Stretching a Behavioral Health EHR to fit County-wide New sites; Ever-changing external requirements; new models of care
Behavioral Health Mental health counseling, family and group therapy, school-based services, case management, wrap around servicescoordination in the community Chemical dependency counseling, group therapy, case management Residential services for MH (adults)
More Behavioral Health Co-0ccuring disorders (MH/CD) Foster Care Housing supportive, independent Crisis Services Deaf Services Developmentally Disabled Services Employment/Vocational Services
Not a medical model most services provided by MHPs-CDPs About 450 employees includes MHPs, CDPs, Psychologists, Employment Specialists, MDs, ARNPs, RNs. Support staff HIM/IT, Finance/Billing, HR, Clerical/Maintenance
6,000-7,000 clients served monthly Service locations in - Seattle - Bellevue - Redmond - Tukwila - Auburn (8 out patient and 4 residential) 2008
Start from almost 0 in 1997 IT beginning to build infrastructure Primary system was billing system difficult to use, almost impossible for data extraction purposes. Growing use of data entry to report to external entities managed care In-house staff of 3 in IT
Huge Changes with 30-90 day time lines to provide seamless quality care 1999 Sound King County addition (6 sites) 2001 East King County addition (6 sites) Result: Increase in clients and employees to more than double the size of the Agency
EHR Rollout - PsychConsult Challenges: Harmonizing new sites Sufficient hardware for all sites Linkage between sites and main campus Training staff who were handwriting notes Security and stability of system
Meeting SMH needs and external requirements Accreditation Licensing and certification community mental health, chemical dependency, residential care, boarding home, foster care, developmentally disabled, domestic violence Contracts more than 30 contracts which have on-site reviews
EHR 2003 Started with Screening/Registration June 2003 added Transactions and Notes and use of the Appointment System All transactions submitted to managed care vendors
Current Snapshot 2008 Infrastructure in place T1 lines between facilities, managing the traffic and load, servers at Capitol Hill and Bellevue campuses, disaster backup at Liberty Lake PCs, laptops, Blackberries, upgraded phone system in place WAN used to prioritize Voice over IP for phones and then EHR
2008 continued Offsite care schools, nursing homes, under the bridge trying wireless (Verizon) connections using laptops Web-based secure portals for Crisis Services to the community and DSHS scheduling of clients in a DSHS program Using Safeword token for external access
2008 - WAN is monitored using intrusion detection software CISCO Security Monitoring, Analysis and Response System - EHR and other systems needed for business continuity Testing use of Biopassword to satisfy one level of password protection Facilities upgraded/consolidated
2008 plus Almost all clinicians are directly documenting care and care coordination processes in EHR Majority of key documents are available in the EHR improvements are a constant process January 2008 began use of DocLocator scanning system linked to EHR with work flow functionality
New Models of Care Recovery Model Client much more actively involved in setting goals and objectives and active participation in achieving objectives. Everyone should live a productive life. Use of peers. Co-occurring disorders mental health and chemical dependency Tx is integrated. Support transition from jail to productive individual, deal with issues and housing.
Take Time to Celebrate Successes!
Continuous Improvement 2009 path