Matthew Wolf, Vice President of Business Operations, quoted in Alcohol & Drug Abuse Weekly
Field moving slowly toward electronic health record
Wednesday, June 10, 2009
Alcohol & Drug Abuse Weekly
The addiction treatment field better
be prepared to contribute to and
participate in an electronic health
record (EHR) — a “virtual” place
where all of a patient’s medical data
will be stored — according to Ronald
J. Hunsicker, president and CEO of
the National Association of Addiction
Treatment Providers (NAATP). Otherwise,
he said, the field may find itself
left out of health care reform.
“All of the details haven’t been
worked out,” Hunsicker told ADAW
last week, “but it’s pretty clear that if
we don’t join that train, we’re not
going to be in health care at all.”
Providers not part of the EHR
will be treated as “something other
than health care,” said Hunsicker.
It’s imperative for addiction and
mental health treatment to be included
in integrated health care, said
Hunsicker. “Once you put all that
stuff into one basket, including the
funding and the paying for it, the
cost offsets make a lot more sense.”
Then, he said, policy makers will
want to mandate at least a minimal
level of services for addiction treatment
on demand. “Everybody now
understands we’re paying for not
treating people,” Hunsicker said.
New York-based Netsmart Technologies
provides EHR systems for
public addiction treatment programs
using its software called Avatar.
Here’s how it would work under an
integrated system, according to
Kevin Scalia, executive vice president
of corporate development.
For example, a patient is diagnosed
with alcohol abuse and opioid
dependence and treated in the public
system. That patient also has a
co-occurring mental disorder, and is
released on medications. Some time
later, the person forgets to take the
medication and starts drinking, becomes
totally “decompensated,” and
ends up with the police taking him
to the hospital emergency department.
“In this new world, all the emergency department needs to do
is figure out who the person is,”
Scalia told ADAW. “Then they can
find out where they were treated before,
what medications they were on,
and what their treatment was.”
As emergency personnel stabilize
the patient, they won’t give him
a contraindicated medication. And
instead of admitting the patient, the
emergency department could call
the addiction treatment provider
that treated the patient previously,
and say, “We want to refer him back
to you so he’s treated someplace
he’s familiar with,” Scalia said.
But before you have an EHR,
you must have an electronic medical
record (EMR) — an electronic instead
of paper system — said Hunsicker.
“As a goal, it’s very important for
the addiction field to become electronic
as the rest of health care becomes
electronic,” said Ronald W.
Manderscheid, Ph.D., a former federal
mental health official and now director
of mental health and substance use programs at the consulting firm
SRA International. “Otherwise, we
will end up as a paper island in an
electronic ocean.”
Matthew Wolf, vice president of
business operations at Seabrook
House in New Jersey, is one of the
field’s acknowledged “techies” —
and he took over 10 years to lock
into an EMR. “I started researching in
1995,” he said. “We chose Sequest [as
the vendor], but I didn’t sign until
2006,” he told ADAW. “I dragged my
feet because I knew it would be a
big project that took a lot of money.”
As it turned out, so much happened
in 10 years — the introduction of wireless and PDAs, for example —
that when Seabrook House finally
went live with Sequest on April 23,
2008, the timing was right, said Wolf.
The initial costs of EMR —
which the American Recovery and
Reinvestment Act (ARRA) will not
help with — are steep, said Wolf.
“You’re going to spend a minimum
of $50,000 to $100,000 on anything,”
he said. “Start budgeting for it, or
get a grant.”
Anecdotally, said Wolf, the EMR
saves time. “All of us are going into
the same record, looking at the same
information,” he said. “Before, you
would ask somebody 10 times — literally
— for their name and address.”
While ARRA provides $40
billion in cash to providers in grants
or incentives to help them roll out
EHR (not EMR), addiction or mental
health providers are not eligible
under its provisions, said Scalia,
who is Chair of the Software and
Technology Vendors’ Association
(SATVA). “The people who need it most — in addiction and mental
health — are the ones who aren’t
getting it,” he said.
Unfortunately, much of the information
about EMR and, now
EHR, is coming from vendors,
which leaves addiction treatment
providers nowhere when it comes
to knowing which to choose. Manderscheid,
formerly with the Substance
Abuse and Mental Health
Services Administration’s (SAMHSA’s)
Center for Mental Health Services,
said the “federal government
has to do more to help,” citing the
need for SAMHSA to have the resources
to do this. •
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