behavioral health primary care integration using the kentucky health information exchange karen...
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Behavioral Health Primary Care Integration Using the Kentucky Health Information
Exchange
Karen Chrisman
Governor’s Office of Electronic Health Information
• CCD exchange• Participation Agreements
From 96 of approximately
130 hospitals
in the Commonwealth • No further consent needed state• Kentucky Cabinet for Health and Family Services
(CHFS) funds and provides support to the Commonwealth’s 14 CBHCs but does not have direct control of the centers
Behavioral Health Background
Sub Award Press Release
• KHIE required modifications• Must release all patient data• Must release all patient data to all providers
in the HIE• Must release all types of data• Must release all data for all uses TPO
• TPO is also required by the GOEHI participation agreement
• Requires a 6 month consent period• If another consent is not signed within 6 months the
consent expires
Consent Form
GOEHI Executive Director
KHIE Project Manager
Behavioral Health Project Lead
and other members as required
Objectives Developed:
Business requirements
Consent requirements
Considered additions to CCD
CCD Components
CCD Technology Workgroup
Behavioral Health
Providers
No Participation Agreement with a behavioral health provider before
March, 2012
Behavioral health providers needed meaningful use
support
Additional attention to 42 CFR Part 2
As a state agency, KHIE required
additional contracting with the community
behavioral health centers
Adapted KHIE processes and
provided site visits
Engaged the Regional Extension Centers within one
week of award announcement
Behavioral Health Providers
There was no standard CCD connection
Began KHIE vendor
onboarding process July 2012
Delivery of the KHIE CCD to
Pennyroyal is in test
Pennyroyal has created a CCD
with a Kentucky Medicaid patient
using vendor software
Process to connect Behavioral Health Vendor to KHIE
KHIE vendor will provide CCD in
production environment
KHIE vendor will deliver Pennyroyal
CCD in test environment
Onboarding Behavioral Health Vendor
KHIE will only respond to the query from Pennyroyal because KHIE recognizes this security certificate.
This ensures that a known KHIE provider is receiving the information.
Pennyroyal has signed the GOEHI Participation Agreement which requires Pennyroyal to use the data from KHIE only for a permitted use.
NetSmart provides a security certificate that is unique to Pennyroyal
KHIE Security
What about Consent??
Only area consent is required in KHIE
Behavioral health providers are valuable information sources
Behavioral health providers already have a consent process
KHIE scheduled site visits to study behavior health provider consent workflow
KHIE has reached consensus on the state consent form
Training
SAMHSA-HRSA Center for Integrated Solutions
PowerPoint PresentationMichael R. Lardiere, Vice President Health Information
Technology and Strategic Development
The National Council for Community and Behavioral Healthcare
Introduction
Patient Consent and Authorization Form for Disclosure
Of Certain Health Information to the
Kentucky Health Information Exchange
Consent Explanation Health Information Exchange Services
Behavioral Health
Assessment
CCD Examples:KHIE CCD Screen Shot
KHIE example CCD
Behavioral Health example CCD
Healthcare IT News “5 Things to Know About CCD”
KHIE Virtual Health Record VHR Example
Health Information Exchange and 42 CFR Part 2 Compliant Consent
PowerPoint Presentation
Maureen Boyle, PhD SAMHSA
KHIE Update
KHIE Training PowerPoint
Making Sense of Consent
• General Rules• Informed
Consent
• Patient• Parent• Legal Guardian
• According to Kentucky Statute
Who may consent? • From Whom/To
Whom• Amount & Kind of
Information
Disclosure
• Aid in treatment and care coordination
Purpose
• At any time with written notice
• Doesn’t stop disclosure of info permitted by law
Revocation
• Specified time frame or
• 6 months from date signed
Effective Period
• Patient, parent, legal guardian
• Proof of legal representation required (Court Order)
Signature
Making Sense of Consent
• SAMHSA Stakeholders Kickoff Meeting March 12, 2012
• Pennyroyal/Netsmart Weekly Status Call Weekly• KHIE/REC by-weekly touch point
