The key tech components every primary care practice needs to deliver exceptional mental health services

A recent Gallup poll revealed nearly 20% of U.S. adults say that they have, or are being treated for, depression, while another 29.5% report being diagnosed with depression during their lifetime. At the same time, roughly 40% of the country lives in a designated mental healthcare desert, according to the Health Resources and Services Administration (HRSA).

These data points reveal a harsh reality about the American healthcare system: the lack of adequate mental health services and providers has reached unsustainable levels. To address this mental health crisis, many primary care practices are adding mental health providers to their staff. For patients, this not only offers greater access to needed mental health services, but also enables enhanced continuity within their healthcare experience.

Considering that a family physician's office is often the first—and sometimes only—place where patients discuss mental health concerns, adding such services within a primary care setting makes sense for both the practice and the communities it serves. But it takes a lot more than clinical capabilities to meet your patients’ mental healthcare needs.

Healthcare technology 101: Primary care versus mental health

As a primary care provider, expanding your services to include mental healthcare is a meaningful way to extend access to those in need. What most practices fail to consider are the required technology implementations needed to support two care models under one roof.

Fortunately, AI advancements within the health care technology space are making it much easier for primary care providers to add ancillary services and create a more equitable mental health care landscape. Still, there are important differences when it comes to the technology solutions for primary care versus mental health. Billing and coding solutions are the clearest example: unlike primary care, mental health services rely on time-based CPT codes, such as those covering 30-, 45-, and 60-minute psychotherapy sessions, along with add-on codes for interactive complexity or extended time.

There are also payer documentation rules for mental health providers that have little overlap with a standard primary care visit built around evaluation-and-management coding. A practice that bills an annual physical the same way it bills a weekly therapy session risks underbilling, denials or compliance headaches.

Patient engagement is another area where the two specialties vary. Mental health intake processes usually involve specific screening tools, trauma history questions and safety assessments that a standard primary care new-patient form was never designed to capture. The same is true of prior authorization workflows: unlike the largely authorization-free nature of routine primary care visits, many payers require prior authorizations for ongoing mental health treatment.

Another major technology difference between primary care and mental health centers on how care is delivered. For mental health providers, telehealth capabilities have increasingly become a baseline expectation. Among traditional Medicare beneficiaries, telehealth now accounts for roughly 44% of behavioral health visits, compared with about 9% of primary care visits, according to industry research.

Bridging the technology gap between primary care and mental health

Historically, only large-scale, corporately-owned medical groups had access to sophisticated technology solutions that enabled multi-specialty practices to run on a single platform. But the introduction of AI-powered solutions that support everything from medical billing and coding workflows to scheduling processes and charting tasks has changed the game, giving independent-providers access to powerful solutions that automate key administrative functions.

To bridge the gap between primary care and mental health services, the following six technology components are key to enabling more streamlined workflows across the practice, while also elevating the patient experience.

1. Billing and coding tools that align with mental health workflows: Time-based codes, add-on codes for extended sessions and payer-specific mental health rules require a system that can apply the right logic automatically, rather than leaving front-office staff to reconcile two separate rule sets by hand.

2. Telehealth is now a non-negotiable: Because telehealth has become a standard offering for mental health groups, the same should be true for primary care practices offering mental health services. And not just a basic telehealth solution, but one that can support the scheduling, documentation, and session-length needs of mental healthcare.

3. Medication management solutions suited to psychiatric prescription processes: Managing mental health medication prescriptions often requires frequent refills, in addition to titration processes that involve adjusting a patient’s medication dosage — usually by starting low and increasing it — until the optimal clinical effect is achieved. Implementing an effective eMAR (electronic medication administration record) solution that aligns with mental health prescription workflows is key to treatment adherence and improved patient outcomes.

4. Prior authorization tools that can track recurring renewal alerts: Because mental health treatment plans are often ongoing, primary care practices that offer mental health services need tools that provide visibility into authorization expiration dates well in advance, giving staff time to renew before a claim is at risk.

5. Patient engagement solutions that understand the nuance of mental health: Appointment reminders, intake forms and communication preferences should be configurable to mental health workflows and messaging, rather than a generic wellness-visit template. Most importantly, any tools that offer automated messaging solutions must be designed to understand the nuance and sensitivities involved with providing mental health services.

6. An AI-powered platform that unifies EHR, practice management and patient engagement workflows: To deliver a truly unified, holistic patient experience across primary care and mental health services requires a single source of truth. Implementing a unified EHR, practice management and patient engagement platform with AI-powered capabilities that bridge the gap between primary care and mental health not only improves efficiencies, but also helps fortify the practice’s financial health.

Moving mental health discussions beyond the primary care exam room

The good news is that none of these technological components require primary care practices to build an entirely new care delivery model. Instead, many can be layered onto existing primary care systems, as long as those systems can be configured to align with mental healthcare workflows.

The reality is that our health care industry must think outside the box to address the increasingly complex mental health crisis we are up against. Because so many patient discussions about their mental health start in a primary care exam room, offering behavioral health and mental health care within a primary care setting is a logical next step.

With the right technology foundation in place, that opportunity becomes far more achievable, allowing primary care practices to offer exceptional mental health services, while keeping their teams operating well within capacity.

Nupura Kolwalkar-Rana is Chief Product and Technology Officer at AdvancedMD.