Survey of MN Psychologists and other professionals about technology in clinical practice

Survey of MN Psychologists and other professionals about technology in clinical practice

Thanks to the 122 colleagues who generously took the time to complete this survey. Three reported that they do not provide clinical mental health services in Minnesota. This means that 119 should have continued with the rest of the questions, but 120 colleagues took the rest of the survey – I guess that two non-clinical participants still wanted to contribute, which leaves us with perhaps a little less pure data, but I appreciate their participation.

Here are the results for the 10 “clinical” questions:

Q2. Primary professional affiliation:
a. Psychologist = 114, or 95%
b. LMFT, LPC or LPCC or “other” = each category was represented by 2 participants, for a total of 5%. Many thanks to the non-psychologists who help make this survey a LITTLE more diverse.

Q3. Currently using an E.H.R.:
Yes = 57, or 48.3%
No = 61, or 51.7%.
My previous survey about E.H.R. issues, which focused on the MN MDH E.H.R. mandate, found at that time, March, 2015, about 41% of 712 respondents were using, or planned to start using, and E.H.R.. So, it appears that there is a small trend towards E.H.R. adoption, but a significant number of MN psychologists and other mental health professionals are not adopting and E.H.R.

Q4. Primary technology for communicating info to another professional:
a. Phone = 62, or 53%
b. Fax =22, or 18.8%
c. Letter = 10, or 8.55%
d. Email-unencrypted = 11, or 9.4%
e. Email-encrypted = 7, or 6%
f. HIE = 2, or 1.7%
g. DSM = 3, or 2.6%
Clearly, MN MHPs are NOT adopting HIE and DSM technology. For more info about these technologies, see my previous posting, which concludes that DSM is the best option for MHPs.

Q5. Professional websites
a. Have a website = 63, or 53%
b. Do not have a professional website = 56, or 47%
Q6. Facebook page for practice
a. Have a Facebook page = 19, or 16%
b. Do not have a Facebook page = 99, or 84%

Q7. Have a blog
a. Yes = 11, or 9.3%
b. No = 107, or 90.7%

Q8. Uses Twitter for professional purposes
a. Yes = 8, or 6.8%
b. No = 110, or 93.3%
Q9. Routinely provide telehealth services
a. Yes = 21, or 17.8%
b. No = 97, or 82.2%

Q10. Routinely recommend apps as therapy resources

a. Yes = 44, or 36.7%

b. No = 76, or 63.3%

Q11. “View technology as”
a. “helpful to my clinical practice = 71, or 59.7%
b. “not helpful to my clinical practice” = 4, or 3.4%
c. “a threat to my clinical practice” = 4, or 3.4%
d. “neutral” = 40, or 33.6%

