OKLAHOMA CITY — Anje Newnam expects to see a decrease in patients if the state adopts policies requiring mental health professionals to participate in a statewide health information exchange.
Citing concerns about divulging patients’ personal information, the licensed professional counselor and school psychologist at Partners in Wellness in Tulsa said she’s likely to stop practicing in Oklahoma if participation in the program becomes mandatory.
“I cannot in good faith participate in the (health information exchange) in any capacity,” Newnam said. “If the (Oklahoma Health Care Authority) says your options are to participate or turn in your license, I’ll probably turn in my license and look at licensure in another state.”
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As a result of a state law passed last year, the Health Care Authority board will consider permanent agency rules that would require all licensed health care providers, including mental health professionals, to join the exchange by July 1. The program is intended to improve patient care by allowing patients’ digital medical records to follow them to any provider in the state.
But some mental health providers are concerned that being required to share sensitive client information, such as a patient’s diagnosis, on the exchange would violate their code of ethics.
A whole-health approach to treatment
Health Care Authority CEO Kevin Corbett stressed that the exchange, which has been years in the making, will be a patient-driven initiative that takes a “whole person” approach to health by addressing both physical and mental health.
“We start with whose data is it — it’s the patient’s data,” he said. “And if they give their providers and us permission to utilize that, we have to protect it. We have to safeguard it.”
Patient participation in the exchange is voluntary. Only medical professionals directly involved in a patient’s care can access that person’s personal information and medical history.
Patients will be able to opt out without any of their personal information being submitted to the exchange, a change from MyHealth Access Network‘s current procedures, Corbett said.
The Tulsa-based nonprofit will run the exchange being built by global technology company Orion Health.
Getting a full picture of a person’s physical and mental health is key to treating all of a person’s ailments, Corbett said. Including mental health providers on the exchange is important because studies show that a majority of adults with a mental illness also have a co-occurring medical condition, he said.
“Just the thought of being able to share amongst all the health providers a full understanding of a person’s condition — we find that to be beneficial, and so do many of the providers that we’ve talked to,” Corbett said.
Patient information that could appear on the exchange includes personal identifying information, current prescriptions, drug allergies, immunization records, diagnoses, lab results and hospital discharge paperwork.
Feeling ‘blindsided’
Judy Branum, a licensed professional counselor at Resolve Behavioral Health in Tulsa, said she’s worried that medical doctors will treat her patients differently if they know their mental health diagnoses.
She said some female patients have told her stories about medical doctors minimizing their health concerns because they had been diagnosed with an anxiety disorder. Branum also questioned how long those diagnoses would stay visible on a patient’s record.
“That whole mental health diagnosis piece just brings out a whole different set of stigmas and concerns,” she said.
Mental health professionals will not be required to include their psychotherapy notes on the exchange, Corbett said.
But Branum said mental health providers haven’t been consulted on the implementation of this new program.
“As providers, we feel like we’ve all been blindsided by this,” she said. “It’s just been decided outside of our control.”
Oklahoma State Medical Association President Dr. David Holden urged the Health Care Authority and the Oklahoma Legislature to slow the implementation of the statewide exchange due to concerns about program costs and the security of patient information.
State law requires that the exchange be in place by July 1.
“It must be implemented thoughtfully and in a way that does not financially burden physicians, hospitals and other care providers,” Holden said in a statement. “In addition, all Oklahomans must be assured that their private health information is secure. We are concerned the (Health Care Authority) may not be able to accomplish these goals by July 1.”
The Health Care Authority estimates that providers will pay on average about $5,000 up front to join the exchange, but the costs will vary, Corbett said. He said he is working with state lawmakers to create a funding mechanism for providers who can’t afford to cover their own costs.
Health care entities can also seek an exemption due to financial hardship, technology capabilities or the size of their businesses.
The Health Care Authority will release more details about provider costs in the coming months, Corbett said.
The agency’s board will meet Wednesday to discuss proposed rules for implementing the exchange. People can submit public comments at oklahoma.gov/ohca/okshine.
If approved, the rules go to the Legislature and governor for final approval.
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