hie-sde sub award kentucky progress
DESCRIPTION
HIE-SDE Sub Award Kentucky Progress. Karen Chrisman Governor’s Office of E lectronic Health Information. Kentucky HIE Background. Query based model CCD exchange 127 “Live” facilities Participation Agreements from 96 of approximately 130 hospitals in the Commonwealth - PowerPoint PPT PresentationTRANSCRIPT
HIE-SDE Sub AwardKentucky Progress
Karen ChrismanGovernor’s Office of Electronic Health Information
• Query based model• CCD exchange• 127 “Live” facilities• Participation Agreements from 96 of approximately 130 hospitals in the Commonwealth • 26 of 31 Participation Agreements are CAH• No further consent needed state• Kentucky Cabinet for Health and Family Services
(CHFS) funds and provides support to the Commonwealth’s 14 CBHCs but does not have direct control of the centers
Kentucky HIE Background
Kentucky HIE-SDE Sub Awardee PlanDecember 2011
• Query based model• Consent workgroup• Interface from behavioral health providers to KHIE• Lab results reporting to behavioral health providers using
KHIE as the delivery system• Training for behavioral health staff in the consent
process and with the KHIE portal• Continuing education support about this program for
both primary care and behavioral health providers
Kentucky Plan
Sub Award Press Release
Parallel TracksDevelopment ofConsent Form
Developmentof Technology
Created ‘Consent Form Workgroup’Input from the Kentucky Cabinet for Health and Family ServicesProtection and AdvocacyMulti-State ConsortiumAdopted the CIHS HIE workgroup form with modifications for the KHIE environment
Consent Form
KHIE required modificationsMust release all patient dataMust release all patient data to all providers in the HIEMust release all types of dataMust release all data for all uses TPO
TPO is also required by the GOEHI participation agreementRequires a 6 month consent periodIf another consent is not signed within 6 months the consent expires
Consent Form
GOEHI Executive DirectorKHIE Project Manager
Behavioral Health Project Leadand other members as required
Objectives Developed:Business requirementsConsent requirementsConsidered additions to CCD
CCD Components
CCD Technology Workgroup
> Patient: Given Name Family Name , Jr. or Sr., etc...Street Address City, State, Zip Codetel:+19995551212 MRN: 123456789 Birthdate: January 1, 1954 Sex: Male Guardian:
> Next of Kin: Given Name + Family Name Street Address City, State, Zip Codetel:(999)555-1212
> Table of Contents> Purpose : Automated Medical History Summary > Payers > Problems > Family history > Social History > Allergies, Adverse Reactions, Alerts > Medications > Immunizations > Vital Signs > Results > Procedures > Encounters
CCD Components
Behavioral Health
Providers
No Participation Agreement with a behavioral health provider before
March, 2012
Behavioral health providers needed meaningful use
support
Additional attention to 42 CFR Part 2
As a state agency, KHIE required
additional contracting with the community
behavioral health centers
Adapted KHIE processes and
provided site visits
Engaged the Regional Extension Centers within one
week of award announcement
Behavioral Health Providers
There was no standard CCD connection
Began KHIE vendor
onboarding process July 2012
Delivery of the KHIE CCD to
Pennyroyal is in test
Pennyroyal has created a CCD
with a Kentucky Medicaid patient
using vendor software
Behavioral Health Vendor neverconnected to HIE previously
Next steps:
KHIE vendor will provide CCD in
production environment
KHIE vendor will deliver Pennyroyal
CCD in test environment
Onboarding Behavioral Health Vendor
KHIE will only respond to the query from Pennyroyal because KHIE recognizes this security certificate.
This ensures that a known KHIE provider is receiving the information.
Pennyroyal has signed the GOEHI Participation Agreement which requires Pennyroyal to use the data from KHIE only for a permitted use.
