What Is EMR Software and How Does It Work?
What is EMR in behavioral health? Behavioral health clinics provide essential services to patients, and patient care is directly affected by administrative tasks such as insurance verification, denial tracking, and preparing medical orders. Electronic medical records (EMR) software automates these tasks, improving efficiency while reducing human error so providers can focus on their patients. EMR software also securely stores patient data, enabling providers to access everything they need in one convenient location.
However, many EMR vendors treat behavioral health as an afterthought. Key features like Medicaid-friendly templates and group notes are optional add-ons, if available at all, and they don’t work as well as they should. Hansei designed Benji specifically to improve behavioral health processes, leveraging over 20 years of practical experience to create the perfect administrative sidekick for your practice.
What Is an EMR?
EMR software is a digitized version of the paper medical charts that healthcare providers keep on patients. It contains a variety of clinical information, including:
- Demographic data (patient name, date of birth, address)
- Insurance data (policy number, plan name)
- Treatment plans (medications, previous visits)
- Medical history (diagnoses, prescriptions)
- Progress notes
- Facility details (name, address, tax ID)
Essentially, EMR software contains a patient’s complete medical history electronically.
EMR vs. EHR vs. Patient Portal and PHR
EMR is often confused with electronic health records (EHR) and personal health records (PHR). All three improve healthcare interactions through a digital format, but there are significant differences in scope, interoperability, typical users, and patient access. Here’s a side-by-side comparison:
| Feature | EMR | EHR | PHR |
|---|---|---|---|
|
Feature
Scope
|
EMR
Stores data to be used at a single care site
|
EHR
Stores a more comprehensive health record to be shared between providers at multiple sites
|
PHR
Provides patients with access to their own clinical data through a convenient patient portal
|
|
Feature
Interoperability
|
EMR
Limited since use is intended for a single site
|
EHR
Strong to support coordinated care between primary care providers (PCPs), therapists, and specialists
|
PHR
Often a feature of a broader EMR or EHR with no interoperability beyond the host platform
|
|
Feature
Typical users
|
EMR
Providers at a single clinic or practice
|
EHR
Providers across multiple clinics and practices
|
PHR
Patients and providers; providers generally to update patients and answer their questions
|
|
Feature
Patient access
|
EMR
No
|
EHR
No
|
PHR
Yes
|
Benji is an EMR with EHR features and a patient engagement portal, allowing our software to deliver aspects of all three.
Core EMR Features and How They Work
EMR provides numerous features to streamline clinical workflows and improve patient outcomes. Here are some of the core features every EMR should have:
Charting and Templates
EMR charting allows providers to use pre-designed or customizable templates to document patient encounters. Clinics save valuable time, and services are automatically coded to support charge capture and streamline claim submissions. Likewise, templates reduce documentation gaps.
e-Prescribing (eRX)
EMR eRX is the electronic transmission of prescriptions directly to a pharmacy. Automated tasks include verifying insurance, flagging potential allergies or drug interactions, and automating prior authorizations and refills. eRX reduces medical errors and eliminates the need to clarify handwritten prescriptions.
Labs and Orders
EMR lab orders provide an integrated system for managing lab work within the patient’s electronic record. Providers order labs directly from a patient’s chart, and the results are sent to the EMR for review. Most EMRs display data in user-friendly formats, allowing for comparisons over time.
Clinical Decision Support (CDS)
EMR CDS refers to integrated tools to assist clinicians at the point of care. Examples include preventative care reminders, medication alerts, and diagnostic support. Effective CDS reduces medical errors while improving efficiency, but providers should still double-check recommendations for mistakes.
Tasking and Inbox
EMR tasking is the system used to assign, manage, and handle tasks, often with a digital inbox for messages, lab results, and orders. Tasking improves patient care by ensuring critical information is addressed promptly while reducing clinician time spent on low-value, routine tasks that can cause burnout.
Reporting
EMR reporting allows healthcare organization stakeholders to track key performance indicators (KPIs) over time. The system reports on behavioral health outcomes, including time-to-follow-up and no-show rates, as well as on revenue cycle management (RCM) details, such as denial reasons and clean claim rates.
Role-Based Access
EMR role-based access limits who can view sensitive information based on role. The front desk needs to see filled appointment slots for scheduling purposes, but shouldn’t have access to detailed progress notes or a patient’s medical history. Role-based access supports HIPAA compliance by protecting privileged patient information.
Benefits and Limitations
EMR implementation offers many benefits to healthcare organizations of all sizes, including:
Enhanced Patient Safety
Automation reduces the risk of human error, making issues such as patient mismatches less likely. Information is also stored more securely than paper charts, which can be mistakenly left in plain sight.
Improved Clinical Efficiency
Removing the administrative burden on clinicians gives them more time to spend with patients. This is especially important in behavioral health settings where the relationship between provider and patient ultimately drives outcomes.
Continuity of Care
EMR software enables providers to review what others have ordered for a patient, ensuring uninterrupted treatment plans even when a patient’s regular clinician isn’t available.
However, there are also limitations associated with EMR software:
Alert Fatigue
Alert fatigue occurs when providers receive so many alerts that they tune them out, leading to burnout and slower response times. Good EMR software mitigates alert fatigue by allowing providers control over the volume of alerts they receive.
