Research

Behavioral Health Information Exchange Project

Beginning in October 2010, CORHIO partnered with a multi-stakeholder behavioral health steering committee to create the Behavioral Health Information Exchange (HIE) Project. The goal of the project was to gather research and broad community input on the opportunities, concerns and priorities for including behavioral health information in HIE. The results from this research are available in a report called Supporting Integration of Behavioral Health Care Through Health Information Exchange (PDF). The project and report were made possible through a grant from the Rose Community Foundation.

Opportunities for Improving Behavioral Health Integration

Although behavioral health is a critical component of a person’s overall health, mental health and substance use  treatment information is currently not integrated with physical health information. This creates significant gaps in health records, potentially leading to fragmented, lower quality care.

Studies have shown that the average life expectancy for individuals with serious mental illness ranges from 13 to 30 years less than the rest of the population.[1] Much of this can be attributed to fragmented, inconsistent and episodic care. Individuals requiring behavioral health services have a unique need for integrated care due to frequent use of the health care system and a greater need to coordinate care among different types of providers.

A study done by JEN Associates found that those with Serious Mental Illness (SMI) have a disproportionate use of medical services compared to those without SMI. The results demonstrated that those with SMI have 3.5 times higher rates of emergency room visits, four times the rate of primary care visits, and five times the rate of specialist visits. In addition, those with SMI have high rates of co-occurring mental and medical disorders. This group is nearly three times more likely to have diabetes and three times more likely to have chronic respiratory disease compared to the general population.Behavioral Health Patient Quote ER

Oftentimes, health care providers providing treatment to individuals with behavioral health disorders lack important clinical information about their patients that contributes to adverse drug interactions and other medical complications. According to the Behavioral HIE Project's research, the vast majority of individuals and health care providers in the behavioral health community believe that better information sharing is needed to improve patient safety and quality of care.

Research Process

CORHIO conducted extensive research on state and national laws, and regulations regarding behavioral health information sharing. Additionally, CORHIO and the Steering Committee participants helped facilitate six meetings in communities across Colorado (Alamosa, Colorado Springs, Denver, Durango and Sterling), which were chosen to represent a broad cross-section of perspectives and attitudes regarding HIE. Participation at the meetings included:

  • Clients / Patients (45%)
  • Health Care Providers (37%)
  • Community Member (8%)
  • Other (10%)

Attendee Breakdown for BH Meetings 2012

Summary of Research Findings

A few key points that came out of the community discussions include:

  • 99% of behavioral health stakeholders surveyed believe that better information sharing can lead to better outcomes for individuals and populations receiving behavioral health care.
  • Over 92% of all participants agreed that it was important to include behavioral health in the development of community and statewide HIE in Colorado.
  • Consumers (patients) expressed significant interest in having access to their health information within the HIE.
  • Both physicians and patients expressed significant concerns, such as privacy issues and inappropriate use of information.
  • Participants expressed they would have more comfort with information sharing if there were more choice about which information would be shared with whom. Current models of all-in or all-out information sharing do not seem to meet the needs of this community.
  • Across all six events, only one participant felt that better information sharing was not needed.

Download a full copy of the report (PDF)

The following organizations comprised the project’s Steering Committee:

  • Colorado Association of Alcohol and Drug Service Providers
    (a.k.a.) the Colorado Providers Association
  • Colorado Behavioral Healthcare Council
  • Colorado Department of Human Services, Division of Behavioral Health
  • Colorado Mental Wellness Network
  • Colorado Regional Health Information Organization (CORHIO)
  • Community Reach Center
  • Federation of Families for Children’s Mental Health – Colorado Chapter
  • Mental Health America of Colorado
  • National Alliance on Mental Illness – Colorado Chapter
  • Quality Health Network

 

[1] Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis [serial online] 2006 Apr. URL: http://www.cdc.gov/pcd/issues/2006/apr/05_0180.htm.