Clinical Management for Behavioral Health Services (CMBHS) May 30, 2008

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

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

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

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

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

Current Data Systems CARE BHIPS NorthSTAR TIERS SAVERR Vendor Systems TMHP NorthSTAR Financial Systems DSHS Physical Health Financial Systems

CMBHS Focus Group 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

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

Clinical Documentation Structure Service Delivery Treatment Plan Progress Notes Assessment Screening Waiting List Discharge Admission Treatment Plan Review Discharge Summary

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

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

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

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

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

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?

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

Options for Provider Use of CMBHS 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 4 CMBHS Online/Data Exchange Provider uses CMBHS as front end to feed data to their vendor system at the backend

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

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

Contact CMBHS You may submit questions to: cmbhs@dshs.state.tx.us CMBHS website is: http://www.dshs.state.tx.us/cmbhs