Privacy Issues in Mental Health and Substance Abuse Treatment: Information Sharing Between Providers and Managed Care Organizations: Final Report. 1. Role of Scientific or Other Research Results in Considering What Information Is Needed

01/17/2003

One important consideration in developing a minimum necessary information set is what role scientific or other research results can play in helping to define what information is needed to manage care.  Unfortunately, the research is sufficient to serve only as an aid to, not a primary basis for, establishing a set of minimum necessary information.  That said, the criteria for patient placement for substance-related disorders developed by the American Society for Addiction Medicine (see Chapter IV) provide more support for identifying the information needed to managed substance abuse care than anything that is readily available to support the information needed to manage mental health care.  More specifically, the ASAM criteria could be a source against which proposals for minimum necessary information might be reviewed to rule out irrelevant information related to substance abuse disorders.  But because the criteria are very detailed, they may not help to isolate the most important pieces of information to collect. 

Our understanding is that there is no similar set of criteria for mental health treatment, and that, in fact, there is little consensus among mental health care providers with regard to what and how much treatment is necessary under many circumstances.  Despite this lack of consensus, managed care plans or other interested parties (such as researchers) could develop a series of examples of how personal health information can be used in conjunction with information from research studies to perform evidence-based quality and utilization checks.  This exercise may point to specific data elements that are critical to many types of well-supported checks. 

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