21st Century framework needed for use of HIT in behavioral healthcare

The use of health IT in behavioral healthcare has fallen behind because of barriers such as lack of data standardization and concerns over privacy, but "opportunities exist to create a twenty-first-century framework for health IT use in an increasingly consumer-driven  healthcare environment," according to the authors of a viewpoint published in the June edition of Health Affairs.

One barrier, they note, is the HITECH Act, which provided incentives for implementation of electronic health records. The law didn't address behavioral health explicitly, and excluded organizations focusing on this from eligibility for financial incentives. Thus, "consumers seeking care for behavioral health conditions have not benefited from the quality and safety gains of health IT implementation," write the authors, who hail from the Department of Veterans Affairs, among other organizations.

In fact, in a study released in April, researchers from Harvard Medical School and Harvard Pilgrim Health Care Institute reviewing the EHRs of patients diagnosed with either depression or bipolar disorder found that about one-fourth of those diagnoses, and more than half of behavioral health visits, were not recorded in the systems.

Other barriers and how they should be addressed, according to the authors, include:

  • Clinical terminologies must represent "behavioral health information at the same breadth and depth at which they represent other medical information."
  • There must be more use of clinical decision support within EHRs geared toward behavioral health.
  • Health IT must facilitate communication and sharing of information between providers, especially as such care is usually given through "fragmented 'nonsystems.'"
  • More research is necessary to evaluate mHealth and online resources in behavioral healthcare, as well as better regulation and oversight of such tools.
  • Mental health professionals should participate in formal health IT training, "especially for clinical social workers, psychologists, and other behavioral health providers.

"Ultimately, EHR enhancements will allow behavioral health providers and consumers to more effectively use available treatments and promote more patient-centered care," the authors say.

To learn more:
- here's the abstract (subscription required)