behavioral health information network of arizona

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Behavioral Health Information Network of Arizona

NextGen Ohio Behavioral Health User Group Meeting


Highlights

• Ways in which exchanging BH data differs from physical health data exchange

• Alerts• 42 CFR Part Requirements• Handling Consent in NextGen• Proposed Rule Changes• Provider buy-in and education• Review of the HIE Technology


Who is Behavioral Health Information Network of Arizona (BHINAZ)?

• Community Stakeholder Owned• Officially formed as a Limited Liability Company

(LLC) in Arizona – June 2013• Arizona statewide initiative


Behavioral Health Information Partners (BHiP)

• Behavioral Health Information Partners (BHiP) is our consulting division. BHiP offers specialty services around Behavioral Health Information Exchange. • Behavioral Health Gap & HIE Workflow Analysis• Consent Services & Solutions• Behavioral Health Crisis-System Services• HIE Education & Training – Staff and Consumer Groups


Differences between Physical and Behavioral HIEs

• Privacy Rules: HIPAA vs. 42 CFR Part 2

• Consent models: Granularity

• Data Sets: Different provider needs

• Workflows: Use of HIE


BH Data Set

• Structured Data Elements• Demographics, Labs, Medications, Allergies, &

Diagnosis

• Clinical Documents• BH/SA Screening Tools, Psychiatric Evaluations,

Assessments, Crisis & Safety Plans, Discharge/Transitions Plans, Progress Notes, etc.


BH Data Set

• NPI Numbers are typically group or organization level NPIs• Much larger numbers of encounters for BH Patients


Crisis Use Case

• BHINAZ has connected multiple NextGen clinics that provide SMI Case-Management services for bi-directional exchange

• Data from the SMI Clinics is available via a portal viewer for crisis providers• Allows for consolidated look-up• Specific information needed for crisis treatment

• Real-time Crisis Alerts route to the NextGen system for BHINAZ connected providers anytime their client has interacted with a crisis provider


Real-time Alerts

• We route real-time ADT information received from hospitals and other sources to our NextGen provider systems.

• We can also configure custom alerts for out-of-range lab values, medication concerns or for other meaningful data.


Real-time Alerts


Data Where Needed*

• Our system has the flexibility to have data download directly to the NextGen EHR• Providers can choose from medication history, labs or any available documents

• Data is also always viewable via our data viewer

*Viewable data is always based on applicable patient consent


Key HIE Factors

• Understanding of Legal Landscape• Federal requirements around 42 CFR Part 2• State requirements• Requirements for minors


Opt In vs. Opt Out

•Patient must OPT OUT•Otherwise, they are

Opted IN by defaultOpt Out

•Patient must OPT IN•Otherwise, they are

Opted OUT by defaultOpt In


Behavioral Health Privacy

• Complicated Federal Laws around Privacy - 42 CFR Part 2

• Requires explicit opt-in consent from patient to share data

• Specific requirements for consent form

• Must have an expiration date

• Break-the-Glass or Emergency disclosure requires notification to providers who must document the disclosure in their EHR


BHINAZ Consent Facts

• Consent is captured electronically through the NextGen EHR• Opt-in consent is valid for 365 days, then a new consent is

collected• Patients can revoke at any time• The consent is “all or nothing” per agency/entity. • Break-the-Glass is allowed regardless of consent status for

valid emergency situations.


Consent Model

• Participant visits Agency A• They sign a consent to allow their Agency A data to be

shared/viewed by ALL BHINAZ organizations• Agency A Data now flows to all other BHINAZ organizations.

Agency A

SMI Clinic

Crisis Center

Detox Center

• Participant visits Detox Center• They choose NOT to share their

detox data• The detox center can see Agency

A’s data• No detox data can be viewed by any

other agency on the network EXCEPT the Crisis Center if there is an emergency

Opt-In


Proposed Rule Changes


Education is Key

• Patients should be a stakeholder to the process• For Behavioral Health, we recommend consent be presented by

clinicians• The value of the HIE should be explained to the patient so they can

make an educated decision about opting-in.

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Questions?


Contact

Laura Young Executive [email protected]

www.BHINAZ.com