Recently I testified to the Office of the National Coordinator for Health Information Technology Policy committee’s certification and adoption workgroup regarding voluntary certification of electronic health records for behavioral health. Many groups were represented in the discussion including consumer advocates, the American Psychiatric Association, the American Psychological Association, SATVA, behavioral health providers, and methadone clinics. There were those who suggested that a behavioral health certification was needed. They felt that it would help smaller practices feel comfortable that the product they chose, if certified under the proposed standard, would meet their specific needs. The National Council representative testified that they did not believe the certification was necessary. I agree, as did most of the vendors.
Here are my thoughts as to why this is the case: I believe the future of healthcare will revolve around the coordination of care. If we water down the interconnectivity requirements for behavioral health providers, or have different requirements for behavioral health and physical health we will prolong the silos between the two and reinforce the stigma associated with behavioral health. I take the other tack. I think we need to expand the current standards to include behavioral health requirements so that physical health systems need to be able to receive behavioral health data and understand it. Data such as DSM-4/5 diagnosis, components of a treatment plan, potentially suicide risk can be added to the current certifications.
We have certified our CareRecords to the existing meaningful use stage 2 requirements so we know it is possible. The data I referenced are the behavioral health data that are important for coordinating care with the physical health side of the world. Having a common vocabulary facilitates communication and is the first step to breaking down the silos and reducing stigma.