diagnostic criteria (as findings or observations) when necessary. Axis IV will go into Social History, and Axis V will, of course, go into Functional Status.

This initial core group of stakeholders expects to add supporters over the coming months, complete a well-tuned CCD Implementation Guide for Behavioral Healthcare Providers, and put it into use in the field. In the meantime we will move forward, with the expectation of obtaining official adoption by the relevant standards bodies.

SATVA has been active in national efforts to keep behavioral health treatment within the mainstream of the conversation about  health care technology and reform. Since the behavioral health community is such a small part of the overall health care picture, a non-profit organization consisting of vendors of technology products, working with other behavioral health advocacy organizations stands a better chance of having an impact.

In September 2005, following the broad call of the Institute of Medicine of the National Academies (IOM) for increased use of electronic health records to increase the quality of health care, SATVA and SAMHSA co-sponsored a Summit on EHRs in the behavioral health community. This initial activity laid the foundation for the development of a profile for standards for behavioral health EHRs, a necessary precondition for developing interoperable products.

The Behavioral Health Interoperability Conference is a natural outgrowth of the progressive work of SATVA and its members to advance the quality and quantity of behavioral health services provided by members’ clients with consumers of care the ultimate beneficiary of all our efforts.

Synergistic Office Solutions, Inc. is proud to have been a member of SATVA since 2004.

In the time since we joined SATVA, the rate of change in the health care marketplace has rapidly accelerated. It is a major challenge for a small company like ours to keep up with all of the information that emerges daily. SATVA is a significant help in that regard. Last year at the late fall meeting, we learned a great deal about certification of behavioral health electronic health record (BH-EHR) programs. This year we discussed the impending release of the draft requirements for that certification and whether it will really be useful for behavioral health organizations.

SATVA has created a section of its web site that is dedicated to keeping a close watch on the certification process. It is a great place for you to get a relatively brief but detailed view of the information related to certification.

We are very proud to be members of SATVA. We are constantly impressed by the individual and collective knowledge of the members of this group and by their willingness to work together in collegial fashion for the well being of the behavioral health community.

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Speaking of certification, the Certification Commission for Health Information Technology (CCHIT), on Friday announced the spring retirement of Dr. Mark Leavitt, the founding chair of the commission. Established initially with federal funding, under Dr. Leavitt’s leadership CCHIT has become a successful not-for-profit organization whose sole purpose is to certify electronic health records (EHR). At the moment, CCHIT is the only certifying body recognized by the US Department of Health and Human Services (HHS).

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And more news about certification…..on Monday, November 16, 2009, CCHIT released the draft requirements for certification of behavioral health software products. This draft is available for public comment until December 11, 2009. If you have curiosity about or input you would like to offer about the certification of behavioral health electronic health record products, now is the time to voice them.

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The Federal Trade Commission (FTC) has again extended the enforcement deadline for the Red Flag rules. At the request of Congress, this has been pushed off until June 1, 2010. The National Council (NCCBH) reported in its Public Policy Update on November 5, that Congress is considering a new bill that would exempt small health care practices from the rules. The FTC had earlier ruled that the rules apply because of the billing practices of many health organizations. Congress is considering exempting practices with 20 or fewer employees. Stay tuned. There is undoubtedly more to come…

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Please share your comments about any of these or related issues by clicking on the title of this article and typing your comment in the box below. We very much appreciate your reading our blog and would love to hear what you have to say!

Clearly, understanding their current work flow is essential to assure that the steps we follow to implement the electronic record will cause minimal disruption of their productivity and maintain their confidence in their billing and cash flow. The goal of the CEO and CFO is to seamlessly provide and document services so payment audits do not result in lowered funding; the goal of the clinical staff is to help addicted people recover from their addictions and become productive citizens; and the goal of the billing staff is to assure that services are accurately reported and billed so the agency is paid for services provided.

The end point we plan to reach is that billing will not occur until documentation of the treatment is in place, but getting to this point will be a gradual process. Helping clinical and business office staff understand the job responsibilities, work flow and the anxieties of their colleagues will allow them to work more effectively as part of a team. The team, of course, shares the goals of providing the best clinical services as efficiently as possible and assuring that payment is obtained for those services so they all can continue doing their respective jobs.

