Transcript Developing and Implementing Electronic Health Records for

Developing and Implementing
Electronic Health Records for
Behavioral Health Services
Strategic Planning for Providers to Improve Business Practices
October 21-23, 2009
Dave Wanser, Ph.D.
Executive Director
National Data Infrastructure Improvement Consortium
[email protected]
http://www.ndiic.com/
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Assumptions
 States and Counties are updating data systems to
improve compliance with reporting requirements and
mandates for electronic health records
 States and Counties will increasingly need timely
access to linked performance and financial
information for management and accountability
purposes
 These expectations will extend to providers
 Governmental entities will become the leaders in
making universal deployment of EHRs a reality
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How do Shareable EHR Systems Assist
States and Counties?
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Quality/standardized record keeping;
High levels of data quality due to business rules and edits
Mechanisms to facilitate service networks;
Ability to monitor compliance and performance;
A way to combine, clinical, research, and financial data; and
State and Federal reporting.
Quality data on a timely basis
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How do Shareable EHRs Help Providers?
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Standardizes clinical records
Improves proper evaluation and placement of clients
Tracks services provided
Determines client progress during treatment
Submits claims to the State or County
Immediate access client records
Fulfills State and Federal reporting requirements
with high quality data
Quality client care
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Reality Check
 There will be universal adoption of EHRS in all
aspects of healthcare
 Substance abuse prevention and treatment is
healthcare
 Patient clinical information will need to be transferable,
and data systems will need to be interoperable across
providers and settings
 Health Information Exchanges will be important
gateways for sharing clinical information
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What is an EBHR?
 It’s a complete, or nearly complete clinical
record.
 It is relational – the various parts of the
record are integrated and interactive with
the rest of the record
 It is real time
 It allows immediate access to quality
measurement and performance
accountability
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States Approaches to EBHRS
 States that have implemented statewide
EBHRS
 States that are planning to within the next
year
 States with a high level plan without a firm
date
 States taking a hands-off approach
 States not ready to think about it.
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Success Factors for States that Have
Implemented EBHRS
 Executive engagement throughout the entire
process
 Dedicated IT resources
 Clear vision and guiding principles
 Cross-functional workgroup with facilitation
 Oversight team meets weekly
 Holding to agreed upon timelines
 Modest beginning with build out
 Multifaceted training and support functions
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Myths About EBHR Implementations:
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There is an off the shelf solution
This is a technology project
Our needs are unique
EBHRS are just like paper records – only on a
computer
It’s best to plan the entire system out and implement
all at once
It solves all our problems (it only solves some
problems)
It can be done in a few months
It will take years (although it could happen if success
factors are ignored)
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Principles for Successful Selection,
Procurement and Implementation
 Perfect is the enemy of good
 One of the most significant challenges of EBHR deployment is
clinical process transformation
 Leadership must be engaged and support needed
organizational and process change
 Workgroups require multidisciplinary engagement
 There are significant tradeoffs for variation
 Workflow changes are enormous and no consultant or vendor
can help in this area
 Oversight or “management team” is essential to manage
change control
 Not a technology project… Yet the solution must still fit within
the State’s technical infrastructure.
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Currently Available Administrative
Features in Many State Implemented
EBHRS
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HIPAA Compliant
Billing Based on Services Provided
Financial and Clinical Eligibility
Capacity Management
Provider Level Security Administration
Outcome Measures
Federal Reporting Mechanism
Desk Audits without Travel
Extensive Data Analysis for Outcomes, Trends, etc.
Decision Support – in it’s infancy
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Features of Current State & County
Hosted EBHR Systems
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Adult and Children’s Screening and Assessment
“Smart” Treatment Plan and Review
Admission, Discharge, and Follow-up
Progress Notes and Client Progress
Billing
Case Management and Automated Messaging
Wait List and Capacity Management
Drug Court interface
Web-based user training
Co-Occurring State Incentive Grant, ATR Voucher System, and SBIRT
documentation
Prevention Services
Automated Referral and Release of Confidential Information
Mental Health and psychiatric emergency services
Reports and Downloads, including automatically generated provider specific
reports
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How is ARRA Meaningful Use Relevant
to Behavioral Health?
 A major focus of meaningful use is the use of
quality data to improve care
 Improving the quality of care will be dependent on
the availability of structured data
 Developing, sharing and continually improving a
common EBHR reference model will provide
substantial opportunities to move behavioral
health treatment from personal opinion and
tradition to data based decision support
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Take Aways
 Does your organization have a data strategic
plan?
 Does your organization have a means to use
timely data to improve clinical practice?
 Is your state leadership at the table in discussions
about HIT and HIE?
 Have you sought assistance in planning?
 This is a pass-fail quiz. Passing score is
answering yes to all 4 questions.
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