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Knotty Problems Surround Substance Abuse Data Sharing via EMRs

Posted on May 27, 2015 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As I see it, rules giving mental health and substance abuse data extra protection are critical. Maybe someday, there will be little enough stigma around these illnesses that special privacy precautions aren’t necessary, but that day is far in the future.

That’s why a new bill filed by Reps. Tim Murphy (R-PA.) and Paul Tonko (D-N.Y.), aimed at simplifying sharing of substance misuse data between EMRs, deserves a close look by those of us who track EMR data privacy. Tonko and Murphy propose to loosen federal rules on such data sharing  such that a single filled-out consent form from a patient would allow data sharing throughout a hospital or health system.

As things currently stand, federal law requires that in the majority of cases, federally-assisted substance abuse programs are barred from sharing personally-identifiable patient information with other entities if the programs don’t have a disclosure consent. What’s more, each other entity must itself obtain another consent from a patient before the data gets shared again.

At a recent hearing on the 21st Century Cures Act, Rep. Tonko argued that the federal requirements, which became law before EMRs were in wide use, were making it more difficult for individuals fighting a substance abuse problem to get the coordinated care that they needed.  While they might have been effective privacy protections at one point, today the need for patients to repeatedly approve data sharing merely interferes with the providers’ ability to offer value-based care, he suggested. (It’s hard to argue that it can’t be too great for ACOs to hit such walls.)

Clearly, Tonko’s goals can be met in some form.  In fact, other areas of the clinical world are making great progress in sharing mental health data while avoiding data privacy entanglements. For example, a couple of months ago the National Institute of Mental Health announced that its NIMH Limited Datasets project, including data from 23 large NIMH-supported clinical trials, just sent out its 300th dataset.

Rather than offer broader access to data and protect individual identifiers stringently, the datasets contain private human study participant information but are shared only with qualified researchers. Those researchers must win approval for a Data Use Certification agreement which specifies how the data may be used, including what data confidentiality and security measures must be taken.

Of course, practicing clinicians don’t have time to get special approval to see the data for every patient they treat, so this NIMH model doesn’t resolve the issues hospitals and providers face in providing coordinated substance abuse care on the fly.

But until a more flexible system is put in place, perhaps some middle ground exists in which clinicians outside of the originating institution can grant temporary, role-based “passes” offering limited use to patient-identifiable substance abuse data. That is something EMRs should be well equipped to support. And if they’re not, this would be a great time to ask why!

New App Supposedly “Alleviates” Depression, According to Recent Study

Posted on June 12, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

There are approximately 58 million people who suffer from depression throughout the United States, according to the NIMH. The report converts this to about 26.2 percent of Americans ages 18 and older (or one in four adults). Pew Research Center reported last year that 35 percent of American adults own a smart phone.

What do these two things have to do with each other? Well, some of those adults who suffer from depression might just have a smartphone, and if so, a new app might help heal their depression.

Viary, the name of the app, uses a common depression treatment called behavior activation. This treatment is a process where the patient and his or her therapist figure out which activities create the most positive feelings for the patient, and from there, create a “matrix” that helps the patient want to participate in those activities. by which the patient and therapist identify activities that are positive for the patient, and then create a matrix within which the patient will be motivated to engage in those activities more often.

The app encourages the user regularly to “engage in about 100 positive behaviors, such as cooking a meal or increasing social contact and participation.” People using the app began with a score, on average, of 25 on the BDI-II scale, which indicates moderate depression. At the end of the study done on the app, on average, participants ended with a score about 13 points higher.The study also claimed that almost 74 percent of the study’s participants were not considered depressed upon completing the study.

The study really was dependent on the app, which makes the results even more interesting. It didn’t include any health coaching or counseling, and the “only contact patients had with a clinician was a weekly email to psychology students about their symptoms and feelings for that week.”

Having suffered from depression myself at one point in my life, I would have loved an app like this. While some people need more than app to help treat their depression, I think many people could benefit from this. I’m interested in seeing if anymore studies come out about the effectiveness of this app.

The app isn’t yet available for download but will be soon.