Case study

Optimizing EHR makes a big difference for behavioral health client

Understanding full EHR capabilities improves care delivery

Jun 25, 2021
Business applications Behavioral health Health care Technology consulting

Our client, a behavioral health and foster care organization, provides services to traumatized and neglected children; youth with serious emotional problems; teens and young adults without families; and families coping with poverty, homelessness, domestic violence, substance abuse and mental illness.

The organization implemented a leading electronic health record system over a decade ago. Changes to the EHR were made over the years but in departmental silos; much of the EHR’s new and rich functionality was not leveraged or organized for optimal impact of care delivery.

The client has continued to struggle across multiple divisions to access information as well as capture the information needed to meet industry standards with their funders and governing bodies. Because of this, they considered seeking a new EHR solution, but then learned their current system was likely not leveraged to its full capabilities. The organization, however, was unclear on how to optimize the solution and desperately needed guidance on appropriate next steps. It also lacked the internal methods to integrate system changes alongside their evolving organization and health care ecosystem.

Their processes required an abundance of manual tasks and duplicative efforts, and provided inadequate reporting and analytic capabilities. Additionally, the improper use of applications and use of external systems (including paper documentation) created inefficiencies, a lack of data integrity and a lack of visibility across the entire organization as there was no defined central view of the individuals served.


RSM US LLP professionals performed an assessment at the operational and technology levels, to develop a prioritized road map of areas to focus on to optimize the existing EHR system. This provided a holistic evaluation of the organization’s applications and technology environment, and assessed operational workflows to meet current and future needs. RSM used the discovery phase to gain an understanding of the organization’s processes and technologies, and built a prioritized future state requirements list that was scored by effort and impact. Work also included building a timeline and identifying resources needed to optimize the solutions. Additionally, the RSM team identified optimization needs as well as measurement for each item by level of complexity, level of impact, priority level, level of effort and time to complete, and best practices recommendations.


RSM found a number of disconnected systems, multiple manual processes, and inadequacies and knowledge gaps among the staff. These areas were addressed and optimized by helping the client build a road map to address priority areas. Project management services were also provided to ensure timely execution. Based on the organization’s capabilities and resource availabilities, RSM handled some of the implementation and training, and teamed with the client on additional areas. RSM continues to work with the client in a managed services capacity to deploy the items identified in their road map.

RSM concluded that it was necessary for the organization to utilize an IT governance model, thereby eliminating departmental silos and ensuring projects and investments were evaluated by a cross-departmental team that developed standards to meet industry best practices.

The entire effort helped the client look internally to identify better ways to optimize their existing technologies rather than go through a time-consuming, expensive and resource-intensive EHR replacement project. These efforts improved overall systems and enhanced the client’s ability to provide optimal care. In addition, the client gained an implementation advisor in RSM. The firm continues to assist this client with further road map execution.

RSM contributors

  • Arvind Rao
    Behavioral and Mental Health Leader

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