The CRISP DC Consent tool allows patients to explicitly opt in to having their substance use disorder (SUD) data protected by 42 CFR Part 2, shared with other members of their care team, through the DC HIE. This allows all members of the patients care team to have a more holistic view of their patients’ health record. 

The CRISP DC Team has been following the progression of 42 CFR Part 2 and have been working closely with our legal teams and the DC HIE Policy Board on a plan for updates to the Consent Tool and our legal agreements to align with the final rule. Please stay tuned for more communications from the CRISP DC team about Consent Tool updates! 

Keep reading to hear from Medical Home Development Group’s Chief Clinical Operating Officer, Zarfishan Zahid, MD, about implementing the Consent Tool and the lessons learned.

At the heart of our success is our commitment to building a trustful relationship with each patient. We understand that for patients to share their Substance Use Disorder (SUD) data with the DC Health Information Exchange (HIE), they need to see the value in it—not just as a procedural necessity but as a crucial step in their health, recovery, and treatment journey. Our strategy involves an “all-hands-on-deck” approach where every staff member, from the front desk to triage to providers, actively engages in educating patients about the importance of data sharing. This collective effort ensures patients understand how their consent can lead to better health outcomes, by avoiding harmful drug interactions and enabling more informed care across their healthcare journey. 

Our workflow integrates consent discussions naturally into various points of patient interaction. By embedding consent processes into our Electronic Health Record (EHR) system, we can efficiently track and manage consent attempts. This allows us to revisit the consent conversation with patients who initially declined, recognizing that their readiness may change over time. We’ve found it critical not to view a first refusal as final but as an opportunity to re-engage at a more suitable moment. 

Our sustained success was partially attributed to incorporating peer support specialists into our workflow. Their ability to share personal recovery stories has proven invaluable in bridging trust gaps, making patients more receptive to consenting. Due to staffing and workflow changes, the consent process was paused. We are in the process of restarting the process.  

Despite our progress, we encounter barriers, including patient apprehension due to stigma and misconceptions about data sharing. To overcome these, we emphasize staff education to ensure compassionate, knowledgeable patient interactions, and patient education to demystify data sharing benefits.  

The most significant lesson learned is the power of empathy and persistent engagement. Understanding and addressing the reasons behind a patient’s reluctance, whether it’s due to a bad day or deeper concerns, is crucial. Our experience underscores the importance of not only educating patients but also ensuring they feel seen, heard, and supported in their decision-making process. 

In conclusion, our experience has shown that trust, education, and empathy are the cornerstones of successful patient engagement in SUD data consent. 

– Zarfishan Zahid, MD
Chief Clinical Operating Officer
Medical Home Development Group