Electronic patient health information regarding mental health and substance abuse are included in the designation "specially protected" health information (SPHI) in many states. With different consent laws across the states this causes serious difficulty in facilitating interstate health information exchange of these types of data. Having incomplete data at the point of care can be dangerous. We need to facilitate a national consent model that will allow the secure and appropriate sharing of electronic SPHI.

Recovery oriented, person centered and strengths based practices must be developed at the heart of HIT systems. If not, deficits based, disease oriented prompts and fields will dominate the EMRs and these will reinforce bad practice, literally hardwiring it into workflow

SAMHSA needs to take into account that most psychotropic medications are prescribed by PCPs who may not have the background to diagnose these issues. They need to be urged to refer their patients to specialists as needed.

While the potential is clearly there for EMR's there is simply no reality that as a nation we are close to having a system that will save money or improve patient care. SAMHSA should concentrate, maybe partner with Google & Microsoft to develop the standards for sharing and protecting the information before anything else.

However, we no that digital info is not secure since insurer's have access to 2 large data banks, w/o client knowledge & permission. HIPPA does not address this situation adequately.