Enhancing Opioid Treatment Program Patient Continuity of Care through Data Interoperability

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The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) is accepting applications for fiscal year (FY) 2013 Enhancing Opioid Treatment Program Patient Continuity of Care through Data Interoperability (OTP-CoC) grants. The purpose of this program is to provide resources to opioid treatment programs (OTPs) that will enable them to develop electronic health record systems that fulfill regulatory requirements, achieve certified status, and become interoperable with other patient health record systems. By enhancing OTP EHR systems in this manner and achieving levels of integration, it is expected that OTPs will improve behavioral health outcomes. In addition, SAMHSA’s Strategic Initiative on Health Information Technology is focused on ensuring the behavioral health system, including states, community providers, and peer and prevention specialists, fully participates with the general healthcare delivery system in the adoption of health information technology (HIT) and interoperable electronic health records (EHRs). SAMHSA has been working to develop Health Level 7 (HL-7) standards for behavioral health information to be included in a standard continuity of care document. All grantees will be expected to provide feedback to SAMHSA on the standard data elements that are needed to be shared across OTPs to support high level clinical care. The behavioral health treatment field, like all health care providers, is enhancing patient health record systems to incorporate interoperable EHRs. Over 1,260 OTPs provide medication assisted treatment for substance abuse disorders (opioid dependence and addiction) with methadone and buprenorphine to hundreds of thousands of patients every year. As behavioral health service providers, OTPs face specific and unique challenges in recordkeeping systems. OTPs must conform to federal confidentiality rules, which significantly restrict the distribution of patient health information. In addition, OTPs are subject to specific recordkeeping requirements set forth by federal (SAMHSA/CSAT, Drug Enforcement Administration), state, and local licensing agencies, and accreditation organizations. OTPs face special needs to continue care to patients displaced by disasters. Accordingly, OTPs, as a subset of behavioral healthcare providers, require substantial and specific assistance to migrate to interoperable EHR systems. Informal assessments suggest that OTPs have been slow to develop and adopt integrated EHR systems. There are few multi-state and multi-provider EHR software systems. Many OTPs use EHR systems that were developed and customized to provide electronic medical systems for just one OTP. Moreover, the majority of programs are patient self-pay and have not historically accessed either private insurance benefits or Medicaid benefits for patient care coverage. As such, only a few OTPs have explored or taken steps to achieve “meaningful use” incentives under the Health Information Technology for Economic and Clinical Health (HITECH) Act. OTPs, as a subset of behavioral healthcare providers, require substantial assistance to migrate to interoperable EHR systems. For example, under SAMHSA regulations (42 CFR § 8.12), OTPs must assure that their record systems, including electronic health record systems for information sharing, are in compliance with the federal confidentiality regulations. The history of localized disasters also indicates a need to improve the capacity for OTP health record systems to respond to instances when programs are closed for extended periods of time, and patients need to relocate. OTP-CoC grants are authorized under Section 509 of the Public Health Service Act, as amended. This announcement addresses Healthy People 2020 Substance Abuse Topic Area HP 2020-SA.

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