Clinical Management for Behavioral Health Services (CMBHS)

1
Clinical Managementfor Behavioral Health
Services (CMBHS) May 6, 2008
2

• Clinical Management for Behavioral Health
  Services (CMBHS) is an integrated electronic
  clinical management system for DSHS behavioral
  health (MH SA) services.
• Electronic Health Record (EHR)
• Integrates billing functionality
• Unifies DSHS behavioral health data
• Interoperable with other HHSC systems

3
Major Components of CMBHS
Online Application EHR used to document and
coordinate services for clients receiving mental
health substance abuse services
Operational Data Store A central repository for
EHR information
4
Developing CMBHS

• Client care vs. data management system
• CMBHS Focus Group members - clinicians
• Focus Group approach to design
• Provide information needed at the point of
  service
• Improve provider efficiency using real-world
  workflow
• Use of data from other systems and providers
• Support clinical best practice
• Ensure compliance with laws and contracts
• Meet DSHS and local data needs

5
Application Development

• Current and emerging policy issues
• Budget and competing needs
• Technical considerations
• Service quality and outcomes
• Clients access to own clinical information
• Clinical quality and compliance reviews
• State and local level reporting needs

6
System Security

• Industry standard Internet security, encryption,
  firewalls
• Individual user IDs and passwords
• User authentication
• Screens and data are assigned by job
  function/role
• Automated consent to allow client control of
  access to different types of records
• Privacy and reason for sharing data

7
Opportunities to Inform Policy and Practice
through Data Integration

• Obtaining a better picture of client problems
• Tracking the whole health and human experience
  over time
• Outcome measures for individual agencies
• Outcome measures for the enterprise
• Understanding the impact of multiple agency
  interventions
• Improved projections of future client needs

8
Data Exchange Issues

• Purpose of sharing data (individual care
  coordination or system change)
• Control of data after release
• Data validity and verification
• Client matching protocols
• Maintaining connections to other data systems

9
BH Data Exchange
State Web EHR (CMBHS)
Service Consumer (EHR Systems)
Financial Systems
Service Consumer (External Domains)
Service Provider
Behavioral Health Business Services
Security/Consent
Security/Consent
Physical Health Providers
DataExchange
DataExchange
SA Provider Proprietary EHRs
Business Components
Law Enforcement
Anasazi
NetSmart
Judicial Systems
BH Service Provider
iServ
Behavioral Health Data
Other Provider BHO Data Systems
Social Services
10
Provider Use of CMBHS

1. Provider use of CMBHS EHR online (includes
   reports and data download capabilities)
2. Provider use of CMBHS EHR online, with provider
   pulling data to feed other applications/systems
3. Provider use of other EHR and provision of
   required data to CMBHS through delayed batch
   exchange

11
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

12
CMBHS Beta Functionality

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

13
CMBHS Production Release
Beta functionality plus the following

• Determination of ability to pay
• Administration of medications
• TIMA documentation
• Crisis documentation
• Nurses Note and Assessment
• Authorizations (UM)
• Waiting List
• Reports downloads

• Consent for release of information
• Consent to Treatment
• Child Assessment
• Case Management
• Referral
• Messaging system
• Claims (SA)
• Additional Work Spaces

14
Final Production Release

• Doctors orders and prescriptions
• Crisis Services documentation
• State Hospital data exchange
• Community MH services claims
• Pharmacy management
• Quality management and compliance
• Medicaid eligibility and billing
• Other

15
CMBHS Project Schedule
Beta Deployed To pilot Sites
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

16
Implementation of CMBHS

• Deployment plan under construction under guidance
  of the DSHS CMBHS Steering Committee
• Staggered approach to implementation
• DSHS will provide training to providers (train
  the trainer and clinical staff)
• Adjust level of training to provider
  implementation approach
• Technical assistance and support will be
  available by phone. May include user groups,
  online etc

17
Contact CMBHS

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

18
QUESTIONS