Health information exchange is key to providing coordinated care. KHIE is the single, trusted source for bringing physical health and behavioral health together.
Behavioral Health is a term used to describe how a person's behaviors impact his or her mental and physical health. While the terms behavioral health and mental health are often used interchangeably, they do not have the same meaning. Mental health refers to a person's state of mind while behavioral health involves a person's state of mind and his or her physical health conditon.
Sharing patient records in KHIE is critical to providing complete patient care and serves as a channel for communication with other healthcare professionals. Improved communication between behavioral health and physical health providers is pivotal to improving holistic patient outcomes.
KHIE is integrating with behavioral health centers to provide access to pertinent health information at the point of care, where it is needed most.
Mental Health Records.
The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides consumers with important privacy rights and protections regarding their health information. Records related to mental health are considered part of a patient's general medical record. The Privacy Rule applies consistently to all PHI, without regard to the type of information. The Privacy Rule recognizes that situations arise where health information may need to be shared to ensure the patient receives the best treatment and for other important purposes, such as for the health and safety of the patient or others. The Privacy Rule is carefully balanced with appropriate protections to allow uses and disclosures of information, including mental health information, for purposes of treatment, payment, and healthcare operations.
What's included in a Mental Health Record?
Mental health records include medical prescriptions, session start and stop times, frequency of treatment, clinical tests, summaries of diagnosis, symptoms, and prognosis. According to HIPAA, this type of information is considered part of a patient's general medical record; thus, it can be shared in KHIE without patient consent.
KHIE does not accept Psychotherapy Notes.
Psychotherapy notes are treated differently from other mental health information because they are the personal notes of the therapist. These notes are not required or useful for treatment, payment, or healthcare operations purposes other than by the mental health professional who created the notes.
Substance Use Disorder (SUD) Records.
Substance Use Disorder Records are not mental health records. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Use Disorder (SUD) records are regulated within the Federal Register under section 42 CFR Part 2. The Part 2 regulations "impose restrictions upon the disclosure and use of alcohol and drug patient records which are maintained in connection with the performance of any federally assisted alcohol and drug abuse program". These records are governed under the SAMHSA and are afforded additional privacy protections. They are provided the highest degree of confidentiality protections granted to medical records. These records require patient's written consent before they can be shared. Additionally, these records cannot be further disclosed without patient consent.
Is your Organization a 42 CFR Part 2 Program?
Your organization is a Part 2 Program if you answer 'yes' to the following three questions:
1. Is the primary function of your organization to provide diagnosis, treatment, or referral for treatment for a substance use disorder (SUD)? Yes___No___
2. Does your organization advertise that it treats substance use disorder? (Do you have an awning on your door or notice on your window that states you provide diagnosis, treatment, or referral for treatment for a SUD?) Yes____ No____
3. Is your organization federally funded for anything? Yes____ No____
Consent to share 42 CFR Part 2 Health Information in KHIE.
42 CFR Part 2 requires 'consent to share' from the patient. A patient must give written permission to healthcare providers to share this type of information with anyone, including KHIE. KHIE doesn't manage consent and, therefore, puts the onus for obtaining patient consent on the Participant. KHIE requires the 42 CFR Part 2 Participant to attend a KHIE training focused on requirements for obtaining consent from the patient. Accompanying materials are available to help the Participant with training staff members and informing patients of the value of sharing this information in an HIE.
Disclosure of Substance Use Disorder Records.
When Part 2 records are shared with a patient's consent, the records must be accompanied by a notice of prohibition on redisclosure so the recipient knows that further disclosure of the information is not permitted without obtaining patient consent. KHIE ensures the specific disclosure language is included on any record with SUD information that is shared through the health information exchange.