These days it seems as though healthcare reform is largely synonymous with turmoil and partisanship without regard for the patients living behind the policies. Consider the flurry of failed ‘repeal and replace’ propositions and the recent resignation of HHS Secretary Tom Price, the missed deadline for the reauthorization of the Children’s Health Insurance Program (CHIP), and the threat from the White House for an executive order enabling low cost ‘skinny’ insurance purchasing across state lines.
Yet somehow, even in healthcare, there are glimmers of hope for bipartisanship and progress in D.C. I’m referring to two recent pieces of proposed legislation that focus their attention on mental health care and the need for better integration with overall health care, better data sharing, and better data privacy and security to enable better behavioral health care delivery.
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- In July, now-former Pennsylvania Congressman Tim Murphy (R-PA) introduced the Overdose Prevention and Patient Safety Act, which seeks to effectively extend HIPAA to ensure that doctors have access to their patients’ full medical records including history of addiction treatment. It is anticipated that the bill will likely move forward under the direction of one of its other co-sponsors.
- In August, Senators Sheldon Whitehouse (D-RI) and Rob Portman (R-OH) proposed the Improving Access to Behavioral Health Information Technology Act. The bill would allow CMS to offer federal incentives to behavioral health providers who adopt electronic health records (EHR). This would address a gap left by the HITECH Act’s Meaningful Use Program which incentivized adoption of EHRs by physicians, but excluded behavioral health providers.
As a physician executive focused on optimizing technology-enabled delivery of behavioral health care, I am encouraged by the two proposed pieces of legislation for several reasons:
Integration of behavioral and medical health benefits patients
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
There is no debate that physical and mental health are highly interdependent. Comorbid behavioral health leads to substantially worse outcomes and total cost of care among those with physical health conditions. Treatment plans that take behavioral health history into account enable care providers to address a patient’s overall health, reducing the likelihood of drug interaction, and in the case of addiction, drastically reducing the incidence of relapse. Legislation to promote sharing of full medical records will help address an imbalanced system that tends to put behavioral healthcare and addiction treatment services in the backseat relative to physical healthcare.
Sharing records between physicians at different health systems enables more coordinated care
In many cases, behavioral health records have traditionally been siloed and inaccessible to physical health providers. Improving the ability for physicians to have access to all information about their patients enables them to appreciate fully a patient’s clinical and sociodemographic needs, allowing them to treat the whole patient. Up-to-date and comprehensive information is essential for a physician to properly care for their patient, and incentivizing the use of EHRs among behavioral health providers would be step one to facilitate this interoperability.
Patient information security is a top priority
Use of EHRs to collect more data elevates the need for proper data security and data privacy. The intense social stigma around behavioral health and addiction issues understandably leaves some stakeholders concerned about the privacy and security of this type of patient information. This valid concern is one that the legislation tries to address through the requirement of a security risk analysis and prohibition of addiction history being used in criminal charges.
What’s next?
Behavioral health has already been proven to be an opportunity for bipartisanship and a catalyst for progress. A consensus is emerging on the impact of behavioral health on overall health and the importance of integration with overall physical health, whether through electronic records, data sharing, or coordination of clinical care. To this end, it’s beneficial for providers and patients. We must urge our elected officials to work together to bring behavioral healthcare legislation into the 21st century. Should these bills see success in D.C., it could pave the way for more bipartisan support for comprehensive behavioral health legislation.
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