Senators Propose HITECH Incentives For Mental Health

A bill proposing to extend Health Information Technology for Economic and Clinical Health Act (HITECH) financial incentives for e-health record use by mental health professionals has been introduced into the U.S. Senate, complementing similar legislation introduced in the U.S. House of Representatives in April.

The Health Information Technology Extension for Behavioral Health Services Act of 2010, introduced last week in the U.S. Senate by Senators Sheldon Whitehouse (D-RI) and Jack Reed (D-RI) aims to expand use of e-health record system by mental health, behavioral health and substance abuse professionals and facilities, including licensed psychologists, clinical social workers and psychiatric hospitals.

The American Recovery and Reinvestment Act's HITECH legislation, which was signed into law by President Obama in February 2009, provides $20 billion-plus in financial rewards to healthcare professionals for their "meaningful use" of health IT such as e-health record and computerized physician order entry systems.

However, mental health and related professionals and facilities are among several groups of clinicians and healthcare providers left out of HITECH. Other healthcare specialties ineligible for HITECH rewards include children's hospitals and rehab facilities.

The proposals by Whitehouse and Reed aim to extend Medicare and Medicaid incentives for the use of e-health record systems to mental health professionals and facilities.

“These providers are the backbone of our mental health care system, and it is vital that they have access to cost-saving, quality-enhancing advances in health information technology,” said Whitehouse in a statement.

“By expanding the use of electronic health records, my legislation will give mental health professionals access to comprehensive and up to date medical histories, enhancing the precision of diagnoses and reducing medication errors," he said.

The Whitehouse bill is "companion" legislation to the HITECH Extension for Behavioral Health Services Act of 2010 (HR 5025) introduced into the House of Representatives by Rep. Patrick Kennedy, also a Democrat from Rhode Island, in April.

The main differences between the two bills is that while the House proposal includes the creation of a new grant program for mental health professionals, Whitehouse's legislation proposes extending mental health professionals' eligibility to tap technical and expert resources of the Regional Extension Centers, which HITECH supports for assisting healthcare providers in their health IT rollouts, said a Whitehouse spokesman.

Mental health professionals say extending HITECH financial incentives to psychologists, psychiatric facilities and other mental specialties currently not covered, makes sense.

"Clinical practice regulation requirements for documentation of [mental health care] are stringent," said Dr. Sigurd Ackerman, medical director and president of Silver Hill Hospital, a 129-bed psychiatric hospital in New Canaan, Conn. in a recent interview with InformationWeek. The use of e-health record systems for the coordination of care for mental health patients is important, he said.

"Mental health is multidisciplinary, it can involve a psychologist or psychiatrist, nurse, social worker and other people contributing to a patient's practice plan," he said.

"Electronic document systems to facilitate this are important for quality of care, reducing medication errors, suicide assessments, and more," he said.

Silver Hill Hospital is an "80% paperless" facility that uses a comprehensive e-health record system, electronic medication order management system, and computerized physician order entry system from Medsphere Systems Corp, whose OpenVista products are a commercialized version of the Dept. of Veterans Affairs open-source VistA e-health systems.

"The appeal of OpenVista is that it's an open platform that could be modified for diverse healthcare settings like a psychiatric hospital," The Medsphere product includes a "group notes" feature important for the collaborative nature of metal healthcare, Ackerman said. Plus, "commercial packages [not based on VistA] cost six to seven times more," he said.

Cost is an important consideration for all healthcare providers with tight IT budgets, but especially to those such as mental health facilities wanting to purchase e-health record systems but aren't currently eligible for HITECH related financial incentives unless extension bills -- such as those introduced by Whitehouse in the Senate and Kennedy in the House -- are passed and become law.