Using Health IT to Integrate Behavioral Health and Primary Care Information

Jodi G. Daniel | September 16, 2013

This is one in a series of blog posts to coincide with National Health IT Week. To follow the conversation on Twitter, look for the #NHITweek hashtag.

Health IT can support better clinical decisions and coordinated care for patients.   As a key factor in health and health outcomes, it is critical to support health IT adoption and use by behavioral health providers and to use health IT to support integration of behavioral health and primary care information.

While the behavioral health community is largely supportive of information sharing across settings, often times, behavioral health systems operate independently from broader health systems and differ in the type and scope of health IT used.

The need for information exchange that leads to better coordination of care could not be clearer.  An estimated 26% of Americans age 18 and older are living with a mental health disorder in any given year, and nearly half will have a mental health disorder over the course of their lifetime. Additionally, 68% of adults living with mental illness have one or more chronic physical conditions – further emphasizing the need for better coordinated, collaborative, and integrated care.

ONC helping behavioral health clinicians embrace health IT

ONC, in partnership with other Federal agencies, is working on activities to help the adoption and use of health IT among behavioral health clinicians as well as support care coordination among primary care and behavioral health clinicians.  ONC activities include:

  • On September 4, 2013, the National Coordinator for Health IT charged the HIT Policy Committee to recommend a process for prioritizing health IT capabilities for voluntary EHR certification, including a specific application of this process for EHRs used in behavioral health;
  • To promote interoperable health information exchange (HIE), ONC recently released certification guidance for EHR technology developers serving health care providers ineligible for Medicare and Medicaid EHR incentive payments;
  • HHS developed “Strategy and Principles to Accelerate HIE”, which highlighted a focus on advancing HIE across providers including behavioral health;
  • ONC funded the multi-state Behavioral Health Data Exchange Consortium to pilot the interstate exchange of behavioral health records among treating health care providers using the Nationwide Health Information Network Direct protocols;
  • Under the HIE Bright Spots Initiative, ONC is showcasing the solutions-focused innovations of State HIE Program grantees and their colleagues such as in:
    • New York, where providers are using HIE entities’ established infrastructure to support mental health care coordination; and
    • Nebraska, where behavioral health providers within Nebraska’s Electronic Behavioral Health Information Network (eBHIN) can obtain physical health information of their patients through the Nebraska Health Information Initiative (NeHII); and
    • ONC convened behavioral health stakeholders for a roundtable focused on using health IT to integrate behavioral health and primary care.

ONC testing approaches for privacy considerations when exchanging behavioral health information

In addition, there are additional privacy considerations for the exchange of behavioral health information.  ONC has taken steps to research and test policy implementation and technical approaches that could be used to support exchange of behavioral health information. ONC coordinated activities include:

  • Conducting pilots under the Data Segmentation for Privacy Initiative External Links Disclaimer which demonstrate ways that the 42 CFR Part 2 prohibitions on re-disclosure notice can be transmitted, along with health information, when a patient consents to its disclosure; and
  • Piloting breakthrough innovations External Links Disclaimer to allow patients’ preferences to be used in filtering data so that only the appropriate providers see the appropriate data as indicated by patients’ preferences.