Substance Use Treatment in a Digital Era: An Open Letter to the Wall Street Journal and Modern Healthcare

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The Modern Healthcare article, “Key Privacy Rule Could Fall to Accountable Care Push” (June 17), touches on important privacy issues but misses the full context. The same is true of “Drug Treatment Swept Up in Push for Medical-Records Sharing” printed in the June 4 edition of the Wall Street Journal.

Far from becoming a “casualty of the push to accountable care, patient-centered medical homes and other population-oriented health plans”, the proposed rule changes update 1970s-era 42 CFR Part 2 privacy regulations to enable coordination of care and save lives.

Coordinating care across facilities and providers is essential for people with substance use issues, who often have complex co-occurring medical conditions. According to a 2011 Robert Woods Johnson Foundation study, 29 percent of adults with medical conditions have co-occurring mental health and substance use conditions, and 68 percent of adults with mental health or substance use conditions also have physical health conditions, such as diabetes, heart disease and hypertension.

The ability to share information with appropriate privacy safeguards is key to treatment and recovery for patients with substance use issues. New care models are forming, comprised of teams of healthcare professionals that coordinate care across multiple providers. Health systems are aligning themselves to provide a continuum of care. Integrating care will not only increase efficiency, it will also improve the quality and breadth of substance use treatment and mitigate the negative impact of co-occurring conditions, while significantly enhancing patient safety.

In addition, the timely, efficient sharing of authorized medical information via the fastest and most complete methods possible reduces risk of medication errors and increases the ability of emergency room clinicians to provide appropriate treatment in that setting.

As a behavioral health EHR provider, we help more than 20,000 behavioral health and addiction services providers, HIEs and RHIOs across the country integrate the exchange of clinical data to provide complete care.

Feedback from our clients, ranging from large, multi-state behavioral health/addiction services providers to small community addiction treatment centers, is that updated rules would enable them to serve their clients even more effectively.

“If the 42 CFR Part 2 regulations are not updated to reflect current technologies, they will fail to assist any of us providing addiction services. I will have thousands of people at risk without the ability to exchange information,” said Senator M. Joseph Rocks, Chairman and CEO, NHS Human Services, the nation’s largest provider of behavioral mental health, addictions, intellectual and developmental disability, and children’s services.

Netsmart also participated in the National Coordinator for Health information Technology (ONC) data segmentation technology pilot project, which demonstrated viable methods to exchange sensitive data, including substance use data protected by federal confidentiality law, between behavioral health and physical health providers.

The overwhelming feedback at the recent SAMHSA day-long listening session was in favor of updating the rules. The confidentiality of substance use treatment records is important, but much has changed in the last 42 years – in fact, much has changed in the past four years! In this digital era, the act in its current form is threatening patient safety by forcing healthcare providers to work in proverbial silos.

Michael Valentine

CEO

Netsmart

Overland Park, Kansas