Despite major advances in healthcare technology, significant disparities remain—especially with behavioral and mental health providers that didn’t qualify for federal health IT initiatives under HITECH funding. Many of these providers reside in underserved markets or outside the Integrated Delivery Networks. Without access to the same sophisticated EHRs and standardized data-sharing frameworks that larger health systems employ, these under-resourced provider groups face a steep digital divide that hinders equitable access to patient data.
Consequently, behavioral health settings must bridge critical information-sharing gaps to ensure delivery of a full patient record and support clinicians in optimal decision-making. Participants in a recent panel discussion at the HIMSS New England Chapter Spring Conference offered a cost-effective pathway toward advancing tech and equitable data exchange.
The digital divide in mental healthcare
About 1 in 4 American adults face a diagnosable mental disorder, with 1 in 20 suffering from acute mental illness. Various clinical, legal and regulatory mandates require providers to collect large sets of data when these patients present to healthcare settings. In addition to both physical and psychological reviews, along with documented treatment plans, regulations require inpatient rounding every 15 minutes, depending on acuity, to continuously collect vital information.
These requirements result in patient records that can exceed 500 pages of data for a single seven-day hospital stay. Collecting all this data is daunting enough; but the real challenge comes in sharing it with other institutions, requiring providers to parse through mountains of paperwork to find important information regarding prescribed medications, recommended treatments and critical diagnoses.
Since behavioral health facilities, substance use disorder (SUD) clinics and other post-acute care settings didn’t qualify for “meaningful use” funds to implement EHR systems under the HITECH Act, these organizations had to adopt their own workflows for capturing patient data—many of them still relying on paper-based notetaking. Notably, more than 80% of hospitals have implemented an EHR, but only 6% of behavioral health facilities and 29% of SUD treatment centers have that luxury.
The manual data entry required to transfer all this unstructured data to other providers in an easily processed, structured format results in drastic delays in care continuity. These tech inequities have serious consequences for mental health treatment, outcomes and readmissions.
Disparities in care transitions
Once a patient is discharged from a behavioral health hospital to a community clinic or SUD treatment center, maintaining continuity throughout the transition is critical. Interrupted medication protocols, delayed care or missing data can lead to dire consequences, contributing to behavioral health readmission rates of 20%, nearly double the readmission rates for patients without behavioral health comorbidities.
“If you don’t have a structured data set and you don’t know what medications they were on, and you don’t know whether or not they actually got this treatment or that treatment—or if they had suicidal tendencies—and they present themselves again, how do you effectively treat them?” asked Todd Haedrich, CEO of Oxehealth, during the HIMSS panel discussion. “If the effective data capture doesn’t happen properly and you’re seeing this readmission, the system’s not working. The system’s broken.”
Because of these communication breakdowns, mental health patients often have to start from scratch each time they visit a different provider, undergoing the same assessments all over again to collect redundant data that wasn’t efficiently transferred from previous admissions. These redundancies add unnecessary costs and undue stress to an already vulnerable population.
That’s assuming they can even access care at all, considering that three-fourths of inpatient mental health facilities are located in urban areas, making care inconvenient for rural residents. According to a study conducted by the National Alliance on Mental Illness, 1 in 4 respondents don’t have a mental health practitioner in their health plan’s network, forcing them to seek more expensive out-of-network care. Plus, with no practicing psychiatrists in more than half (51%) of all U.S. counties, less than one-third of the population (28%) has adequate access to mental health professionals.
“You’ve got data issues. You’ve got access issues. You have physical capacity issues,” Haedrich said. The barriers keep accumulating for mental health patients.
Bridging the digital divide
As the mental health crisis continues to escalate, the digital divide only widens. The need for tech equity is imperative to supply providers with timely, complete data to deliver the best possible care for behavioral health patients.
The federal government has tried pushing for interoperability standards to enable seamless clinical data sharing through initiatives like the TEFCA framework, which uses structured FHIR data to exchange patient records. Unfortunately, investing in these capabilities is almost as daunting to under-resourced clinics as implementing an EHR. Requiring these facilities to adopt FHIR frameworks would effectively exclude them from healthcare data exchange altogether.
A more pragmatic and cost-effective solution is to utilize existing tools paired with innovative yet affordable technologies. For example, 63% of healthcare providers today rely on fax to share patient information, with smaller practices reporting even higher usage (71%). When cloud-based, digital fax is paired with advanced tech that supports information exchange via Direct Secure Messaging protocols, mental health patient records can be more easily shared and accessed via digitized and centralized communications.
This is especially critical when dealing with large patient records. Some behavioral health faxes contain hundreds of pages per patient, and finding important information becomes an administrative challenge, especially upon handoff from another provider. If the most critical diagnosis is found on page 50, it can be missed by the next care team member. Taking it a step further, digital fax combined with AI-powered intelligent data extraction provides a significant advantage: instantly finding critical information, even deep within multi-page documents. Once fax data is structured, AI can be prompted to pinpoint details such as the latest diagnosis or the first time a diagnosis was uncovered.
A pragmatic and cost-effective solution for providers, even those without an EHR, is to combine digital fax with advanced tech. This approach offers a cost-effective, easy-to-implement pathway to better patient experiences and improved health outcomes, supporting more equitable mental healthcare.
By Bevey Miner, EVP, Healthcare Strategy & Policy, Consensus Cloud Solutions
