MindHealthBiz

It’s amazing how much information you can get about a business without talking with anybody there.

The reviews for the purpose of this blog skim the surface for professionals interested in purchasing an electronic record for their consumers’ records, and to satisfy some curiosity of some consumers. Some Electronic Health Records (EHR) are appropriate for organizations, some have solo practitioner applications, and all of them claim they work for behavioral health.

Celerity’s CAM product is an ASP, or Application Service Provider setup that’s delivered over a secure internet connection meeting mandated consumer confidentiality requirements. I particularly like this approach to information technology because it eliminates the need to buy a fileserver and a bunch of expensive equipment up front and pay somebody to maintain it…and servers do need maintenance. And speaking of maintenance, whenever a professional buys software, it’s usually required that an annual maintenance fee is forthcoming to the vendor. With an ASP, work you’d need to do yourself in spite of the software support, is usually done by the vendor. I like it when the vendor is responsible for updating the software when new federal requirements come out or new features come available with an update. Celerity’s far from the only company that offers this option, and it’s just one of the things to be aware of if you reach out to the company to investigate the CAM EHR.

There are two major suggestions in the industry about functionality that improves organizing the treatment a professional provides. First, if you work in an organization with multiple professionals, a central scheduling module is a great way to help the professionals stay busy when appointments cancel and time slots need to be filled. Celerity talks quite about this, and their EHR includes nifty features like color coding appointments so certain items jump out at you when you bring them to the screen.

EHR software that’s been updated to current technology generally has features you see when you visit internet sites, like when you buy airline tickets or something off amazon.com. This includes the ability to enter information one time and have it pop up somewhere else to fill in other forms on the screen. For the EHR this means that when an assessment, note or other document is written, it can pull previously entered information that’s required to meet the ever-expanding barrage of rules and regulations for documentation automatically. Usually this requires a rule-based system that assures the software electronically inspects to certain documents to make sure data has been entered and then grab it. Cautionary notes include a careful review of exactly what data is moved from one form to another, because person-centered care dictates original writing…professionals need to avoid cookie cutter documents. Also, if I were shopping, I’d ask Celerity to show me all the documents I’m likely to use and if they need modification to work in a professional’s business I’d want to know who’s responsible to do the modification and how much time and money changes like this would involve.

Billing is a big deal, simply because it’s so doggoned hard to jump through all the hoops to get paid by the insurance company. CAM brags about their billing module, and I’d recommend investigating this completely before buying, and ask Celerity to help set expectations regarding when the checks would start rolling in…sometimes setting this up is arduous, and the operation of the billing system requires a specialized professional.

Insurance billing often requires pre-authorization or services rendered, and that means somebody has to contact the insurance company directly. Once that’s done, the authorized services and dates the insurance can be charged need to be easily accessible. CAM appears to have that information easily accessible and color coded for easy review.

Another concern for professional organizations is being able to use information that’s stored in the EHR. Once a consumer has been served by a professional, there’s a hope that some good will come of it. Assessments can be used as measurement tools to assure a consumer is getting better, not worse. Access to notes from previous sessions and treatment plans on the computer during a session help the consumer and professional review what’s been done in a session, and to measure progress in treatment. Another important aspect of an EHR is reports. Reports can keep a business on track, provide a means to measure effectiveness of treatment for multiple consumers and generally help a professional do his job better. Celerity says they have a “robust report writer”. If I were purchasing an EHR, I’d want to know whether I could use that report writer or not; in short, how complicated is it? The only way I know to determine that is to use it, which is entirely possible in a web presentation.

Celerity is doing business in 28 states, which is important simply because they have been challenged to meet state-specific rules and regulations. If you’re interested in Celerity, make sure there are folks in your state using the product successfully. About the only way I know to do that is to get a report card from a half-dozen professionals using the system. I like to try to poll customer satisfaction in several areas, like billing, clinical, and administrative functionality. Separate references from different organizations are a really good thing.

