A May 22 meeting of the Health IT Policy Committee’s certification and adoption workgroup focused on stakeholder reaction to a draft set of voluntary electronic health records certification criteria for behavioral health, long-term and post-acute care settings.

Workgroup members heard comment on the criteria that targets providers not eligible for the Medicare and Medicaid EHR Incentive Programs but may aid in better use of EHRs and inform future decisions in the meaningful use program. Many of the draft voluntary criteria align with the 2014 Edition requirements, particularly criteria that support transitions of care.

Nancy Lorey, applications specialist for HealthLINC, a health information exchange in Indiana, endorsed the voluntary EHR certification criteria and standards as being critical to easing the transitions of care. “Practices for behavioral health and long-term care have special needs for care transitions since they are by definition serving patients that need or will need multiple healthcare services,” said Lorey.

Pamela Russell, business development and program manager for the Colorado Regional Health Information Organization, told the workgroup that long-term and post-acute care providers would benefit from having access to behavioral health data, especially as it relates to patient medications and behavior issues at the time of and prior to admissions.

According to Russell, approximately 50 percent of Colorado’s skilled nursing, home health and hospice providers use EHRs but to date CORHIO has not integrated with any of these EHR vendors--though progress is being made. She said that her organization’s experience with some of the EHR vendors targeted at behavioral health and long-term and post-acute care “sometimes lacks the robust functionality--the HL7--needed to exchange that data effectively with an HIE.”

Russell indicated this limitation is particularly true with regard to granular patient consent, which is needed to ensure that certain sensitive data--for example, substance abuse treatment data--is only shared with very clear constraints on access.

“A particular concern of behavioral health is managing consent for information to be shared,” said Lorey. “The inability to manage consent leads for behavioral health providers to prevent access to all information, not just related to substance abuse.”

The Pennsylvania Homecare Association, which represents more than 500 home health and hospice agencies, submitted a written comment to the workgroup arguing for establishment of the voluntary EHR certification criteria. However, PHA CEO Vicki Hoak asserted that even if these criteria are put in place EHR adoption among home care providers could begin to “level off or even decrease” because they are not eligible for the monetary and technical assistance provided under the HITECH Act.

“There cannot be a widespread adoption of home health EHR systems if homecare is not valued the same as other providers and given an incentive to expand the use of EHRs,” said Hoak.

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