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March 1, 2006
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Leadership changes and the confusing development of IT standards will not stop the field's progress

A warm welcome to the more than 6,000 new Behavioral Healthcare readers, who bring our circulation to 27,000+. There's plenty to look at already across behavioral health's future and who will take us there.

First, let's look at some of the work being done that was suggested in the new Institute of Medicine (IOM) report, Improving the Quality of Health Care for Mental and Substance-useConditions (note the absence of “behavioral healthcare” in the title—a terminology change that is a step in the right direction). Several groups have been hard at work addressing the six aims of high-quality healthcare, as well as the ten rules for the redesign of healthcare, cited in the report (first described in the IOM's landmark 2001 report).

One such group, the Forum on Performance Measures for Behavioral Health and Related Service Systems, has met to discuss chapter four (“Strengthening the Evidence Base and Quality Improvement Infrastructure”). The Annapolis Coalition on the Behavioral Health Workforce is tackling chapter seven (“Increasing Workforce Capacity for Quality Improvement”). The bulk of the work, however, seems to be centered around chapter six (“Ensuring the National Health Information Infrastructure Benefits Persons With Mental and Substance-use Conditions”).

I didn't get very far into the IOM report when Tom Trabin, PhD, executive director of the Software and Technology Vendors’ Association (SATVA), told me about Health Level Seven (HL7). You don't know what HL7 is? Don't worry, I didn't either!

HL7 is an Ann Arbor, Michigan-based nonprofit volunteer group in the business of coming up with clinical and administrative technology standards. Until recently, Dr. Trabin reports, behavioral health had no input on those standards—not a good situation, considering HL7 is charged with creating standards for the exchange, management, and integration of electronic healthcare information.

SAMHSA and SATVA have been working feverishly to rectify the situation, and they are now onboard to see that behavioral health has a say. Part of the rush is because the Certification Commission for Healthcare Information Technology (CCHIT) is using HL7's work to develop software certification standards. Details are available at www.satva.org.

If those weren't enough acronyms to remember, you're also likely to hear about RHIOs (regional health information organizations). There are more than 200 of them with more to come, mostly funded through federal initiatives and grants. Our sister publication, Healthcare Informatics, ran a panel report about RHIOs moderated by Don Mon, PhD, in its October issue. Dr. Mon, in fact, was an attendee at the behavioral health IT summit in September, and he is an advocate of EHR interoperability with behavioral health, as well as a supporter of behavioral health's move to increase its role in determining EHR standards.

As all of this has been going on, three important behavioral health IT advocates left the federal government: Ron Manderscheid, PhD, chief of the Survey and Analysis Branch in the Center for Mental Health Services (see p. 20); Mady Chalk, PhD, director of the Division of Services Improvement in the Center for Substance Abuse Treatment; and Stephanie Colston, MA, senior advisor to SAMHSA Administrator Charles Curie, MA, ACSW. These three were planners for the behavioral health IT summit and are ardent supporters of behavioral health informatics. (Dr. Manderscheid will continue to serve on Behavioral Healthcare's Editorial Board.)

These changes in leadership certainly raise questions about the direction of mental health and substance use care in the public sector, as well as the future of the projects described above. Despite these leadership changes and the dizzying evolution of EMR standards, behavioral health can—and will—make the transition to an IT-centered future. It has to.

J. Chip Drotos, MSW, CEAP, is National Accounts Manager for

Behavioral Healthcare.