The Camden Coalition Health Information Exchange (HIE) has given South Jersey providers real-time access to critical health and social information about their patients since 2010. This October, the HIE marked a pivotal milestone as its first community-based behavioral health provider, Oaks Integrated Care (Oaks), began contributing clinical data to the exchange. Camden Coalition and Oaks are longstanding partners, with Oaks participating in the Pledge to Connect initiative, embedding its behavioral health navigators in emergency departments (EDs) in four regional health systems. These navigators use the HIE to coordinate patient transitions to outpatient care at Oaks, which is a Certified Community Behavioral Health Clinic (CCBHC), or other providers, as appropriate. The addition of Oaks’ patients’ health records, which includes behavioral health diagnoses and treatment data, to the HIE builds on this existing relationship and workflow, further strengthening the South Jersey behavioral health ecosystem.

We sat down with Camden Coalition’s Associate Director of Community and Health Information Exchange, Arley Styer, and Mike D’Amico, Vice President of Oaks Integrated Care and Michelle Joo, Director of their Certified Community Health Clinic (CCBHC) in Burlington County, to understand the significance of this new initiative.

As of this launch, Oaks staff can now access data from the Health Information Exchange (HIE) in real-time via your electronic health record (EHR) and data from Oaks’ EHR is flowing into the HIE. How does this bi-directional exchange change how your staff is able to provide client care?

Michelle: We have had access to the HIE for a few years, but now that we have the bi-directional feature set up, our teams are able to utilize this data in a totally different way. As a leadership team, we often use the HIE to track our programs on an aggregate level over time. We’re able to use the data to look at things like if this program’s hospital utilization is decreasing or increasing. If there’s an increase from a certain program, we ask ourselves if there are changes that we need to make at a community-based level in order to improve that outcome.

On an individual level, now that this information is going directly into our EHR in real-time, our staff are able to prep before meeting with a client and get key information. Our clinicians are able to start off the session by saying, ‘Hey, I’ve seen that you went to the hospital over the weekend. Can we talk a little bit more about that?’ It helps them seamlessly orient themselves so they’re able to address major factors like if there are medication changes that we need to be aware of or a psychiatric emergency that we otherwise might not know about.

And now that Oaks’ records are also visible to other providers via the HIE, clinicians in acute settings like the ED are able to see that the client is also receiving care in a community-based setting. This helps us then work with those providers to determine a discharge plan that includes coming back to us when they’re ready for a lower threshold of care.

What is the significance of a behavioral health partner participating in the HIE?

Mike: There has been a big shift recently in healthcare toward recognizing behavioral health as a very critical part of the healthcare system and understanding the role that mental health and social determinants of health play on the overall health and wellness of people. The HIE has been the mechanism to bring us closer to these healthcare partners and bring us to the table and work with them as an integral part of the system. Bi-directional integration has really opened up doors for us in terms of improving quality of care and really actualizing the concepts of integrated care and collaboration that we have been embracing in our Certified Community Behavioral Health Clinic (CCBHC) program.

Arley: Many people with complex health and social needs receive behavioral health care throughout their lives. The HIE is meant to serve as a centralized, reliable source of an individual’s comprehensive medical history, but if all their behavioral health care is missing, how comprehensive could it really be? What is the level and quality of care you can provide without that data? It is such a significant limitation to providing care.

This partnership specifically builds on the work of Pledge to Connect, which aims to connect ED patients to timely outpatient care, by closing the loop with the availability of outpatient data from Oaks. Previously, when patients were referred to Oaks’ CCBHC via Pledge to Connect, in the absence of real-time data, the program team would assume that patients actually engaged with the CCBHC. In reality, often this wasn’t the case, especially for high acuity patients. Now with the availability of the data in real-time, the program team will be able to track patient follow-up and conduct timely outreach to support patients who were referred to outpatient care.

This new integration is also particularly of note because, of course, Oaks provides substance use disorder treatment. Generally, data coming from a substance use disorder treatment provider is regulated by an additional set of protections beyond HIPAA, called 42 CFR Part 2. It can be rare to see behavioral health providers participating in exchanges like this because patients have to consent for that protected data to be shared with a HIE.

