Thursday, June 01 | Care Coordination, EHR Solutions and Operations, Interoperability, Legislative/Policy, Videos
Sarah C. (fictional name) has battled an addiction to opioids for almost five years. She was prescribed medication for severe pain after back surgery, and due to complications the back pain continued and even increased in severity for several months. The pain abated after a second surgery, but by then Sarah had developed an addiction to the pain med. She sought treatment at a county-operated addiction treatment facility, making good progress. Sarah also had several co-occurring disorders – asthma, diabetes and a heart dysrhythmia – for which she sought treatment intermittently from a local urgent care center operated by a regional hospital system.
Sarah and her children relocated to another state to be closer to relatives, where she hoped to continue her addiction treatment and get ongoing treatment for her chronic illnesses. She sought care from an integrated care provider, which was part of an Accountable Care Organization (ACO). During her evaluation visit to the new provider, she was asked to sign a consent form authorizing the transfer of her medical records. But when she mentioned that she would also like to continue her substance use disorder (SUD) treatment, the care coordinator told her that would involve a complicated, time-consuming process and that it would be in Sarah’s best interest to seek SUD treatment elsewhere. Unhappy and confused, Sarah left the facility to search anew, but she delayed her efforts and relapsed into the opioid addiction. Her asthma also worsened, and she was eventually hospitalized for several weeks, and is still recovering.
This was a fictional story, but the “complicated process” mentioned was first established decades ago with well-intentioned federal privacy regulations designed to protect the medical records of persons with a history of addiction treatment from being shared without their consent.
The Substance Abuse and Mental Health Services Administration (SAMHSA) published a Final Rule in an effort to update these regulations (commonly referred to as 42 CFR Part 2). Netsmart was heavily engaged in this process, including submitting comments to the initial SAMHSA public “listening session,” in-person meetings with SAMHSA and the Office of Management and Budget (OMB), and filing comments during the public comment period for the Notice of Proposed Rulemaking.
Our most recent comment filing was in connection with the Supplemental Notice of Proposed Rulemaking (SNPRM) published by SAMHSA along with the Final Rule.
Two key points we made in that filing were to:
Why is Netsmart involved in this effort? Because we believe that enabling persons to share information with their treating providers with appropriate but updated privacy safeguards is key to successful treatment and recovery. Simplified disclosure rules will also help improve the quality and breadth of SUD treatment, especially in integrated care settings like ACOs, Medicare Health Homes and Health Information Exchanges. It can also mitigate the negative impact of co-occurring conditions, significantly enhance patient safety and reduce the stigma associated with SUD.
Does it make a difference? Yes. For example, SAMHSA agreed with Netsmart’s position and chose not to adopt more stringent “From Whom” provisions in the Final Rule. Put simply, this allows for disclosure to and among the participants in an intermediary, such as an HIE, ACO, Health Home or other care coordination entity. Retaining the existing “From Whom” regulations allows for multi-party bi-directional consent to facilitate the exchange of a patient’s information among multiple treating providers. It also allows for re-disclosure between and among treating providers in a care coordination entity.
To achieve true coordinated, “whole-person” care, the ultimate goal of consent should be that any person – whether suffering from mental illness, diabetes, a SUD or multiple co-occurring conditions – be able to share his or her health data with their healthcare providers, utilizing today’s technology, with equal simplicity, regardless of their diagnosis, if they so desire. If someone does not wish to do so, they should have the clear option to either opt-out or choose not to opt-in to sharing that information.
We’ll continue to engage on this issue on behalf of our clients…and theirs…both in the regulatory arena and for statutory changes by Congress.
Provider perspectives and conversations with your legislators can make a difference. Visit www.ntst.com/legislation for more information. To lend your voice to our key policy advocacy efforts, contact Dave Kishler, Director, Industry Relations at email@example.com
Using EHRs to Increase Employee Satisfaction and Retention
Monday, February 27 | Thought Leadership,EHR Solutions and Operations,Human Services
Historically, EHRs weren’t designed to improve care. Instead, much of their focus was on solving non-clinical problems, like how to bill for services or provide management reports. But more recent advances in technology are reshaping how users interact with these systems to provide better care with ease and efficiency. This can benefit your workforce at all levels and functions –– saving time, preventing burnout and increasing job satisfaction.More
Thursday, February 23 | Thought Leadership,Human Services,EHR Solutions and Operations
The pandemic may be over, but virtual healthcare is here to stay. Our industry is becoming more telehealth focused, and that's good news for you. In this recap of a previous webinar, you'll learn how integrated telehealth can increase efficiency, boost staff retention and improve your bottom line.More
Wednesday, February 01 | Human Services,EHR Solutions and Operations,Interoperability,Value-based Care
Netsmart was proud to be part of the recent AHCA Population Health Summit in Washington, D.C. featuring presentations from multiple Netsmart clients and experts including Mark McClelland, MD, PhD, former administrator of the Centers for Medicaid and Medicare (CMS); and Ellen Lukins, deputy director of the CMS Innovation Center. If you were not able to attend, here are four takeaways based on the many excellent presentations and our discussions about the challenges of value-based care with long-term care executives and leaders.More