The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the National Coordinator for Health Information Technology (ONC) will partner to invest more than $20 million of SAMHSA funds over the next three years in an initiative to advance the technology health information (IT) in behavioral health care and practice settings. The project supports her HHS Roadmap for Behavioral Health Integration and is consistent with The President’s call for action to prevent, treat and provide long-term recovery support for mental illness and substance use disorders.
Health IT adoption among behavioral health providers currently lags behind other providers. This is partly due to their inability to participate in health IT incentive programs, such as those under the Centers for Medicare & Medicaid Services. ONC analysis American Hospital Association survey data from 2019 and 2021 found that 86% of non-federal general acute care hospitals had adopted a 2015 Version certified EHR. In contrast, only 67% of psychiatric hospitals had adopted a 2015 Version certified EHR. Additionally, SAMHSA’s ONC analysis survey data as of 2020 shows that psychiatric hospitals are lagging even further in adopting interoperability and patient engagement features.
Lack of access to health IT and associated higher-level capabilities and efficiencies (eg, patient access, alerts, clinical decision support, care planning, data sharing, analytics, and reporting) impact the ability of behavioral health providers to provide access to treatment through tools such as telehealth. It also limits the integration of behavioral health data with primary care and other physical health entities, posing a significant barrier to cross-functional sharing of behavioral health data across the continuum of care.
To address these challenges, the Behavioral Health Information Technology (BHIT) Initiative will identify and pilot a behavioral health data set with SAMHSA exclusion for substance use prevention, treatment, and recovery services ( SUPTRS BG) and Community Mental Health Services Block Grantees (MHBG). The data elements will be coordinated through a new USCDI+ behavioral health sector to improve efficiency and reduce costs of data collection, use and sharing for behavioral health providers.
How the BHIT Initiative will advance Health IT
USCDI+ for Behavioral Health
Behavioral health providers have a distinct set of challenges compared to those providers who practice in other clinical settings. Documentation of behavioral health encounters is generally in the form of a detailed narrative, often supplemented or accompanied by additional quantitative or other discrete information (such as symptom scale scores or indices). This can lead to difficulties in effectively sharing behavioral health information with primary care providers and hospitals to support continuity of care. Content standards developed as part of this USCDI+ project will support the capture of key behavioral health data at the point of care (eg, depression screening) to improve continuity of care between behavioral health providers and other clinical care providers the same patient. This will reduce the reporting burden faced by SAMHSA beneficiaries by improving the ability of mental health and substance use treatment providers to measure, evaluate, and report on the care they provide.
In 2024, ONC, SAMHSA, and other federal partners will begin identifying data elements for the USCDI+ project as part of the broader BHIT Initiative. This collaborative approach will incorporate input on behavioral health priorities from a variety of individuals and entities, including clinicians, beneficiaries, states, and advocates. SAMHSA and ONC will coordinate with technology developers and participating providers on how best to include USCDI+ behavioral health data elements in Health IT and pilot their use.
A resource for BHIT
ONC will develop a behavioral health information resource to support behavioral health care and integrated practice settings for HHS grantees and the public, similar to previous ONC resources focused on Pediatric Health Informatics (PDF | 1 MB) and Neonatal abstinence syndrome (PDF | 807 KB). The resource will support those wishing to use USCDI+ health behavior data elements by providing specific details useful for implementation. For example, it may include information on using health IT to address clinical priorities, support for improved workflows, and technical information on integration into behavioral health settings.
Technical support
ONC will provide technical assistance to pilot participants from SUPTRS BG and MHGB programs to inform health informatics implementation to support improved state and local capacity for substance use and mental health treatment and recovery support services. This may include, for example, developing educational resources for adopting health IT capabilities and technical resources for BHIT data coding and data quality.
Looking Ahead – What’s Next
The BHIT Initiative will advance Health IT in behavioral health across HHS programs and beyond. Moving forward, you can expect to see more updates and opportunities to participate and help inform this work. Sign up for email updates to learn about ONC’s activities.
