Maine and Rhode Island were two of five states to receive $600,000 in federal funding to help support the electronic sharing of health records among behavioral health and general medical providers.
The Center for Integrated Health Solutions, which is funded by the Substance Abuse and Mental Health Services Administration and the Health Resources Services Administration, awarded the contracts.
In Maine, the State of Maine and HealthInfoNet will provide 25 behavioral health care organizations and 200 individual providers with new ways to securely share medical records, including use of the health information exchange (HIE) – an electronic system where health care providers share patient health information with the patient’s consent – and access to a secure provider-only email service.
More than one million Maine residents already participate in the HIE, says Shaun Alfreds, HealthInfoNet’s chief operating officer. The HIE is “opt-out” for general medical records (meaning patients are enrolled unless they choose not to be). Until 2011 legislation, behavioral health provider organizations couldn’t participate in the HIE. For mental health records, patient participation will be “opt-in,” meaning residents have to choose to share those records with their primary care doctor or others using the HIE.
HealthInfoNet will also build upon the work of a state-wide behavioral health information technology taskforce.
Alfreds says the inclusion of behavioral health professionals in the HIE has numerous benefits.
“At the highest level, we know there’s been a history in our country of separating the head from the body, in regard to medical care,” Alfreds says. “We know that doesn’t promote the highest quality care or the best care for the patient.”
With the HIE, “it moves information to allow a primary care provider and behavioral health provider to be able to coordinate care better and actually share information through technology,” he says.
“Secondly, it allows the patient to be more empowered by giving patients choice as to who sees their information and what they see,” he says.
In R.I., the Rhode Island Quality Institute (RIQI), a not-for-profit organization dedicated to improving the quality, safety and value of healthcare in R.I., will use the funding to extend access to currentcare – the statewide HIE – to the behavioral health community and to connect them to a secure email service for exchanging patient information.
Under the subcontract, nine community mental health organizations will be added to the first group of currentcare users.
Rich LeClerc, president and CEO of one of those organizations, Gateway Healthcare and also secretary of the RIQI Board of Directors, says the sharing of information will help behavioral health and primary care physicians to better coordinate care.
“People with severe, persistent mental illness die 25 years earlier than the general population and that’s not because of suicide,” he says. Rather, complicated health conditions contribute to early deaths. Some medications affect the kidneys and liver or contribute to weight gain. Also, lifestyle, poverty and poor diet can have negative effects.
Further, many patients don’t follow through on their medical appointments or take medications as directed.
“We’re hoping that by being able to view this information our team will be able to know their treatment regime,” he says. “The care coordination of knowing what other medications they are on or what conditions they have, is important for us to be able to support that and communicate with the primary care physician.”
Currentcare can also help avoid duplication of testing, he says and cut down on errors related to drug interaction or incorrect dosage. “Our treatment can be reflective of what other medications they are on.”
He notes his facility has been encouraging its patients to sign-up for currentcare for several years and will expand those efforts. He says some patients have been reluctant to share their information, in part because of the stigma of mental health conditions.
Charles Hewitt, RIQI’s director of the HIE Program, says more than 220,000 Rhode Island residents are currently enrolled.
Hewitt says teams are educating patients on the fact that information is only released to providers who have signed an agreement to participate. No other entity, including insurance companies or employers, will have access to this information and patients will have the ability to see who has viewed their medical information.
Hewitt says the HIE will give providers a more complete picture of the patient’s health; and should help drive health costs down, with fewer hospital readmissions and redundant labs.
“The goal of the program is to support integrated care – treat the whole patient – and that involves providing the exchange of health information throughout the whole system.”
By Pamela Berard