title: Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination.
abstract: Health information technology (HIT) and care coordination for individuals with complex needs are high priorities for quality improvement in health care. However, there is little empirical guidance about how best to design electronic health record systems and related technologies to facilitate implementation of care coordination models in behavioral health, or how best to apply user input to the design and testing process. In this paper, we describe an iterative development process that incorporated user/stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. First, we review foundational HIT research on how EBHIS can enhance efficiency and outcomes of wraparound that was used to inform development. After describing the rationale for and functions of a prototype EBHIS for wraparound, we describe methods and results for a series of six small studies that informed system development across four phases of effort-predevelopment, development, initial user testing, and commercialization-and discuss how these results informed system design and refinement. Finally, we present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT. The research team's experiences reinforce the opportunity presented by EBHIS to improve care coordination for populations with complex needs, while also pointing to a litany of barriers and challenges to be overcome to implement such technologies.
authors.affiliation: University of Washington School of Medicine, Seattle, WA, 98105, USA. ebruns@u.washington.edu.|Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Ave E, Suite 200, Seattle, WA, 98102, USA. ebruns@u.washington.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Bruns
authors.affiliation: Social TecKnowledgy, LLC, Santa Fe, NM, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Hyde
authors.affiliation: University of Washington School of Medicine, Seattle, WA, 98105, USA.
authors.forename: April
authors.initials: A
authors.lastname: Sather
authors.affiliation: University of Washington School of Medicine, Seattle, WA, 98105, USA.
authors.forename: Alyssa N
authors.initials: AN
authors.lastname: Hook
authors.affiliation: University of Washington School of Medicine, Seattle, WA, 98105, USA.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Lyon
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D002662:Child Health Services; D057286:Electronic Health Records; D063005:Health Information Systems; D006801:Humans; D008490:Medical Informatics; D008605:Mental Health Services; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management; D010347:Patient Care Planning
keywords: Care coordination; Health information technology; Implementation; Measurement feedback system; Usability; Wraparound