The Arizona Health-e Connection (AzHeC) Board of Directors has approved a plan to integrate physical and behavioral health information into The Network, the statewide health information exchange (HIE) it operates. The plan was approved unanimously in late January by the AzHeC Board and the Network Leadership Council, and outlines how physical and behavioral health data will be exchanged via The Network while meeting all requirements of HIPAA, state and federal law.

Melissa Kotrys, CEO of AzHeC, said that the plan sets forth a new and expanded role for AzHeC. “We are pleased to confirm the Board’s approval of this strategic direction for The Network. There is strong consensus among our Board members and community stakeholders that integrating physical and behavioral health information through The Network will be an important step in improving health care quality and outcomes for many Arizonans,” she said.

The integration strategy includes a plan to create unified communications and messaging for both physical and behavioral health providers as well as a commitment to a unified fee structure, Kotrys added. With the elimination of participation fees for community providers in October 2015, this policy is now extended to include community behavioral health providers.

AzHeC’s plan for integrating physical and behavioral health information mirrors efforts across the country aimed at providing better access to both physical and behavioral health information. Approximately one in four adults in the United States suffers from a mental illness in any given year, and many do not seek treatment or obtain inadequate care. Of these adults, nearly 70% have a co-morbid chronic disease and are more likely to have higher rates of hospital admission and readmission. With the growth of shared-risk and outcomes-based reimbursement models, it will become increasingly important for providers to access both physical and behavioral health information on their patients, Kotrys said.

The essential challenge in integrating physical and behavioral health data is the complex statutory framework that governs these two types of data. There are three basis sets of laws that apply: the Health Insurance Portability and Accountability Act (HIPAA), the federal substance abuse treatment privacy laws (42 CFR Part 2 in the Code of Federal Regulations), and Arizona’s health information organization (HIO) law.

AzHeC’s integrated HIE will employ a hybrid approach that meets all state and federal legal requirements for patient notification and consent while affording all patient rights under the laws. The Network’s current technology vendor has the capability to manage the appropriate patient consent requirements, so no new technology will be required to implement the integrated plan.

To support the widespread integration of physical and behavioral health information into The Network, AzHeC has collaborated with Mercy Maricopa since last fall and is currently finalizing the implementation of a crisis portal within The Network to support the crisis network in Maricopa County.

This portal will then likely be extended to providers in the northern and southern areas of the State, in collaboration with Cenpatico Integrated Care and Health Choice Integrated Care. The Network today includes clinical data for over 5.1 million Arizonans, with 86 participating community providers, payers, hospitals, behavioral health providers and state agencies. Significant Network growth among behavioral health providers is anticipated in 2016 due to the integration of the data available through The Network, the new crisis portal functionality and the elimination of participation fees for behavioral health providers.