NetSmart provides a security certificate that is unique to Pennyroyal
Security
Pennyroyal Center
When a patient requests an accounting of disclosures from Pennyroyal, KHIE can audit the request for the Pennyroyal CCD because KHIE is a Business Associate of all GOEHI participants. When web services technology is used, the requester must be able to confirm the individual within the covered entity’s system who accessed that record in their EMR.
Security
Pennyroyal Center
If the requester uses edge services, the KHIE will be able to audit the user name and facility ID to the individual who accessed the record. KHIE logs the attestation of a provider’s treatment relationship.
Security
What about Consent??
In the beginning unknown process for KHIE
Behavioral health providers are valuable information sources
Behavioral health providers may already have a consent process
KHIE scheduled site visits to study provider workflow
KHIE has reached consensus on the state consent form
Training
SAMHSA-HRSA Center for Integrated SolutionsPowerPoint Presentation
Michael R. Lardiere, Vice President Health InformationTechnology and Strategic Development
The National Council for Community and Behavioral Healthcare
IntroductionPatient Consent and Authorization Form for Disclosure
Of Certain Health Information to theKentucky Health Information Exchange
Consent Explanation Health Information Exchange Services
Behavioral HealthAssessment
CCD Examples:KHIE CCD Screen Shot
KHIE example CCDBehavioral Health example CCD
Healthcare IT News “5 Things to Know About CCD”
KHIE Virtual Health Record VHR Example
Health Information Exchange and 42 CFR Part 2 Compliant Consent
PowerPoint PresentationMaureen Boyle, PhD SAMHSA
KHIE Update
KHIE Training PowerPoint
KHIE “Patient Consent” Training for Behavioral Health Providers
Objective: To assist behavioral health providers in understanding the consent form created to authorize the disclosure and sharing of behavioral health records with primary care providers via the Kentucky Health Information Exchange.Consent Required: 42CFR Part 2
Federal regulation that requires specific consent by a patient in a federally-assisted drug and alcohol treatment program before the patient’s records can be transferred to another entity.
KRS 210.235 State regulation that requires specific consent by a patient before
a Kentucky Cabinet for Health and Family Services record of a hospitalization can be transferred to another entity.
KHIE “Patient Consent” The Plan
A. Incorporate KHIE “Consent Form” into provider’s existing workflow
Site visit to review provider work flow Additions may be made to the Consent form but no language may be
removed Created “Consent Explanation”
Created to guide the initial training program; use as support for ongoing training and training for new employees
Created Training Guide
B. ‘Train the Trainer’ approach Outreach Coordinators
Assist behavioral health providers with training staff on “consent form” Educate staff on benefits of sharing data through KHIE and how it can be
used to improve the overall healthcare of their patients Focus additional outreach efforts to primary care providers of behavioral
health centers
Making Sense of Consent
• General Rules• Informed
Consent
• Patient• Parent• Legal Guardian
• According to Kentucky statute
Who may consent? • From Whom/To
Whom• Amount & Kind of
Information
Disclosure
• Aid in treatment and care coordination
Purpose
• At any time with written notice
• Doesn’t stop disclosure of info permitted by law
Revocation
• Specified time frame or
• 6 months from date signed
Effective Period
• Patient, parent, legal guardian
• Proof of legal representation required (Court Order)
Signature
Making Sense of Consent
Behavioral Health Education Center Partnership
UK HealthCare CECentral
Mission StatementUniversity of Kentucky HealthCare CECentral delivers high-quality live and enduring continuing professional development activities to health care professionals using evidence-based practice, adult learning principles and innovative web-based technology.
Vision StatementUK HealthCare CECentral aims to be the premier provider of continuing professional development for health care professionals in Kentucky and to establish our educational and technological resources worldwide.
PurposeUK HealthCare CECentral provides health care professionals continuing professional development activities to increase knowledge, competence and performance levels for better patient-centered care, improved patient safety and enhanced clinical outcomes.
UK HealthCare CECentral
KHIE will be hosting Behavioral Health Education Center modules on the University of Kentucky HealthCareCECentral.comwebsite.
