EHR Technology in a University Setting
January 28, 2015
We’re proud to present our article below in a collaboration between Valant, everythingEHR, and John F. Kennedy University. In our case study about JFKU, you’ll learn about the:
- Reasons to begin the search for an EHR
- Needs for technology in a clinical training setting
- Criteria to evaluate multiple vendors
- Goals of adoption & implementation
- Specific features and benefits
- Scalability of outcomes to clinicians and patients
JFK University and Valant
Teaming Up to Train Tomorrow’s Behavioral Health Providers
At John F. Kennedy University in Pleasant Hill, California, technology isn’t seen as a whim or way to simply impress students. Rolled out effectively, it can be an investment used to ensure their students leave their classroom walls with all the necessary tools to lead the professional pack. Since 1964 the nonprofit, private university led by current president Dr. Mac Powell has put a focus on providing an educational atmosphere that’s both interactive and student-focused. And through the recent purchase of a behavioral healthcare electronic health record system, its doctoral psychology students—and an untold number of future patients—are prepared to reap the benefits that such top-notch training provides.
A Growing Need
Leading the drive for such superior student training is Alvin McLean, Jr, PhD, a professor of clinical psychology and co-director of clinical training at John F. Kennedy University’s Doctorate in Clinical Psychology Program. Well-published among various research avenues, McLean’s current focus is on training clinical doctoral students in psychological assessment and approaches to integrated healthcare. He coordinates the clinical practicum training of the roughly 150 students who are enrolled in the university’s doctoral program at any given time.
When students choose JFK University’s doctoral clinical psychology program, they put their confidence in an APA-approved program that has been training top mental health providers for more than two decades. Known across the nation for its focus on multiculturalism and diversity of its training, McLean is especially proud of the program’s commitment to social justice and on serving underserved communities.
With the prevalence of EHR systems in the US healthcare system, and value (or outcomes) trumping volume more every day, one might expect that such systems are commonplace among university training programs. Not so, says McLean, who cannot name one other educational institution (in the Bay Area or otherwise) that offers such a system in their training clinics.
David Lischner, MD, is the CEO of Valant, the company JFK University entrusted with its EHR purchase. While Dr. Lischner says adoption of EHRs for training purposes is low for universities in general, he believes adoption has been even slower for behavioral healthcare—and there are a couple reasons for this.
For one, he says behavioral health providers aren’t big consumers of technology in general. And they’re just too inundated (and possibly intimidated) to jump into such a large project.
“That’s changing, especially for EHRs but more broadly where behavioral healthcare organizations are seeing the value of incorporating technology into what they do to improve outcomes and workflows,” he says.
Such a lack of training on EHR specifics is a detriment to students, says Kristin Walker, CEO of everythingEHR, who assisted JFK University in their search for the right EHR product for their needs. And it’s handicapping students before they even enter the workforce.
“The next generation of providers should know what’s available to them in terms of technology,” she says, referring to the many institutions who continue to train behavioral health students with pen and paper or outdated legacy systems. “What happens when those students graduate? They’re out there in the world joining community mental health organizations or starting their own practices, and they’ll be completely behind when it comes to the kind of technology they can use to provide mental health services.”
According to McLean, the need for adding such specialized training to its doctoral program was evident in the feedback he so often received from the community mental health centers and hospitals where students received their clinical training. Instead of diving head first into this real-world experience, students were hit with an unexpected roadblock—learning the EHR system at these respective clinics.
“That’s a major stepping stone for the students as they go into these different hospitals and clinics that can slow their clinical work as they try to adjust to a system of care that they are not accustomed to,” says McLean.
In addition to giving students firsthand experience with real-world tools, McLean says this EHR technology will also aid research efforts and help expand reimbursement for the university’s three counseling centers where the EHR system is being deployed in Concord, Oakland, and Sunnyvale.
The Search for the Right EHR
After JFK University decided it wanted to offer students a technology training experience, the arduous search process began for the best product fit. Initially coordinated by a clinical supervisor, the search and vetting process eventually led JFK University to Walker.
“Walker was tremendously helpful in assisting us in identifying what features and benefits we needed to consider in an EHR product that would meet our clinical training, patient management, and clinical research needs,” says McLean, who notes how Walker guided them to the benefits of a system specializing in behavioral healthcare.
“There are many, many choices out there when it comes to EHRs,” says Walker. “Behavioral health is different than any other sector of healthcare, from the clinical workflow as well as billing. There are many EHRs out there that handle general healthcare and many top general healthcare EHRs have dropped mental health billing or mental health altogether because it is so complex.”
After many hours of consideration and input from multiple parties, JFK University decided to move forward with Valant’s behavioral health EHR system.
Valant’s EHR is a SaaS product that is built for behavioral health professionals, by behavioral health professionals. Indeed, Lischner is a practicing psychiatrist, cofounder and CEO of the Evidence Based Treatment Centers of Seattle, a 30+ provider group practice.
