Sep 29 , 2017

EHRs and Mental Health: What Needs to Change?


More than 300 million people around the world suffer from depression. 264 million suffer from anxiety. Today, our society is gradually chipping away at the stigma surrounding mental health and illness. It’s becoming an increasingly important focus in our technological world.

EHR And Mental Health

The World Psychiatry journal recently published research that showed smartphone applications might be able to help people with depression. The study tracked almost two dozen mental health apps and found that, through various methods, they significantly helped reduce symptoms for people with mild to moderate depression. This research brings to mind a more general question: with the gradual adoption of technology across the industry, what does an ideal marriage of tech and mental health services really look like?

App creators and tech giants are taking steps to help people who seek better mental health. For example, Apple is trying to develop Siri to provide comfort and reassurance to people asking for help. But as it stands, Siri, and other apps, cannot replicate or replace the interaction and trust that another human being can provide.

A separate research consortium in Europe is currently working on designing mobile, wearable and personalized health technologies that will help patients manage their mental health issues. Technology could empower patients to find care, track their medication and/or self-manage their symptoms.

But not everyone may appreciate the influx of technology into healthcare, particularly within the patient-provider encounter. Providers could be resistant due to the struggles with EHRs and other mandated technology use.

For instance, Dr. Lloyd Minor, dean of Stanford University Medical School, says “that most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record.” He also noted that the tech has distracted from patient care. Providers ‘[are] thinking about the mechanics of the documentation, rather than the implications of the symptoms and findings.”

When doctors are in an exam room with a patient, a third of the time is spent on the EHR. In the case of a primary care physician treating someone with a common cold, this is less of an issue then in the case of a psychiatrist treating someone with schizophrenia. Distracting from patient time and risking a misdiagnosis, or prescribing the wrong medication, could lead to fatal consequences.  

EHRs, like the ones Dr. Minor critiques, are bad for mental health providers and patients, and take away from the caregiving process. However, an EHR that can solve those problems; that can work with the provider; that can enhance and help the patients care – that is an EHR system the industry could trust.

Imagine this scenario: a patient with anxiety disorder is referred to a therapist by their psychiatrist. After meeting the patient, the therapist can quickly, electronically share his clinical notes with the psychiatrist, who can upload directly into his notes. This allows for a seamless continuum of care and enables better care-coordination. Better for the the patient, all around.

But that’s not all – instead of the psychiatrist doing an anxiety index on paper and manually calculating scores, the technology can allow him to enter it directly into the system. From there, the software will automatically configure graphs to show various contributing factors and will help calculate the anxiety index score. During the encounter, the provider will be able to see historic graphs that can help him objectively evaluate the patient’s progress.

Dr. Minor does have some legitimate critiques of our industry. It’s the little details that take providers’ time and focus away from their patients. If we as an industry can address these aspects of EHR software, mental health providers will be better able to focus on their specialty.

The technology industry is addressing a real need in our society while also becoming more inclusive to people with mental health issues. Whether a personal smartphone application that alleviates some symptoms of depression or an EHR designed to refocus a provider on patient diagnoses and care… the possibility that tech might help us, as a society, address mental health in a more effective way is an uplifting thought.