Costs for providers to purchase, deploy and maintain a behavioral health EHR can vary based on a number of factors. The provided estimates are based on general assumptions about the costs for each agency – including the purchase, installation, deployment, and operating costs for a cloud-based, full-featured EHR.

Primary care health systems and providers have long benefited from the implementation of Electronic Health Records (EHR) systems. These digital records contain comprehensive and real-time information about a patient and can be shared across different authorized health care settings.

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided funding for primary health care providers to adopt EHR technology – unfortunately, most behavioral health providers were not eligible to participate in this program. Due to this exclusion from available funding, behavioral health providers to this day still substantially lag behind primary care providers in adoption rates of EHR systems.

Consistent with Bipartisan Policy Center recommendations, the BHIT Coalition strongly supports full funding for the Section 6001 CMMI Behavioral Health IT Demonstration in the SUPPORT Act (P.L. 115-271). Digital information flow between primary and behavioral health care would establish integrated treatment and an increased quality of care for patients.

The BHIT coalition believes in improved integrated care for individuals seeking mental health and addiction treatment – this improvement starts with federal funding for behavioral health providers to establish a foundation of modern documentation and exchange of patient records through EHRs.

Cost Estimates for Health Information Technology Adoption for Mental Health and Substance Use Treatment Providers

Why We Need EHRs

Netsmart, a member of the BHIT Coalition, provided these cost estimate scenarios

EHR Helps Rosecrance Track & Engage Clients, Even After Discharge

Barbara* began drinking cough syrup at 9 as a result of feelings of inadequacy and anxiety about school. By 13, cough syrup became beer. When she was abused as a teen, the perpetrator provided her with free beer to “keep her quiet.” ​​​​

As she got older, bouts with depression led to cocaine use alongside the drinking, until finally, nearly 35 years, later she hit rock bottom. Barbara was faced with heart disease and realized she could not use alcohol as a means of coping any longer.

In 2010, she entered detox at Rockford, IL-based Rosecrance and then entered its inpatient program, finally getting clean. Today, four years later, she is off alcohol and drugs, watching her children and grandchildren grow up.

Rosecrance’s electronic health record (EHR) allows the organization to track clients’ overtime, engaging them in support groups and its other alumni programs, even after discharge.

“We are here to help people,” says Denise Popp, Director of IT for Rosecrance. ““Whatever tools we can use to enhance their recovery, we are going to go there. An EHR is one of those tools.”

*All names changed

In 2010, she entered detox at Rockford, IL-based Rosecrance and then entered its inpatient program, finally getting clean. Today, four years later, she is off alcohol and drugs, watching her children and grandchildren grow up.

Co-morbidity between mental and medical conditions is the rule rather than the exception:

  • 68 percent of Americans with mental health disorders also have co-morbid cancer, heart disease, diabetes and asthma (Robert Wood Johnson Foundation, "Mental Disorders and Medical Comorbidity")
  • People with schizophrenia and bipolar disorder are up to three times more likely to have three or more chronic medical/surgical conditions compared to Americans without these mental disorders.

This patient population possesses an exceedingly poor overall health status:

  • Patients/consumers served in state mental health systems die 25 years sooner than other Americans (Centers for Disease Control and Prevention (CDC), Preventing Chronic Disease Vol. 7, No. 6 )
  • 33% of the 9 million dually eligible Medicaid/Medicare beneficiaries have a primary diagnosis of severe mental illness.

This patient population adds significant cost to the health care system:

  • Nearly 3 times more cost per capita to Medicaid for treatment of patient with co-occurring hypertension, diabetes and mental illness and drug/alcohol (vs. patient with no mental illness and drug/alcohol).

The benefits of EHR outweigh the cost:

  • According to a 2011 Health Affairs study, the average cost of EHR implementation is approximately $46,000 per physician with annual expenses just over $17,000 per physician. 

Consumer Examples

The mother reported to the inpatient psychiatric treatment facility that she had never sought mental health services or received an evaluation, but was now open to support. PEHMS had recently connected to Suncoast Center, Inc., an outpatient behavioral mental health center, through Netsmart’s CareConnect. After the client agreed, PEHMS was able to activate this connection and complete an electronic referral. The referral included all necessary documents upfront, including progress notes, assessment and support plan to summarize the family’s current needs for services.

“The client was contacted within 24 hours and scheduled for an assessment within the week. Suncoast followed up with System Navigator to inform her of the scheduled appointments to assist with ensuring she arrived,” Pasker says. “This client was able to immediately connect with case management and therapy to support herself and her family in this very stressful time. Connecting families/individuals to the right service at the right time truly ensures they get the care they need.”

Single Mother Receives Swift Support through Direct Electronic Connection Between Inpatient & Outpatient Treatment Facilities

A single mother of two children entered Personal Enrichment through Tampa Bay area-based Mental Health (PEHMS) Family Services Initiative program for System Navigation due to multiple needs, including homelessness; the family was residing in a hotel after being evicted from their home. The oldest child had been diagnosed with autism and was stressed by the new environment. The mother was lower functioning due to depression and stress.