The Colorado Regional Health Information Organization (CORHIO) expects to launch a pilot later this year in which the HIE will take behavioral health data on a patient-by-patient basis—for those patients that have signed a consent—and share it with healthcare counterparts in long-term care and hospitals.
Federal regulations governing the confidentiality of alcohol and substance abuse treatment records (42 CFR Part 2) require patient consent for disclosure of such information. It requires that a patient give explicit written consent each time treatment records are released; the consent must include to whom the records are released, and be for one time only.
However, according to a Substance Abuse and Mental Health Services Administration (SAMHSA) survey only 25 percent of HIEs are currently sharing data electronically that is subject to the federal regulation.
“Health information exchanges are typically built to exchange data based on HIPAA, and of course with HIPAA, if it’s for purposes of treatment, payment and operations, you don’t need patient consent,” says Toria Thompson, CORHIO’s behavioral health information exchange coordinator. “So adding some level of tracking of patient consent can certainly change the way that an HIE has to operate. But HIEs are finding ways to do that.”
Under the Office of the National Coordinator for Health IT’s Advance Interoperable HIE Program, CORHIO and Quality Health Network—Colorado’s two HIEs—received a grant last year to improve transitions of care and help ambulatory providers, behavioral health, and long-term and post-acute care organizations to exchange clinical data.
As part of that grant, CORHIO will create a consent management portal for patients at an as-yet undisclosed behavioral health center, giving them the option of having their information exchanged with other providers in the community.
“They’ll be given a way to electronically choose, probably on an iPad, which community providers they would like the information to be shared with automatically,” according to Thompson, who said that the pilot will leverage SAMHSA’s Consent2Share, an open source tool for consent management and data segmentation that is designed to integrate with EHR and HIE systems while implementing 42 CFR Part 2 protections in the exchange of behavioral health patient information.
With the electronic consent of patients, she says CORHIO will receive continuity of care documents from the behavioral health pilot site. The documents summarize clinical information during transitions of care so patients can be treated by community providers who will have access to more details on the care patients have received at outside facilities.
“It will not just include hospital data, but it will now also include behavioral health information to bridge care between providers,” says Thompson. “We will have things like the medications they are on and their diagnosis as well as certain information on the last visits they’ve had.”
If successful, CORHIO hopes to broaden the pilot to other behavioral health centers, she adds. For its part, Quality Health Network also will be launching a similar pilot. However, QHN will not be involved in gathering patient consent directly, according to Thompson, who says they will rely on community mental health centers to obtain that consent.
Dina Passman, acting team lead for health IT at SAMHSA, says her agency funded a pilot last year with Michiana Health Information Network, an HIE in Indiana, and two opioid treatment programs in the Bronx, N.Y., which used “something very similar to Consent2Share to create a siloed data set that could also manage consent and segment data.”
According to Passman, a second SAMHSA pilot is planned to launch this year to include an HIE and a minimum of four opioid treatment programs, which will have the option of using Consent2Share. “We think the standard is viable and we continue to work with it,” she concludes.
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