Wednesday, April 6, 2011

Addressing Behavioral Health

The Substance Abuse and Mental Health Services Administration (SAMHSA) within HHS has released the draft of their plan that identifies eight Strategic Initiatives to reduce the impact of substance abuse and mental illness in communities.

The plan “Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014” reports that by 2020 behavioral health disorders will surpass all physical diseases as a major cause of disability worldwide.

The plan stresses the need for the mental health field to use information technology to share information. By using technology, information can be obtained from national surveys, surveillance activities, and on evidence-based practices. Also, the web, print, social media, and public appearances should be used to reach the general public, providers, and other stakeholders involved in the mental health field.

The plan points out that in the past, the specialty behavioral health system has often operated independently from the broader health system and this has resulted in differences in the type and scope of information technology used.

The goal for SAMHSA is to work collaboratively with the Office of the National Coordinator for HIT, to drive the adoption of HIT and EHRs, and to enable specialty behavioral health to be easily exchanged with primary care by 2014.

On the state level, Nebraska has faced slow growth in their technical infrastructure because of limited investment capital. According to Nebraska’s Operational eHealth Plan, the state’s behavioral healthcare services are operated on a shoestring, and many of the providers rely on fundraising efforts to be able to continue to deliver services.

In general, consumers in the state are actively participating in Nebraska’s largest active health information exchange the Nebraska Health Information Initiative (NeHII). Consumers are also extremely satisfied with the telehealth services provided through the Nebraska Statewide Telehealth Network.

The state is continuing to improve behavioral health resources, and as a result, the new state Health Information Exchange “Behavioral Health Information Network” (eBHIN) will be activated in Region V in the southeast part of the state. According to Wende Baker, the Network Director for eBHIN, the system will go live in June 2011

eBHIN will include software with enterprise architecture a software solution that operates on a single database supporting the requirements of multiple organizations, multiple practices, and multiple locations.

Federal funds made available through the State HIE Cooperative Agreement program will help fund eBHIN’s Central Data Repository (CDR) as proposed for the HIE system. The CDR with a centralized database will maintain wait lists, referrals, and provide easy access to centralized consumer data, and lab results.

The system will reduce redundant data entries, improve consumer safety through clinical data sharing, have capabilities to report data at any level, decrease the cost of deploying and maintaining software across regions, and accomplish all of the goals while complying with HIPAA. The CDR will operate in a web-enabled environment located at an existing state-of-the-art data center with the capability to assure system security 24/7.

Very importantly, CDR will provide the Virtual Behavioral Healthcare records that can be uploaded to NeHII and be available to medical providers across the state. This will be the vehicle by which medical records available from NeHII will be available to behavioral healthcare clinicians.

The initial pilot includes Blue Valley Behavioral Health, Community Mental Health Center of Lancaster County, and ByanLGH Medical Center Behavioral Health Services. The pilot will be based on the current Community Health Solutions database purchased from Nextgen.

It will be eBHIN’s responsibility to collaborate with stakeholders, the NITC eHealth Council, the State Health Information Technology Coordinator, NeHII, and the Office of the National Coordinator to comply with reporting requirements. For more information, email Wende Baker at