- The Department of Health and Human Services (HHS) has issued a final rule to ease health data exchange of certain behavioral health information and touches on the health IT implications for sharing these records electronically.
Dubbed the Confidentiality of Alcohol and Drug Abuse Patient Records, the Substance Abuse and Mental Health Services Administration (SAMHSA) update is intended to protect the privacy of patients in need of treatment for substance abuse disorders (42 CFR part 2), as well as improve any overly-burdensome regulations currently in place.
“SAMHSA wants to ensure that patients with substance use disorders have the ability to participate in, and benefit from health system delivery improvements, including from new integrated health care models while providing appropriate privacy safeguards,” the federal noted in the final rule.
HHS estimates that implementing the provisions of the update will cost over $70 million in its first year.
The advantages to updating the final rule are many. HHS anticipates the update will advance opportunities for those suffering with substance use disorders to engage in new health care models and health information technology, as well as promote health information exchange within the healthcare industry in support of new models of integrated healthcare technology. Overall, the federal agency predicts the update will improve patient safety while enhancing their privacy and personal security.
In addition, as a result of these advanced privacy protection measures, HHS expects more individuals with substance use disorders will participate in health information exchanges (HIEs) and coordinated care organizations. This increase in participation is expected to improve the quality of health care population management.
Finally, HHS sees the revisions made to the research provision in the final rule as a means to increase the breadth of scientific research regarding substance use disorders leading to quality improvement of part 2 programs and program services.
Ensuring security for patients with substance use disorders will become increasingly important as SAMHSA initiates the full transition from paper to electronic records across the healthcare industry for behavioral health facilities. In collaboration with ONC, SAMHSA intends to modernize the exchange of EHRs regarding behavioral health while keeping stakeholders and third party payers up to speed on the transition.
SAMHSA has issued a supplemental notice of proposed legislation (SNPRM) to invite further dialogue on the matter.
“The modifications modernize the rule by facilitating electronic exchange of substance use disorder information for treatment and other legitimate health care purposes while ensuring appropriate confidentiality protections for records that might identify an individual, directly or indirectly, as having or having had a substance use disorder,” the organization noted in their published official document.
SAMHSA has acknowledged that many technical barriers obstruct providers from fully implementing electronic behavioral health records into their systems in a timely manner. For one thing, only half of all substance abuse disorder treatment facilities have computerized administrative information systems in functioning order.
SAMHSA plans to release an updated version of Consent2Share with recommendations regarding improved functionality and ability to meet the list of disclosure requirements. A facility already equipped with the technology to support EHR implementation that can partner with an HIE using Consent2Share or related software will have the capabilities to implement the updated version for between $6,000 and $10,000.
While making concessions for behavioral health data may be a necessary impediment to streamlining HIEs, there are certain steps providers can take to minimize the complications inherent to protecting the privacy of specific patients.
One example how providers can facilitate health data exchange while also complying with regulations surrounding behavioral health data can be found at Arkansas’ Office of Health Information Technology (OHIT). OHIT has developed an onboarding process for linking behavioral health providers to Arkansas HIE, the State Health Alliance for Record Exchange.
“Because this provider population often lacks access to robust electronic health records (EHRs) and other health IT systems, OHIT’s initial onboarding efforts are focused on increasing access to SHARE’s clinical portal and DSM to give providers a basic set of tools they need to obtain data about their patients,” the ONC stated in a brief.
Increased privacy regulations surrounding behavioral health data exchange will pose challenges to HIEs, but developers will likely be able to manage these challenges through adapted healthcare technologies.