TY - JOUR
KW - Community Health Centers/organization & administration
KW - Community Mental Health Services/organization & administration
KW - Continuity of Patient Care/organization & administration
KW - Electronic Health Records/organization & administration
KW - Humans
KW - Medical Informatics
KW - Patient Care Team/organization & administration
KW - Primary Health Care/organization & administration
KW - behavioral health clinicals
KW - Electronic Health Records
KW - integrated care
KW - primary care
KW - Qualitative Research
AU - T. T. Woodson
AU - R. Gunn
AU - K. D. Clark
AU - B. A. Balasubramanian
AU - K. K. Jetelina
AU - B. Muller
AU - B. F. Miller
AU - T. E. Burdick
AU - D. J. Cohen
A1 - 
AB - BACKGROUND: Electronic health records (EHRs) are a key tool for primary care practice. However, EHR functionality is not keeping pace with the evolving informational and decision-support needs of behavioral health clinicians (BHCs) working on integrated teams. OBJECTIVE: Describe workflows and tasks of BHCs working with integrated teams, identify their health information technology needs, and develop EHR tools to address them. METHOD: A mixed-methods, comparative-case study of six community health centers (CHCs) in Oregon, each with at least one BHC integrated in their primary care team. We observed clinical work and conducted interviews to understand workflows and clinical tasks, aiming to identify how effectively current EHRs supported integrated care delivery, including transitions, documentation, information sharing, and decision making. We analyzed these data and employed a user-centered design process to develop EHR tools addressing the identified needs. RESULTS: BHCs used the primary care EHR for documentation and communication with other team members, but the EHR lacked the functionality to fully support integrated care. Needs include the ability to: (1) automate and track paper-based screening; (2) document behavioral health history; (3) access patient social and medical history relevant to behavioral health issues, and (4) rapidly document and track progress on goals. To meet these needs, we engaged users and developed a set of EHR tools called the BH e-Suite. CONCLUSION: Integrated primary care teams, and particularly BHCs, have unique information needs, workflows and tasks. These needs can be met and supported by the EHR with a moderate level of modification.
AD - Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA. woodson@ohsu.edu.; Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA. gunnr@ohsu.edu.; Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA. clakha@ohsu.edu.; Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health-Dallas Campus, Dallas, TX, USA. Bijal.Balasubramanian@UTSouthwestern.edu.; Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health-Dallas Campus, Dallas, TX, USA. Katelyn.Kassarjian@UTSouthwestern.edu.; Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA. mullerb@ohsu.edu.; Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine, Denver, CO, USA. Benjamin.Miller@ucdenver.edu.; Department of Community & Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Medical Informatics & Clinical Epidemiology, OHSU School of Medicine, Portland, OR. teburdick@gmail.com.; Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA. cohendj@ohsu.edu.
BT - Journal of innovation in health informatics
C5 - HIT & Telehealth
CP - 3
CY - England
DO - 10.14236/jhi.v25i3.998
IS - 3
JF - Journal of innovation in health informatics
M1 - Journal Article
N2 - BACKGROUND: Electronic health records (EHRs) are a key tool for primary care practice. However, EHR functionality is not keeping pace with the evolving informational and decision-support needs of behavioral health clinicians (BHCs) working on integrated teams. OBJECTIVE: Describe workflows and tasks of BHCs working with integrated teams, identify their health information technology needs, and develop EHR tools to address them. METHOD: A mixed-methods, comparative-case study of six community health centers (CHCs) in Oregon, each with at least one BHC integrated in their primary care team. We observed clinical work and conducted interviews to understand workflows and clinical tasks, aiming to identify how effectively current EHRs supported integrated care delivery, including transitions, documentation, information sharing, and decision making. We analyzed these data and employed a user-centered design process to develop EHR tools addressing the identified needs. RESULTS: BHCs used the primary care EHR for documentation and communication with other team members, but the EHR lacked the functionality to fully support integrated care. Needs include the ability to: (1) automate and track paper-based screening; (2) document behavioral health history; (3) access patient social and medical history relevant to behavioral health issues, and (4) rapidly document and track progress on goals. To meet these needs, we engaged users and developed a set of EHR tools called the BH e-Suite. CONCLUSION: Integrated primary care teams, and particularly BHCs, have unique information needs, workflows and tasks. These needs can be met and supported by the EHR with a moderate level of modification.
PP - England
PY - 2018
SN - 2058-4563; 2058-4555
SP - 158
EP - 168
EP - 
T1 - Designing health information technology tools for behavioral health clinicians integrated within a primary care team
T2 - Journal of innovation in health informatics
TI - Designing health information technology tools for behavioral health clinicians integrated within a primary care team
U1 - HIT & Telehealth
U2 - 30398459
U3 - 10.14236/jhi.v25i3.998
VL - 25
VO - 2058-4563; 2058-4555
Y1 - 2018
Y2 - Oct 31
ER -