The Office of the National Coordinator for Health Information Technology Health IT Playbook

Section 10


Specialists have unique electronic health record (EHR) needs for clinical documentation and care coordination with other specialties, subspecialties, primary care, and other care settings.

Historically, very few specialists have adopted EHRs, but that’s changing with the advent of specialty templates and modules optimized for specific specialties, such as ophthalmology and dermatology. EHR options for multi-specialty groups are also evolving and gaining adoption in certain specialties.

This section provides EHR and health information exchange guidance for specialists.

It also offers:

  • Workflow tools
  • Case studies
  • Best practices

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are 43.6 million adults in the U.S. — ages 18 or older — with some form of mental illness. This number represents nearly 1 in 5 Americans.

Adoption of health IT in behavioral health care is significantly lower than other specialties. Reasons for this may include:

  • Unique confidentiality needs
  • Limited resources or expertise
  • Ineligibility for EHR incentive programs

As primary care is often the gateway for individuals to address their behavioral health needs through their primary care provider (PCP) and, as a result, more PCPs are offering integrated behavioral health care services. This presents unique health information exchange challenges due to confidentiality rules surrounding sensitive health information.

Behavioral health information — such as psychotherapy notes, substance abuse treatment records, and psychiatric diagnoses — legally qualifies as sensitive health information. In addition to federal regulations, individual states may have specific laws for disclosing or exchanging sensitive information.

EHRs and health information exchange solutions are evolving in their ability to best capture and segment sensitive health information to facilitate use of health IT to better manage and coordinate care.

ONC partner resources

The Office of the National Coordinator (ONC) works with various federal agencies to support behavioral health IT. This section provides resources to support adoption of health IT and care coordination in behavioral health. For example:

A Guidebook of Professional Practices for Behavioral Health and Primary Care Integration: Observations from Exemplary Sites

A Guidebook of Professional Practices for Behavioral Health and Primary Care Integration: Observations from Exemplary Sites

This guide helps primary care and behavioral health professionals identify best practices for developing integrated care. Eight high-performing primary care organizations with integrated behavioral health participated in the study

Who it’s for
Primary care and behavioral health practices

When it’s used
To learn about integrating behavioral health into primary care organizations

Download A Guidebook of Professional Practices for Behavioral Health and Primary Care Integration: Observations from Exemplary Sites [PDF - 1.2 MB]

Case Studies of HIT for Behavioral Health Integration

Real-world examples of health systems and group practices that have adopted health IT tools for integrative purposes

Who it’s for
Behavioral health and primary care providers

When it’s used
To find examples of health IT for behavioral health and primary care integration

Visit the Case Studies of Health IT for Behavioral Health Integration website

Pediatricians — both primary care and pediatric subspecialists — also face unique challenges in the areas of functionality, documentation, and privacy when it comes to implementing and using health IT.

For example, documentation needs for pediatric practices include:

  • Growth charts
  • Weight- and age-based dosing
  • Clear indication of smaller units of measure
  • Pediatric normal ranges for vitals, labs, and other measurements
  • Mother-baby documentation
  • Gestational age

Pediatric practices also deal with specific privacy requirements around parental involvement for adolescents and consent, or for custodial, foster, guardian, or adoptive care.

Below you will find a key resource to support pediatric practices’ electronic health record (EHR) implementation and optimization, and health information exchange participation.

Children’s Electronic Health Record Format

Information for EHR developers and others about critical functionality, data elements, and other requirements needed for pediatric EHR systems, especially those enrolled in the Children’s Health Insurance Program (CHIP)

Who it’s for
Pediatricians and EHR vendors

When it’s used
To find guidance on capturing EHR data elements and standards most relevant for children

Visit the Children’s Electronic Health Record Format website

Content under development

We plan to expand this section over time, so check back periodically for additional specialties, tools, and resources. Do you have suggestions to make this playbook even better? Please share your feedback with us.

Section 10 Recap

Use health IT to support specialty care delivery, coordination, and documentation.

  • Find resources for behavioral health IT
  • Find resources for pediatric health IT

Join the conversation.

Let us know how we can improve and expand on Specialists.

Content last updated on: May 31, 2017