I’m excited to share an update on a big change coming to how BHRS documents and coordinates care: our transition to Epic, a new electronic health record (EHR) system and one of the most widely used health record platforms in the country. This change is part of Epic Mosaic, San Mateo County Health’s initiative to bring all of its services onto one shared health record. 

Today, BHRS documents care in Avatar/Netsmart, which is separate from the systems used by our partners across County Health. Moving to a single shared record supports whole-person care, so that a client’s mental health, substance use, and physical health providers can work from the same up-to-date information. The change also builds on our Transformation Journey, strengthening our ability to deliver high-quality, measurable care and to meet growing state and Medi-Cal expectations around outcomes and transparency. 

For clients and families, the biggest difference will be connection. Instead of repeating their story at every door, clients will have one record that follows them across County Health services. Common screenings and assessments will be built directly into the system, and the confidentiality protections that apply to behavioral health and substance use records are being designed in from the start. For staff, Epic will mean less duplicate data entry, more modern tools, including better support for teams providing care in clients’ homes and in the field, and training and support well before any changes take effect. I won’t pretend a system change of this size is easy. How we document, schedule, and coordinate care will change, and our commitment is that no one goes live without the training and support to feel ready. 

This is not an off-the-shelf installation. Since the project kicked off in May 2026, I’ve had a front-row seat as BHRS staff take their place at the design table. A Behavioral Health Advisory Council and six BHRS workgroups, covering regional clinics, crisis services, specialty services, substance use, care in the home and field, and residential and long-term care, meet regularly with the Epic team to walk through how we work today and to shape how the system is built. Dozens of BHRS staff are driving this effort, serving as chairs, co-chairs, and members of these councils and workgroups, and bringing behavioral health expertise to the many Epic Mosaic councils and workgroups guiding other parts of the build, from intake and scheduling to billing, patient confidentiality, data and analytics, and virtual care. Their leadership is ensuring the system reflects how behavioral health care is actually delivered in our county.  

The work ahead follows a phased path. Through August, teams are walking through current workflows and configuring the system. User and system testing will run from August 2026 to February 2027, followed by training for all staff who will use Epic from February to April 2027. Go-live is planned for April 24, 2027, and dates may be adjusted as the project moves forward. 

I’ll share more updates in the months ahead as this work moves from planning to build. Thank you to the many BHRS staff and partners already contributing their time and expertise. Your input is what will make this system work for the people we serve. If you have questions about the Epic transition, please reach out to me at jberry@smcgov.org. 

-Jen Berry, Health Information Technology Integrated Health Services Manager