I had to chuckle when I read “user-friendly” in a recent list of demands from software.

We’ve been trying to capture that goal for the Electronic Health Record (EHR) on the personal computer since the pioneering days of the 1980s, and we keep working. The result has been software that’s pretty user friendly these days, and that’s part of the message Amazing Charts is trying to get across about its EHR.

I like the part on the web site that says Amazing Charts is low-cost, and so do professionals in this business. Now, “low-cost” is a relative term, and before I spill the beans on the dollars, it’s important to know what the heck is available in this package.

User Friendly
When using an EHR It seems it can take “dozens of clicks” to get things done in many aging software packages, and although a general exaggeration, more than three clicks to get to a progress note is too many, neighbor…professionals find software navigation is often tedious and wish for a simple approach, which is what Amazing Charts claims in describing their process flow. To this end, the Amazing Charts website indicates the system is sensitive to your workflow. This is a big deal to me and if you’re looking for software the secret to this sort of success is to make sure it’s configurable to your needs with design tools to make the treatment notes, assessments, reports and treatment plans your own. Working with a software company’s rigid idea of a document can be a pain. Many software vendors need to pay one of their programmers to do work like this, and pass the charge along to the customer; it’s another thing to inquire about. If the tools are available, make sure you have somebody with time and the aptitude to use them and make the software work for you.

Meaningful Use
This is a good one. The Office of the National Coordinator requires certification in order to collect the incentives of over $60,000 for every prescribing professional using the software. I’ve written many posts tracking this, and am a proponent of taking advantage of these incentives; they can more than pay for the system. Amazing Charts has a testimonial from a customer that’s received a check from Medicare. Medicaid is part of the program in most states.

Hardware
Unless I missed something, this may be a drawback to some folks. Amazing Charts appears to be deployed on a local server (which the professional treatment organization must buy and support, which carries an annual cost), and is not delivered via the web. Many professionals want the server hosted by a technical organization and deployed via the web, others don’t; there are pros and cons both ways, so consult with somebody like yours truly before you buy.

Interfaces
One of the major concerns in purchasing an EHR is interfaces to other software either on a Behavioral Health organization’s practice management software or sources of data that can be securely accessed over the web like laboratory and pharmacy programs. It’s much better to receive outside data on a patient electronically for two reasons: you don’t have to pay somebody to enter the results into the computer and because humans aren’t involved, the data that does go into the system tends to be more accurate. At first blush, Amazing Charts gets an “A+” in this area.

Other Stuff
Amazing charts includes a scheduling module, electronic prescribing that’s Sure-Scripts certified and an internal messaging system for multiple provider organizations. Nice. A superbill can be generated, and insurance billing appears to be via a billing service, which can be worth the price if a professional is busy enough to need help with this. You can even review a chart on your smart phone for an after-hours call with the app. This is another “A+”

Price
$1,995 per user is a reasonable price. A three month trial period is a good idea for any software company simply because after the ordeal of implementing software and getting used to having it around, a professional isn’t likely to dump it. Ongoing software support is $995, which seems a bit steep until I look at it as less than $83 a month…look at software support as insurance; it’s just something you gotta have. They’re maintaining a healthy GPA regarding price.

If I were buying, I’d want to know more about Amazing Charts specific Behavioral Health penetration. I am old-school in serving mental health and addictions and it remains clear to me that these disciplines of treatment are special. There’s a lot of talk about physicians on their website, and this is fine if you’re a mental health professional working a Federally Qualified Health Center (FQHC) or are partnered with an MD. With the integration of care and the relationships that seem to be building among professionals providing treatment for ills of the body, mind and spirit in the same facility, there’s value to the ability to track all this.

After all is said and done a behavioral health professional considering Amazing Charts should talk to a few people in a 200 mile radius that are using the software, and if it still seems like a good idea, make sure it meets your professional needs and workflow processes.