Absence of EHRs in Mental Health, SUD Treatment Hinders Opioid Interventions

Absence of EHRs in Mental Health, SUD Treatment Hinders Opioid Interventions

Privacy laws designed to protect individuals with mental health or substance use disorders (SUDs) when HIPAA was first implemented now hinder the care and treatment of people with opioid addictions, according to a new Bipartisan Policy Center report.

According to study authors, the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was successful in requiring most types of healthcare providers to implement electronic health records (EHRs). But it did so to the detriment of mental health and substance abuse providers who were not offered financial incentives to make the transition to EHRs, and thus fell behind on otherwise widespread adoption. Additional regulations, such as the Confidentiality of Alcohol and Drug Abuse Patient Records statute implemented in the 1970s, also helped ensure the privacy of medical records for mental health and SUD providers by keeping them separate from the patient’s other records.

However, the study’s authors say this arrangement has made it harder to address the opioid epidemic.

“Today’s opioid addiction crisis has highlighted the need for easier data sharing. 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,” the report’s authors wrote.

The report discusses barriers to the integration of clinical healthcare and mental health services, along with options to address them, in multiple areas:

  • Insurance coverage and payment barriers (including private insurance, Medicaid, and Medicare)
  • Workforce barriers
  • Administrative barriers

The four key administrative policy options the report authors list include:

  1. Report on the impact of programs serving patients with mental illness—this step, which is required by the 21st Century Cures Act, would involve expanding reporting and include such additions as recommendations on how best to improve program coordination
  2. Direct federal funding to standalone mental health facilities
  3. Encourage or require mental health providers to use EHRs—this step would also involve permitting the availability of HITECH funding to mental health and SUD providers
  4. Provide health information—while the 21st Century Cures Act directs the Department of Health and Human Services Secretary to offer guidance to help providers understand their responsibilities under HIPAA, additional focus should be given to this area, as confusion continues

Click here to read the full report.

Mary Butler is the associate editor at Journal of AHIMA.