Trayt Community Perspective: EMRs are for Billing, not Improving Patient Outcomes

We sat down with Trayt’s CMO to hear his thoughts on the current state of Electronic Medical Records (EMRs). Here's what he had to say:

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“Psychiatrists and other mental health professionals are very frustrated and unhappy with most current EMR formats and requirements. These versions are very time -consuming to complete and take considerable time away from providing treatment. Their purpose appears to be to to justify the billing code charges by documenting the diagnosis of the patient and then itemizing which procedures from a pre-packaged, approved list the doctor applied during that particular patient encounter. It is something akin to what the itemized billing a car-owner would receive if they brought their car in for repairs.

What actually happens in a behavioral health care encounter is that the doctor listens carefully to what each individual patient has uniquely to say to describe their perception of adaptive difficulties in their lives they are encountering because of subjectively experienced symptoms. The doctor then has to use all her skills, experience and training to ask additional questions to elucidate the patient’s narrative. Doctor and patient then interact by conversation in a complex way, unique to the specifics of the patient’s personality, social, cultural, and medical context for the purpose of providing guidance and treatment recommendations or modifications.

Much of this conversation is about tracking the patients progress and outcomes (or lack of it), but also includes the presentation of recent adverse events or difficulties adhering to the treatment. The big question is always documenting if the patient is getting better or not, and how can obstacles to progress be overcome.

Sadly, the current EMR’s do not come even close to documenting that reality. That is where Trayt comes in.
The Trayt approach is entirely focused on lucidly and graphically tracking the progress the patient is making in getting better, as described and recorded by the patient, while relating that to the timing and changes of specific treatment regimens, adherence to the treatment, occurrence of new real-life challenges. The interaction of the behavioral health outcomes with the patient’s overall health and medical is an equally high priority.


In this way, the Trayt documentation of patient outcomes is devoted to facilitating successful treatment outcomes and supporting doctor-patient communication.

In contrast, current EMR’s exist as an accounting procedure to justify patient billings by leading doctors through a standardized documentation process consisting of checking off adherence to a set of pre-packaged  procedure templates. The actual templates for reporting are frustratingly irrelevant to the dynamic process of patient care, while the time and attention required to complete them depletes the energy and good will of doctors. It also consumes large quantities of time that could better be applied to helping more patients get better.”

- Dr. Carl Feinstein, Trayt CMO

Malekeh Amini

AVA Health, 3150 Porter Drive, Palo Alto, CA, 94304, United States