Successful Behavioral Health IntegationIn an effort to improve the community standard of care QHN and Mind Springs Health have completed a multi-year project to integrate behavioral health information into QHN.
QHN, Mind Springs Health Partner in Behavioral Health IntegrationOn April 11, 2016 Mind Springs Health (MSH) began securely exchanging their Clinical Care Reports (CCRs) electronically through Quality Health Network (QHN). This is the culmination of a multi-year, intensive effort by a combined Mind Springs and QHN project team, the first health information exchange (HIE) and community mental health center in Colorado to successfully partner on this type of electronic exchange of records.
The vision of improving the community standard of care through the exchange of behavioral health and physical health information began with discussions between primary care providers, local hospitals and Mind Spring Health (MSH) as early as 2007. “The integration of behavioral health care and primary care is a long-term strategic goal of Mind Springs Health, “ says David Hayden, VP of Quality and Compliance at MSH. “Initially the big driver for us to get information into QHN was really the recognition that primary care providers need to know what medications their patients are on upon discharge from West Springs Hospital and they need to know their patient was discharged.”
Behavioral health impact on physical health interventions
With nearly 1 in 5 American adults suffering from mental illness, providers in western Colorado have long recognized the need to integrate behavioral health information into primary care to improve the quality and coordination of care. “Statically we know that behavioral health conditions have a tremendous impact on physical health outcomes. With the sharing of information via QHN we help providers adjust their physical health interventions to be more effective, they can take the patient’s behavioral health condition into account.”
In 2012 MSH began exchanging some behavioral health information, hospital discharge summaries, with authorized providers via fax. However, faxing created security, access and workflow problems and in early 2015 the two entities initiated a joint commitment to share the expense, policy work and potential liability risk, to explore the exchange of behavioral health information electronically utilizing QHN. “We knew the faxing process wasn’t efficient and didn’t allow for close care coordination, so once the legal framework was completed, a joint QHN, Mind Springs workgroup was convened and started to meet weekly.”
Goal: 100 percent electronic delivery of reports via QHN
The electronic exchange of behavioral health information, via HIE, creates some unique patient consent challenges. This exchange is not only regulated by HIPAA but by special privacy protections afforded to alcohol and drug abuse patient records by 42 Code of Federal Regulations (CFR) Part 2. The challenge for HIEs is patient consent management; assuring consent is completed and that the notification of the additional consent requirements are always “connected” to, and follow, the information in the system.
“We have asked our consumer focus groups for their input on this project; their initial response was one of caution as they were worried about the stigma. Once they understood that they have control to opt out and that it’s in their hands to decide whether or not to share information with their primary care providers, they have unanimously said, yes, they think it’s good that we are collaborating.”
Currently 50 percent, of close to 200 reports sent out weekly by MSH, are being sent electronically via QHN. As we continue to complete the build out of the architecture for direct delivery into provider’s EHRs this percentage will increase. “We hope to reach 100 percent delivery of our reports electronically via QHN. We have put a lot of resources into this collaboration; this has been a big investment for us. This is the first step into a new era; we look toward to more collaboration with QHN in our population health management work using QHN services such as alerts and subscription.”