Finally, I received 26 comments for this question, with varying amounts of detail; all are appreciated. I found them to be so informative that I am providing them all, with a few brief comments in italics. They are provided exactly as written:
1. Telehealth answer would be phone and email for scheduling and reminders incl text message reminders
2. I choose to minimize the use of technology.
3. Technology is helpful in many ways–storage of psych evals and treatment data, sometimes expedite billing processes, storage of essentially my entire life work with easy capacity to update and extend my work, etc. It also adds more costs. I am now expected to find and download insurance EOB’s, find information at insurance company websites that are sometimes poorly designed to quickly access information, keep various passwords to access data, and deal with multiple insurance company variations in applications of technology. I might have 200 patients within one system and 5 patients in another–I still need to be familiar with all of the policies, procedures and technology applications of the systems in which I have few patients. On balance I checked “helpful” above because there are so many useful applications of technology–but I could have just as easily checked “a threat” because of the down side to technology. It is not the “fact” of technology that is threatening at times, it is the “application” of it that can be so arbitrary and burdensome at times. Take something as simple as billing Medicare. Their technology system does not even allow for saving diagnostic data from one billing to another–so our office must double our time commitment to do simple billings. Dick, thank you for all of your public service work for all of us that are perhaps more technology-challenged than you! (name deleted, but thanks for your nice compliment!)
4. I use texts and phone coaching with clients, and ITV with the DBT Consultation Group.
5. Actually, both helpful and a threat. There are aspects that facilitate communication and/or treatment and there are severe privacy/confidentiality issues.
6. I have a DSM account recently. Until more psychologists have DSM it’s not easy for me to interact other than the old fashioned way, via fax, phone, mail. I’d be interested hearing what question you are hoping to answer with your particular questions. (just wondering what others are doing)
7. While I find tech helpful, it is sometimes tedious and frustrating to make it work or to develop patterns of incorporation.
8. Technology seems inevitable, think about this survey. (that is part of why I did this survey!)
9. A necessary annoyance
10. Overall, I think technology helps our practice. I find the most common technology we use is our EHR, email, and invoicing using our payment system with Square. I have found myself experience the most hesitancy when clients may ask about conducting sessions over the phone.
11. I’m not averse to using EHR, but as a part-time, solo practitioner it becomes a fairly major expense on top of many other expenses to practice. I appreciate being able to opt out of EHR.
12. I have begun to do some FaceTime sessions Solo practitioners fortunately are exempt from e. H. R. Apple changed it to her! The insurance companies have too many requests for updates as it apparently is so easy and cheap for them to shoot of an email that brings about all kinds of dumb work for a solo practitioner who has hardly ever any changes. If we did we would let them know. And many never refer! Had a website twice but in the process of changing companies now.is on my to do list.
13. Technology can be either helpful or harmful. The one overriding concern is that given the ubiquity of hacking private information there is no level of security for client progress notes that is adequate to meet the demands of privacy protection for the profession. For that reason we will not use EHR. There is no adequate way to protect them. Many law firms now employ hackers to find information about opponents and often look for mental health records to use to discredit witnesses.
14. I like that apps can provide clients with mood tracking, couple’s exercises and things of that nature. I do not like EHR and view it as threat to a my client’s privacy. It makes sense to me to mandate EHR if you work in emergency medicine at a hospital, but outside of that narrow specialty, I see it as a privacy encroachment.
15. If I knew how to use it (I am unclear if this is wistful or something more negative)
16. I work in a small group practice that has their own website. We use Procentive EHR and if our clients sign a release, we internally fax a cover sheet, etc that says the client is being seen at our clinic. Our office staff does that–I don’t even know how. I prefer to call directly and usually talk with a care manager of the medical clinic (they are usually the ones that do the leg work for the MD). I have a few clinics that refer to me directly. I use my cell phone because I’m not at my office everyday and I work 1-8pm, so it just is easier. I have a love hate relationship with our EHR. I’m still learning it and we’ve had it for 3 years. I don’t think I’ve learned all the short cuts and I spend way too much time doing my notes. I’m 61 and am feeling my age–especially when it comes to the new systems and all the changes in our field. Many of my colleagues (that were 60-70 yrs old a few years ago) decided to retire early–not re-upping their licensure, etc. They just wanted out before all the changes happened. Five left in one year two years ago and they are all doing well. I still need the money, but am now PT. My husband works FT and carries our medical benefits. I would like to work FT, but seriously, I know I wouldn’t be able to keep up with my EHR’s!! Enough of my rant.. I’m in the office (on a Friday night) doing what else–DA’s and notes that I can’t finish during the day…so back to the keyboard I go!! Thanks for allowing me to give you my short story. FYI–I’m not on Facebook at all, but I am on Twitter, Tumblr & Instagram, but don’t use the clinic name and don’t respond if a client finds me. I’m not active on LinkedIn because too many of my clients found me and I didn’t know how to handle it, so I just don’t use it. Yikes! Thanks again for all your efforts and hard work to make our profession better!! (again, thanks for the nice compliment, and thanks for participating and writing such a detailed and thoughtful comment!)
