Report: Behavioral Health Data Exchange Across States Possible

July 1, 2014 in News

Behavioral health data can be successfully exchanged across state lines despite policy and technology challenges, according to a report released Friday by a consortium of states and federal agencies, Modern Healthcare reports (Conn, Modern Healthcare, 6/30).


Many health care providers and patients have expressed interest in using electronic platforms to exchange behavioral health data, according to a “Health IT Buzz” blog post. However, federal and state laws make such exchanges difficult, as privacy protections for behavioral health data are more restrictive than those set by HIPAA. For example, the “Health IT Buzz” blog post noted that some of the policies “require written patient consent prior to the disclosure of such information, even for treatment” (Rancourt/Westley Clark, “Health IT Buzz,” 6/27).

Report Details

The report was based on a pilot project conducted by the Behavioral Health Data Exchange Consortium and in partnership with the Office of the National Coordinator for Health IT and the Substance Abuse and Mental Health Services Administration, FierceEMR reports.

The states in the consortium are:

  • Alabama;
  • Florida;
  • Iowa;
  • Kentucky;
  • Michigan;
  • Nebraska; and
  • New Mexico (Durben Hirsch, FierceEMR, 6/28).

The pilot, which began in 2010, aimed to demonstrate at least one successful behavioral health data exchange across state lines using Direct secure messaging, while adhering to state and federal privacy rules (Bresnick, EHR Intelligence, 7/1).

In addition, the report stated that the project aimed to “create policies and procedures that could be replicated in other states and regions” (ONC State Health Policy Consortium Project, June 2014).  

Report Findings

Overall, the pilot project found that the electronic exchange of behavioral health data is “complex but possible.”

By the project’s end:

  • Alabama and Florida had successfully exchanged behavioral health data; and
  • Three other states developed an underlying framework for such data exchange (EHR Intelligence, 7/1).

The report stated that the “study shows that when data are needed for treatment, no barrier should exist for exchanging that information electronically as long as all parties adhere to the state and federal requirements for the disclosure of that information” (ONC State Health Policy Consortium Project, June 2014). 

Barriers to Behavioral HIE

However, the report also acknowledged there were some technical challenges that need to be overcome if behavioral health data are to be successfully exchanged nationwide, including:

  • Electronic health records’ inability to separate data that requires specific processes or permissions prior to disclosure; and
  • A lack of “widespread understanding and agreement about the requirements for consent and disclosure of behavioral health data” (Slabodkin, Health Data Management, 6/30).


The report listed three recommendations to improve behavioral health data exchange, including:

  • Bringing policy in line with the technical capabilities of EHR systems;
  • Increasing general understanding of behavioral health data exchange; and
  • Incorporating behavioral health data exchange in ongoing discussions about health information exchange networks (ONC State Health Policy Consortium Project, June 2014).
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