John J. Flynn, Ph.D. Revision Date: 9/20/12 Data Entry PEI Outcome Measures Application for Mental Health Integration Program (MHIP) John J. Flynn, Ph.D. Revision Date: 9/20/12

Learning Objectives Learn about PEI Outcomes history & purpose Discuss how to organize and check PEI Outcome questionnaire scores from clinicians Learn how to enter MHIP scores in the PEI OMA application Learn how to spot and fix problems with PEI outcome measures data Learn about PEI Outcomes What are they? How do they get collected and entered? Discuss how to organize and check PEI Outcomes from Clinicians What are the forms we’re going to see? What do we need to do to get them organized? Learn how to enter PEI Outcome Data How to logon and enter data…first, The “Happy Path” and then the “Rocky Road” Learn how to spot and fix problems with PEI Outcome Measures Data How to deal with errors…the “Rocky Road” 2 2

The What and Why of PEI Outcomes Outcomes are basically questionnaires to help us understand what’s effective State Mandated: we receive funds from the MHSA, so we need to report outcomes Your clinicians are being trained in collecting outcomes for a variety of different Evidence-Based Practices (including MHIP) DMH has built you a custom application to do data entry: the PEI Outcome Measures Application State mandated under MHSA (Prop 63) – PEI outcomes are the second largest component of MHSA funding Need to capture outcomes to justify the funding from the State. Who among you are Community Partners? How will this info be used? Our clinicians are supposed to use it to understand what’s working on an ongoing basis…it’s part of their toolkit. The State and County will use this data to evaluate what’s working in PEI services.

What are PEI Outcome Measures? At larger agencies, clerical staff are going to be getting paperwork on all sorts of different measures…basically, different kinds of assessments. These assessments need to be SORTED and checked out…you’re going to need to think of this in terms of two basic steps: SORTING/CHECKING the data and ENTERING the data. COMPLICATED! It’s up to us to sort them out!

“How are we going to organize this, Team?” When you get back in your office, you need to meet and talk about how the paper is going to go from one place to another, you need to know WHAT you’re going to be getting (in terms of questionnaires), and what the schedule and the expectations are. Make a point of having a staff meeting that deals with these issues! Avoid traffic jams! Make sure you know what questionnaires you’ll be getting, what the schedule is, and what the workflow is!

PEI Outcome Workflow Clinician Meets with client, goes through one or more Questionnaires, and then scores these questionnaires. Those scores are what you’re going to be entering into the PEI Outcome Measures computer application. The first one is a PRE assessment, and there are rules about the dates we’ll talk about in a minute. We’re going to look at these different scoring worksheets in a minute, but you should know that they should only be created or corrected by the clinicians. 2. Next up is you: Data Entry. You’re going to need to do a quick check to make sure the form looks like it’s generally OK. Do you have the client ID? Are there blank spaces? Is it legible? Are you missing important items like Diagnosis, Date of Assessment? 3. Did you find problems? Take it back to the clinician to figure out what needs to be done. You’ll probably want to talk not just to the clinician but to your team about how to make sure the process is working correctly. 4. Finally, you’ve got data entry. If you’ve got more than one or two clients to enter, you are going to want to SORT them so that you can minimize mistakes and be more efficient. You should sort all those Questionnaires by Focus and Evidence Based Practice: this makes it much easier to enter stuff into the PEI OMA. Now you might still encounter problems here…the OMA PEI Computer Application might give you errors because the clinician didn’t fill things in correctly. In that case, back to Step 3…consult with the clinician.

MHIP Focus of Treatment and EBPs

Focus and EBP Remember: for MHIP providers…you only click on MHIP! Version 1, June 19, 2012

MHIP Questionnaires DEPRESSION ANXIETY TRAUMA Patient Health Questionnaire - 9 (PHQ-9) ANXIETY Generalized Anxiety Disorder - 7 (GAD-7) TRAUMA PTSD Checklist - Civilian version (PCL-C) Version 1, June 19, 2012

MHIP Treatment Cycle DEFINITION: A Treatment Cycle is a single completed EBP: from “Pre” assessment to “Post” assessment. It may include Updates. MHIP is a little different from other PEI’s…there’s no “POST” … the last Update is the Post.

