Planning, Using, and Adapting County Data Systems CalMHSA PEI TTACB Work Group March 5, 2014 Facilitated by RAND and SRI Planning, Using, and Adapting

Planning, Using, and Adapting County Data Systems

CalMHSA PEI TTACB Work Group

March 5, 2014

Facilitated by RAND and SRI

Planning, Using, and Adapting County Data Systems

CalMHSA PEI TTACB Work Group

March 5, 2014

Facilitated by RAND and SRI

The California Mental Health Services Authority (CalMHSA) is an organization of county governments working to improve mental health

outcomes for individuals, families and communities. Prevention and Early Intervention programs implemented by CalMHSA are funded by counties

through the voter-approved Mental Health Services Act (Prop 63). Prop. 63 provides the funding and framework needed to expand mental health

services to previously underserved populations and all of California’s diverse communities

© Copyright 2014 RAND Corporation

Today’s work group is part of RAND’s CalMHSA TTACB project

Today’s work group is part of RAND’s CalMHSA TTACB project

• Collaboration between CA counties, community-based service providers, CalMHSA, SRI, and RAND

• Provide support for PEI implementation throughout CA

• Collaboration between CA counties, community-based service providers, CalMHSA, SRI, and RAND

• Provide support for PEI implementation throughout CA

Today we will focus on electronic data systems being used or planned by counties for capturing PEI process and outcomes information.

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AgendaAgenda

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• Welcome and introductions

• Key components of a PEI outcomes data system

• Presentations from counties using different data systems− Los Angeles, Modoc, Monterey & Placer

Counties

• Counties sharing experiences – Session 1 and 2− Break out groups around different platforms

• Adapting data systems to changing requirements




Counties




AgendaAgenda

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Counties

• Lunch – catch up with colleagues






Counties

• Lunch – catch up with colleagues




• Functionality required should dictate the components to incorporate

• Some functions require similar components while others require unique components

− Sometimes you cannot have both

• Some functions require real-time data, some do not

• Some functions may be done well enough already or be too costly to even consider

• A team of users and experts can best address this question

• Functionality required should dictate the components to incorporate

• Some functions require similar components while others require unique components

− Sometimes you cannot have both

• Some functions require real-time data, some do not

• Some functions may be done well enough already or be too costly to even consider

• A team of users and experts can best address this question

What do you want a PEI outcomes data system to do?

What do you want a PEI outcomes data system to do?

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• Compliance reporting and contract management

• Clinical supervision and clinician training

• Client-counselor service planning and progress review

• Workflow monitoring and billing and case management

• Performance management

• Program continuous quality improvement (CQI)

• Local/statewide evaluation and/or research support

• Compliance reporting and contract management

• Clinical supervision and clinician training

• Client-counselor service planning and progress review

• Workflow monitoring and billing and case management

• Performance management

• Program continuous quality improvement (CQI)

• Local/statewide evaluation and/or research support

Possible functions of outcome data systemsPossible functions of outcome data systems

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• Today’s audience includes users of at least 16 different software systems

• Presentations from four counties and breakout groups will provide opportunities for sharing experiences

• Vendors and users of other systems in your county can also be consulted

• Demonstrations are another way to assess options

• Today’s audience includes users of at least 16 different software systems

• Presentations from four counties and breakout groups will provide opportunities for sharing experiences

• Vendors and users of other systems in your county can also be consulted

• Demonstrations are another way to assess options

Selecting a system to meet your needs and goals

Selecting a system to meet your needs and goals

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• Consider what it would take to adapt or replicate a system to meet your needs− Does it make sense to build your own or purchase?

• Assess capacity within your county providers and administrators to run and support a system

• Capacity is more than funding to build and install a system− Provider, clinician, agency staff skills e.g., for data

entry, data processing, data analysis, interpretation and reporting

− Technology (hardware and IT support)− Data systems already in place

• Consider what it would take to adapt or replicate a system to meet your needs− Does it make sense to build your own or purchase?

