State Leadership Conference

For Aaron Harris, PhD, a clinical health psychologist at the Robert J. Dole Veterans Affairs Medical Center in Wichita, Kan., electronic health records are just one sign of how integrated psychological services are in veterans' overall health care. "Mental health is part of the team," Harris told participants at APA's 2012 State Leadership Conference. And having all of a patient's records in one place helps all members of that team.

Primary-care physicians know what mental health issues patients are facing, said Harris, while psychologists learn about patients' physical illnesses. A quick scan of a patient's record might show that he recently had a cardiology visit, for example, which may be related to his panic attacks.

That kind of coordination of care is one of the main advantages of electronic health records, said Stacey Larson, JD, PsyD, director of legal and regulatory affairs in APA's Practice Directorate.

"Electronic health records focus on the total health of a patient," said Larson, explaining that records' "interoperability" means that providers can share information with each other. "An electronic health record is basically just a copy of a patient's records; the difference is it's all of the patient's records in one place."

Other anticipated advantages of using electronic health records include more patient-centered care, improved quality, greater efficiency and convenience and cost savings.

And while Health Insurance Portability and Accountability Act protections apply to electronic health records, said Larson, the records themselves also build in protections. The technology can limit access to certain information to specific users and track who has accessed what information.

To be eligible for financial incentives for adopting electronic health records, providers must use them in a "meaningful" way—to improve care, enhance safety and promote care coordination. Unfortunately, said Larson, psychologists aren't currently eligible for those incentives. The Behavioral Health Information Technology Act (S. 539) would extend those payments to psychologists.

Of course, many psychologists are already using electronic health records. Vanessa Jensen, PsyD, uses them in her work as a pediatric psychologist at the Center for Pediatric Behavioral Health at the Cleveland Clinic Children's Hospital.

Jensen cited a long list of benefits she discovered after she made the switch. "The biggest benefit is coordination of care," she said. When she gets a referral from a nephrologist, cardiologist or any other provider, she can review the patient's chart and get up to date—all without playing phone tag.

It's also easy to keep track of what's going on with her own patients. If a transplant patient has a crisis two years after Jensen last saw her, for example, Jensen can quickly review the electronic records to bring herself up to date on her patient's health status and care. Emphasizing the security and privacy of electronic health records, Jensen noted the flexibility and convenience of being able to access them in her office or at home through a secure online portal. Plus, other providers can instantly pick up a patient's care if Jensen is out of town or unavailable.

In addition, said Jensen, the system makes paperwork easy. In the Cleveland Clinic's system, templates and "smart phrases" that let users type two letters to prompt pull-down menus result in more accurate, detailed records. "I am so much more caught up on progress notes than I've ever been in my life," said Jensen. "And I can read my own writing!"

Ensuring the integrity of records is another plus, added Harris. In the old days, he said, providers would simply hand paper records over to military members heading to a new base. With electronic health records, the transfer of complete records from provider to provider or facility to facility happens electronically. That also means records don't get lost or delayed when patients change providers or providers make referrals.

—R.A. Clay