Mental Health Professionals Debate Use of EHRs, Incentives

A coalition of mental health professionals and advocates has asked Congress to approve financial incentives to help mental health providers adopt electronic health records, but some professionals have raised privacy concerns about the use of EHRs among such providers, Kaiser Health News/Washington Post reports.
Background
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.
Currently, the program does not include:
- Emergency medical services providers;
- Mental health clinics;
- Nursing homes;
- Psychologists; and
- Psychiatric hospitals.
According to Avalere Health, including such providers in the meaningful use program would cost an additional $1 billion.
Providers Push for Incentives
Some mental health professionals and patient advocates say that EHR systems would allow providers to share patient information seamlessly. They note that data sharing is particularly important for patients with mental health issues because they typically see several health care providers and take various medications.
However, since they are not able to receive federal incentives under the meaningful use program, many providers have paid out of pocket to implement EHR systems and share electronic records with patients' primary care physicians.
For example, John Duggan, a mental-health counselor in Maryland, said his EHR system costs about $500 per month, including fees for a billing and claims services, a cloud service and the ability to exchange data with other providers.
The coalition has attracted interest among some lawmakers, who last year introduced five bills that would have offered incentives to mental health providers. However, none of the bills advanced out of committee.
This month, Rep. Tim Murphy (R-Pa.) plans to reintroduce a bipartisan measure that would include a provision to extend the federal EHR incentives to mental health providers, according to KHN/Post.
Concerns
However, some mental health providers and patient advocates have raised concerns about potential privacy violations.
For example, Burt Bertram, a mental health counselor in Orlando, Fla., said that mental health records could include patients' treatment plans and histories, which could have details about family members or former spouses. He said, "If a broad base of health professionals had access to mental health records that include psychotherapy notes, I am concerned about the potential for privacy violations ... not only for the patient, but also for the others who are involved in the patient's life."
Meanwhile, others have expressed concerns about investing more taxpayer dollars into the meaningful use program when many EHR systems are struggling with interoperability.
John Graham, senior fellow at the National Center for Policy Analysis, said that officials "need to take a breather and reassess" the program to determine its outcomes before approving more money (Gillespie, Kaiser Health News/Washington Post, 3/8).
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