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Recently, NextGen Healthcare partnered with Xtelligent Healthcare Media to conduct a national survey of provider organizations who offer behavioral health (BH) and primary care services. We had a few objectives in conducting this survey:

  • To gain a better understanding of how integrated these service lines were in provider practices
  • To learn how practices were using technology solutions to support their services
  • To find out what challenges practices experienced if utilizing more than one technology platform or electronic health record (EHR) to meet the distinct needs of these patient populations

First, a little about the respondents to put this in context. We heard back from a broad base of organization types, about half (49%) were from health systems or physician groups that are affiliated with a health system; and half (51%) were from smaller organizations such as federally qualified health centers (FQHCs), home health agencies, community clinics, independent physician group practices and dedicated behavioral health organizations. Respondents held many functions within their organizations such as chief executives, clinical, financial management, and other senior management in IT and non-IT roles.

The Move Toward Integration

Let’s frame with the big picture. From an operations perspective, most organizations indicate they intended to fully integrate their behavioral health and physical health services. Integration is an active focus of about half of practices who provide both services, which is a great trend to see as this fosters more patient-centered care, can help difficult to serve populations get better access to care, support transitions management and support continuity.

Interestingly, of the 58% that are actively working on integration, they split fairly evenly at different stages on the integration journey with about one third having an intent, but no plan, one third in planning and one third testing or rolling out those plans.

For those on the integration path, fully 75% expect their organization will offer fully integrated services in the next two years. So, our survey shows there is currently a lot happening in this space.

Over 40% indicated they have integrated these services already, so are past the planning stage, and are continuing to optimize that integration.

Technology Functions and Multiple EHRs

The next area our survey evaluated were the different types of technology functions practices implemented. The capabilities practices are commonly using today speak to the need for interoperability, patient engagement functions, and telehealth; all key tools in managing the pandemic. Less present were capabilities for mobile, population health management or workflows and data fields that support the particulars of BH or primary care practice, however those capabilities were still present in over half of practice’s platforms.

What stuck out was how leaders responded when we asked about what challenges their organization faced if they did use more than one EHR for their operations. Most troubling was fully 62% of respondents experienced additional provider burden, lack of coordination for patients and administrative complexity. Regarding the challenges faced from using multiple EHRs, 47% experience higher operating costs and extra staff to manage multiple EHRs, while impacts to patients included lack of coordination (40%) and delays in care (36%).

NextGen Healthcare Chief Medical Officer and NextGen Advisor Dr. Betty Rabinowitz provided additional commentary regarding the survey results, “When you provide whole person care and integrated care, but you support that care with two disparate technology platforms…it really is dissonant. It makes total sense to have a single, integrated tool that allows seamless flow between the behavioral health aspects of the patient’s care and the physical health aspects, with some of that information being available in real time to providers on both sides is absolutely critical for safety, quality of care, patient engagement and patient satisfaction.”

Patient Experience Rises to the Top

Another noteworthy finding from the survey was that 74% of respondents indicated their primary motivation for offering a patient portal was to improve the patient experience. The pandemic over the last year has shown how important this capability is for keeping in touch with patients, allowing them to communicate with care providers, schedule appointments, or do a virtual visit.

Finally, when considering the most important part of an integrated healthcare solution, leaders sought capabilities which too often are siloed in separate EHRs. They called for the ability to integrate information required for community mental health center and FQHC needs by integrating population health and care management with behavioral and physical workflows across disciplines. 

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Graham Brown
Graham Brown
Senior Vice President, NextGen Advisors
Graham Brown is a principal and senior vice president with NextGen® Advisors focused on transforming care with provider organizations. His practice centers on accountable and value-based care strategy, population health management programs, and technology solutions for providers enabling new models of care delivery across the United States.

Mr. Brown is a former s...