Upon starting his private practice, Lischner says almost immediately he saw a need for technology that didn’t exist. “I was pretty quickly frustrated with and disappointed by the lack of support and tools to help us run our business but also practice the way we wanted to,” he explains. “I wanted to do something that would have a broader impact on not just our patients but others that were trying to do the same thing.
“For me nothing was as satisfying as seeing people get better,” adds Lischner, “and seeing that happen through people we had trained or technology we had developed, which made it feel more scalable, was especially satisfying.”
Founded in 2005, today an estimated 1,600 organizations, and over 6,000 clinicians, are utilizing Valant’s EHR to provide mental health services.
While many factors played into the final decision, including the depth of Valant’s team (which includes a number of mental health providers, certified billers and coders as well as former insurance auditors on its staff) several features of Valant’s EHR were key to swaying McLean and other decision-makers in their direction:
Clinical outcomes measures: According to McLean, how the system handles clinical outcomes measures, particularly through its patient portal was significant. “The client portal allows the clinician to communicate with the client in a very proactive manner,” says McLean, who notes the helpfulness of being able to have clients undergo assessment even before their first therapy session, data that is then available at their first clinical assessment. Ongoing assessments as well as ongoing communication are additional features available through the patient portal.
“For healthcare to move in the direction that we need to be moving in, we do need to be able to demonstrate the accountability of creating good clinical outcomes,” notes McLean. “And you can’t achieve that unless you have good baseline data from which to compare.”
Students can also toggle between outcomes measure scores and the system’s extensive knowledge base to help them learn what specific scores mean, which only helps aid them in their treatment and understanding of what these measures are meant to portray, says Walker.
Calendar: Another feature that McLean expects to be very helpful is the scheduler, which he says can assist in practice management and ensure optimal efficiency. “The calendar gives us the ability to look and see how efficient we are in managing the therapy rooms at the respective three clinics as well as to do comparisons across the three clinics in terms of how we’re utilizing the space and managing the students’ time,” he says.
Billing: The way Valant’s EHR system integrates both billing and the clinical work, which allows the university to access and track the billing information on its own, will also be invaluable, says McLean. “Particularly given the fact that we are moving toward Medi-Cal billing because we have Valant, that’s going to be very useful for us, ensuring quality assurance in the level of tracking that the state requires,” notes McLean.
Dashboard: Walker says the dashboard specifics of Valant’s EHR are of special significance, and add another dimension of workflow efficiency than she’s never seen before. Offering two separate dashboards, one for clinical information and the other for billing, was all about filling a need—a need specific to behavioral health providers, says Lischner.
“By focusing on behavioral healthcare, we’re able to only include elements that were relevant for our market, for our practitioners,” says Lischner. “I’ve seen very complex EHR dashboards but the whole idea is that everything on there gets you a step closer to something you do on a very regular basis. It gives you intelligence that you’d want every time you look in the EHR.”
Better-Prepared Students, Better Patient Care
All clinical psychology doctoral students, as well as master’s students, will be introduced to this technology through a broad overview, but students will receive most of their in-depth EHR training while working at the university’s counseling centers.
According to McLean, the EHR rollout is already in progress, and baseline data collection has already begun. Students have started using the EHR technology with their clients at two of the university’s three counseling centers (soon to be three), and with Valant’s assistance reminders have been set up to ensure students new to the process know where to begin. “We now have a mandate that all clients will be entered into the Valant system,” says McLean.
While this technology investment will directly benefit students in their doctoral training, McLean notes that the end goal is not just to deliver students that are well-rounded and ready to work in behavioral healthcare—it’s also meant to improve behavioral healthcare itself.
“Because EHRs help in the clinical conceptualization of the patient’s care, this leads to better and more accountable care for the patients,” says McLean. “The structure of the EHR also allows the trainee and the supervisor a systematic approach for reviewing the care plan and thus provides a methodology for case review, which allows trainees to find out what they did well and in what areas they could improve,” says McLean. “This process of clinical quality assurance or quality improvement invariability results in enhanced patient care.”
Such patient care improvements can be expected for any EHR system students up end up working with down the road, says McLean. “This EHR training and knowledge helps the new clinicians to conceptualize cases better,” he says. “It structures students’ thinking clinically and provides tangible prompts as to what data they need to be collecting. It teaches them to be comprehensive in their documentation and it links a financial accountability to their clinical accountability.”
For Lischner, working with JFK University is a collaboration to effectively train the next generation of behavioral health clinicians, something he doesn’t take lightly. “This is an important area for us, working with universities to train the next generation of clinicians, and I wanted to make sure we got it right. We hope the exposure to an EHR puts students in a better position to be good, informed providers and utilizers of technology.”
According to Walker, offering up an EHR as a training tool is the best way to ensure students enter the workforce with not only the educational tools but the technological knowledge to expect the best for themselves—and their patients.
For JFK University, offering better technology today means better training for students who will be better professionals for it, ultimately offering better patient care tomorrow.
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