• Sharing Behavioral Health Data: Moving from Concept to Reality

    Laura Young Apr 14, 2016

    Laura YoungPopulation health management and value-based care are predicated on comprehensive information exchange. Organizations have to share patient health information across settings to get a complete picture of a patient’s health and treatment needs and foster cross-continuum collaboration. Although a number of states and communities have formed health information exchanges (HIEs) to enable ready access to patient health data, most of these house only traditional clinical information pulled from hospital and physician practice electronic health records.

    Just as important as clinical information is a patient’s behavioral health history, such as information about any mental health care the patient has received, substance abuse treatment, and crisis-oriented care. But due to the sensitivity of the information and the difficulties in addressing patient privacy, many communities tend to shy away from exchanging this type of data.

    Behavioral Health Information Network of Arizona (BHINAZ) is helping to pioneer a path in this space with an HIE dedicated to sharing behavioral health information. The potential benefits far outweigh the challenges, and the healthcare field will need to recognize the value of this data and commit to overcoming roadblocks to fully realize population health and value-based goals.

    Crisis Care: A Key Opportunity

    Nowhere are the benefits of accessing behavioral health data through a focused HIE clearer than in crisis care management—and the impact is twofold.

    First, when an individual seeks assistance from a crisis care provider connected to a behavioral health HIE, the provider can quickly determine whether the patient has been seen by a mental health professional and view the patient’s behavioral health records to get a sense of the patient’s treatment history, current medications, and other relevant information.

    Historically, crisis care providers have had to rely on patients and family members to give health history and relevant details. Patients could unintentionally or intentionally omit key information, forcing providers to make critical and sometimes life-changing decisions based on incomplete and inaccurate data. Conversely, having timely access to behavioral health information helps providers understand whether patients are a danger to themselves or others. Such access can also point providers in the right direction for treatment, allowing them to deliver prompt and appropriate services based on current care plans and needs—an essential component of crisis care management.

    The second benefit is that an HIE that shares behavioral health information can alert primary and mental health providers when their patients seek crisis care. Not only can these professionals serve as resources for crisis counselors, but they can also follow up after patients are out of crisis to ensure their needs are fully met. For instance, if a patient enters the hospital, notification from an HIE would allow the provider to make the appropriate follow-up appointments after discharge, preventing situations in which patients leave the hospital unsupported.

    Facilitating Population Health Management

    A behavioral health HIE also has the potential to help providers better treat the whole patient, supporting tighter population health management. Nearly 70 percent of adults with mental disorders have comorbid conditions. Imagine a future where a primary care provider who treats a patient with diabetes can see the patient’s behavioral health history—and potentially discover that the individual battles depression, which can influence treatment compliance. The provider can then tailor the treatment plan to address both the physical and mental conditions.

    Similarly, a mental health provider who treats a patient with asthma could make sure the patient stays on the clinical treatment plan so as to avoid a negative health incident that could exacerbate the mental health problem.

    Regulatory Obstacles

    The privacy and security hurdles involved with behavioral health information exchange can be daunting. For example, most HIEs take an opt-out approach to gaining patient consent, meaning individuals must explicitly request that their information not be shared. With regard to mental health data, in contrast, HIEs are required to use an opt-in methodology—patients have to give formal permission for their information to be used. This requirement often necessitates a change in infrastructure and policy, which can be a tall order.

    In addition, different types of behavioral health data are governed by various regulations, such as 42 CFR part 2, which deals with the confidentiality and exchange of substance abuse information. It can be hard for an HIE to separate the different kinds of data and ensure total compliance.

    Despite the difficulties, organizations like BHINAZ are moving the needle, getting closer to seamless behavioral health information exchange. Although there’s no magic bullet, and the effort can sometimes feel like trying to ride a bike while building it, the potential is tremendous. As the industry further commits to working collaboratively to test out new information-sharing ideas, healthcare organizations can realize the benefits of behavioral data and turn a compelling vision into reality.


    Laura Young is executive director at Behavioral Health Information Network of Arizona (BHINAZ).

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