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

Electronic Health Record: Pulling It All Together

Terry McLeod Updated: Jan 28th 2013

It's continuously newer, better, and always adding more bling! It's the Electronic Health Record!

laptop computer and dataOne of the great things about the Electronic Health Record (EHR) is its constant advancement. Lately that's been guided by Meaningful Use incentives, money from the American Recovery and Reinvestment Act (ARRA). The original idea for these legislations was at least twofold: (1) extend the EHR's use, and (2) get some money pumping through the economy. It's worked out pretty good for everybody involved, generally speaking. And now it feels like everything is constantly changing.

The consumer wins with the EHR. I figure I'm like many Americans, and I have a tendency not to keep prescription details in my mind, reading assignments fall through the cracks unless I have them set as alerts in my SmartPhone, and Appointments? Fugghedaboudit, I must have both telephone reminders from the professional I'm working with and a calendar item set in my SmartPhone in order to focus on my healthcare issues before winding up in a place I don't want to be, like an emergency room.

The EHR helps the consumer by recording the next appointment scheduled and creating a tickler list for calling the consumer with a reminder to make the appointment. The EHR also records what happened in the previous appointment and what direction treatment is supposed to take in the next appointment. That sort of information can be securely accessed in a "Consumer Portal". The concept of a consumer accessing by actually using their consumer portal is a key to true participation in treatment, and just coming into use in many EHRs.

If the professional isn't using their EHR to help the consumer focus on joint development of the treatment plan, one appointment at a time, then the software may not be living up to its potential. The professional's records can actually help increase treatment effectiveness by keeping the treatment plan current with emergent issues and such, and assure it's being constantly referenced. There are tons of regulations in play to enforce this practice, so it's a good idea to optimize the treatment plan and let it do its job in this respect.

The organizations the professionals work for, behavioral health clinics, hospitals, emergency rooms and the like benefit from the improvement of treatment records on many levels. Primarily, there's billing. What a nightmare insurance billing can be. The codes required and the rules of using them baffle PhDs across the country, and without the EHR to track what services are provided, when, and document that they meet insurance billing rules, payment may not be forthcoming. That said, the real culprit is not linking the billing portion of the software to the consumer's medical record. When something's done, it needs to be billed. Professionals in treatment may not be acquainted with billable services, and the software can be smart enough to automatically bill for services once a progress note is written or when a consumer successfully completes an appointment with the professional.

The software manufacturers sell software, and by reviewing the last year or so of my blog entries at, you'll see most of the top-tier EHR programs in this industry have incredible features to help in that selling focus. They meet Meaningful Use incentive requirements, and they can do about anything a professional may need to improve both the clinical and business end of their work. Where all these benefits hang up is implementation. A professional can spend a tremendous amount of time and energy selecting just the right software, working with the perfect vendor, and in the end, if it doesn't get used, it won't work.

Implementation is a large project, lots of moving parts that touch every area of an organization trying to get the most out of the EHR. A lot of research goes into process workflows, insurance billing requirements, state licensing agency requirements and auditing requirements, and the result of this research needs to be part of the implementation. Too often, the implementation drags on and momentum is lost and the EHR ends up not performing as advertised because it's not fully implemented.

And that's not all.

Once the EHR is up and running, it's constantly improved by the manufacturer, requiring work on the professional's end of the equation. Constant optimization of the software adds to the complexity of the EHR implementation…it seems never ending. It's a constantly changing world, and to respond to changing needs, software needs to be reconfigured from time to time to keep the EHR relevant and helping the consumer, the professional and mental health treatment organizations.

And that's a never-ending story in itself.


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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