ONC asks for help on EHR disclosure consent requirements

In a “Dear Colleagues” note addressed to the behavioral health field, H. Westley Clark, MD, the director of SAMHSA’s Center for Substance Abuse Treatment, has asked behavioral health providers and advocates to review and comment on two "critical" segments of the proposed Definition of Stage 3 Meaningful Use of Electronic Health Records (EHRs) involving the management of patient consents required to control the disclosure of sensitive health information and the means by which providers may gain access, at the point of care, to state prescription drug monitoring programs.    

First, Clark asked providers to comment on item MU04 (page 29), which contains questions from ONC’s Health IT Policy Committee (HITPC) about appropriate means for managing the patient consent information required to comply with federal and state laws that restrict the release of sensitive personal health information. Among these laws is 42 CFR Part 2, the federal law that requires patient consent to disclosure of addiction treatment information and restricts re-disclosure of that information by the recipient.  

According to SAMHSA, “most primary care EHR systems do not have the capacity to manage these consents or to control the re-disclosure of select types of information … This lack of capacity in the emerging EHR infrastructure constitutes a significant barrier to the integration of primary care and specialty behavioral health care; and can inhibit appropriate health seeking behaviors where conditions can lead to stigma, prosecution or embarrassment.”

Second, Clark asked providers to comment on item SGRP 125 (page 21), which offers alternatives by which prescribers and emergency departments could rapidly access state prescription drug monitoring program (PDMP) information or integrate such information automatically into patient electronic medical records.

“PDMPs collect a considerable amount of useful information that can help providers identify patients with prescription drug abuse problems; however, many states do not use these databases adequately,” said SAMHSA in a statement. “Providing health care providers with real-time access to the information contained in the PDMPs will facilitate the use of this information at the point of care.”   

Behavioral health providers and advocates may offer comments on the proposed Stage 3 requirements until noon on January 14, 2013.