While this flow charting was a time-consuming process, it was most instructive. One thing we have learned in almost 25 years in business is that our customers rarely use our products in the way we designed them. . . .and each organization does things differently. This customer was no exception. For us to make assumptions about how the counselors and business specialists in this or any of our customer organizations do their work would be foolish, at best.

A couple of months ago, our business development manager indicated that she gets frequent questions from prospective users wondering how they will integrate an EMR into their current work flow. Should they enter the progress note into the program while the consumer is in their office? If they wait until the client leaves, won’t it take too much time? Trish suggested that we write a blog article on how clinicians utilize our EMR in the course of their work. We decided to ask a couple of our customers to describe their work process so we could get a more accurate idea of how they work.

The answers to our inquiry were very interesting, and different from one another. As could be expected, the work flow of a psychiatrist/psychopharmacologist and that of a psychologist/psychotherapist were quite different. We are grateful to Scott P. Hoopes, M.D. of Meridian, ID and Scott Gale, Ed.D. of Franklin, TN for their input.

We were interested to find that neither Dr. Hoopes nor Dr. Gale enter a progress note while the patient is in the room; that happens after the patient has left. We also learned that neither provider relies upon a staff assistant to enter clinical information; they are both comfortable with a keyboard and prefer typing their own note to the more involved process of dictating, reviewing and correcting transcription, copying the note to the patient file and signing it. Dr. Hoopes does manage prescriptions while the patient is present, including reviewing, creating and sending the prescription to the pharmacy.

We learned that Dr. Gale, in spite of his use of our electronic clinical record since 1992, still scribbles notes and thoughts on paper while the patient is in his office. He scans these notes into electronic storage and shreds the paper. (As a solo provider without support staff, he does everything in his practice.) While he could attach these scanned documents to the patient’s file in the EMR, it is my impression that he considers this brief process note to be his work product. . .the psychotherapy note that HIPAA allows a psychotherapist to keep and store separately and not to release to an insurer. His note in the EMR is the formal record of the service provided. While some recommend against maintaining a separate set of psychotherapy notes, we have found that many of our customers do so. For some, this is the main reason not to move to an EMR. . .they are not sure how they would continue to maintain these psychotherapy notes while also using an electronic record.

Dr. Hoopes’ work flow was developed after time working in a community mental health setting where he was expected to see five patients in an hour. In 1995, not very long after starting his private practice and struggling for a while with paper records, he started using our software for billing, electronic claims filing and clinical records. Eventually, he also added scheduling.

His current work flow allows him to see his schedule at all times. Prior to the arrival of his patient, he brings their record onto the screen and makes a quick review. He duplicates the last progress note into one with today’s date for editing after the patient leaves. In the fifteen minutes he spends with each patient for a medication check, he is able to be engaged with them to determine their progress or lack thereof. Based on the information obtained, he decides to continue or alter their current medication, making any needed adjustments and sending the prescriptions to the pharmacy. He walks the patient out to the receptionist, who electronically schedules their next appointment. He returns to his desk, edits the progress note with today’s status, signs the note, and calls up the record of the next scheduled patient, repeating the process between 20 and 32 times a day.

My guess is that other users of our EMR product and of other products in the marketplace follow both very similar and very different work processes in their organizations. After all, while most of our customers provide behavioral health services, each is different, with varying clinical and business cultures. In every case, to most effectively implement a behavioral health EMR, it is essential to have a clear picture of your pre-EMR work flow and your goal for use of an EMR. Both of these will make it easier to choose and to implement the EMR of your choice.

Please share your experiences with the work flow in your business. Is work flow analysis something you have ever done? If so, what was your motivation? We would also love for you to share your work process experiences with implementing an EMR, if you have done so. What changes were necessary in your work flow to fully utilize the EMR? How successful have you been in that process?

If you would like to enter a comment, just click on the title of this article and enter your comment in the box at the bottom of the page. Please let us know your thoughts.