Perhaps the greatest challenge to successfully implementing an electronic health record (EHR) is developing a working partnership between the behavioral health software vendor and the treatment provider organization purchasing the software. In 2003 a group of treatment providers from the Mental Health Corporations of America (MHCA) and the Software and Technology Vendors’ Association (SATVA) began working together to identify areas in which both industries could improve EHR selection and implementation, as well as ongoing relations.

In February 2006, the two organizations released a comprehensive document entitled Planning Your EHR System: Guidelines for Executive Management. This document is being featured on many Web sites and at national conferences. This article describes the process by which a working partnership evolved between these two trade associations, which led to the production of this important document.

The first step was for SATVA to demonstrate serious attention and commitment to increasing the credibility of the software industry. We did this by establishing and committing ourselves to a code of practice that we call “Guidelines for Business Practice” now posted on our Web site (www.satva.org). This was an important step that showed both sides how beneficial the relationship between us could be.

A joint task force was created, comprised of three software company CEOs and three behavioral health treatment organization CEOs, with support from Don Hevey, president/CEO of MHCA, and Tom Trabin, executive director of SATVA. The original goals of the task force were:

Task force members set certain principles and ground rules for proceeding with our work:

1. We are in this together—for better or worse.

2. What's past is past and it's ugly—leave it alone.

3. No sense thinking or speaking destructively toward ourselves or each other.

4. Maintain an industry-to-industry perspective—believe it or not, this is really not about us.

As with any group process, the task force took time to come together and understand one another. Our task force members were all executive managers within their organizations, with our time and energy in great demand by the organizations we led. Nevertheless, we maintained our focus with the intent to develop materials that would help the behavioral health field prepare for and meet the challenges of EHRs.

The content of numerous meetings and conference calls was detailed discussions on selection, implementation, and continued beneficial use of EHRs. There were many disagreements and expressions of strong feelings and experiences that required analysis and reevaluation.

The team's first product and collaborative presentation was at the Quarterly MHCA Meeting on August 4, 2004, followed by a panel presentation at the National Council for Community Behavioral Healthcare Annual Conference on March 15, 2005, entitled, “Two Left Feet: How to Avoid Missteps in Software Selection and Implementation” (see www.satva.org/educational/index.html). These presentations reinforced the group's increasing sense that we had all mutually benefited from our work together and had come to speak with one voice. The task force decided to continue working with one another and to create a white paper targeting CEOs and other executive managers of behavioral health and substance abuse organizations.

Task force members were at times far from agreement on the reasons for failed implementations. We considered the common processes inherent in RFPs, sales demonstrations, and implementations, and we began to understand that often treatment providers do not know what they want/need or can support in EHRs until they are already contractually linked to a vendor, who might not have the best-fitting product. The vendor representatives were able to explain the vast differences between their and other products to make the treatment provider representatives aware that not all software is the same or requires the same provider support. This key discussion yielded a new aspect of the white paper—an organizational readiness assessment for EHR adoption. The assessment questionnaire and explanation of its theoretical underpinnings enable treatment provider CEOs to assess their organizations’ internal readiness—and its implications for the type of software arrangement they need to seek in their evaluation of software vendors. Task force members concluded that this is a crucial step toward successful EHR implementation, and we therefore dedicated a substantial amount of energy and thought to it.

Many topics were reviewed from each side of the provider/vendor relationship, with some being more crucial to one side than the other, but the white paper embraces them all. Planning Your EHR System: Guidelines for Executive Management provides CEOs and others a blueprint for all aspects they will need to face related to the highly challenging tasks of selecting and implementing an EHR system.

My past experience has demonstrated that the process can be as important as the product. The inevitability of EHR implementation will require providers and vendors to work much more efficiently in the future. The dysfunctional relationship that once existed in many such business arrangements will not be viable in this decade of behavioral health information technology. The growing partnership between MHCA and SATVA has come the great distance it has because of each member's dedication and interest in the betterment of the behavioral healthcare industry. Similarly, the partnerships of individual treatment provider organizations and their software vendors are vital to successful EHR implementations. As with any relationship there are challenging times, but if the goals are mutually beneficial, then both parties can usually work collaboratively.

The process of improving the partnership relationship between MHCA and SATVA was vital to producing our white paper. The full document can be obtained for free at www.satva.org.