Electronic Health Records (EHRs) are being used more and more in the healthcare industry, but the use among behavioral healthcare providers has lagged behind that of other healthcare providers. This is due in part to the fact that behavioral healthcare providers aren’t eligible for Medicare and Medicaid incentive programs.

The need is there
According to Health IT, physical maladies can often trigger behavioral health issues. The news source noted that people who are dealing with diabetes and cardiovascular ailments are twice as likely to experience depression as the population as a whole. In addition, there are numerous external factors that have been driving up the numbers of people experiencing mental health and substance abuse issues. The poor economy, unemployment and general uncertainty about the future can exacerbate preexisting mental health issues.

The source goes on to say that there are also gaps in specialties such as pediatric care and gynecology. In New Jersey this triggered efforts to encourage such specialists to adopt EHRs for the purpose of coordinating care with patients’ behavioral healthcare providers. This battle has not been in vain, and by the end of 2012 nearly 300 eligible providers were in the process of adopting EHRs.

What’s standing in the way?
In a letter to the U.S. Senate Committee on Financing, CEO of the Association for Behavioral Health and Wellness Pamela Greenberg noted that behavioral healthcare providers face a number of obstacles (PDF, 312 KB) with regard to the implementation of EHRs, including ineligibility for Medicare and Medicaid reimbursements:

“Another hurdle is the lack of adoption of electronic health records (EHRs) in behavioral health settings…Without access to these funds the uptake in use of EHRs by certain behavioral health providers is diminished,” Greenberg wrote.

Another issue that behavioral healthcare providers face in adopting EHRs is a federal law aimed at keeping the identities of people treated for drug and alcohol abuse private. Greenberg noted that the goal of the law, which is to avoid impeding patients from seeking care due to the social stigma attached to substance abuse, is a noble one. However, it also means that not all of the health records of a patient seeking treatment for substance abuse can be shared with all of the patient’s doctors. In addition to hindering data sharing among doctors, Greenberg pointed out that it makes it difficult to detect when patients are doctor shopping, which is seeking prescriptions from numerous doctors to fuel addiction.

Greenberg also cited the exclusion of licensed mental health counselors and marriage and family therapists from Medicare as a challenge facing behavioral health patients. Despite constituting 40 percent of licensed workers, neither are eligible to participate in Medicare, and Greenberg maintains that they are perfectly qualified to do so.

She also echoed the concerns that sparked the effort to expand data sharing in New Jersey and explained that mental illness and substance abuse often walk hand in hand, and many times that walk ends in the grave.

“There is significant overlap and comorbidity between mental health and substance use disorders,” Greenberg wrote.

The ultimate goal of behavioral healthcare providers adopting EHRs and expanding data sharing is to treat the “whole person”. By doing this healthcare providers will be able to better treat patients with behavioral health problems, and reduce the chances for relapse among substance abusers, and deterioration among mental health patients.


About the author

McKesson Business Performance Services offers services and consulting to help hospitals, health systems, and physician practices improve business performance, boost margins and transition successfully to value-based care.