Just 29% of substance abuse treatment centers only store health records electronically

According to new data released last week by ONC, more than half of substance abuse treatment centers nationwide use a combination of electronic and paper methods when it comes to storing and exchanging client health information.

A 2017 survey of 13,585 centers found that about three in ten exclusively used electronic methods of storing and maintaining health records, while 13% used paper only. About six in ten used both.

When it came to exchanging client information, however, the numbers differed dramatically. Fewer than 10% of centers relied solely on electronic methods in 2017 to send and receive client health information, and about a quarter used only paper methods. The majority, again, used a combination of both.


The 2018 National Survey on Drug Use and Health, administered by the Substance Abuse and Mental Health Services Administration, found that more than 20 million people in the United States had a substance use disorder.

For those who seek treatment, the ONC brief notes, electronic health records and interoperability can contribute to streamlined services. 

“Electronic technologies, such as electronic health records, enable individuals and their providers to more easily manage and exchange treatment records to support care coordination. Effective use of these technologies can also improve quality of care, reduce treatment gaps, and provide cost savings to health systems,” wrote Wesley Barker and Christian Johnson, who authored the ONC brief.

However, the implementation rate for electronic health information technology was inconsistent.

The survey found that hospital-affiliated treatment centers store client information electronically at a higher rate than unaffiliated ones; the same is true for centers that operate opioid treatment programs versus those that do not.

“SAMHSA certification of opioid treatment programs requires centers to establish and maintain recordkeeping systems to adequately document and monitor patient care,” explained Barker and Johnson. 

“These systems must comply with federal and state reporting requirements when treating opioid use disorder, and may be associated with higher reported use of electronic methods to store and maintain health information,” they continued.

Centers operated by the federal government – including Veterans Administration, Department of Defense and Indian Health Service centers – had the highest rates of electronic information management use, with a whopping 72% storing health records using only electronic methods and about a quarter relying on a combination of both electronic and paper.

“Federally-operated centers benefit from the investment made by the federal government to digitize health care, as do centers affiliated with U.S. hospitals, who benefit from federal health IT investment incentives,” observed Barker and Johnson.


When it comes to substance use – especially opioids – top healthcare leaders have stressed the importance of information sharing among organizations, both to reduce over-prescription rates and to provide effective treatment.

“Sharing information about patients’ experience with opioids and addiction, whether or not they have active prescriptions, is absolutely essential,” wrote John Glaser and Dr. Michael Fadden, then Cerner executives, in 2018. 

“That information is, rightly, hedged with privacy safeguards both federally and at the state level, and it will take close collaboration with policymakers to figure out how to share information among providers in ways that help patients without compromising their privacy,” Glaser and Fadden continued.

Other hospital leaders have relied on EHRs, automated patient alerts, telehealth, and continuous electronic monitoring to address opioid addiction and possible misuse.


The survey, wrote Barker and Johnson, “does not specifically capture EHR or health IT use among centers.”

However, they continued, “the use of electronic methods to perform certain information management tasks is a good proxy to understand how centers are managing client records, and exchanging data with its care partners.”

“These results provide an initial understanding of how substance abuse treatment centers manage their client’s health information,” they concluded.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich

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