Bi-Weekly (March – July 2012)• SAMHSA Grantee Status Call Monthly• KHIE Monthly Update Call
Monthly (March – October 2012)• National Council for Comm Behav Healthcare Conf April 14-17, 2012• Pathways - Official Intake Call May 1,
2012• KY Health Info Management Association Meeting June 4, 2012• Site Visit Pennyroyal Center
June 13, 2012• SAMHSA - UK CECentral Meeting July 16, 2012• National Council Sub Award Consent meeting July 17, 2012• KHA Advisory Committee Mtg July 26,
2012• SAMHSA Consent Mtg-Washington DC August 7, 2012• REC/QIO/KHIE Joint Training Session August 15,
2012• GOEHI Privacy and Security Meeting August 20,
2012• PAIMI Consumer Group
August 28, 2012• UK CeCentral/KHIE Behavioral Health Mtg September 13, 2012• Bost Forum-HIE-SDE Presentation
September 17, 2012• SAMHSA Stakeholders Statewide Mtg/Training September 18, 2012• Voices for Healthy Kentucky
September 28, 2012• Multi-State Coordination and Communication Webinar October 9, 2012• Kentucky Primary Care Association Conference October 15, 2012• PC-BH Collaboration Universal Consent October 16, 2012• KHIE/Pathways Site Visit
October 18, 2012
Outreach
Primary Behavioral Health Care Integration
Pennyroyal Center
received a grant under the PBHCI initiative
Pennyroyal Center has a primary care
license
KHIE delivered KHIE CCD to Pennyroyal
with Medicaid claims data
and all “live” provider lab
results10-25-2012
Pennyroyal will share
consolidated CCD with medical trading
partners 12-15-2012
Current live medical trading
partners Trover Medical
Center, Madisonville,
Lourdes Hospital, Paducah
11-01-2012
Primary Behavioral Health Care Integration
Community Behavioral Health Center
KHIE CCD to Pathways with Medicaid claims
data and all “live” provider lab results
12-01-2012
Pathways shares consolidated CCD with
medical trading partners, primary care
providers currently live King’s Daughters
Medical Center, Fleming County Hospital, St.
Claire Regional Medical Center 1-31-2013
Primary Behavioral Health Care Integration
Community Behavioral Health
Center
Currently teaming with primary care
providers
KHIE CCD to Kentucky River Community
Care with Medicaid claims data, all “live” provider lab results
Kentucky River identified team practices: ARH,
Quantum Healthcare, Mercy Medical Clinic.
Will use KHIE to deliver KRCC CCD consolidated with
Medicaid claims data, all “live”provider lab
results to these providers
Primary Behavioral Health Care Integration
Community Behavioral Health
Center
Partnering with FQHC Primary
Plus
KHIE CCD to Comprehend with Medicaid claims data, all “Live”
provider lab results including
St. Claire Regional Medical Center
and Fleming County Hospital
Comprehend using KHIE to
deliver Comprehend CCD,
Medicaid data and lab results to
Primary Plus
Psychiatric Hospitals in Kentucky Beds County
Central State Hospital 192 Jefferson
Cumberland Hall 91 Christian
Eastern State Hospital 323 Fayette
Kentucky Correctional Psychiatric Center 97 Oldham
Lincoln Trail Behavioral Health System 140 Hardin
Northkey Community Care-intensive Services 57 Kenton
Our Lady of Peace 396 Jefferson
Ridge Behavioral Health System 110 Fayette
Rivendell Behavioral Health Services 125 Warren
River Valley Behavioral Health 80 Daviess
The Brook - Dupont 88 Jefferson
The Brook Hospital - KMI 98 Jefferson
Western State Hospital 495 Christian
Behavioral Health in Kentucky
Community Mental Health Centers (CMHC) City County
Adanta Somerset Pulaski
Bluegrass Lexington Fayette
Communicare, Inc. Elizabethtown Hardin
Comprehend, Inc. Maysville Mason
Cumberland River Corbin Whitley
Four Rivers Behavioral Health Paducah McCracken
Kentucky River Community Care, Inc Hazard Perry
Lifeskills, Inc. Bowling Green Warren
Mountain Comp. Care Center Prestonsburg Floyd
NorthKey Covington Kentucky
Pathways, Inc. Ashland Boyd
Pennyroyal Regional Center Hopkinsville Christian
River Valley Behavioral Health Owensboro Daviess
Seven Counties Services, Inc. Louisville Jefferson
The MORE Center Louisville Jefferson
Transitions, Inc. Bellevue Campbell
Identified – Future Needs
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113103
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Average Daily Census
Kentucky State-Owned Behavioral Health Facilities
For additional information contact:
Karen.Chrisman@ky.gov or
Polly.Mullins-Bentley@ky.gov
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