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

2. 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

3. 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

4. Why Develop CMBHS?
SAMHSA: Develop a single system for persons with co-occurring disorders
State Legislation: House Bill 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

5. 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

6. 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

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

8. 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

9. 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

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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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?

17. 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

18. Options for Provider Use of CMBHS1
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

19. 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

20. 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

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