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Historically, behavioral health data hasn’t been part of the clinical medical record, yet this information can help providers more accurately predict health behaviors.
YoungAs healthcare providers aim to deliver holistic care, they are seeking information outside of traditional clinical sources to better understand patients, appreciate their medication and health history and provide more targeted and effective treatment. One specific type of information gaining importance is behavioral health data, including background on mental health conditions, substance abuse treatment and crisis intervention.
Historically, behavioral health data hasn’t been part of the clinical medical record, yet this information has strong potential to help providers more accurately predict health behaviors and furnish comprehensive, holistic care.
Oftentimes, mental health conditions are closely intertwined with physical ailments. If not treated together, the patient may suffer unnecessarily from either or both perspectives.
Patients with behavioral health issues frequently have multiple comorbidities-diabetes and depression, for instance. If a provider treats the patient’s diabetes without addressing the depression, the patient may skip or delay insulin doses, facing setbacks on both fronts.
Conversely, if a provider responds to the patient’s depression but does not consider the diabetes, the patient can suffer negative physical outcomes, which can exacerbate the depression. The scenario can quickly degenerate into a vicious cycle, repeatedly leading the patient back to the hospital and stalling his or her recovery.
Accessing behavioral health information can be especially beneficial when prescribing medication. As a clinical health provider considers how to pharmacologically treat a patient’s physical condition, making the right choice can be difficult if the physician does not have a full appreciation of all of the individual’s medications.
Unless the patient shares information on behavioral health prescriptions-anti-depressants, anti-psychotics or anxiety treatments, for example-the physician can inadvertently order a medication that conflicts with the other drugs. As a result, one medication could limit or cancel the effects of the other or even cause a negative reaction. At the very least, the provider could unknowingly deliver an ineffective intervention. The worst case would be he or she actually causing patient harm.
The emergency department (ED) is another logical place to weave behavioral health data into the patient’s medical picture. When an individual comes to the ED acting abnormally, it can be helpful to know his or her mental health history to understand whether any manner changes are due to a physical ailment or a more underlying condition that warrants attention.
In addition to the patient care advantages of using behavioral health information, there are financial benefits as well. Providers that use both clinical and behavioral data can reduce unplanned hospital readmissions by gathering and responding to a more complete picture of the patient’s health, thus reducing the likelihood of costly fines and driving up patient satisfaction.
A robust data picture can also help providers work smarter and more efficiently, ensuring less duplication of services and saving time because clinicians don’t have to make phone calls and fax information to obtain details about a patient’s mental health status.
While being able to call up and review behavioral health data certainly has its advantages, it is not often easy for providers to do. Ideally, a physician could access this information along with other community health data through a health information exchange (HIE). However in reality, sharing this kind of data requires organizations to follow very strict privacy and security rules with exhaustive consent policies.
Traditional HIEs usually don’t have the necessary infrastructure to support the stringent requirements, and it can be difficult to obtain patients’ consent to share behavioral health data with physical providers due to the information’s personal nature. As a result, many clinical HIEs shy away from including this kind of data in their program.
Behavioral Health Information Network of Arizona (BHINAZ) addresses these challenges by offering the first statewide HIE for behavioral health data. Sponsored by seven non-profit behavioral health organizations, the HIE gathers data from many sources, including substance abuse programs, crisis professionals, general mental health practitioners and children’s behavioral health specialties around the state, and makes that information available to participating providers.
Although BHINAZ is still relatively new, and focuses mostly on sharing data between behavioral health providers, it is making inroads to exchanging data with physical health providers as well.
For example, BHINAZ currently receives alerts whenever patients are admitted to or discharged from the hospital, allowing participating behavioral health providers to reach out to the patient’s clinical-care physician and discuss treatment or schedule follow-up appointments.
BHINAZ also receives alerts whenever a patient calls a crisis hotline or enters a treatment center. This lets the patient’s primary mental-health provider offer real-time input into care and follow-up with the patient afterwards to ensure no one falls through the cracks.
Recently, BHINAZ launched a pilot program with a physical-care provider who makes several referrals to behavioral health specialists. The participating entities are working on a way to seamlessly share information when a referral is made and following the appointment. So, if the primary-care physician refers a patient to a behavioral health organization, he or she can immediately communicate the patient’s health history to the organization through BHINAZ.
Once the behavioral health provider has seen the patient, he or she can provide notes to the clinical provider about what happened during the appointment and next steps for treatment. Through this pilot, the participants are hoping to find ways to enable more collaborative patient care to reduce risk and drive positive patient outcomes.
Ultimately, the ready exchange of behavioral health information will improve care delivery across the continuum. However, organizations need to be cautious in how they proceed.
There is a balance between sharing relevant information and too much information, overwhelming the recipient and lessening effectiveness. As such, providers must work together to identify the critical elements to sharing and the best ways to exchange the information. Doing so will help to smoothly integrate this into work flow, rounding out the patient picture and allowing more holistic care.
Laura Young is the executive director of The Behavioral Health Information Network of Arizona (BHINAZ).