UK HealthCare CECentralplans to issue statementsfor up to 1 hour of creditper module for AMA PRACategory 1 Credit™,Social Work andPsychology to eligibleparticipants completingthe CE Activity.
Planned Modules for Behavioral Health CE Credit include:
I. An OverviewII. Integrated Care IIII. Integrated Care IIIV. Consent Form OverviewV. Consent Form Case
Studies
UK HealthCare CECentral
KHIE & UK HealthCare CECentral collaborated in developing a needs assessment, learning objectives, goals, expected outcomes and an evaluation tool for the CE Activity.
Activity Modules
UK HealthCare CECentral
Overview
• What is KHIE?• Medicaid Patient PCP
and BH Case Study• National Perspectives• Behavioral Health
Overview
Integrated Care I
• Overview of IC• Reflection from a
Primary Care perspective on IC
• MCO Implications for BH
Integrated Care II
• Traditional IC• Pennyroyal’s
Story• Non Traditional IC
Consent Form I
• Overview• Why, Who,
When?• Form Details
• Screen Demo
Consent Form II
• Cases in Consent• Patient
Situations• Options
• Refusal?
UK HealthCare CECentral will issue statements of continuing education credits to eligible participants once training has been completed.
• SAMHSA Stakeholders Kickoff Meeting March 12, 2012
• Pennyroyal/Netsmart Weekly Status Call Weekly• KHIE/REC by-weekly touch point
Bi-Weekly (March – July 2012)• SAMHSA Grantee Status Call Monthly• KHIE Monthly Update Call
Monthly (March – October 2012)• National Council for Comm Behav Healthcare Conf April 14-17, 2012• Pathways - Official Intake Call May 1,
2012• KY Health Info Management Association Meeting June 4, 2012• Site Visit Pennyroyal Center
June 13, 2012• SAMHSA - UK CECentral Meeting July 16, 2012• National Council Sub Award Consent meeting July 17, 2012• KHA Advisory Committee Mtg July 26,
2012• SAMHSA Consent Mtg-Washington DC August 7, 2012• REC/QIO/KHIE Joint Training Session August 15,
2012• GOEHI Privacy and Security Meeting August 20,
2012• PAIMI Consumer Group
August 28, 2012• UK CeCentral/KHIE Behavioral Health Mtg September 13, 2012• Bost Forum-HIE-SDE Presentation
September 17, 2012• SAMHSA Stakeholders Statewide Mtg/Training September 18, 2012• Voices for Healthy Kentucky
September 28, 2012• Multi-State Coordination and Communication Webinar October 9, 2012• Kentucky Primary Care Association Conference October 15, 2012• PC-BH Collaboration Universal Consent October 16, 2012• KHIE/Pathways Site Visit
October 18, 2012
Outreach
Kentucky Health Information Exchange Outreach Coordinator Regions
Adair
Allen
Anderson
Ballard
Barren
Bath
Bell
Boone
Bourbon
Boyd
Boyle
Bracken
Breathitt
Breckinridge
Bullitt
ButlerCaldwell
Calloway
Campbell
Carlisle
Carroll
Carter
Casey
Christian
Clark
Clay
Clinton
Crittenden
Cumberland
Daviess
Edmonson
Elliott
Estill
Fayette
Fleming
Floyd
Franklin
Fulton
Gallatin
Garrard
Grant
Graves
Grayson
Green
Greenup
Hancock
Hardin
Harlan
Harrison
Hart
Henderson
Henry
Hickman
Hopkins
Jackson
Jefferson
JessamineJohnson
Kenton
Knott
Knox
Larue
Laurel
Lawrence
Lee
Leslie Letcher
Lewis
Lincoln
Livingston
Logan
LyonMcCracken
McCreary
McLean
Madison Magoffin
Marion
Marshall
