National Council Magazine - Winter 2009 - 56

Tech Notes cannot be overemphasized. Many of HCCNs are able and willing, as was the Alliance, to enter into partnerships and work with behavioral health centers to meet their EHR needs and requirements. DEFINING OUR NEEDS If such a gap in behavioral health EHRs exists, then where do we start to ensure that those gaps are ﬁlled? The place to start is with the Certiﬁcation Commission for Health Information Technology. This organization sets the requirements for interoperability for EHRs and tests them to ensure that when they are marketed as interoperable, they in fact are. In 2009, CCHIT will begin to address the standards for behavioral health EHRs. Go to their website, www. cchit.org, to review the speciﬁcations. Make comments and let them know what does and does not work and what your needs as a behavioral health clinician, administrator, or patient are. If EHRs are to meet the requirements of integrated care, clinicians, administrators, and patients all need to share information in a secure and conﬁdential manner. Clinicians may feel that this task is overwhelming; you would become bleary-eyed reviewing a list of speciﬁcations. I still get bleary-eyed at times; however, this is why we must develop partnerships with other providers who don’t become overwhelmed with reviewing speciﬁcations and who can provide reasonable explanations of what these things mean. Because I am a clinician with an IT systems background, much of what I do involves reviewing speciﬁcations. When you review speciﬁcations, think outside your own practice or organization. Ask yourself, “If I were receiving data from someone else and wanted to provide good-quality care to my patient, what would I need?” or, “What would another provider to whom I am referring my patient need to provide good-quality care?” Think of the core components and how we make that work. Be aware of the emerging technology and the National Health Information Network. This network of networks ties various healthcare providers together, including hospitals, laboratories, behavioral health centers, emergency rooms, community health centers, pharmacies, radiology centers, nursing homes, and so on. The goal is to have the right information to the provider at the point of care so that he or she can make the best decision for the patient at the time (e.g., “Maybe I don’t need to order this test for the patient for the third time, because I have the result from yesterday in hand” or “Maybe I will order a different medication, because now that I actually know what medications the patient is on, I can avoid a contraindication or adverse medication event”). Another area to begin to focus on is identifying the “value case” for sharing the data and the mecha- nisms that make this most efﬁcient. The National eHealth Collaborative (www.nationalehealth.org) will be placing a call for value cases in the next several weeks, and I cannot think of a better value case than community health centers and community behavioral health centers identifying the information and processes they need to easily pass data among each other. This process not only would beneﬁt centers that have systems in operation now but also would set the stage so that future adopters of EHRs would have ready-made templates and processes in place to make sharing patient data an easy and uniform process. PATIENT PRIVACY ISSUES We should try not to let privacy and conﬁdentiality issues stop us from moving forward to provide quality care. We need to work through some challenges, and some laws need to be changed, but we should not allow “perfect” to get in the way of “good.” We can address many issues with patient education and informed consent at the time of service and by ensuring that we honor the request of patients who opt out of sharing their information. Many behavioral health organizations and community health centers that currently routinely share patients have modiﬁed their consent forms to include each organization, and they make this known to patients. Few patients are opting out. Be transparent; there is nothing to hide. Provide the patient education. Give patients the opportunity to expect communication, collaboration, shared treatment plans, and joint decision making from their providers. It’s what I expect for me and my family! I think it should be what our patients expect as well, but nothing will change unless we make the effort to educate them about the beneﬁts of HIT and shared information to improve quality care. Michael R. Lardiere, LCSW, is the Director of Health Information Technology and Senior Advisor on Behavioral Health at the National Association of Community Health Centers (www. nachc.com). He is also on the board of the National eHealth Collaborative. Lardiere has more than 30 years of healthcare experience in inpatient, outpatient, managed care, for-proﬁt, and nonproﬁt organizations. He is responsible for developing strategy and for assisting health centers across the nation in implementing various health information technology strategies to improve quality care. Lardiere obtained his master’s degree in social work administration from Fordham University in New York City. He also holds the “R” certiﬁcation for social workers in New York State. The goal is to have the right information to the provider at the point of care so that he or she make the best decision for the patient at the time — “Maybe I don’t need can to order this test for the patient for the third time, because I have the result from yesterday in hand” or “… now that I actually know what medications the patient is on, I can avoid a contraindication or adverse medication event.” 52 / NATIONAL COUNCIL MAGAZINE • WINTER 2009

National Council Magazine - Winter 2009

Table of Contents for the Digital Edition of National Council Magazine - Winter 2009