Rules about Dates Be careful when entering dates. All dates have their own validation rules. Date of First Session cannot be later than any updates. Questionnaire Administration Date cannot be earlier than Date of First Session. Date of Last Session cannot be earlier than the Questionnaire Administration Date of any pre or update. Version 1, June 19, 2012

What will the data you get look like? The one on the left is an example of the optional worksheets DMH is providing to clinicians. The one on the right is a SAMPLE of the scoring sheet for the PHQ-9 You might also get scores in a spreadsheet format…or even scrawled on lined paper! There’s no set method for providing the scores to clerical staff. The worksheet will be provided on the MHIP Wiki site once it is complete. PLEASE GET TOGETHER WITH YOUR TEAM AND DISCUSS THIS! It’s important that you all agree on how the data is going to get to you! It depends! Version 1, June 19, 2012

Sorting: what have I got here? First…what do we have here? We need to sort different EBP’s We also need to sort different PROVIDER ID’s, if you have more than one. You should also be on the lookout for problems… forms that are missing required information, dates that are incorrect, data you can’t read (DON’T guess, ask the clinician!), missing questionnaires. Version 1, June 19, 2012

Sorting…what problems have I got here? These problems are going to make sense a little later when we start in on the application…but for now I just want to invite you to look this over…what problems do you see? Blanks on the Therapist ID and the administration date is wrong. Version 1, June 19, 2012

Example: What is missing?

What if the clinician is unable to collect a questionnaire? Clinicians do have the option of marking a “Unable to Collect” and providing a reason. Version 1, June 19, 2012

What do you do when you find those mistakes? Do you fix them? If you do encounter mistakes…do you fix them? NO! It’s up to the clinician to make any corrections to the assessment! Good clinical practice demands that you NOT alter the documents…that is the responsibility of the clinician! Put a Post-It on it, and talk to the clinician! Version 1, June 19, 2012

MHIP Program Information Go Live date for all contract agencies to enter data into the PEI-OMA for MHIP is October 1, 2012 MHIP Policy Questions and Answers Invalid Outcome Measures should not be entered into OMA (i.e., incomplete screening tools) Only one focus of treatment and the respective screening tool should be entered into the OMA

And now…the PEI Outcome Measures Application… HANDOUT: Samples for Happy Path So now we’re going to actually get in and look at the PEI Application. This time through we’re going to look at the ideal, “Happy Path” version. Things are not always easy, though! Things go WRONG! So after we travel the Happy Path, we’ll try the Rocky Road! The HAPPY PATH version… Version 1, June 19, 2012 19 19

And now, the Rocky Road…. Careful! Errors on sheets Bad scores Missing information Version 1, June 19, 2012 20 20

Time for Hands-On Sample Data on correct Worksheets Data’s already sorted Sample Client ID’s for everyone Training Environment: http://clsxtrainweb/PEIOutcomeMeasures Login as User Name: rrivera Password is: 123 HANDOUT: Step By Step Guide Now we’re going to work through the application with clean, correct worksheets and our Step-By-Step guides. Sample Data on correct Worksheets Data’s already sorted Sample Client ID’s for everyone Login as User Name: jflynn Password is: data Please refer to the STEP BY STEP guide for help after this class! 21

Application Support MHIP Wiki page Help Desk: (213) 351-1335 http://dmhoma.pbworks.com/w/page/54889262/PEI%20MHIP To register for PEI-OMA training for MHIP Announcements Release notification Key Staff Roster Help Desk: (213) 351-1335 Issue description, Provider #, Focus of Treatment, EBP and client ID Help Desk will triage your call