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Organizations Connecting Behavioral Health Providers through HIEs

November 10, 2016
by Heather Landi
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Health information exchanges (HIEs) are making progress with connecting behavioral health providers with HIE services, in order to facilitate better data exchange, according to two briefs released by the Office of the National Coordinator for Health IT (ONC) this week.

ONC featured two awardees of its Advance Interoperable Health Information Exchange program in “bright spots” briefs—the South Carolina Health Information Exchange (SCHIEx) and Arkansas’ Office of Health Information Technology (OHIT).

The South Carolina Health Information Partners (SCHIP) maintains the SCHIEx which enables providers to find, send, receive, and use health data including diagnoses, medications, lab results and clinical care summaries. The SCHIEx connects 29 hospitals and federally qualified health centers as well as 240 rural health center and medical practice participants with approximately 1.3 million patient lives covered. Within the SCHIEx, there are 8.7 million clinical documents available and 8,465 direct secure messaging (DSM) messages are sent each month.

One of SCHIP’s goals is to leverage SCHIEx to address the fragmented nature of mental health care delivery resulting from a lack of communication and care coordination between mental health providers  and other providers along the care continuum. Often, mental and physical health conditions are treated separately despite their intertwined impact on the overall well- being of an individual. The ensuing gaps in care can lead to poorer health outcomes and patient safety concerns, according to the ONC brief.

SCHIP is working closely with the State Department of Mental Health to onboard the state’s mental health providers to SCHIEx.

“DMH operates 17 community mental health centers as well as other facilities. DMH affiliated sites leverage a homegrown EHR system, which has single-sign on capabilities with the SCHIEx clinical portal and DSM services. However, the system does not have a mechanism for consistently sharing care summaries through SCHIEx,” according to the ONC brief.

Access to a patient’s medical history, medication lists, and lab results can help mental health providers gain a more holistic picture of the patient’s overall health. SCHIEx’s DSM capabilities facilitate communication and information exchange among providers, especially as patients are referred to and from mental health care facilities, treatment programs, and community and social services.

SCHIP is largely focused on enabling mental health providers to access data from other points along the care continuum that is otherwise difficult to obtain. In the future, SCHIP hopes to increase the amount of data flowing out of South Carolina’s mental health organizations in order to better support the state’s mental and physical health integration efforts.

In Arkansas, the OHIT is expanding health information exchange to providers in Arkansas through a statewide HIE known as the State Health Alliance for Records Exchange (SHARE). Forty-four hospitals are live or implementing SHARE and 754 practices and other facilities are live or implementing SHARE. And, the HIE links the health records of close to 2 million patients.

“One of OHIT’s primary goals is to extend SHARE’s services to providers that have not historically exchanged data with other providers. In particular, behavioral health has long been treated independent of physical health. As a result, data from each of these points along the care continuum is often unavailable to providers in the other. OHIT is trying to help bridge the gap by onboarding behavioral health providers to SHARE,” according to ONC in the data brief.

One of the key behavioral health populations OHIT is targeting is Arkansas Medicaid providers offering Rehabilitative Services for Persons with Mental Illness (RSPMI). “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,” ONC wrote.

OHIT has developed a robust and systematic onboarding process to familiarize providers with data exchange and increase utilization, including a readiness assessment, comprehensive training sessions, ongoing support and technical assistance, and surveys to evaluate user satisfaction.

Looking ahead, OHIT will continue to expand adoption and utilization of SHARE among behavioral health and primary care providers and is exploring strategies to facilitate the exchange of data from patients with substance use disorders. Additionally, OHIT is currently seeking funding to create separate system for storing and maintaining behavioral health data to provide additional securities to behavioral health providers sending data into the HIE.

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