Behavioral Health Information Technology: From Chaos To Clarity

Abstract

The use of health information technology (IT) in general health care has been shown to have significant potential to facilitate the delivery of safe, high-quality, and cost-effective care. However, its application to behavioral health care has been slow, limiting the extent to which consumers seeking care for mental health or substance use disorders can derive its benefits. The goal of this article is to provide an overview of the use of health IT in behavioral health and to describe some unique challenges experienced in that domain. We also highlight current obstacles to, and recommendations for, the use of health IT in improving the quality of behavioral health care. We conclude with recommendations for prioritizing the work that we believe will move the US health care system toward more effective, efficient, and patient-centric care in behavioral health.

Improving the Patient-Physician Dialogue through Health Information Systems (HIS): Misconceptions and Miscommunication

“…We have presented examples where miscommunication occurs because different codes are used by patients and physicians, leading to different constructions of patient information. This stands in contrast to extant literature in which the assumption is that the use of HIS generally, and digital PRO instruments specifically, leads to improved patientphysician communication [5,16,19] and understanding [7]. Moreover, we suspect that miscommunication happens more often than we can detect using our research methods.…”

“…In turn, this leads researchers to conclude that HIS help improve patient-physician communication and interaction [5]. Ultimately, it is argued that HIS help improve overall public health [19].…”

“…Consequently, the literature on HIS points to benefits such as more reliable PRO data, increased patient engagement and patient-centeredness, and improved communication between patients and physicians. As a result, it is argued that HIS for PRO data management and use improve patient-physician understanding, which may ultimately lead to better health treatment [19].…”

Measuring and improving the quality of mental health care: a global perspective

“…Despite some incentives to implement electronic health records (e.g., the HITECH Act in the US), there is no specific requirement worldwide to include mental health data in electronic records. Currently, many mental health care quality measures are not linked to existing data sources, which mostly rely on claims data rather than data derived from electronic health records or electronicallyreported patient outcomes 26,65 . As a result, these measures cannot be automated to generate meaningful data 60 , which in return could support quality measurement and inform routine medical practices and procedures.…”

“…These initiatives reward providers for outcomes improvement and are also increasingly becoming used in mental health care 90,91 . Other innovations involve care beyond the clinic walls, including the measurement of recovery-oriented services 92 and incorporation of mobile health to capture outcome data 65,93 . The US Centers for Medicare & Medicaid Services is also deploying initiatives that seek to improve provider use/engagement in evidencebased practices as well as delivery system changes to sustain them.…”