Mental health and addiction treatment providers today face a critical issue - how can they best manage information to improve patient care and safety while protecting patient rights and privacy. Behavioral health is part of the broader healthcare industry, which is in the midst of a massive transformation to better manage patient health information. This transformation has been occurring almost naturally because of advances in information technology and management. It promises an improved healthcare system that will hopefully put an end to the 44,000 to 98,000 patient deaths that occur annually due to preventable information related mistakes.
The federal government is participating in healthcare's information technology transformation. In 2004, President Bush issued Executive Order 13335 that called for the widespread adoption of information technology in healthcare and established the Office of the National Coordinator of Health Information Technology (ONCHIT) to help achieve this goal. To a service provider, the Electronic Health Record may sound like a software issue, but it is in fact a retooling of business practices affecting patient safety and quality of care.
How can behavioral health become part of healthcare's information technology transformation? Behavioral health providers must first decide on essential mental health and addictions treatment information for inclusion in a common EHR. This decision must resolve five key policy issues:
1. What unique behavioral health information must be incorporated into an EHR?
2. Should there be time limits on behavioral health information in the EHR - for instance, should a diagnosis of alcoholism be maintained 25 years after sobriety has been attained?
3. What opportunities exist for the behavioral health field to participate in the development of the EHR?
4. What role should behavioral health consumers and service providers play in actively managing behavioral health information and other data standards?
5. How should the EHR address privacy and confidentiality?
How is the behavioral healthcare faring so far in this transformation? Unfortunately, not very well. Information technology used in behavioral health generally supports only administrative reporting and is a far cry from fulfilling the potential to improve clinical decision-making and program planning.
To help behavioral health better react to this transformation, the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment sponsored the Behavioral Health Treatment Standards Group (BHTS) in 2005. The mission of BHTS is to increase knowledge, understanding, and use of behavioral health data standards in addictions treatment and mental health. BHTS members include a mix of organizations representing addictions prevention and treatment, and mental health services as well as software vendors involved in developing EHRs for behavioral health providers.
BHTS is achieving results. One important result has been to get standards-setting organizations that are shaping the design of the technology and information infrastructure for EHRs (like Health Level Seven) to reflect the unique needs behavioral health patients and providers with regard to privacy and confidentiality. BHTS is also raising awareness and understanding within the public and private sector about the significant potential of EHRs in clinical services and administrative matters, especially for reporting to the multiple entities that fund behavioral health services. BHTS is now working to collect information about the cost of adopting such systems and to learn more about reporting requirements for behavioral health providers. This knowledge will be used to better shape the public effort to make behavioral health part of the transformation occurring in healthcare.