Electronic Health Record (EHR) Software Review: Netsmart

Mental health and addictions professionals require tools. For a couple decades, Terry McLeod has been a trailblazer providing those tools in the form of Electronic ...Read More

If the Electronic Health Record (EHR) selection process was a beauty contest, Netsmart’s myAvatar product would likely take the prize.

The look and feel of the software as it was set up for a recent presentation I attended was excellent. One of the problems that can arise with EHR software is a lack of attention to making the software work within the special workflows in a mental health clinic. myAvatar’s workflows were well designed, suiting process flows for different user roles like billing, executive and clinical users. The idea is still along the lines of displaying sub-windows and rows of documents, activities and appointments; It’s easy on the eyes. As I’ve shared before, when an EHR takes this sort of detail into account, it makes for a more complete record of treatment, and the professional is better able to address the specific needs of each individual consumer. When information is at a professional’s fingertips, it’s more likely to be used; if not, and the records of previous sessions aren’t reviewed, is the consumer getting the best care?

Additionally, the inclusion of pulling data from Outlook is a plus for the Case Managers in the field. There is likely a way to launch Outlook from a hyperlink embedded in the program. I say this because it’s simple technology and a feature that was included in a previous version of the product. Data can also be pulled and pushed internally. The example was pushing problem data from an assessment to the treatment plan, and pulling goal and objective data from the treatment plan into a progress note. Professionals are human, and can be under pressure to see a high number of consumers in a given week. Those two factors conspire to make time-saving features like these vital to make the most of a professional’s time while giving her the information she needs to treat the consumer’s problems.

The reporting engine for Avatar is Crystal Reports, and although many vendors are moving toward internal reporting engines, Avatar provides a great map to the fields where certain data resides called “option documentation”; it’s quite simple to use, organizing the electronic record so it’s simple to pull data out of the system. As long as you have a person around to write the Crystal Reports, you’re set. From my experience, folks like yours truly can write Crystal Reports much less expensively than Netsmart (NTST) staff, so your organization may wish to consider outside consultants.

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The EHR’s RADplus toolkit is essentially a design tool that enables the customer to build their own system. In fact, this is what a number of customers have done. Because the RADplus is so robust, it also requires a level of skill somewhere between the design tools I’ve seen in other products and those of a programmer. If I had to guess, I’d say a slightly better-than-average Crystal Reports writer would have no problem using the tool. I’ve designed a number of screens and associated reports to them, and the outcomes have been good for the professionals using the system.

It’s tempting to use the RADplus tools and Crystal Reports to design a system from the bottom up because it would seem perfect. It would not be. The tried and true method to use for implementation is the same as for any major product on the market. Start with the existing forms and reports, modifying slightly during the implementation and approach improvements to make the system truly “my Avatar” only after the initial implementation has progressed to a level of Meaningful Use, billing and regulatory compliance.

The use of RADplus to design dashboards was flashy and impressive. Widgets can be included on dashboard screens to track whatever metrics exist in the system, from census to treatment plans due to authorizations due.

Predictive Modeling is a recent addition to NTST initiatives, encouraging research by sharing de-identified patient treatment information among the user group, a program reminiscent of the MindLinc business model. I’m not sure how far along in the process of bringing this offering to life, but if research is your bag, this is the sort of work that broadens data samples required to measure new methods of treatment and can help consumers recover on a grand scale.

Like most of the systems we’ve seen, Utilization Review and Quality Assurance problems are avoided by the customer adding compliance rules to specific activities like treatment plan reviews coming due and insurance prior authorization renewals. This removes most of the labor intensive data management from these two functions, and transfers tasks to a sort of “informed policing” of data and activities.

Netsmart has acquired a number of EHRs over the years, as well as ePrescribing, on-line education and other options. This has made them the largest EHR provider in mental health and addictions treatment and worth a look if you’re a professional whose organization is in the market for an EHR.

Disclaimer Added 10-16-14 from Terry:

Let me clarify that I haven’t worked for Netsmart for around five years, and have absolutely no ties to that company and am not employed by any software company…I’m busy enough with my own business.  I try to keep reviews positive, and usually they are based on demonstrations, which is a great opportunity for a software company to put their best foot forward.  As you might guess, software demonstrations given by the manufacturer may ignore a product’s shortcomings.  I encourage folks to post their clinical, billing, administrative and IT experience with the products I review because my experience with products that are on the market today lies in managing projects for selection, implementation and optimization of Electronic Health Records.  I’m always interested in learning about practical experience in the field.

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