Clinical Management for Behavioral Health Services CMBHS

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Clinical Managementfor Behavioral Health
Services (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 Application EHR used to document and
coordinate services for clients receiving mental
health substance abuse services
Data Warehouse A central repository for EHR
information
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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
  HHSCs IT strategy
• DSHS Process Improvement Eliminate duplicative
  and non-integrated systems

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Data Integration Informs Policy

• 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

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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 Systems
TIERS
CARE
BHIPS
SAVERR
Vendor Systems
TMHP
NorthSTAR
Financial Systems
DSHS Physical Health
Financial Systems
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CMBHS Focus Group

• The Focus Groups members are clinicians
• IS business analyst and SMEs participate
• The Focus Groups 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

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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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Clinical Documentation Structure
Discharge Summary
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CMBHS System Security

• Meets HIPPA compliant data security standards
• Industry standard Internet security, SSL
  encryption, firewalls
• Unique user IDs and passwords
• Access to screens/data are controlled by job
  function and role
• Data shared between providers controlled by
  client consent as per laws and rules

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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
Will include Beta functionality plus the
following

• 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

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CMBHS Final Production Release
Will include Release 1 functionality plus the
following

• Doctors orders and prescriptions
• Crisis Services documentation
• State Hospital data exchange
• Quality management and compliance
• Medicaid eligibility and billing
• Other?

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CMBHS Project Schedule
Beta Deployed To pilot Sites 1/14/08
11/01/07
01/09
10/13/05
04/01/06
Phase One
Phase Two
Phase Three

• Milestones
• Catapult Consulting
• Business Analysis
• Technical Analysis

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

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

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Options for Provider Use of CMBHS
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Plan for Deployment of CMBHS

• Staggered approach over the course of months
• DSHS will provide training to providers (train
  the trainer and directly to clinical staff) and
  at multiple locations
• Level of training will be adjusted to provider
  implementation approach (see page 18) and
  Contract Type (MH, SA, BHO)
• 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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Contact CMBHS

• You may submit questions to
• cmbhs_at_dshs.state.tx.us
• CMBHS website is http//www.dshs.state.tx.us/cmbh
  s