By Christopher D. Carroll, M.Sc., SAMHSA Principal Deputy Assistant Secretary and Thomas Keane, M.D., M.B.A., Assistant Secretary for Technology Policy, National Coordinator for Health Information Technology | samhsa.gov
Patients with behavioral health conditions are often dually-burdened with chronic physical health conditions. Consequently, providers caring for these patients must coordinate their care to get the best possible health outcomes. The lack of reliable health information exchange and integration of health data across care settings can inhibit this essential care coordination. For example, individuals may face duplicative tests, medication errors, or gaps in care at critical moments. HHS recognizes the vital role that innovative health information technology (health IT) plays a vital role in solving these challenges. Improved electronic data exchange can expand access to behavioral health care, support enhanced care coordination, empower clinical decision-making, and lead to improved health outcomes.
The Behavioral Health Information Technology (BHIT) Initiative is addressing the need for improved data exchange in behavioral healthcare settings. Nine new pilot projects will advance health data exchange to improve behavioral health care coordination. View press release announcing the pilot projects.
Behavioral Health Information Technology Initiative
The BHIT Initiative is a $20 million effort led by ASTP/ONC and the Substance Abuse and Mental Health Services Administration (SAMHSA). The effort includes partnering with the industry to develop the USCDI+ Behavioral Health (USCDI+ BH) dataset and the FHIR® Behavioral Health Profiles Implementation Guide (BH IG) to provide standardized data elements and technical specifications to improve the state of behavioral health data exchange across care settings. The pilot projects will test the USCDI+ BH dataset and the FHIR® BH IG to assess behavioral health data exchange in real world settings across the country.
Pilots Selected
The testing will not only improve the standards and technical specifications of the USCDI+ BH dataset but will also provide vital information about providers’ implementation experience as well as legal and policy considerations for the broader provider community. Pilot participants represent 45 exchange partners across Colorado, Connecticut, Delaware, Florida, Massachusetts, North Carolina, Oregon, Rhode Island, and Washington, DC. Along with technical assistance, ASTP/ONC and SAMHSA will provide funds ranging from $300,000 to $690,000 to implement innovative, community-driven projects that test the USCDI+ BH dataset and FHIR® BH IG, and support improved behavioral health information exchange over the next year.
The pilot projects will identify effective practices and opportunities that can support improved behavioral health data exchange for patients and providers. This includes care coordination, federal and state reporting, patient access and consent, and consent management for entities covered by federal requirements for the confidentiality of substance use disorder patient records (42 C.F.R. Part 2).
Many pilot projects also are leveraging health information exchanges as infrastructure for data sharing, and two are exploring innovative uses of artificial intelligence alongside the use of USCDI+ BH data elements. Importantly, these pilot projects include participants at varying levels of health IT maturity, increasing the likelihood that the solutions developed can scale across diverse provider types and settings.
Looking Ahead
The pilot projects have already begun the initial phase of their work, and will be complete by the end of 2026. The lessons learned from the pilot projects will inform refinements to the USCDI+ BH data elements and FHIR® BH IG technical specifications. The knowledge gained also will shape the development of the Behavioral Health Information Resource – a comprehensive tool that incorporates lessons learned and best practices from the pilots, with a planned release in 2027. Stay tuned for more updates and find the informational resource on our website next year.
These pilot projects represent an important step toward a more interoperable healthcare system that supports integrated behavioral and physical health care. By testing standardized data exchange in real-world settings across the country, we’re building the foundation for scaled adoption that can improve continuity of care, improve exchange of data across care settings, and deepen the connection between two parts of the healthcare system that are often siloed.
Stay Engaged
We encourage stakeholders to stay tuned for updates on pilot project progress and for opportunities to provide feedback on the USCDI+ BH dataset and FHIR® BH IG.
