Behavioral Health Information Exchange

Review and engagement process for requirements gathering process

Review/Information Gathering Objectives

• Review the current data elements to support for Behavioral Health information exchange– Review for completeness: are the data elements sufficient to support

the needs of the stakeholders– Information exchange requirements included so far

• Referral/transfer-of-care (with primary care)• Reporting to state/federal agencies

– New information exchange opportunities may need to validated• Electronic information exchange with state systems

– Education– Criminal Justice– Homeless – Employment– Training

– Allowed values/codes to for coded data elements

Data Elements: Requirements• New data elements required to support existing and new

interoperability requirements– E.g. last date used

• Changes to data elements to represent the information correctly– Clarify definitions– Clarify purpose of data– Specify if a data element is numeric, a range of values, a textual string, a date,

a time, a true/false finding, optional/required, repetitions of data elements• Change to value sets for encoded data elements

– Specify a list of allowable values for encoded data elements(e.g. administrative gender, biological gender, etc.)

– Provide complete values/list items, if consensus exists– Provide representative values/list items (e.g. representative assessment types,

assessment sections)

2

Walkthrough(initial)

1

Work SessionsWalkthrough (Review Changes)

Revised

RIM and Vocabulary Harmonization Cycles

Completed data requirements document

New requirements

Review and Engagement Process

3

Proposed Review Process• Initial walkthrough to review/presentation the current data set

– Including proposed value sets– Date: Thu. Feb. 7th, 2013 @ 11 am (90 minutes)

• Three interactive work sessions proposed (90 minutes each):– Tues. Feb. 12th @ 4 pm EST– Thu. Feb. 14th @ 10 am EST– Mon. Feb. 18th @ 3 pm EST– We recommend that you plan to attend:

• Initial Walkthrough• One work session• Final Review Walkthrough

– The feedback received in each seminar will be incorporated in the materials for the next reviews

• Data elements, value sets

• Final Review Walkthrough of the proposed changes– Wed. Feb. 20th @ 1 pm EST

Orientation

How to review the data set spreadsheet

ioana@eversolve.com

Behavioral Health data elements

• Organized along domains– Patient Demographics– Episode Of Care – Assessment– Problems/diagnoses– Procedures– Medications– Immunizations – not elaborated in this spreadsheets,

using standard immunization records– Substances of abuse

class Report Information Analysis

BehavioralHealthReport

assessmentDate :dateTimeconfidentialityCode [0..1] = confidentiality...documentId :IdentifierreferralDate :Date [0..1]referralSource :ReferralSource [0..1]replacesDocumentId :Identifier [0..1]submissionDateTime :Date

Client

behavioralHealthCategory :BehavioralHealthCategory [0..1]clientId :IdentifierdateOfBirth :DatedisabilityStatus :OMHDisabliityStatus [0..*]effectiveTime :Date [0..1]ethnicityCode :OMHEthnicity [1..6]gender :AdministrativeGendergenderIdentity :GenderSelfIdentity [0..1]maritalStatus :MaritalStatus [0..1]name :PersonNamepreferredLanguage :PreferredLanguage [0..1]pregnancyStatus :PregnancyPuerperium [0..1]raceCode :OMHRace [1..*]religiousAffiliation :ReligiousAffiliation [0..1]sexualOrientation :SexualOrientation [0..1]

EpisodeOfCareReference

completionStatus :EpisodeOfCareCompletion [0..1]endDate :Date [0..1]episodeOfCareStatus :SubmissionTriggerepisodeOfCareType :EpisodeOfCareType [0..1]startDate :DatetreatmentParticipationQualifier :TreatmentParticipation [0..1]

Organization

organizationId :IdentifierorganizationNameaddress :Address [0..1]legalAuthenticator :Provider [0..1]

SocialHistory

correctionalSystemReference :CorrectionalSystemInvolvement [0..1]educationalAccommodation :EducationalAccommodationProgram [0..1]educationLevel :FormalEducationLevelemploymentStatus :EmploymentStatusnumberOfDependentChildren :int [0..1]numberOfRecentArrests :int [0..1]otherProgramCoordination :StateProgram [0..*]postPartum :boolean [0..1]pregnancy :boolean [0..1]primaryResidenceSetting :PrimaryResidence [0..*]socialSupportParticipationForSubstanceAbuse :int [0..1]treatmentEngagement :EngagementInTreatment [0..1]veteranStatus :boolean [0..1]

