Crisis Care Needs Real-Time Data, and HIEs Are the Missing Link

In a behavioral health crisis, every second counts. Yet too often, the providers on the front lines (mobile crisis teams, crisis stabilization units, 988 call centers) are flying blind. They’re responding to calls with little or no knowledge of the person’s history, diagnosis, care team, or prior interventions.

Meanwhile, that critical information? It often already exists. It’s just stuck in a silo.

A What-If Worth Considering

Meet Darius, a 32-year-old man in the midst of a psychiatric crisis. A concerned bystander calls 988 when they see him pacing in traffic, shouting at passersby. Police are dispatched alongside a mobile crisis team. Darius is agitated, nonverbal, and resistant to help.

Now imagine two scenarios:

🚫 Without HIE Support:

The crisis team has no idea who Darius is. There’s no access to his records. They transport him to the ER, where he sits for 8 hours before being discharged with a paper referral and no follow-up. He’s back on the streets the next day. No connection to services. No continuity of care.

✅ With HIE-Facilitated Exchange:

As soon as the crisis team engages, they query the HIE. Within seconds, they see:

• Darius has an SMI designation and a history of schizoaffective disorder

• He was recently discharged from an inpatient unit 3 weeks ago

• His crisis plan lists specific calming techniques and preferred providers

• His case manager’s contact info is included

The team de-escalates using personalized approaches from his care plan. His case manager is contacted on the spot. Darius is safely transported to a crisis stabilization unit that already has his records, and a warm handoff occurs the same day.

Same crisis. Entirely different outcome.

This isn’t science fiction. It’s smart data exchange. And it’s exactly what HIEs are built to do.

Proof It Works: BHINAZ and Real-Time Crisis Support

This "what if" isn’t just a dream scenario. It’s grounded in reality.

The Behavioral Health Information Network of Arizona (BHINAZ) implemented a model just like this nearly a decade ago. By collaborating with crisis providers and the state Medicaid agency, BHINAZ created real-time access to behavioral health records for designated crisis teams and stabilization units.

Crisis teams in the field could view:

• Behavioral health history

• Medication lists

• Treatment plans

• Designated SMI status

• Assigned care teams and contacts

The result? Faster stabilization, less duplication of services, and improved safety for patients and responders alike.

But Also... It Saves Money

Let's talk dollars and sense.

When HIEs enable real-time crisis data exchange:

• Fewer people are taken to the ER unnecessarily

• Inpatient psychiatric beds are used more efficiently

• Repeat 911 calls drop

• Law enforcement spends less time on scene

• Care coordination reduces costly service duplication

In Arizona, this model reduced avoidable inpatient admissions and improved engagement in outpatient care. That led to real cost avoidance for Medicaid and county systems. Crisis care that’s coordinated, informed, and timely isn’t just better care. It’s cheaper care.

If your HIE can help prevent just one unnecessary ER admission or inpatient stay, it more than pays for the infrastructure to support this work.

Addressing 42 CFR Part 2: Yes, You Can (With Guardrails)

Concerned about sensitive data? You should be. But you shouldn’t be stopped by it.

Under 42 CFR Part 2, behavioral health and substance use disorder (SUD) data can be accessed during a bona fide medical emergency. This is the classic “break the glass” provision. It is designed for exactly these crisis situations.

HIEs are well positioned to:

• Document when and why emergency access occurs

• Limit access to only designated crisis providers

• Audit access events and maintain compliance

With the right policies, tech, and training in place, HIEs can be part of the solution, not a liability.

Time to Plug In, Not Opt Out

Crisis systems are evolving rapidly. States are funding 988 call centers, mobile teams, and stabilization units. But too many are doing it without fully integrating with their existing HIE infrastructure.

Let’s be clear. If your HIE isn’t in the room, you’re missing the opportunity to drive sustainable, interoperable crisis care.

Whether it’s flagging high-risk individuals, enabling real-time access in emergencies, or improving handoffs between crisis and outpatient care, HIEs offer the backbone for a more responsive and connected crisis response system.

Want to Build Something That Works?

Converge Health helps HIEs and states activate crisis data exchange without spinning wheels on segmentation or reinventing the wheel. If you’re ready to finally connect the last mile of crisis care, let’s talk.

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