Planning Your EHR System: Guidelines for Executive Management

Planning Your EHR SystemRecommendations for a Request for Proposal to Acquire Information Technology Systems

The application of information technology (IT) to support and improve the delivery of healthcare has evolved rapidly in the last several decades and now is considered an essential component of an effective business model. Its abilities to support tracking of patient information and coordination of human and capital resources to speed response times and to guide treatment are proving invaluable to administrators and care providers.

The behavioral healthcare industry (in this paper, the term “behavioral health” is used to refer to services for both mental and substance abuse conditions) has not adopted and reaped the benefits of information technology at a similar pace for a number of reasons, many stemming from the financial realities of business. The size of the behavioral healthcare industry relative to general healthcare restricts investment dollars available for IT research and development. At the same time, financial pressures within individual behavioral healthcare providers further limit IT product development.

Beyond financial restrictions are other factors that have slowed the IT revolution within behavioral health. The foundation of behavioral health care was built in community-based programs. Impassioned community volunteers often created these programs as storefront clinics that operated on very limited funds. The advent of the community mental health movement in the 1960s provided an organizational model and federal funding to provide clearer definition for these clinics. It stimulated additional state funding that further shaped the development of the system. Creation of the Medicaid program, development of “managed care” and the change to block grant funding were added as layers on top of what came before them, further defining and molding the delivery of behavioral healthcare.