How did you approach the legal and operational complexity of getting consent from clients and integrating this sensitive information and data?

Mike: We started out by talking about all the legalities and identifying what we had to do to comply with 42 CFR Part 2. This quickly morphed into thinking about how we could be better partners and collaborators with the individuals that we’re serving rather than just doing the minimum that the law would otherwise require. We decided we wanted to partner with folks so that they understand how their information is being used– whether it’s 42 CFR Part 2 protected or not — which meant getting consent from everyone we’re sharing information for.

This wasn’t just going to be handing them a form and asking them to sign here, but instead it was a conversation about, ‘Here’s how we’re using your data, this is why we are using your data this way, and here’s how it helps us to improve care for you.’ This was important to us because ultimately, we want people to be the drivers of their care. We’re just a vehicle to help them achieve their goals around wellness and so that conversation about their data and their information is paramount, whether it’s 42 CFR Part 2 protected information or not.

Arley: We went in knowing we wanted to really respect patients as owners of their own data and be very careful about making sure the data was used properly. On the technical side, because this was our HIE’s first time having data that would fall under 42 CFR Part 2, we had to do some configurations on the back end. This started with segmenting the data in the HIE to ensure that only the data of Oaks patients who had consented was accessible in the HIE.

The next round of configurations focused on ensuring that the available data was only being seen by the parties who should have access to it. We set it up so that Oaks’s patient data is only viewable to users who are given permission in the HIE based on their direct role in the treatment and coordination of care of Oaks patients. In Pledge to Connect, for example, providers who are members of the program team are granted permission to view Oaks’ data to determine follow up care. Providers in our local hospital EDs also need access to Oaks’ data to be able to make treatment decisions, such as medication administration, in the event that an Oak’s patient seeks care at an ED for a mental health crisis.

What are some of your team’s takeaways from launching this initiative?

Mike: When we were early in the process, our EHR vendor said, ‘You have access to Epic Care Everywhere, so we can just plug you in with all your hospital partners.’ We thought about it and while we knew it would be easier to implement, it would not help us to establish partnerships with organizations like the Camden Coalition and Trenton Health Team [another state-designated Regional Health Hub HIE operating in South Jersey]. With this, we’re not just exchanging data, but rather we are partnering with other system providers to help inform system-level changes and coordination. It’s not just about the data, it’s also about how that helps to build the foundation for partnership and improving our systems and identifying opportunities for improved coordination and collaboration.

We really don’t want to be the first and only behavioral health providers in the network–we want to be the first of many. I hope the more behavioral health providers that are seeing what we’re doing will join us because it’s just going to enrich our systems. More providers will help coordination and improve overall care in New Jersey.

Michelle: I also think that similar to the move from pen and paper to electronic health records, taking part in these shared systems like the HIE is not something that is going to be optional in ten years. The best way to keep up with the new world of healthcare is to change with it and using bioinformatics and these shared systems is invaluable for pushing us forward. The HIE has supported us and allowed us to develop so many different facets of the agency because it facilitates patient-level and system-level change. It has large spread implications from informing treatment, to providing insurance and financial data, to showing individual and population trends. I think getting ahead of that curve now and giving ourselves the time to implement this with a phased approach was our smartest decision.

Arley: One of our biggest takeaways is that launching this effort required us to think beyond the technical work of connecting systems. We had to pause and reflect on what it really means to exchange behavioral health information in a way that is safe, intentional, and rooted in trust. This process showed us that data sharing isn’t just an IT function—it’s a relationship and also part of a larger health and social care ecosystem. It requires alignment, shared values, continuous communication, and a shared commitment to the people we serve.

This experience made clear how essential strong, open, and accountable partnerships are to building a truly comprehensive regional HIE. We’re grateful for Oaks’ commitment to this work and for their dedication to strengthening the South Jersey ecosystem of care.

About Oaks Integrated Care:

Oaks Integrated Care is a private, nonprofit organization dedicated to improving the quality of life for children, adults and families living with a mental illness, addiction or developmental disability. The organization offers over 230 health and social service programs throughout New Jersey designed to meet the needs of our community with compassion. By focusing on integrated care, we can begin to treat the whole person to achieve both mental and physical wellness.