• Assess capacity within your county providers and administrators to run and support a system

• Capacity is more than funding to build and install a system− Provider, clinician, agency staff skills e.g., for data

entry, data processing, data analysis, interpretation and reporting

− Technology (hardware and IT support)− Data systems already in place

Assess fit and capacity within your county

Assess fit and capacity within your county

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Key components of a PEI outcomes data system

Key components of a PEI outcomes data system

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• The infrastructure is the foundation and organizational structure and support needed for data system operation

• The interfaces are the users who enter and receive the data

• The content refers to the data elements the system captures

• The infrastructure is the foundation and organizational structure and support needed for data system operation

• The interfaces are the users who enter and receive the data

• The content refers to the data elements the system captures

Key components of a data systemKey components of a data system

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• Platform selection

• Integration capacity

• Security levels

• System administration– Expertise – Users’ support

• Adaptability

• Platform selection

• Integration capacity

• Security levels

• System administration– Expertise – Users’ support

• Adaptability

PEI outcomes data system infrastructurePEI outcomes data

system infrastructure

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• Desktop or web-based platform selection options

− Security and access are key considerations

• Counties here today use

− MS Excel

− MS Access

− Anasazi or Avatar EHRs

− Existing county server based systems

− Systems custom built/adapted for MHSA/PEI outcomes

• Desktop or web-based platform selection options

− Security and access are key considerations

• Counties here today use

− MS Excel

− MS Access

− Anasazi or Avatar EHRs

− Existing county server based systems

− Systems custom built/adapted for MHSA/PEI outcomes

Infrastructure – platform selectionInfrastructure – platform selection

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• Potential integration capacities include:

− Billing

− EHR/EMR

− Other MHSA/BH/county agencies/community providers’ data systems

− Contract compliance reports

− Primary care

• Potential integration capacities include:

− Billing

− EHR/EMR

− Other MHSA/BH/county agencies/community providers’ data systems

− Contract compliance reports

− Primary care

Infrastructure – integration capacityInfrastructure – integration capacity

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• Protects client privacy and compliance with federal HIPAA regulations and other relevant MediCal and state regulations

• With individual data access will need to be strictly controlled

− Levels of access can vary with type of user and limit access to private information

• MOUs across agencies can articulate data sharing and privacy provisions

• Need to consider internet, application, and physical security

• Protects client privacy and compliance with federal HIPAA regulations and other relevant MediCal and state regulations

• With individual data access will need to be strictly controlled

− Levels of access can vary with type of user and limit access to private information

• MOUs across agencies can articulate data sharing and privacy provisions

• Need to consider internet, application, and physical security

Infrastructure – securityInfrastructure – security

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• System administration requires expertise in:− Information technology (IT)− Auditing− Data processing− Data analysis− Report interpretation

• Users’ support may include:− Training and technical assistance− Help desks for error resolution and new queries− Site visits to review audits − Q&A− User support groups

• System administration requires expertise in:− Information technology (IT)− Auditing− Data processing− Data analysis− Report interpretation

• Users’ support may include:− Training and technical assistance− Help desks for error resolution and new queries− Site visits to review audits − Q&A− User support groups

Infrastructure – system administrationInfrastructure – system administration

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• Deserves consideration at the start of a system design to understand what changes are possible and what are their costs

− The addition of a new program can mean the need to add new outcome measures

− Changing reporting requirements can mean the addition of data elements and data linkages

• Customization by role promotes user friendliness

− Screen customization for data entry and reports

− Data query and ad hoc report customization can facilitate analysis and utility of the data

• Deserves consideration at the start of a system design to understand what changes are possible and what are their costs

− The addition of a new program can mean the need to add new outcome measures

− Changing reporting requirements can mean the addition of data elements and data linkages

• Customization by role promotes user friendliness

− Screen customization for data entry and reports

− Data query and ad hoc report customization can facilitate analysis and utility of the data

Infrastructure – adaptabilityInfrastructure – adaptability

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• Infrastructure

• Interfaces

• Content

• Infrastructure

• Interfaces

• Content


• Data Input users− Direct data entry (individual and batch)− Data import to ease burden of data entry

• Data quality can be built in (notifications, automated checks, audits)

• Role-based interfaces are user friendly− Front desk− Clinician or service provider and supervisors− QA− Billing− IT− Management

• Data Input users− Direct data entry (individual and batch)− Data import to ease burden of data entry

