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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

Worlds are Colliding: Physical Health and Mental Health Software

Terry McLeod Updated: Dec 21st 2010

It's an old saying, "You don't go to the hardware store for a loaf of bread!" When it comes to mental health and substance abuse treatment, it seems that's what people are doing...and that complicates the business behind treatment.

stethescope on a laptopI reviewed a presentation by Laurie Alexander, a peer in the behavioral health consulting world, and Karl Wilson of Crider Health Center, and was surprised to discover that when people seek mental health or substance abuse services, the first place they go is to their primary care provider. Upon consideration, I guess it makes sense, simply because we're all connected, body, mind and spirit. Difficulty could enter the equation when the consumer may get a prescription without qualified, licensed counseling, and in this age of mergers and acquisitions and forging of business partnerships, that problem is being resolved.

Relating this to technology is not a reach. Mental and physical health software systems may have the same goal (to document health problems and solutions), however the way they work are tremendously different. At least one software program rooted in hospital-based, physical healthcare has tried to include feature-functionality for our sector. According to the customers I have met in my work, they had a tough time developing the software and never really got that part of the product off the ground, simply because they lack experience in the different way of documenting mental health and substance abuse services. The workflows are quite different for mental and physical health treatment.

Physical health software concentrates on a limited number of types solutions for health problems. Documentation tends to include electronic results from X-Ray, lab, MRI and other machines that are created automatically from the machine's results. Other elements are fairly predictable, using a lot of check-boxes and very little narrative. Documentation of physical healthcare has grown into a pretty simple documentation solution for that Electronic Health Record (EHR).

Mental health /substance abuse software tends to focus on assessments that are developed in an agency and may or may not be suited to a bundle of check-boxes and drop-down elements for the sake of measuring outcomes. Treatment plans that consist of a series of problems, goals and objectives, and progress notes with a lot of narrative leave mental health and substance abuse treatment professionals forever writing. For decades software developers have tried to come up with a simple (EHR) that serves these needs, and have found that an important key to successfully implementing software is to suit the customer's workflow patterns. This has been a trial. We are finding that staff transience among agencies and other factors are leading to a more homogeneous solution, seeing the same software features in many of the mental health/ substance abuse treatment EHRs on the market

Once I went to the CEO of a software company I worked for with an idea to include physical health documentation in the mental health software. He'd spent over 25 years building software specific to our sector. He chuckled at the idea saying, "We can't even spell what they want to track!" In other words, it wasn't the software's core competency and including physical health features, while possible, was not advisable simply because the company didn't have the rich experience in physical healthcare-it was a different world to us.

It's true that physical health and mental health oriented software can both generally handle each other's business, and the difficulty in crossing those lines is that the manufacturers just don't have the widespread experience in all areas of their business to readily handle both worlds…yet. That experience is being gained now.

Because 1/2 of all mental health and substance abuse services are performed by physical health clinics, and because the trend in mental health is to have physical health professionals on staff, software is evolving, and companies in both business sectors are coming to know the other side of the coin. Electronic Health Records (EHRs) are getting better, including more functionality that's sensitive to workflows both in physical health and mental health/substance abuse treatment.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

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