Introduction

Mental and behavioral health providers have historically had low adoption rates for electronic medical records and other health IT software. Considering the relative absence of Meaningful Use incentives for mental and behavioral health providers, it is little surprise that many providers have opted out of the burden of implementing what can be a costly system. However, the Affordable Care Act and Mental Health Parity and Addiction Equity Act have increased the importance of health IT adoption by mental health providers for care coordination, patient engagement, and overall healthcare reform.

Mental and behavioral health providers have unique needs when compared to many other medical specialties. Most generic medical software systems don’t satisfy their requirements, and most specialty-specific solutions don’t include all the functionality needed, usually necessitating the creation of a custom healthcare IT solution for each provider or facility.

Mental and behavioral health professionals can work in numerous environments including private offices, outpatient clinics, large inpatient rehabilitation centers, or long-term care facilities. Most software systems are intended for some, but not all of these environments, so be certain to select an option that includes support for your specific workflow and care delivery model. All of the systems included in this category should satisfy the needs of Psychiatrists, Psychologists, Clinical Social Workers, or other licensed therapists and their support staff. Software in this category can be split into two main subcategories: software to manage the administration and workflow of your practice, and software that helps manage your patient records and care delivery. We’ll take a look at each of these specialties, then highlight some of the market leaders in behavioral health software.

Administrative Medical Software

Software that manages the administrative side of your practice or care facility can include, but is not limited to: patient scheduling software, appointment reminder software, billing or coding software, hospital information systems, etc. For the purposes of this guide, and for overall simplicity, it is called practice management software. It usually includes functions for:

Patient Registration

Input patient demographic information, such as name, age, address, health history, etc. Some software supports pre-registration, where patients can input this information themselves ahead of time. Some systems offer a tablet interface that allows the front desk to hand the patient a tablet instead of a form.

Patient Scheduling

Schedule patient appointments. Some software includes support for appointment reminder automation either built-in, or through an integrated third-party vendor.

Resource Utilization

Manage facilities, such as room schedules, equipment use, tracking, or maintenance. Features such as these tend to be less common, and are usually only found in institutional or other enterprise-level solutions.

Insurance and Billing

Platforms with insurance and billing features can handle send bills, superbills, and other payment management functions. Software with claims management can handle billing codes and all other reimbursement management. Most software includes support for other third-payers and also self-pay. Some vendors also offer complete third-party revenue cycle management, either themselves or through direct relationships with third-party medical billing and coding specialists.

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Clinical Software

Software that manages the clinical aspects of your practice or organization can include electronic health records software, electronic medical software, e-prescribing software, patient portal software, etc. It usually includes functions for:

Charting / Notes

The software supports clinician documentation, usually through a familiar patient chart or note-taking interface for progress notes.

Order Management

Software that includes order management features usually supports computerized physician order entry. For inpatient facilities, this could also include physician orders for nurses or other medical and support staff.

E-Prescribe

Software with e-prescribing ability allows physicians to use a built-in electronic prescription pad and interface with popular services such as SureScripts. Many systems for mental and behavioral health professionals lack e-prescribing capabilities, so if it is needed for your practice, make sure to check if it includes or supports a third-party e-Prescribing interface.

Patient Portal

While it can’t truly be called clinical software, a patient-facing internet portal is a requirement for certain in and outpatient medical providers and facilities to guarantee certain incentives, to be discussed a bit later. These systems may or may not include the ability to bill and accept payments from patients electronically, allow patients to request or schedule their own appointments online, or allow them to view, download, and transmit their health information.

Market Leader: PIMSY EHR

PIMSY, developed by Smoky Mountain Information Systems, founded in 2007, is a relatively new entrant to the health IT marketplace, but already has garnered favorable reviews from users and health IT experts. It is fully certified for both stages of the Meaningful Use Incentive Program, which is relatively uncommon for a behavioral health software program. It is a modular system, allowing providers to select either a full range or just the functionality desired, and includes several pricing tiers, depending upon the functionality selected. It is primarily web-delivered, meaning providers don’t have to invest in expensive on-site servers, and can access the software from any Windows device (a Mac version is currently in development, as of November, 2014). PIMSY can be installed in a traditional on-site server architecture, but is significantly more expensive up-front and requires that practices invest in dedicated hardware. PIMSY has received high marks in almost all areas from several independent ratings agencies, especially for customer service and flexibility.

Pros:

• Flexible delivery, via SaaS on-premise
• Excellent customer service Affordable, comprehensive integrated practice management with electronic medical records
• Included e-Prescribe capability
• Fully certified for both stages of Meaningful Use

Cons:

• Only support Windows devices currently
• Somewhat steep learning curve

Other Considerations

There are several other considerations to be made when purchasing software for your mental and behavioral health practice or facility.

Cloud vs. On-Premise

Choosing between a cloud or on-premise software solution means deciding whether you want to install the software on-site, using your own servers, or instead access the system via the internet (and rely on the vendor for hosting). Cloud-based systems are usually delivered through a web browser based interface, but some offer a purpose-built application. The systems are priced differently as well; cloud-based systems are usually paid via a monthly or annual subscription, and may or may not include additional fees for certain services. On-premise systems usually have a much higher upfront cost, and sometimes can require multiple licenses, depending upon whether or not the vendor charges per user, physician, or facility. In general, smaller practices will want to look at cloud software, while large healthcare networks are better equipped to manage on-premise systems.

Practice Size

What size of practice or institution will this system serve? Is it an inpatient or outpatient facility? Solo providers have a great many more software options than institutions or other large care delivery organizations. There are also some systems that can scale and satisfy the needs of small or large user groups, usually through modular, cloud-based software licenses.

Input Interface

Consider what sort of input interface best suits the needs of your practice and processes. Some systems offer traditional keyboard/mouse input, others a touch or stylus tablet-based interface. Others offer built-in voice recognition, or support third-party applications. One benefit of browser-based cloud-delivered software is that it usually can be accessed on a tablet or smartphone, allowing the provider to choose which interface works best for them.

Meaningful Use Certification

Physicians or organizations attesting or who plan to attest for Meaningful Use incentives need to make sure that the systems selected are certified for the appropriate stage of the incentive program. It is also important to note that there has been some attrition of systems as stages have progressed, many systems that were certified for Stage 1 have not yet been certified for Stage 2. Make sure any vendor you select has the same commitment to Meaningful Use as your practice, and has plenty of development bandwidth to support new requirements for Stage 3 and beyond.

All-in-One or Standalone Solution

Lastly, mental and behavioral health providers must decide whether they want an all-in-one, modular, or several standalone software solutions. All-in-one systems can have a lower total cost of ownership, but if it lacks certain features, options are limited. Modular, pre-integrated medical software systems allow providers to pick and choose systems or features, but often selecting all or a majority of the modules can be more expensive than purchasing a similar allin- one solution. Providers may also attempt to construct a solution with products from different vendors. This option can often provide the best fit to a unique situation, but can often result in duplicate data entry or other inefficiencies if the systems cannot be integrated without expensive custom development.

Taking Action

As always, our Technology Advisors are available to answer your questions about the software and technology needs of your practice. Our no-cost, no-obligation advice has already helped hundreds of medical providers manage the various vendors and purchasing process for their software needs. Call or email us today for a free list of custom software recommendations, tailored to meet the unique needs of your practice.

• • Which Behavioral Health Platform is right for your practice?
  • Find out now