ONC is transforming US healthcare through standardization of data collection and exchange in EHRs. It improves patient care coordination and patient access to their healthcare data. And, it makes reporting to public health agencies, regulators and payers less burdensome and more accurate.

ONC facilitates rolling out new regulations. For example, when the information blocking rule was passed, ONC was charged with certifying that EHRs were prepared to support it. The rule dramatically improved patient access to their healthcare information with minimal burden to providers because the changes were made in the EHRs.

ONC’s promise depends on wide adoption. A critical mass of US physicians (>95%) now use ONC-certified EHRs. Unfortunately, less than 1% of behavioral clinicians in private practice do. Thus, behavioral clinicians are at risk becoming more isolated as the rest of healthcare is learning to work together more efficiently.

The stakes are high. Provider incomes, professional autonomy and the well-being of patients hang in the balance.

Risks for Behavioral Providers

Reduced referrals: A provider with an ONC-certified EHR can generate and securely send a referral with a few clicks. The receiving clinician creates and sends a feedback report with a few more clicks. Both clinicians can reconcile and integrate the data they receive into their EHRs. The ease of electronic referrals will give behavioral clinicians with ONC-certified EHRs an advantage over behavioral clinicians who use phone and fax.

Information blocking: ONC-certification means an EHR can provide patients with real-time access to their records while clinicians can protect sensitive data when necessary. The blocking rule does not require the use of an ONC-certified EHR, but it is not clear how providers can comply without one.

HIEs. In 2022, North Carolina will require providers serving Medicaid and state employees to submit data to an HIE. Only ONC-Certified EHRs support submission to HIEs, meaning some clinicians will not be able to serve these patients.

Quality Management Reporting. Medicare requires quality reporting for full reimbursement. An ONC-Certified EHR can be used for this type of reporting, while non-ONC-Certified EHRs cannot.

Interoperability. Minnesota has taken the lead in requiring providers to be able to interoperate with each other via an ONC-Certified EHR. Again, providers using other EHRs will not be able to serve some patient populations.

Certified Community Behavioral Health Clinics. A federal initiative to provide enhanced Medicaid reimbursement to clinics that provide comprehensive services to vulnerable populations, requires ONC-Certified EHRs.

Having a successful behavioral health practice without an ONC-Certified EHR will only get more difficult over time. It behooves behavioral clinicians to make this transition sooner rather than later.