In announcing the release this week of the final Federal Health IT Strategic Plan for 2015-2020, National Coordinator for HIT Karen DeSalvo, M.D., said ONC is looking to better support behavioral health providers not eligible under the Medicare and Medicaid Electronic Health Record Incentive Programs.

Current federal rules prevent behavioral health providers treating mental and substance abuse disorders from receiving incentive payments for implementing EHRs that meet Meaningful Use criteria. In addition, federal confidentiality statute and regulations designed to protect the rights of consumers using substance use disorder services have been an impediment to electronic sharing of behavioral health clinical information.

Nonetheless, DeSalvo said ONC will be “paying more attention to adoption across the care continuum beyond more traditional Meaningful Use providers,” and is working at “identifying ways that we can incorporate behavioral health and long-term post-acute care, and solve financial, policy, and technical challenges.” However, at the same time, she emphasized that “there are ways that we can use existing levers in hand without creating a new program.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the Department of Health and Human Services that leads public health efforts to advance behavioral health. According to DeSalvo, ONC continues to work with SAMHSA on including behavioral health in HIT efforts. Last year, ONC’s Health IT Policy Committee developed a draft set of voluntary certification criteria for behavioral health, long-term, and post-acute care providers focused on interoperability, privacy, security, and modularity to improve EHR functionality.

“We have been working with our partners at CMS and SAMHSA in particular on ways that we can incorporate the need to have digitization of care in those environments,” said DeSalvo. Areas of collaboration include SAMHSA’s grant program and technology solutions such as Data Segmentation for Privacy (DS4P), she said.

DS4P applies a set of metadata and encryption onto a clinical document, enabling a provider to send it to a receiving system with compatible technology to recognize that the data is from a behavioral health or substance abuse program and to segregate it.

“We want to make sure that the care continuum is extended to support the person instead of segmenting those environments and creating silos of data” provided there are appropriate privacy and security protections,” said DeSalvo.

Earlier this month, the American Academy of Nursing issued a policy brief calling attention to the critical need to incorporate social and behavioral patient data into EHRs.

“There is strong evidence that social and behavioral factors influence health; however, they may not be addressed in clinical care for shared decision-making. It is imperative that all stakeholders in healthcare collaborate to include this information in electronic records, including EHR vendors, health systems, providers and funders,” said Cheryl Sullivan, CEO of the American Academy of Nursing.

Also See: Addressing Challenges of Substance Abuse Data in the Age of EHRs

Likewise, Cara English, director of the Doctor of Behavioral Health program at the Cummings Graduate Institute for Behavioral Health Studies, argues that the current state of EHRs doesn't allow for behavioral health specialists to share information that could greatly impact the quality of life of a patient and the role of mental and behavioral health interventions within primary care settings.

“By just treating the medical or physical alone we are not treating the whole patient,” says English, who charges that EHRs are missing behavioral and social data critical to successfully and holistically treat patients. “One of the biggest barriers is that behavioral health providers are not eligible for the Medicare and Medicaid EHR Incentive Programs.”

To address this barrier, Reps. Tim Murphy (R-Penn.) and Eddie Bernice Johnson (D-Tex.) have introduced a bill that would allow behavioral health and addiction treatment providers to receive payments from the EHR Incentive Programs. The Helping Families in Mental Health Crisis Act seeks to expand Meaningful Use incentives eligibility to include mental health treatment facilities, psychiatric hospitals and substance abuse treatment facilities, as well as the types of providers that are eligible to receive these funds including clinical psychologists and licensed social workers.

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access