- The Bipartisan Policy Center recently recommended policymakers encourage or require mental healthcare providers to adopt EHR systems in a January report detailing opportunities to integrate clinical and mental healthcare.
The Washington, DC-based think tank examined existing obstacles to clinical and mental healthcare integration and identified potential policy options that could promote collaboration between clinical and mental healthcare providers.
“In 1996, the Institute of Medicine concluded that treating behavioral health and primary care independently leads to lower-quality care and noted that the integration of services is critical to the diagnosis and treatment of mental illness,” wrote report authors. “Integration of primary care and behavioral health has been linked to cost savings, better treatment outcomes, and lower rates of mortality.”
One existing barrier inhibiting the integration of clinical care, mental healthcare, and substance use disorder (SUD) treatment is the lack of health data exchange between organizations across care settings.
“The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009, which was part of the American Recovery and Reinvestment Act of 2009, provided billions of dollars in subsidies for medical providers to purchase and maintain electronic health records, but the act did not make incentive payments available for mental health and SUD providers,” wrote authors.
“While the adoption of electronic health records has increased among other health care providers and entities, adoption by mental health and SUD providers has lagged,” authors continued.
In addition to encouraging or requiring the use of EHR systems in mental healthcare delivery, the Bipartisan Policy Center also recommended the assistant secretary for mental health and substance use expand its biannual report on inter and intra-agency coordination efforts.
Authors recommended Congress expand the report to include information required under the Government Performance and Results Modernization Act of 2010, recommendations on how to improve care coordination across care settings, and efforts to avoid fragmentation and duplication of services.
“The report should include an estimate of the number of individuals who receive treatment under grant programs and who also have insurance coverage,” wrote authors. “The report could also make recommendations to Congress on how best to transition stand-alone grantee providers to integrated provider systems.”
Authors of the report also recommended consider offering direct federal funding to stand-alone mental health facilities, and guidance about engaging in health data exchange in compliance with HIPAA regulations.
“Today’s opioid addiction crisis has highlighted the need for easier data sharing,” stated authors. “Primary care practitioners, for example, have no way of knowing about a patient’s SUD and accompanying treatment unless the patient discloses that information during a visit.”
“By contrast, the Health Insurance Portability and Accountability Act (HIPAA) allows patient information to be shared in order to provide care coordination,” authors continued. “HIPAA allows disclosure without the consent of the patient for purposes of payment, treatment, and health care operations.”
This push to improve the integration of clinical and mental healthcare comes after Congress passed a bill promoting behavioral health EHR incentives in June, 2018.
The legislation authorizes the Center for Medicare and Medicaid Innovation (CMMI) to incentivize health IT demonstrations for behavioral healthcare providers.
The bill is designed to close the digital divide between behavioral healthcare and other areas of care in which EHR use, health data analytics, and health data exchange are more widely utilized.
Integrating mental, behavioral, and clinical healthcare may help providers tailor their treatment plans to patients’ various needs and identify obstacles that may affect a patient’s care management.