Technology:

Keeping Electronic Records with Carepaths

Colleen Byrne, Ph.D.

Since early 2005, the Psychology Clinic at the University of Maryland in College Park has been using the Carepaths for electronic record-keeping. In hopes of both simplifying our record-keeping and also cutting paper costs, we switched to electronic record-keeping with Carepaths. I originally learned about Carepaths from Eric Sauer. Although I had intended to use it only for the OQ45, I gave the electronic record-keeping function a trial run and ended up liking it a lot. CarePaths offers the eRecord, “a multi-modal, web-based Behavioral Health Electronic Medical Record (EMR) and Practice Management system.” It is a “secure, web-based and HIPPA-compliant record-keeping system”. It is also highly customizable. Our Clinic uses only 30-40% of Carepaths’s available services.

For our Clinic, the main benefits of using Carepaths are 1) low cost as compared to products like Titanium, 2) the convenience of access from any secure, internet-connected computer, and 3) the security provided by customizable access levels for supervisors, practicum students, and support staff. Additionally, electronic record-keeping has increased efficiency and accountability for practicum students and supervisors alike. The web-access is a good fit for students with hectic schedules; I find that students have been more likely to write progress notes on time now that the time and date are electronically stamped. This has been true for supervisors as well. Electronic record-keeping has made it easier for supervisors to monitor the progress of a multiple students’ work. Also, students in need of assistance are more easily identified and can be provided with feedback before the end of the semester.

At the UMD Psychology Clinic, we primarily use the following the Carepaths modules: Progress Notes, Clinical Screenings; Assessment Center, Intake Assessments, Treatment Planning, Discharge Planning, Patient Management, and System Administration:

* In the Progress Notes module we use the Individual Progress Note, Miscellaneous Contact Note, and Miscellaneous Service Note;
* In the Clinical Screenings module we use the Clinical Screen template to record basic information about a client’s presenting problem and treatment history;
* In the Assessment Center module we use the OQ45.2, YOQ30, YOQ30-SR, and WAI;
* In the Patient Management module we enter demographic and contact information for waitlisted clients. (With a quick change of the medical record number, this becomes their electronic chart when they are assigned to a therapist); and
* In the System Administration module, which has restricted access, we use the Groups feature (to specify user levels) and Security Keys.

Practically, it works like this. After logging on, a user can enter text for a progress note directly into the template or they can cut and paste from a MS Word document. The practicum students “sign” their work (by entering their password next to their name) as “pending”, which allows supervisors to review and/or make corrections before signing a document as “completed”. If a student wishes to have time to self-edit, they can sign their work as a “draft” so that only they have access until they are ready to submit the document as “pending.”

Carepaths has many features such as scheduling, internal email, accounting, and billing that we have chosen not to use. (Since collected funds are processed through our Psychology Department’s business office, we keep billing and scheduling on separate programs to maximize client confidentiality.) One drawback with Carepaths is that I still need to rely on the practicum students and supervisors to let me know when a case is closed. Further, unlike Titanium and some other products, Carepaths does not offer query-type searches of clients based on demographic or diagnostic variables. (So, if I wanted to know how many depressed males came to our Clinic in the last year, there is no quick way to find out). I can’t say that Carepaths will work for every Clinic, but it has been wonderful for us.

To contact Carepaths: Go to http://carepaths.com call 800.357.1200. Ask for Geoff Gray and identify yourself as a Clinic Director and member of ADPTC.