Health IT beneficial to behavioral health patients, experts say

Health IT holds great promise in improving the quality of care for patients with behavioral health issues, according to speakers at a Feb. 27 Agency for Healthcare Research and Quality (AHRQ) webinar.

Patient engagement, improved EHR at the point-of-care, and improved health information exchange (HIE) all can significantly enhance treatment for persons with mental illness--a health disparities population with extensive medical histories and care between multiple providers, they said.  

A recent 6-month pilot study, in which mental health patients received basic computer training and instruction on utilizing personal health records (PHRs), demonstrated how health IT can motivate patients to take better charge of their health, according to Silke von Esenwein, PhD.

“We talked to developers of a shared care plan and we did a series of focus groups, and consumers were excited about it and looked forward to taking control of their healthcare,” said von Esenwein. “They felt they were wasting time running from one end of the system to another end of the system.”

Computer access was not a major barrier, as even those lacking computers knew friends or family who could set them up, or they knew how to access the internet at the library, Von Esenwein reported. Those lacking computer literacy skills received training from nursing students, who also assisted clients with adding their medical and lab information to the PHR. From there, the client could access diagnoses, care team information, a health log, medication lists, self-developed personal health goals--and print out wallet-size cards of their medical histories for providers.

The pilot study results found that in the following 12 months, patients accessed their records two to three times per week on average and received more physician exams, recommended vaccinations and preventative services. Also patients sought out more healthcare education compared to a group who did not participate in the study.

“Providers found the records helpful, and people came in more organized,” Von Esenwein said, adding they trusted the information in the PHR.

The point-of-care moment was the focus of Ketan Mane, PhD, MA, who presented ways to deliver meaningful information through EHRs to physicians through better visualization of patient history coupled with easy-to-digest visual data analysis of similar patients. These efforts especially are useful to patients with mental illness who often have intensive backgrounds and medical histories.

Better data potentially will reduce the number of deaths stemming from medical errors, he said.

With large sets of de-identified patient data available through MincLinc, “we have the opportunity to develop a learning ecosystem,” Mane said.

Physicians typically have five minutes to make clinical decisions, and Mane studied how EMRs can alert them to patient histories while bridging evidence gaps from clinical trials through strong design that features visualization.

For example, he said physicians could have data at their disposable offering insight on how similar patients have reacted to particular medications in the past. This could include whether certain populations visited the emergency room more after medical interventions.

Wende Baker, ED, addressed how the behavioral health community could benefit from adjustments in HIE protocols. Some useful enhancements could include crisis intervention and emergency contacts.

Improved HIEs would render follow-up care more inconsistent, especially for patients with episodic need for acute care who frequent multiple treatment centers, she said. Providers in a region would submit the same data to register and discharge patients, and thus enhanced care coordination across treatment settings.

With the mental health population, their concern security and privacy are especially of paramount importance, thus can be addressed with the proper disclosure forms.

These efforts require buy-in from providers’ stakeholders, thus tying the importance of enhanced data integrity and meaningful outcomes to HIEs is crucial, she added.