eBehavioral Health
Solutions
(eBHS)
CBHDA CSOC Meeting 8/20/15
Rikke Addis
Small County Data Center
Project: Phase 1
• Health reform is transforming health and behavioral
health service systems and practices, and increasing
need for IT capacity
• Small counties have unique needs and challenges
collecting, analyzing, and meeting data reporting
requirements
• Lack the resources to invest in complex information
technology systems and personnel dedicated specifically
to evaluation and quality improvement performance
measurement.
• Pilot Goal: Develop and implement a web-based data
solution to address the technical assistance and data
system needs of the small counties.
Building eBHSolutions (eBHS)
• CIBHS contracted eCenter Research Inc. -Canadian corporation specializing exclusively in
Software as a Service for mental health and
addictions treatment providers, regional authorities,
and research organizations in over 50 countries.
• Annual licensing model avoids the high cost of
application development, secure server hosting, ongoing expenses for technological infrastructure, and
costly desktop software programs that do not evolve
as user needs change.
Building eBHS
•
CiBHS engaged the small counties in collaboration with CBHDA to
identify and prioritize the system functionality desired by the counties:
– Flexible, real-time reporting and querying to support individual client, population, and
system improvement and outcome tracking
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Data collection
Data storage
Uploading from existing EHRs and local databases
Analysis
Querying and reporting
– HIPAA and 42CFR compliance
•
The eBHS platform was designed to address Small County priorities:
– Routine collection, analysis, tracking, and reporting of standardized measures (e.g.,
PHQ-9 and GAD-7)
– Data tracking capacity/registry function for counties participating in the Advancing
Recovery Collaborative and the Care Coordination Collaborative
– Analytic functions currently employed in CIBHS evidence-based practice (EBP)
program performance and outcome evaluation protocols (specifically the Youth
Outcome Questionnaire (YOQ) that are currently being used for treatment planning,
monitoring, and outcome evaluation across multiple programs in several counties.
Participating Counties by
Function/Capacity Testing
Imperial
X
Data Tracking/Registry
Function to Support Care
Coordination and
Advance Recovery
Practices
X
Modoc
X
X
Mono
X
X
Tuolumne
X
X
Participating County
SCDC Standardized
Measures Collection and
Reporting
Amador
X
Colusa
X
Lake
X
Trinity
X
Data Collection and
Analytic Functions for
Evidence-Based Practice
Program
X
Value of eBHS Functions:
County Feedback
• “Reporting is more straightforward than using crystal reports
with EHR, which take time and resources to develop and use”
• “Parameters of data reports change according to different
reporting requirements; and a report writer must be available
to make the changes, which is now possible in eBHS”
• “The volume of data is multiplying exponentially and eBHS
shows promise helping us manage it”
• “Systems resources are needed to run reports off our EHR,
but eBHS is more flexible and easier to use”
• “Reminders to administer the tools on an ongoing basis are
not embedded in the EHR system, but can be developed in
eBHS”
Data Entry: County Feedback
• Measuring, tracking and supporting care coordination and
client recovery
• Measurement that informs work improvement
• Data gathering and reporting of key measures on a monthly
basis
• Moves data collection from manual to electronic format
• Helps systematize collection of data
• Structures data collection for clinicians when face to face with
clients
• Allows for information sharing with clients to improve their
understanding of their health, behavioral health, and recovery
status and progress
• "1-click analytics"
Data Upload: Imperial County
Feedback
Imperial County reported the following experience piloting
the upload function of their PHQ-9 data from Avatar to eBHS:
 Successfully conducted reconciliation of systems - different
names for same data points – with no issues
 Data anomalies are handled expeditiously (consumer transfer
to another program)
 24 hour Help Desk for system issues was responsive and
helpful
 The upload process appears to be seamless
 Secure data exchange site was straightforward and easy to use
Reporting
Small counties requested the following analytic and reporting
capabilities:
 Calculation of scores associated with each clinical measure
 Number and percent of clients above and below clinical cutpoints
 Aggregate report functionality that allows the user to "hover" over
the clinical cut points and provide a list of clients that fall into an "atrisk" category.
 Aggregate pre- and post- comparisons
 Reliable change formulas to accurately classify observed pre/post
change into three groups (reliable negative change, no change,
reliable positive change)
 Individual reports on clients to show change over time
 Graphical reporting appropriate to share with clients and other
stakeholders, as appropriate
Report: GAD-7 Individual
Report: PHQ-9 Individual
Report: PHQ-9 Aggregate
Phase 2: Ideas for eBHS
Improvements and Expansion
• Improve and expand clinical functionality to support clinical
functions, such as:
– 1) Shared care planning across providers
– 2) Clinical prompts and reminder flags to promote proactive care and
prevention
– 3) Treatment Reconciliation across providers
– 4) Treatment progress and measurement
– 5) Communication and information exchange
• Expand clinical measures, e.g.: substance use screens and
treatment assessments, evidence-based practices, and recovery
measures
• Develop client portal function
• Expand reporting function to include tailored data dashboards to
enable tracking of clinical outcomes for quality improvement and
clinical monitoring, and overall population management