Twenty-nine percent of all people with a physical health condition also have a behavioral health condition and 68 percent of adults with a mental illness have at least one physical medical condition.1 As a behavioral health provider you know that patients requiring both physical and behavioral health services have a unique need for coordinated care. Many times primary-care providers, specialists and behavioral health professionals lack critical information about a patient that can delay diagnosis or result in harmful drug interactions.
With WISHIN Pulse, providers have access to both physical and behavioral health patient information at the point of care – allowing providers to better understand the whole health of their patient so they can make more informed treatment decisions.
What Behavioral Health Information Can Be Shared?
There is a maze of federal and state laws governing the exchange and disclosure of mental and behavioral health information. Many of these laws were written long before electronic systems like EHRs and HIEs were even contemplated and make it difficult to understand what information can legally be shared, how it can be shared, and for what purposes.
In Wisconsin, the new HIPAA Harmonization – Mental Health Care Coordination Act (2013 WI Act 238, Wis. Stat. § 146.816) alleviates barriers to coordination of care for patients receiving behavioral-health treatment. The Act aligns aspects of Wisconsin’s behavioral-health privacy laws with HIPAA (the Federal Health Insurance Portability and Accountability Act of 1996 and its implementing regulations). The Act is not mandatory and many providers may still have challenges separating AODA and behavioral-health treatment records from other patient records they maintain in their EHRs.
In alignment with Act 238, WISHIN Pulse participants have the option to share behavioral and mental health data via WISHIN Pulse. As an added level of protection, participating organizations can mark mental and behavioral health data as “sensitive” in which case it would only be disclosed during a medical emergency.
While Act 238 is a significant step for behavioral-health care coordination in Wisconsin, there are still some federal laws that pose challenges to sharing data via an HIE like WISHIN Pulse. Because of this, some behavioral health data cannot be shared via WISHIN Pulse, including (1) alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program – commonly referred to a “42 CFR Part 2”, and (2) psychotherapy notes as defined under HIPAA. Significant progress is being made nationally to overcome the barriers to exchanging these types of data. In the meantime, many providers are using secure point-to-point messaging, like WISHIN Direct+, which does not have these same challenges and is an effective and efficient tool for care coordination.
1Robert Wood Johnson Foundation. Policy Brief: Mental disorders and medical comorbidity, February 2011. www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf69438