SubstanceOfAbuse

ageOfFirstUse :int [0..1]dateLastUsed :dateTimefrequency :Frequencyroute :RouteOfAdministration [1..*]substance :SubstanceOfAbuse

Assessment

assessmentType :BehavioralHealthAssessmentTypeauthoringProvider :Provider [0..1]date :dateTime [0..1]interpretation :string [0..1]normalRange :NumericRange [0..1]score :int

SubstancesOfAbuseSection

primarySubstance :SubstanceOfAbuse [0..1]secondarySubstance :SubstanceOfAbuse [0..1]tertiarySubstance :SubstanceOfAbuse [0..1]

ProblemsDiagnoses

axis-I-problem :Problem [0..5]axis-II-problem :Problem [0..2]axis-IV-problem :Problem [0..2]physicalProblem :Problem [0..5]principalDiagnosis :Problem

Subscore

score :intnormalRange :NumericRangesection :BehavioralHealthAssessmentSectionType

CareTreatmentPlan

authoringProvider :ProvidercarePlanEvidence [0..1]effectiveDate :Date

Immunizations

Procedures

typeOfService :Procedure/Service

Problem

problemCode :ProblemdateOfOnset :Date [0..1]dateOfResolution :Date [0..1]dateEntered :Date [0..1]authoringProvider :Provider [0..1]

Assessments

assessment :Assessment [0..*]

CorrectionalSystemInvolvement

correctionalSystemInvolvementStatus :CorrectionalSystemInvolvementStatus [0..1]correctionalSystemType :CorrectionalSystemType [0..1]criminalJusticeInteractionStatus :CJComplianceCondition [0..1]

PrescribedMedications

Procedure/Service

authoringProvider :ProviderdateOfService :Date [0..1]procedureCode :Procedure

MedicalService (rename Services)

serviceCode :Procedure

Homeless

housingStatus :HousingStatus [0..1]

Income

incomeAmount :intincomeSource :IncomeSource [0..*]nonCashBenefit :int

reportingOrganization 0..1

substances0..1

services

providerOrganization

1

client 1

problems1

episode

1..*

assessments0..1

socialHistory

0..1

medications0..1

associatedCarePlan0..1

procedures0..1

immunizations0..1

receivingOrganization*

0..*

subscore 0..*

Episode of care

Patient Demographics

Social History

Substances of Abuse

Procedures

Assessments

Problems Medication

Immunization

The first tab “Orientation” provides quick guidance to the reviewers

regarding the contents and organization of the spreadsheet and

the purpose of this review and requirements gathering

Each element has a name and definition and a format/type

Each “domain” contains data elements described below:

“Coded type” indicates that there is a list of items (value set) associated

with this data element

Second tab contains the complete list of data

elements organized by domain

Gender identity data element

“

“Coded type” indicates that there is a list of items (value set) associated with this data element –link to the value set

worksheet

List of allowable items for “GenderSelfIdentity” – this is an example

value set, you can suggest additional changes

New items will be added at the end of the list

Changes to existing items will be suggested here

Structured Data

• If a data element contains sub-elements they are detailed in the “Field Format/Type” column

Provider details… verify if any are missing, suggest changes

Repetitions, optional/required

• Some data elements are optional or required to meet the business requirements

• Other data elements may repeat Indicator regarding

optional/required and repeating fields

How to review this document

• For completeness (30 min or less)– to ensure that all the data elements relevant are included – Review “Behavioral Health Elements”

• Second worksheet

• Value sets contents – if in addition to completeness you would like to review how encoded data elements are represented– Follow the links in the “Value set” column and open

the worksheets associated with the list of allowable items for that data element Value set contentsData elements by

domain

Next … let’s review

• 30 minute review of the spreadsheet• To communicate your requirements

– Off line at your convenience• Review• Add your comments • Email to ioana@eversolve.com (cc: serafina@eversolve.com)

– During on-line work sessions• Join the web meetings• Add your comments• Discuss