Success Factors for and Barriers to Integration of Electronic Mental Health Screening in Primary Care

Currently, only a third of primary care providers screen for substance use, which is a growing epidemic. This quality improvement study aimed to improve the screening process by integrating the Drug Abuse Screening Test without information systems support into the electronic health record to increase completed screenings and provider interventions for positive screenings in adult patients at an urban primary care clinic. Electronic drug abuse screening should include a prescreen followed by the Drug Abuse Screening Test, interprofessional approach, comprehensive education, and utilization of generic tools to create new screening forms. Staff participated in a new drug abuse screening process, and chart audits and staff interviews were conducted. There was a 9% increase in completed screenings by medical assistants with electronic versus paper screening (30% vs 21%, respectively; P < .001). There was a 33.4% increase in provider intervention for positive screenings with electronic versus paper screening (55% vs 21%, respectively; P = .1081). Primary care providers can play an increased role in drug abuse treatment by using available technology to overcome barriers to screening independent of information systems support. By adopting the new electronic screening documentation process, this clinic was able to increase its screening outcomes.