Including more providers

Behavioral health providers have sought inclusion in the Meaningful Use and information exchange for some time. During the most recent Health IT Policy Committee meeting, the group voted to move forward recommendations regarding sending and receiving capabilities for behavioral health data.

Considering the restrictions on behavioral health data and the high level of sensitivity, the Privacy and Security Tiger Team recommended both required certification criterion for behavioral health providers and voluntary certification criterion for general providers.

Before any exchange of information, these providers must get the consent of patients before they can share any data that potentially identifies them as having been in a substance abuse program or having a history of substance abuse. If a patient provides consent, the sending provider must pass along the fact that the data are subject to restrictions. The recipient also is required to not disclose the information without the consent of the patient.

The Privacy and Security Tiger Team described the current state of behavioral health information exchange as Level 0—Part 2-covered data are not provided electronically to general healthcare providers. Part 2-covered data is shared only via paper.

In Level 1, the recipient EHR can receive and automatically recognize documents from Part 2 providers, but the document is sequestered from other EHR data. Document-level tagging can help prevent re-disclosure.

The Tiger Team recommended that Meaningful Use Stage 3 requirements include Level 1 send and receive functionality in the voluntary certification program for behavioral health providers. Behavioral health EHRs must be able to control which recipients can be sent Part 2-covered electronic documents. Only recipient providers interested in being at Level 1 would request the capability from vendors. “It’s far from ideal,” said Devin McGraw, chair of the Tiger Team, but the provider can see what’s going on with the patient and treat accordingly.

The Tiger Team acknowledged that this is “a baby step from a technical standpoint, at least as it moves from the status quo of zero digital exchange to this very initial level. To get there, you really do need catchers to be empowered to at least receive and view the data.”

Including this segment of care providers can only help further information exchange across the care continuum. Do you agree?

Beth Walsh

Clinical Innovation + Technology editor