For a variety of reasons, behavioral health organizations are investing significant time, money and manpower into health IT systems.
Yet too often, they still run into outdated tools, implementation hurdles and gaps in return on investment.
That’s according to recently conducted research from Behavioral Health Business, which surveyed industry leaders on their electronic health record (EHR) and care coordination technology strategies earlier this year. In addition to asking about EHR adoption and must-have features, the initiative explored who holds the purchasing power, what drives spending and why tech upgrades often come with friction.
The survey, conducted in early summer 2025, gathered responses from a broad cross-section of behavioral health leaders. The majority of respondents said they worked for for-profit organizations, with 58% describing their job title as one in executive leadership.
Respondents came from a mix of behavioral health organizational types, with most saying their respective companies operated in the mental health space. About 46% said their organizations were in the substance use disorder (SUD) space, with less than one-quarter identifying their companies as autism therapy-focused.
Who’s making the tech calls
Buying decisions around EHR and care coordination tools tend to rest with senior leadership, BHB’s research suggests.
More than half (66%) of respondents said their executive or C-suite team is an important decision-maker. Another 48% said decisions are often made by clinical leadership, while 29% said buying was frequently driven by CIO, CTO or IT leaders specifically.
How often are those EHR and care coordination technology decisions being made? About one-quarter of respondents reported that their organizations evaluate their health IT systems annually, with another 19% saying their organizations evaluate tech every two to three years.
The bulk of respondents (28%) said they evaluated EHR and care coordination technology needs on an ongoing basis. In contrast, just 16% of respondents said they evaluated it only when issues arose.
Generally, this evolution isn’t cheap, BHB’s survey reveals.
For 21% of respondents, the average annual spend on EHR and care coordination tools hovered between $50,000 and $150,000. For 19% of respondents, that average annual spend was greater than $150,000.
Implementation challenges
Despite the strategic importance of technology tools, many of the leaders that BHB surveyed said they routinely face serious challenges when implementing them.
More than half (53%) pointed to staff resistance, training and change management as major barriers, for instance. That’s not surprising in a sector where clinicians are already overwhelmed with administrative burdens and workforce shortages.
Other challenges weren’t far behind, however. In fact, about 48% of the respondents in the survey cited integration difficulties with existing systems as a top challenge, with another 39% saying that the cost of implementation or maintenance fees were major obstacles to greater EHR and care coordination adoption.
Vendor responsiveness and a lack of behavioral health-specific features were both cited as common challenges by over 20% of respondents as well.
Even with the pain points, behavioral health leaders flagged several potential benefits to investing in EHR and care coordination technology.
When asked about the most significant benefits of EHR and care coordination system usage, 63% of respondents said these platforms lead to better client engagement and retention. Improved clinical documentation quality and improved staff productivity were both identified as top benefits as well, by 60% and 58% of respondents, respectively.
Beyond the day-to-day clinical and operational realities shaping EHR and care coordination technology adoption in behavioral health care, BHB wanted to know about the macro-level trends influencing providers’ decisions.
When asked “what trend is most shaping your IT and care coordination strategy?” 47% of respondents cited the push for integrated physician and behavioral health care, 42% cited increasing acuity of behavioral health patients, and 41% cited tech-enabled care for remote or mobile teams.
Somewhere surprisingly, just 33% of respondents said that value-based care was a major catalyst in behavioral health IT decisions.
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.
