eHealth Initiative Foundation Releases Brief on Sharing Behavioral Health Information
and Tracking Prescriptions Amid the Opioid Crisis

Washington, D.C. – June 25 – eHealth Initiative Foundation released an information brief, Sharing Behavioral Health Information Amid the Opioid Crisis, that examines patient privacy and security issues related to the epidemic. The brief provides industry perspectives from a recent executive roundtable, held in conjunction with Manatt, Phelps & Phillips, and aims to provide potential solutions for tackling the opioid crisis. It addresses the role of electronic prescribing of controlled substances (EPCS), regulations, and legislation, including 42 Code of Federal Regulations Part 2 (42 CFR Part 2), the Health Insurance Portability and Accountability Act (HIPAA), and the Prescription Drug Monitoring Program (PDMP).

“Unfortunately, the regulations on sharing behavioral health data is somewhat murky when it comes to the opioid crisis.” said Jennifer Covich Bordenick, Chief Executive Office, eHealth Initiative Foundation. “When patients receive treatment for opioid addiction, they are rightly concerned about how knowledge of their addiction may be shared. Similarly, clinicians worry they won’t have knowledge about addiction issues when making treatment decisions—which can also negatively impact patients. Clearly there are competing concerns about how this confidential information should be shared. Our executive discussion provided a rich tapestry about the complex issues.”

The eHealth Initiative Foundation brief provides a thorough examination of the current status of legislation and regulations affecting the epidemic, while providing industry recommendations for possible solutions. Some important takeaways from the brief include:

• Electronic prescribing could help to dramatically improve opioid tracking. Electronically prescribing opioids significantly improves the tracking ability of pharmacies and providers, enabling collection and sharing of more accurate patient information regarding frequency, length of time, and dosages of patients using opioids.
• Currently prescribers are not electronically prescribing opioids at the same level of other drugs, which means tracking information about opioids is not available. According to Surescripts data, in 2017, 77% of medications were e-prescribed but only 21% of those prescriptions were for controlled substances (opioids).
• Few prescribers have installed the required technology to actually prescribe controlled substances electronically. According to Surescripts data, in 2017 more than 90% of pharmacies were enabled for EPCS, however less than 25% of prescribers were enabled. Some of the technology required by the DEA to prescribe controlled substances (such as two-factor authentication) has not been adopted because it is considered burdensome.
• Despite attempts to clarify regulations, many providers remain confused about key regulations, which guide the manner in which most organizations share behavioral health related data. Misinterpretation about 42 CFR Part 2, HIPAA, and state prescription drug monitoring programs (PDMPs) continues to hinder behavioral health data sharing.

Solutions discussed included:

• Promote and support clinicians to electronically prescribe controlled substances. In order to improve tracking and data sharing about opioid usage more clinicians need to prescribe electronically. Clinicians need support getting systems online.
• Update regulations and technology to make electronic prescribing easier for clinicians. Update regulations and create more nimble laws that are flexible enough to keep pace with the changing healthcare industry and technologies, such as two factor authentication requirements.
• Standardize systems and data that conveys a patient’s substance use status. Create a standard format to share information about patients through workflows, PDMP data, and enforcement histories for federal and state laws.
• Create clear laws that protect patients from discrimination and alleviate fears about the unintended consequences of sharing their behavioral health data. Patients fear of discrimination is dissuading individuals from sharing their data with clinicians, even when care could be impacted.
• Improve transparency and better processes for communication. Help patients better understand their consumer rights around privacy and consent for data sharing. Help clinicians and medical staff understand when sharing is appropriate and lawful.

“The opioid epidemic has increased the need for healthcare stakeholders to take a more active role in managing behavioral health, as well as in exploring ways to improve the sharing and protecting of behavioral health data,” said Helen Pfister, Partner, Manatt Health. “The roundtable offered an exciting opportunity for leaders from across the healthcare industry and government to join together in examining the policies and technologies that affect the use of behavioral information in patient care and discussing innovative approaches to overcoming the challenges. Through the issue brief, we are able to provide the key insights and recommendations from the roundtable discussions to help advance the integrated care models that are critical to effectively addressing the opioid crisis.”

eHealth Initiative’s research and work on privacy and security was supported by Manatt, Phelps & Phillips. The brief is available for download in the eHealth Resource Center and on the Manatt website.

About eHealth Initiative
eHealth Initiative (eHI) & Foundation is a Washington DC-based, independent, non-profit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology. eHI is the only national organization that represents all stakeholders in the healthcare industry. Working with its membership, eHI advocates for the use of health IT that is practical, sustainable and addresses stakeholder needs, particularly those of patients, www.ehidc.org.

About Manatt Health
Manatt Health integrates legal and consulting expertise to better serve the complex needs of clients across the healthcare system. Combining legal excellence, first-hand experience in shaping public policy, sophisticated strategy insight, and deep analytic capabilities, Manatt provides uniquely valuable professional services to the full range of health industry players. Their diverse team of more than 160 attorneys and consultants from Manatt, Phelps & Phillips, LLP and its consulting subsidiary, Manatt Health Strategies, LLC, is passionate about helping clients advance their business interests, fulfill their missions, and lead healthcare into the future. For more information, visit https://www.manatt.com/Health.