Martin
Mason
MeadeMenifee
Mercer
Metcalfe
Monroe
Montgomery
Morgan
Muhlenberg
Nelson
Nicholas
Ohio
Oldham
Owen
Owsley
Pendleton
Perry
Pike
Powell
Pulaski
Robertson
Rockcastle
Rowan
Russell
ScottShelby
Simpson
Spencer
Taylor
ToddTrigg
Trimble
Union
Warren
Washington
Wayne
Webster
Whitley
Wolfe
Woodford
Region 1 – Laura ShonkRegion 2 – Teresa PoffRegion 3 – Ann O’HaraRegion 4 – Dawn GasserRegion 5 – Pat Robinson
Kentucky Regional Extension CenterService Area Map
Kentucky REC (Counties with * are served by Kentucky REC under Tri-State REC) Tri-State REC / NeKY RHIOADAIR GRAYSON MCLEAN BATHALLEN GREEN MEADE BOONEANDERSON HANCOCK * MERCER BOYDBALLARD HARDIN METCALFE BRACKENBARREN HARLAN MONROE CAMPBELLBELL * HARRISON MUHLENBERG CARTER* BOURBON HART NELSON ELLIOTT
* BOYLE HENDERSON OHIO FLEMINGBREATHITT HENRY OLDHAM GALLATINBRECKINRIDGE HICKMAN * OWEN GRANTBULLITT HOPKINS OWSLEY GREENUPBUTLER JACKSON PERRY KENTONCALDWELL JEFFERSON PIKE LAWRENCECALLOWAY * JESSAMINE POWELL LEWISCARLISLE JOHNSON PULASKI MAGOFFINCARROLL KNOTT ROCKCASTLE MASONCASEY KNOX RUSSELL MENIFEECHRISTIAN LARUE * SCOTT MONTGOMERY* CLARK LAUREL SHELBY MORGANCLAY LEE SIMPSON NICHOLASCLINTON LESLIE SPENCER PENDLETONCRITTENDEN LETCHER TAYLOR ROBERTSONCUMBERLAND LINCOLN TODD ROWANDAVIESS LIVINGSTON TRIGG WOLFEEDMONSON LOGAN TRIMBLEESTILL LYON UNION* FAYETTE * MADISON WARRENFLOYD MARION WASHINGTON* FRANKLIN MARSHALL WAYNEFULTON MARTIN WEBSTER* GARRARD MCCRACKEN WHITLEYGRAVES MCCREARY * WOODFORD
Regional Extension Center County Listing
Importance of explaining use of health information for treatment
PowerPoint explaining source and development of the consent form gives it credibility
Importance of explaining form for release of behavioral health records and 42 CFR Part 2 only
Finding
Goal to determine if consumers understood the consent form
Consumer Input
The patient needed assistance from medical office staff, advocate, or mental health mentor to complete the form
Finding
Goal to determine if consumers agreed form needed staff assistance for completion
Consumer Input
Open comments received:
Form should have larger font even if increased number of pages
Signature from guardian only allowed if guardianship order produced
Suggestion that KHIE video Kentucky doctors discussing the use of KHIE and how it helps doctors treat patients
Primary Behavioral Health Care Integration
Pennyroyal Center
received a grant under the PBHCI initiative
Pennyroyal Center has a primary care
license
KHIE delivered KHIE CCD to Pennyroyal
with Medicaid claims data
and all “live” provider lab
results10-25-2012
Pennyroyal will share
consolidated CCD with medical trading
partners 12-15-2012
Current live medical trading
partners Trover Medical
Center, Madisonville,
Lourdes Hospital, Paducah
11-01-2012
Primary Behavioral Health Care Integration
Community Behavioral Health Center
KHIE CCD to Pathways with Medicaid claims
data and all “live” provider lab results
12-01-2012
Pathways shares consolidated CCD with
medical trading partners, primary care
providers currently live King’s Daughters
Medical Center, Fleming County Hospital, St.
