Tuesday, May 13, 2014

Medical History Recited: Problems & Solutions (Part 2)

Utila is just back from the National Council for Behavioral Health conference in Washington DC.  Billed as THE largest mental health conference, #NatCon14 provided a window into the evolving landscape of behavioral healthcare.  On plain display in the "Marketplace" of vendors was the patchwork insanity that is Healthcare IT in the United States.

In my last entry, I reflected on a fundamental problem with the American medical / mental health chart.  Namely, personal health information lives in different offices under different locks and keys.  And unless you've had the same provider all your life, there is a good chance that potentially important chunks of your history are unknown to you and your provider.

Here is how our healthcare system at large is dealing with the problem.

Health and behavioral healthcare organizations invest gobs of money to hire IT companies to engineer customizable software solutions to house personal health information.  The fancier health record solutions have the potential to communicate with other systems, which require further gobs of money to engineer the communication pathways.  Not so quick though!  Only certain types of patient data can be shared, and different data is subject to different privacy laws in different states.  Want to feel more confused?  Let HealthIT.gov walk you through the labyrinth that is Health Information Exchange (HIE).

So what is the mental health care field to do?

Instead of providers being the gatekeepers of a patient or client's most important information, I believe that whenever possible clients should also be the owners of their information.  I feel strongly this way as both a client and provider of mental health services.

As a client, I want my provider to be open and honest with me.  And yes, if my provider gives me a 5-axis diagnosis, which I am confident that he and she has, I want to see that information, and keep that information to share with another therapist in the future.  As a client, I do not want to have to track down my previous providers, sign consents, and hope that they fax documentation to my new provider in a timely manner.  Because who are we kidding, these HIE communication pathways are not getting the job done for most mental health professionals.

As a provider, I realize there is certain information that I might not want to communicate with my client, that may be helpful to another provider.  That being said, the more honest and open we are with the information that we transmit to our clients, the better.  Not only do I believe that we improve our own treatment by challenging ourselves to share difficult information, we reduce the headache our clients experience if they go somewhere else for treatment.  This means giving paper copies of important information, or if feasible per HIPAA standards, electronic copies are even better.

I would be interested in hearing how providers share electronic health information with clients.  And if you are a provider looking for a solution sign up to be a beta-tester of Utila.

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