17. I believe in face to face interactions to promote self-understanding and change. There are internet resources I recommend that can be a helpful intervention/educational tool for selected patients. But overall, I experience face to face contact as the most beneficial way to meet and work with patients. I don’t have a blog or web page because I have so many requests for services that I can’t meet as it is.
18. In general, I have rather negative views about EMR and their use in Mental health practice. I have seen confidentiality violated and medical bureaucrats showing little concern or willingness to rectify the breach. From a personal standpoint, I am the survivor of a brain hemmorhage at the age of 63, and though reasonably still pretty healthy and competent in most aspects of my profession, I struggle a lot with technology. I have found that though I am still an excellent psychotherapist and have years of experience in psychology, am still considered a very intelligent and capable person despite my disability, and am still a compassionate and caring person I am not able to participate in most areas of psychology because of my limitations with technology. It is rather shocking to me that a field which is supposed to be exist to help others has become so obsessed with technology that it cannot figure out ways to make accomodations for a highly qualified and educated person with a disability.
19. 1. Having to use interoperable EHR would be a threat. As a solo practitioner, I don’t have to have that. I would have retired rather than adopt interoperable EHR. (I am 67 yrs old.) 2. I will email with clients if they sign a release just for purposes of setting up, changing or canceling appts. or in response to an email to me inquiring about my services. 3. My Facebook page just has my contact info, nothing else. No one can post to my wall. 4. I am concerned about the inaccuracies of EHR of medical providers, makes me question the accuracy of info in med. records. (Providers forced to check a box before proceeding with the next part of an electronic note often have to check something that is inaccurate or downright wrong, due to lack of categories such as “n/a” and “other.” In that sense EHR’s are actually dangerous, I think. My brother who is an MD is seriously concerned about this issue, and I have heard providers interviewed on NPR voice the same concerns.
20. I meet with clients worldwide via Skype, including in Australia, NZ, UK, Canada as well as clients in other states. It gives the face to face experience and wide reach.
21. Have had some difficulty identifying and using electronic resources. Know any helpful sites? (excellent question, and I plan to follow up with regular blog posts as I come across this type of resource- you can subscribe to my blog on www.mhconcierge.com)
22. Tele-psychology is an abomination. To abandon the human interaction and the wealth of information that is present in the room with your client is to ignore all that we as a profession have learned about the subtle nuances inherent in human relations and the important information that is present in those interactions. To move to a telehealth model for psychology is to ignore many of the common factors that make therapy effective. Additionally, for many of my clients, coming to therapy sessions is one of the few things that get them out of the house, and is often the only significant interpersonal interaction that they have. The therapy gets them out in the world with others over time, it seems unlikely to do so, when they do not experience the actual benefits of in person interactions.
23. Technology obviously provides many benefits to the entire human race, particularly with opportunity for mass communication, quick and widespread distribution of information, and connecting both nationally and internationally/globally; however, this inherently allows for potential problems and threats to all of us; nonetheless, most would agree that the benefits far outweigh the possible risks. The balancing act of having intelligent sophisticated systems to protect us, while allowing everyone have full benefits of technological advances (including internet access) is imperative.
24. depends on the app; some are really useful, others seem to be all bluster. With no required EHR for solo practitioners in the state, I am more comfortable with not sharing patient info
25. Given the news reports on hackers holding records “hostage” and hacking medical files, I sometimes worry about the threat to clients from EHR. I also find excessive rigidity in the way EHR is set up (at least at my facility), that can create interference with being able to approach clients from a more individual perspective (bureaucracy overtakes the clinical needs).
26. There always seems to be another technology that emerges and I find I am not using which makes me feel antiquated. I don’t like that feeling, I have a little motivation to acquire new technologies but feel that I “should”.

THANKS TO ALL WHO PARTICIPATED, PARTICULARLY THOSE WHO COMMENTED, AND PLEASE FEEL FREE TO SHARE THE LINK TO THIS REPORT WITH OTHERS WHO MIGHT BE INTERESTED. YOU ARE ALSO WELCOME TO SUBSCRIBE TO MY BLOG AT WWW.MHCONCIERGE.COM
Richard Sethre, Psy.D., L.P.

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