Clinical ManagementClinical Managementfor for

Behavioral Health Services Behavioral Health Services (CMBHS)(CMBHS)

May 30, 2008

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Clinical Management for Behavioral Health Services (CMBHS) is an integrated electronic clinical management system for DSHS behavioral health (BH) services (MH & SA).

Electronic Health Record (EHR) Includes billing functionality Unifies DSHS behavioral health data Interoperable with other HHSC systems

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Major Components of CMBHS

Online ApplicationOnline ApplicationEHR used to document and coordinate services for clients receiving mental health & substance abuse services

Data WarehouseData WarehouseA central repository for EHR information

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Why Develop CMBHS?Why Develop CMBHS?

SAMHSA: Develop a single system for persons with co-occurring disorders

State Legislation: House Bill 2292 - consolidate organizational structures and functions

HHSC: Update current data systems consistent with HHSC’s IT strategy

DSHS Process Improvement: Eliminate duplicative and non-integrated systems

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Obtaining a better picture of client needs and problems

Tracking the whole health and human experience over time

Improved measuring of outcomes for providers, agencies and the HHSC enterprise

Better understanding of the impact of multiple agency interventions

Improved projections of future client and population needs

Data Integration Informs Policy

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Project Policy Environment

Legislative requirements and innovation opportunities (SB 839, HB 921)

Information exchange policy requirements (HIPAA, state Law, 42 CFR)

Development of single system for persons with co-occurring disorders

Client considerations include access to records and consent for disclosure of information

Integration with Mental Health System Transformation initiative

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Current Data SystemsCurrent Data Systems

BHIPSCARE

NorthSTAR

FinancialSystems

Vendor Systems

SAVERR

TIERS

TMHP

FinancialSystems

DSHS Physical Health

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The Focus Group’s members are clinicians IS business analyst and SME’s participate The Focus Group’s purpose is to collect and

document the system requirements in such a way that they can be used by the software developers to create the application

System requirements for CMBHS must support clinical best practices, comply with laws and contracts and meet DSHS and local data needs

CMBHS Focus Group

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Considerations During Development of CMBHS

•Current and emerging policy issues•Budget and competing state and local needs•Client care vs. data management system•Technological advances and limitations•Service quality and outcomes•Oversight for clinical quality and compliance•Facilitate meeting state and local data and reporting needs•Support clinical best practices•Facilitate compliance with laws and contracts

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Service Service DeliverDeliver

yy

AssessmentAssessmentScreeningScreening Progress Progress NotesNotes

TreatmentTreatmentPlanPlan

WaitingWaitingListList

AdmissionAdmission

Treatment Treatment PlanPlan

ReviewReview

DischargeDischarge

Clinical Documentation Structure

Discharge Discharge SummarySummary

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Meets HIPPA compliant data security standards

Industry standard Internet security, SSL encryption, firewallsUnique user IDs and passwordsAccess to screens/data are controlled by job function and roleData shared between providers controlled by client consent as per laws and rules

CMBHS System Security

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Beta Pilot Process

Sites include MH, SA and BHO Training provided to 1 to 3 staff from each site Focus on the clinician as key users Evaluation of user interface (UI) and clinical

appropriateness of data fields and functions Online Help included and technical assistance

available through call system Opportunities for pilot feedback through routine

teleconferences; DSHS addresses feedback Approximately 30 changes implemented to date

based on pilot input

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CMBHS Beta Test Sites

Helen Farabee Regional MHMR Centers NorthSTAR - ValueOptions and Lakes Regional

MHMR Center Lubbock Regional MHMR Center Tarrant County MHMR Community Center Amarillo Council on Alcoholism Managed Care Center For Addictive/Other

Disorders, Inc. Recovery Resource Council

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CMBHS Beta Functionality Includes

Provider Set-up Client Search Client Profile Screening Assessment (Adult, Adolescent, MH, SA) Assessment Narrative Progress Notes (Clinical, Administrative) Treatment Plan Treatment Plan Review Discharge documentation

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CMBHS Production Release #1

Financial Eligibility Assessment

Administration of medication & TIMA

Crisis documentation Service authorizations

(UM) Waiting list Reports & downloads

Consent for release of information

Consent to treatment Child Assessment Referral Messaging system Claims (SA) Additional work

spaces

Will include Beta functionality plus the following:

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CMBHS Final Production Release

Doctors orders and prescriptions

Crisis Services documentation

State Hospital data exchange

Quality management and compliance

Medicaid eligibility and billing

Other?

Will include Release #1 functionality plus the following:

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CMBHS Project Schedule

Milestones•Beta Application Complete•Release to 7 Pilot Sites•Functionality: 27 Use Cases•Data Exchange Proof of Concept Complete

11/01/07 01/0910/13/05 04/01/06

Milestones•Online Production Release•Functionality: 55 Use Cases•Data Exchange•DPS Interface•Drug Court Interface

Phase Three

Phase TwoPhase One

Milestones•Catapult Consulting •Business Analysis•Technical Analysis

Beta DeployedTo pilot Sites

1/14/08

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1 CMBHS Online

Web client Provider uses CMBHS online for all functions

2 CMBHS Data Exchange 1

Batch Provider uses vendor system to feed data to CMBHS

3 CMBHS Data Exchange 2

Conversational near real-time

Provider uses vendor system to feed data to CMBHS

4 CMBHS Online/Data Exchange

Web client Provider uses CMBHS as front end to feed data to their vendor system at the backend

Options for Provider Use of CMBHS

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PlanPlan for Deployment Deployment of CMBHS

1. Staggered approach over the course of months

2. DSHS will provide training to providers (train the trainer and directly to clinical staff) and at multiple locations

3. Level of training will be adjusted to provider implementation approach (see page 18) and Contract Type (MH, SA, BHO)

4. Technical assistance and support for providers will be available by phone

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Next Steps

CMBHS Beta extended through June 15, 2008 Conference calls with providers will continue Focus Group will continue development of

new use cases New CMBHS functionality will be user tested

prior to release DSHS will continue to share information about

CMBHS and obtain feedback from users

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You may submit questions to: You may submit questions to:

cmbhs@dshs.state.tx.uscmbhs@dshs.state.tx.us

CMBHS website is: CMBHS website is:

http://www.dshs.state.tx.us/cmbhshttp://www.dshs.state.tx.us/cmbhs

Contact CMBHSContact CMBHS