Copy-Paste Risks
Copying and pasting is convenient, but it can also propagate inaccurate or outdated information that could lead to misdiagnoses, fraud claims, and legal liability. Providers can mitigate these risks by regularly double-checking the accuracy of patient records.
Data Silos
Data silos are isolated pockets of patient information that clinicians may miss when reviewing records, especially during crises. EMR software can mitigate data silos by interoperating with third parties such as Fast Healthcare Interoperability Resources (FHIR).
Behavioral Health Use Cases
While all healthcare providers benefit from EMRs, behavioral health clinics have unique use cases that some vendors aren’t prepared for. Verify that any platform you’re considering is equipped for the following:
- Standardized screeners (Personal Health Questionnaire-9 [PHQ-9), General Anxiety Disorder-7 [GAD-7])
- Progress and group notes
- Ongoing treatment plans
- Compliant telehealth documentation
- Segmented access to sensitive substance use disorder (SUD) data
EMR, Billing, and RCM
EMR software helps clinicians document patient encounters, providing a comprehensive record of everything that occurred in a session. The software can then map those services to the appropriate International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) codes to facilitate charge capture and prompt reimbursement for the valuable services you provide.
EMR software will also help your practice’s stakeholders track claims and cash flow, discover why claims were denied so the issue can be corrected, and explore KPIs including days in A/R and clean claim rates.
Interoperability in Practice
Interoperability sounds good on paper, but what does your practice really need to integrate with? The answer varies among providers, but might include:
- Labs and eRX interfaces
- Health Information Exchanges (HIEs)
- FHIR
- Consolidated Clinical Document Architecture (C-CDA) exchanges
You want to know your system will interoperate as you expect, and Benji offers a pre-go-live interface testing checklist to ensure there aren’t any unwelcome surprises on launch day.
Security, Privacy, and Compliance
American healthcare organizations must obey two major compliance standards: HIPAA and 42 CFR Part 2. HIPAA requires providers to implement administrative, physical, and technical safeguards to protect patient information, including end-to-end data encryption, role-based access controls, and regular data audits.
42 CFR Part 2 provides stricter standards for SUD treatment records. This regulation limits when and how records can be disclosed, often requiring proactive patient consent even to share information between clinicians at the same clinic. EMR software facilitates consent management to ensure compliance.
Naturally, behavioral health clinics have an obligation to secure patient information beyond compliance. All users should follow healthy device hygiene practices and understand basic breach response protocols, including how to identify a breach, isolate affected data by restricting access, and preserve evidence to eliminate the threat and bring the system back online.
Implementation 101 from Selection to Go-Live
What is the EMR learning curve? There will be a transition period, but all team members should feel comfortable with the software by the time you go live. You’ll want a data migration plan for scanned vs. discrete import and sandbox training opportunities so users can practice without jeopardizing sensitive information. Benji also supports a super-user model, allowing team members to earn the right to help their peers with the platform. Consider a phased rollout to launch your EMR gradually and prepare for a rollback if anything goes awry. Our readiness checklist will help you determine if you’re ready to go live.
Costs, Contracts, and Data Ownership
EMR software is a significant investment for healthcare providers, especially smaller clinics with limited budgets. There are license and implementation fees, interface and support costs, exit clauses, SLAs, and data exportability and portability costs. Some vendors engage in predatory practices such as revealing fees only after installation or writing large price increases into the contract, but we believe in price transparency at Benji. We will deliver a clear list of costs upfront so you know exactly what to expect.
Reporting and Quality Metrics that Matter
Benji offers clinical and operational dashboards covering chart closure times, no-show rates, behavioral health outcomes, denial reasons, and a host of other KPIs providers need to be able to reference. Stakeholders can curate reports to see what matters most to them, and analyze monthly reviews to keep everyone on track.
Troubleshooting and Downtime Procedures
EMR software should be up and running most of the time, but downtime is still possible. Look for read-only access protocols and downtime paper kits to ensure data remains accessible during system downtime. Additional features you need include clear reconciliation steps upon the system’s return to service, duplicate chart prevention, and vendor escalation paths.
Schedule a Demo with Benji’s EMR Software
You came here asking, “What is an EMR?”, and now you know. We could explain what makes Benji the best administrative sidekick for behavioral health practices all day, but wouldn’t you rather see it for yourself? Book a demo today and experience everything Benji has to offer firsthand.
What Is EMR: FAQs
No. EMRs are generally used within a single care site, while EHRs are built for interoperability to coordinate care between providers at different clinics.
There’s a learning curve for all EMR software, but Benji’s white-glove support, sandbox practice opportunities, and super-user model can help anyone feel comfortable with the software. The exact time to proficiency varies between individuals.
Yes, Benji provides a suite of template governance features, including HIPAA-compliant templates and regular updates to ensure data accuracy and relevance.
Alert fatigue occurs when providers receive too many notifications, causing burnout and slower response times. Benji mitigates alert fatigue by allowing clinicians to control what messages they receive.
EMR or PHR patient portals give patients convenient access to their health information and facilitate communication with providers. However, they are not a substitute for clinic visits and should not be relied on for immediate assistance. Patient portals may also contain errors, so the information provided isn’t foolproof.