• Data quality can be built in (notifications, automated checks, audits)

• Role-based interfaces are user friendly− Front desk− Clinician or service provider and supervisors− QA− Billing− IT− Management

PEI outcomes data system interfacesPEI outcomes data system interfaces

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• Data output users

− Data exports

− Standard reports for roles and for audits, e.g., missing data reports

− Individual participant

− Aggregate program, provider, site

− Annual community report

− Custom reports that users can design and modify easily

• Data output users

− Data exports

− Standard reports for roles and for audits, e.g., missing data reports

− Individual participant

− Aggregate program, provider, site

− Annual community report

− Custom reports that users can design and modify easily

System interfaces – output usersSystem interfaces – output users

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• Infrastructure

• Interfaces

• Content

• Infrastructure

• Interfaces

• Content


• Levels

− Individual• Clients, families, clinicians

− System• Providers, programs, counties

− Community• Population and target populations

• Structure and process information

• Outcomes information

• Levels

− Individual• Clients, families, clinicians

− System• Providers, programs, counties

− Community• Population and target populations

• Structure and process information

• Outcomes information

PEI outcomes data system contentPEI outcomes data system content

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A Logic Model for Understanding the Impact ofPrevention and Early Intervention (PEI) FundingA Logic Model for Understanding the Impact ofPrevention and Early Intervention (PEI) Funding

PEI Funding

Co

mm

un

ity P

lan

nin

g P

roc

es

s•

Iden

tified n

eeds

•Targ

et po

pu

lation

s

Are there public health benefits?

Reduced suicide

Mental-health related

• Prolonged suffering• Incarceration• Homelessness• School drop out• Foster care• Unemployment• Differences across

groups

Where is it going?

(Programs)

New and enhanced prevention resources• Public awareness

campaigns• Training and

education of gatekeepers

• Education and counseling programs

• Community strengthening programs

New and enhancedtreatment resources• Treatment of mild-

moderate mental illness

• Treatment for new onset SMI

Increasedcollaboration and coordination among agencies• System change

efforts

What is it doing?(Program activities)

More and better prevention• Exposure to social

marketing efforts• More teachers trained• More parents

receiving coping skills training

More and better early intervention• Access/utilization of

first-break early intervention programs

• Use of school-based counseling services

Does it make a difference?

(Short and long-term outcomes)

Changed knowledge, behaviors and attitudes• Increased general

knowledge about mental illness

• Increased identification of at-risk clients

• Increased help-seeking• Decreased risk

behaviors Improved resilience and emotional well-being• Increased social

connections• Decreased

psychological distress• Increased family

functioning• Improved school

performance

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• Information about clients or program participants

− Unique identifiers for unduplicated counts• Individual and family, program, counselor links

− Client characteristics such as target population status

− Demographics for reporting requirements, QI and evaluation

− Client services utilization/attendance/participation

− Program status and service duration• From start to completion or other disposition

− Collateral services/systems• Referrals and transfers to and from other services

• Information about clients or program participants

− Unique identifiers for unduplicated counts• Individual and family, program, counselor links

− Client characteristics such as target population status

− Demographics for reporting requirements, QI and evaluation

− Client services utilization/attendance/participation

− Program status and service duration• From start to completion or other disposition

− Collateral services/systems• Referrals and transfers to and from other services

PEI structure and process informationPEI structure and process information

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• Benchmark against goals and objectives of treatment plan or program standard

• Assess symptoms/ dx./ baseline score on standard measure at outset of program (‘pre’)

• Repeat data collection to measure progress/change over time (‘post’)

− Core measures (across programs, agencies, counties)

− Custom measures (specific to a program)

• Benchmark against goals and objectives of treatment plan or program standard

• Assess symptoms/ dx./ baseline score on standard measure at outset of program (‘pre’)

• Repeat data collection to measure progress/change over time (‘post’)

− Core measures (across programs, agencies, counties)

− Custom measures (specific to a program)

PEI outcomes informationPEI outcomes information

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Did services received make a difference?


Thank You!Thank You!

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Documents

Planning, Using, and Adapting County Data Systems CalMHSA PEI TTACB Work Group March 5, 2014 Facilitated by RAND and SRI Planning, Using, and Adapting