Claire Regional Medical Center 01-31-2013
Primary Behavioral Health Care Integration
Community Behavioral Health
Center
Currently teaming with primary care
providers
KHIE CCD to Kentucky River Community
Care with Medicaid claims data, all “live” provider lab results
Kentucky River identified team practices: ARH,
Quantum Healthcare, Mercy Medical Clinic.
Will use KHIE to deliver KRCC CCD consolidated with
Medicaid claims data, all “live”provider lab
results to these providers
Primary Behavioral Health Care Integration
Community Behavioral Health
Center
Partnering with FQHC Primary
Plus
KHIE CCD to Comprehend with Medicaid claims data, all “Live”
provider lab results including
St. Claire Regional Medical Center
and Fleming County Hospital
Comprehend using KHIE to
deliver Comprehend CCD,
Medicaid data and lab results to
Primary Plus
Psychiatric Hospitals in Kentucky Beds County
Central State Hospital 192 Jefferson
Cumberland Hall 91 Christian
Eastern State Hospital 323 Fayette
Kentucky Correctional Psychiatric Center 97 Oldham
Lincoln Trail Behavioral Health System 140 Hardin
Northkey Community Care-intensive Services 57 Kenton
Our Lady of Peace 396 Jefferson
Ridge Behavioral Health System 110 Fayette
Rivendell Behavioral Health Services 125 Warren
River Valley Behavioral Health 80 Daviess
The Brook - Dupont 88 Jefferson
The Brook Hospital - KMI 98 Jefferson
Western State Hospital 495 Christian
Behavioral Health in Kentucky
Community Mental Health Centers (CMHC) City CountyAdanta Somerset PulaskiBluegrass Lexington FayetteCommunicare, Inc. Elizabethtown HardinComprehend, Inc. Maysville MasonCumberland River Corbin WhitleyFour Rivers Behavioral Health Paducah McCrackenKentucky River Community Care, Inc Hazard PerryLifeskills, Inc. Bowling Green WarrenMountain Comp. Care Center Prestonsburg FloydNorthKey Covington KentuckyPathways, Inc. Ashland BoydPennyroyal Regional Center Hopkinsville ChristianRiver Valley Behavioral Health Owensboro DaviessSeven Counties Services, Inc. Louisville JeffersonThe MORE Center Louisville JeffersonTransitions, Inc. Bellevue Campbell
Identified – Future Needs
Centra
l Stat
e Hosp
ital
Centra
l Stat
e ICF-M
R
Del Mari
a ICF-M
R
Easter
n State
Hospital
Glasgo
w SNF
Hazelw
ood ICF-M
R
Kentucky
Correctional P
sychiat
ric Cen
ter
Meadows IC
F-MR
Oakwood
Outwood
Western
State
Hospital
Western
State
Nursing
Windsong ICF-M
R
61
24
8
125
84
118
50
7
121
43
113103
8
Average Daily Census
Kentucky State-Owned Behavioral Health Facilities
Summary
Infrastructure1. Policy Development
KHIE Policy for primary care provider receiving a 42 CFR Part 2 record Behavioral Health Provider Policy requiring the use of Consent Form
2. Workforce Development Training KHIE Intake Coordinator and 5 Outreach Coordinators trained Behavioral Health identified consent resources within CBHC trained Development of web training materials
3. Financing KHIE designated resource to track financing for project and to assist with Medicaid/Meaningful Use
questions4. Organizational change
KHIE Intake Coordinator developed new training manual and training protocol Outreach Coordinators, Staff Attorney, Technical Analyst trained in new manual and protocol
CBHC changed consent form to be consistent across state5. Partnerships/Collaborations
Foundation for a Healthy Kentucky PAIMI Protection and Advocacy Kentucky Voices for Health Kentucky REC, GOEHI, and Department for BHDID
6. Accountability User name, facility ID, attestation Security certificate, pre-fetch the patient record
For additional information contact:[email protected] or