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
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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:
[email protected]@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