THINK TANK | The Challenges and Opportunities of Care Coordination Involving Behavioral Health Data

by Marlowe Greenberg, CEO, Foothold Technology

As an electronic health record (EHR) vendor, we know there are challenges and opportunities related to care coordination in an ever-evolving landscape. There are challenges related to data, workflows, resources, and understanding and implementing the concept of coordinated care. I’ve written about some of these topics before. To address these challenges, Foothold Technology continues to enhance our software, but we also continue to collaborate with partners, leading experts, and our customers on issues related to healthcare IT and interoperability. Whether it’s our participation in cutting-edge projects with NYU and MCTAC to create reporting standards for our customers, or our partnership with companies like Healthix to successfully support our customers participating in Health Homes, Regional Health Information Organizations (RHIOs) and/or Health Information Exchanges (HIE), our focus remains on our customers and their ability to organize and use their data in a way that supports their work and ensures quality care for those they serve.

A few weeks ago, I was asked to be part of a roundtable series sponsored by HIMSS, called “The Challenges of Care Coordination Involving Behavioral Health Data: A Panel Discussion.” I was joined by colleagues to share viewpoints on the legal issues, technology and resource constraints, and recent improvements related to behavioral health data and how it’s being used. As the moderator of our discussion, Michael Lardieri the Assistant Vice President of Strategic Program Development at Northwell Health, pointed out, it’s estimated that at some point in time half of the general population will experience a behavioral health disorder. And to paraphrase his comments, if we aren’t integrating care across the spectrum, we aren’t providing good quality care. If we aren’t providing good quality care, we aren’t providing cost-effective care. From a money standpoint, as many of our customers know, the cost of care increases for those with behavioral health issues across the spectrum, including private institutions, Medicaid and Medicare. These issues aren’t going away. In fact, as highlighted in the Surgeon General’s recent Report on Addiction, we have many more challenges to overcome.

So we know sharing information is a necessary step in care coordination, and yet we know there are barriers to sharing data with HIEs. As I shared on the panel, in my experience I’ve heard three main barriers described by behavioral health organizations:

  1. Money – realistically, funds are required to pay for the cost to exchange data. Funds for technology and software, but perhaps more importantly, the internal resources required to manage the exchange. To be successful, it’s important to have someone with the authority and responsibility to decide what data is being shared, how it’s being shared, and how it’s being managed.
  2. Providing care coordination is extremely important, but for many agencies, hesitation to move forward comes from history. For some, providing care has meant operating in a world where behavioral health issues have been (and in some cases continue to be) highly stigmatized. Agencies continue to work hard to protect the dignity and information related to those they serve and sharing data and information demands a great deal of trust. Trust between traditional health and behavioral health providers, trust between providers and those they serve, and trust between providers and their EHR vendors.
  3. Perhaps the largest barrier is motivation. Why would you, as an agency, or we, as an industry, share information? What do you get from sharing this information? We’re seeing great success with some Foothold customers working with other organizations, HIEs, RHIOs, etc. to integrate the sharing of information into workflows that provide positive outcomes for those they support, but it does require a mindshift. I remain optimistic as more agencies are motivated to exchange data and as we see more legislation calling for it.

As discussed on the panel, we all know there are other barriers like SAMSHA regulations, special rules around consent of the individual, privacy concerns, as well as overcoming technical barriers with data flowing in the direction that honors and respects the client. So what do I recommend healthcare providers do to better prepare and comply with true care coordination? Start by working together to create more standardization. We need some strict rules of the road when it comes to exchanging data. The more we can develop and agree upon standards, the more we can ensure data is flowing in a way that supports those individuals receiving services. What do I recommend behavioral health providers do to prepare? Tackle the conversations around consent, privacy and person-centered planning now, and partner with an EHR like Foothold who stands ready to support your workflows. Foothold Technology continues to be part of these innovative conversations about data exchange on the national level and in the communities where our customers operate. Proudly, our customers are vocal, collaborative, and eager to partner with us to meet these challenges head on.

HIMSS LTPAC Roundtable – The Challenges of Care Coordination Involving Behavioral Health Data: A Panel Discussion

Panelists: Marlowe Greenberg, Foothold Technology; Renée Popovits, POPOVITS LAW GROUP, P.C.; Tom Moore, Healthix; Ioana Singureanu, Eversolve, LLC; Michael Lardieri, Northwell Health (moderator)


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