Early last fall, the National Association of State Mental Health Program Directors (NASMHPD) and the National Association of State Alcohol and Drug Abuse Directors (NASADAD) teamed to host a meeting of states at the leading edge of electronic health record (EHR) development. State mental health agencies from Connecticut, Massachusetts, Nevada, North Dakota, Oklahoma, Tennessee, and Virginia were represented, as were state substance use care agencies from Alaska, Maryland, Nevada, New Hampshire, New York, North Carolina, and Utah. Support for the meeting came from SAMHSA's Office of Applied Studies, SAMHSA's Center for Mental Health Services Division of State and Community Systems Development, and Janssen Pharmaceuticals.
Keynoter Dr. Robert Kolodner, HHS's national coordinator for health information technology, emphasized the states' important role as field laboratories that will promote the development of a national consensus on a system of interoperable EHRs. The National Governors Association (NGA) and the National Conference of State Legislatures both reported on initiatives they have under way to help develop state EHRs. In fact, HHS is funding NGA to implement a state e-Health Alliance for information sharing and problem resolution.
Several states have begun integrating separately developed EHR systems for mental health and substance use as a consequence of state agency integration. Participants called for closer collaboration with state health agencies and the need for larger state investments in modern IT.
As our fields move forward in this work, it is very clear that EHRs and personal health records (PHRs) will foster closer coordination between mental health and substance use care, as well as between each of these fields and primary care. Just as the medical home has been designed to accommodate many different types of healthcare, the electronic home will accommodate information from many different care sources, providing a basis for understanding their interactions.
As states assume more responsibility for healthcare, including universal health insurance coverage, preparedness for future disasters, and integration across specialty, primary care, and public health agencies, EHRs and PHRs will become critical tools to promote effective and efficient care. Interoperability will be required across an entire state and between states. For these reasons, states need to play a dominant role in such efforts, assisted by private software development companies.
Ronald W. Manderscheid, PhD, currently Director of Mental Health and Substance Use Programs at the consulting firm Constella Group, LLC, worked for more than 30 years in the federal government on behavioral health research and policy. He is a member of Behavioral Healthcare's Editorial Board. For more information about the NASMHPD/NASADAD meeting, visit
http://www.nasadad.org/resource.php?base_id=1196. To contact Dr. Manderscheid, e-mail
firstname.lastname@example.org. Behavioral Healthcare 2008;28(7):22.