Integrating Behavioral Health Information into the EHR

The hardest part of including behavioral health information in the EHR has surprisingly little to do with technology, according to Milisa Rizer, a Columbus, Ohio-based family practice physician. That's because the real work comes when trying to get physicians and patients to understand the importance of including behavioral health data within the patient record.

This is a challenge for physicians because, historically, behavioral health information has been stored and maintained separately from the patient record that stores information about their physical health. While negotiations with physicians at her practice weren't easy, what made the conversations possible was "keep[ing] the patient at the forefront," she says.

Ensuring that behavioral health information is in the EHR is what's best for patients, according to Rizer. It's much easier for the clinical team to provide a continuum of care when it has access to as much information as possible about their patients, she adds.

Still, she highlights that there are types of information that are kept out of the general patient record in the EHR. Those include instances where a patient has been hospitalized at an institution that's identified as a psychiatric facility or where they received treatment for alcohol or drug addiction.

Confidentiality is foremost on patients' minds when it comes to the storage of their behavioral health information in the EHR. Thus, here's how Rizer addresses the topic with her patients: "When you come here, we take care of [all of] you. In order to do that, we need to [include information about your behavioral health in the EHR]."

When their physician takes the time to explain to patients that this ties in with the practice's mission of taking care of the entirety of their patients' needs, patients embrace including their behavioral health information in their patient record, she says.

What it comes down to, Rizer says, is "breaking down barriers. This enables us to take better care of our patients."

The approach taken by Yaquta Patni's practice in Joliet, Ill. is very similar. Patni is a geriatrician and works with Erin Richardson, a clinical social worker at her practice, to ensure her patients' records include behavioral health data.

Richardson meets with Patni's patients before their initial visit with the geriatrician. It's during that psycho-social assessment that the social worker asks for permission from patients to take handwritten notes. Once the patient has left the room, Richardson updates the EHR with information about her findings.

All of that data – including a memory assessment scanned into the EHR – is available in the patient record in the EHR, which Patni accesses before and during her initial patient visits.