EHRs and Collaboration: Leveraging Technology to Help Patients with Substance-Use Disorders

The following is a guest article by Charlie Hutchinson, CFO at InSync Healthcare Solutions.

The growth in substance use disorders [SUD] across all demographics and income brackets has impacted the role of primary-care providers [PCPs].

Physicians, especially those in rural and/or underserved parts of the country, who are most affected by the opioid epidemic, have had to step up their engagement with patients to help them physically, mentally and emotionally. They’ve also had to increase collaboration with behavioral health providers, including SUD professionals.

In 2018, CMS unveiled a new Psychiatric Collaborative Care Model in the Physician Fee Schedule that would enable providers to generate revenue when they co-manage patients with a psychiatrist or other behavioral health professionals. And in August, the Department of Health and Human Services [HHS] proposed updates to 42 CFR Part 2 — the federal regulations governing the confidentiality of patient records created by SUD treatment programs — to improve care coordination and outcomes for patients with substance-use disorders.

These are just two of many efforts intended to foster a more collaborative relationship.

Yet for many PCPs, integrating care with behavioral health providers is tougher than it sounds. A 2016 study of provider collaboration published by the International Journal of Integrated Care noted that providers’ collaboration across all contexts is frequently “hampered by organizational and individual factors,” such as differences in professional power, knowledge bases and culture. Because of this, behavioral health patients often experience inadequate, fragmented care.

What physicians need, moving forward into the 2020s, are better tools and strategies for effective collaboration. Having the right electronic health record [EHR] system and other communications technologies will be key.

Addressing Challenges

The problem isn’t that physicians don’t know that collaboration influences outcomes. It’s that they don’t always know how to approach collaborative relationships or share information.

One reason for this is that EHR adoption rates lag across the behavioral health provider community, including those who specialize in substance abuse. As recently as 2012, fewer than one in four (21 percent) behavioral health providers said they used EHRs, according to one study. While that number is steadily climbing, “beliefs about both the efficacy of EHRs and the extra layers of privacy rights for behavioral health records” were partly to blame for slower adoption, said researchers.

Another barrier to collaboration is legislation such as 42 CFR Part 2, which has put the onus on safeguarding patient privacy over information sharing. The good news is that the recent proposed changes to 42 CFR Part 2  by the HHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) suggest that the industry is working to find an optimal balance to advance collaboration. The updated rule would broaden provider access to patients’ substance use records by giving them access to central registries to identify patients enrolled in SUD treatment programs.

Aligned with InSync

As expected, improving collaboration starts with communication. Physicians and their provider partners need to talk to one another and ensure they’re on the same page and committed to working together.

Technology—especially EHRs—can also play a key role in facilitating collaboration. As such, PCPs should consider three important characteristics of technology that support collaboration with their behavioral health provider partners:

  1. Collaboration through Interoperability. As the International Journal of Integrated Care study noted, one of the tenets of effective collaboration is the free and open exchange of information. In order to collaborate effectively, clinicians need to use technology that facilitates seamless data exchange. For example, if there are updates to a patient’s medication assisted therapy (MAT) protocol or medication adherence issues, a behavioral health specialist can push a timely alert to the physician.
  2. Usability. The most effective technology is intuitive and enables providers to quickly scroll through charts, view clinical information and document care in less than five minutes, so they have more time to engage with patients, provider partners and other stakeholders in patients’ care teams.
  3. Flexibility. A provider’s workflow is as unique as his or her patients. Their EHR should be too, whether the provider needs fully customizable group charting templates or one-touch access to telemedicine applications. Having technology that can adapt as regulations change will save providers time and energy as they navigate new collaborative partnerships and patient relationships.

As physicians move into the next decade, collaboration and technology will enable them to help patients lead their best physical, mental and emotional lives.