A majority of behavioral health providers are using outdated and disjointed electronic health record (EHR) and care coordination systems – and they know it.

That’s one of the clearest takeaways from a new Behavioral Health Business research initiative, which found that nearly 85% of respondents rely on multiple systems or platforms that are either partially integrated or fully siloed.

Behavioral health has lagged behind physical health providers in terms of EHR adoption. This is in part because behavioral health providers were left out of the 2009 HITECH Act, which gave health care providers funding to encourage the meaningful use of EHRs.

Despite high satisfaction scores among some users, the survey reveals cracks forming across the behavioral health IT foundation as providers wrestle with interoperability, flexibility and long-term viability.

The research, conducted in early summer 2025, surveyed provider executives across the behavioral health space to assess where the industry stands with EHR and care coordination technology. More than half of the 129 respondents were in executive or leadership roles.

About 81% of respondents said their organizations provided mental health services, with 46% saying they provided substance use disorder (SUD) treatment. Less than a quarter came from organizations that provided autism-focused services.

Figuring it out

When asked about the current state of their health IT infrastructure, 43% of respondents said they rely on multiple systems with only partial integration, while 42% said they’ve adopted a single integrated platform for EHR and care coordination. Just 9% described their infrastructure as fragmented into point solutions.

The platforms in use vary widely, but most respondents in BHB’s survey said their organizations rely on behavioral health-specific systems, with others using adapted general medical EHR platforms or separate care coordination tools.

For survey respondents, the average system in use has been in place for just over three years – a figure that may soon shift.

While 40% of respondents said they have no plans to upgrade or replace their systems in the next 12 to 24 months, another 41% are either planning to add functionality or replace their existing tools entirely.

When selecting a new EHR or care coordination platform, providers place a premium on behavioral health specificity.

About 73% of the respondents in BHB’s survey said behavioral health-specific workflows and forms were one of their top three buying criteria. Integration with scheduling and billing was the second-most cited factor, followed by ease of use for clinical staff.

These priorities align with broader goals aimed at improving usability and streamlining reporting.

Top pain points

The most eye-opening finding from the survey may be what provider executives say is going wrong.

When asked about the biggest pain points in their current EHR or care coordination systems, 47% of respondents flagged limited integration with external partners – a direct barrier to better coordinated care. Another 47% pointed to reporting and analytics limitations.

Configuration challenges and poor user experience for clinicians were also common frustrations.

For an industry already grappling with staffing shortages and administrative burden, these system shortcomings have real-world implications. What’s more, integration and adaptability are critical for providers hoping to take on more value-based care arrangements with payer partners.

“Across the entire industry, if you went to [behavioral health] inpatient and sub facilities, you would see a prevalence of paper that you don’t see in other parts of health care,” Acadia Healthcare (Nasdaq: ACHC) CEO Christopher Hunter explained at the JP Morgan Healthcare Conference in 2024. “It’s pretty difficult for payers to enter into value-based arrangements where there’s so much on paper. That’s one of the reasons strategically we felt like we needed to make investment into advancing technology getting [EHRs] in place, so that we would have data that we can show payers and ultimately put some value-based contracts in place.”

Better EHR adoption in the SUD space could be particularly impactful.

Specifically, integrating decision-support tools into EHR systems could help close critical gaps between primary care and SUD treatment, recent research highlighted. Doing so could enable earlier intervention, better care coordination and improved outcomes for patients with SUD.

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This story is based on research on EHR and care coordination technology conducted by Behavioral Health Business in May and June 2025. To request a copy of the research, please reach out to Robert Holly at [email protected].

BHB will host a webinar focused on the findings with industry leaders on Aug. 28 at 11 a.m. CT. Register for free here.