When personal computers were introduced to the consumer marketplace in the late 1970s, many considered them to be very expensive toys with limited practical application. Now computers are ubiquitous, and many of us—especially our youngest colleagues—have difficulty in imagining life without them.
Computerized information resources are being introduced into psychiatric practice settings, but some psychiatrists question whether they are really needed. Yet the entire health care system, including psychiatry, is progressively “going digital,” and there seems to be little question that within the coming decade, the vast majority of health care information will be digital.
Although the benefits may not be immediately apparent and there are risks that need to be considered, the adoption of health information technology (HIT) in psychiatric practice is necessary for the optimal integration of mental health care in overall health care service delivery. HIT has the potential to substantially improve quality and efficiency of psychiatric services.
Although many psychiatrists who work in multispecialty group practices, hospitals, community mental health centers, and residential treatment programs are likely to already be using electronic medical record (EMR) systems, many independent psychiatry practices are in a “pre-contemplative” stage of change in regard to the adoption of HIT.
What HIT can do for your practice
Although psychiatrists have lagged behind their colleagues in other fields of medicine in the adoption of HIT in their practices, many are learning the benefits of this technology.1 Federal government incentive programs have stimulated the implementation of HIT; however, these programs have not been readily accessible to psychiatrists in private practice. Nonetheless, the advantages of EMRs and related resources are quite compelling.
Financial. The Agency for Healthcare Research and Quality (AHRQ) has reported substantial savings for practices that implement an electronic health record.2 Cost-benefit analyses over a wide range of practice types uniformly show that long-term financial benefits outweigh initial investment costs. Of course, the actual financial impact of an electronic health record may vary according to the size of the practice, the features and design of the technology, the existing overhead structure of the practice, and the effectiveness of implementation.
In psychiatry, for example, an EMR system with efficient use of templates and speech recognition software can eliminate transcription costs and automate various clerical tasks. With the minimal overhead expense of most private psychiatric practices, improvement in the efficiency of clerical tasks can directly reduce uncompensated time and effort of the psychiatrist.
Coordination of care. HIT facilitates communication across specialties and the practice of collaborative care. The adoption of the medical home model across health care has created a critical need for specialists to effectively communicate with primary care physicians. While true interoperability between various HIT products continues to be an elusive goal, there is currently a great deal of momentum in the development of systems for health information exchange, allowing for health information to be transmitted between different EMR systems. This will allow the information to follow the patient as he or she moves between various components of the health care system.
Until these health information exchange systems are implemented, EMR systems can automate the preparation and transmission of clinical information to providers outside of a specific EMR system through secure messaging technology as well as traditional channels, such as fax and regular mail.
1. Moran M. Physician EHR use gains steam, but psychiatrists slow adopters. Psychiatr News. 2011;46(6):7-8.
2. Shekelle P, Morton SC, Keeler EB. Costs and Benefits of Health Information Technology. Rockville, MD: Agency for Healthcare Research and Quality; April 2006. Evidence Reports/Technology Assessments 132. http://www.ncbi.nlm.nih.gov/books/NBK37988. Accessed November 14, 2012.
3. Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc. 2008;15:585-600.
4. Terry K. Rev up your EHR: how to optimize performance. Learn ways to increase revenue, improve practice efficiency and quality. Med Econ. 2011;88:S4-S6, S8-S9.
5. Barrows RC Jr, Clayton PD. Privacy, confidentiality, and electronic medical records. J Am Med Inform Assoc. 1996;3:139-148.
6. American EHR Partners. http://www.americanehr.com. Accessed October 31, 2012.