A Plan for a Sustainable Community Behavioral Health Information Network

Western States Health-e Connection Summit & Trade ShowSeptember 10, 2013

What is a BHINAZ?

BHINAZ brings together behavioral health providers, consumers, and public agencies around a shared vision: using information technology to make behavioral healthcare safer and more efficient throughout Arizona. The development of a behavioral health driven information network will improve quality, safety, create efficiencies, reduce health disparities, engage patients and their families, improve care coordination, protect patient health information, and improve the population and public health while protecting and maintaining the integrity of the behavioral health system.

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Key Drivers

Health Care Reform / Patient Affordable Care Act (ACA)

Heath Information Technology for Economic & Clinical Health (HITECH) Act

Meaningful Use of Certified Electronic Health Records (EHR) – Stage 2 coming soon

Integration between physical and behavioral health

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Clinical models like Stanford disease management and WHAM

Collaborative Care Development of Health Home Concept Performance Contracting Maricopa County ADHS/DBHS RFP

Key Drivers

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HIE

The Vision

PCP/Specialist

Behavioral Health

Health Information Network of Arizona

Laboratory

Pharmacy

Hospital/Health Systems

Patient

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Public Versus Private HIEPublic

Availability and efficient distribution of a large volume of patient data

Efficient exchange of standards-based data (CCD, IHE, etc.)

Gateway to the National Health Information Network

Arizona’s HINAZ

Private* Coordination of care among the

providers in a community – workflow improvement

* Connecting systems and users with different technical capabilities and workflow needs

* Access to the community patient chart

* Business intelligence service to optimize pay-for-performance and quality improvement

* Support for emerging integrated delivery networks

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Offers additional services EHR Light – This value add would give

providers the ability to document within the HIE at an additional cost. Additional costs for expanded EHR light services: Portal Lab Ordering - eLabs SureScripts/RxHub - ePrescribing Basic Individual Referral Management

Closed Loop Referral Management

Value of a Community-Owned Health Information Exchange

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Offers additional services (continued) Special Report/Data Analytics Annual Dashboard Service Population Management Patient Portal Secure Messaging (Direct)

Value of a Community-Owned Health Information Exchange

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demographics (Name, date of birth, address, social security number, marital status, sex, and age)

diagnosis allergies prescribed medications lab results documents (including progress notes, treatment

plans, patient summary, discharge report, crisis plans, etc.)

HIE Data that can be shared

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The ONC recently developed a governance framework to adopt an approach that is less restrictive, more agile, and better able to keep pace with developments in health IT.

The governance framework comprises four principles: organization, trust, business, and technical.

Privacy & Consent

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the ONC has enumerated six components that should comprise an organization’s HIE policy and enable patients to: access a “Notice of Data Practices” that

explains the purpose(s) for which personally identifiable information (PII) and de-identified data, consistent with applicable laws, would or could be electronically exchanged;

Privacy & Consent

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receive a simple explanation of the privacy and security policies and practices in place to safeguard electronically exchanged patient PII as well as who is permitted to access and use electronic HIE services;

be provided with meaningful choice as to whether their PII can be electronically exchanged as consistent with applicable laws (i.e., patient consent);

Privacy & Consent

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request data exchange limits based on data type or source (e.g., substance abuse treatment) as consistent with applicable laws;

access and request corrections to their personally identifiable information electronically as consistent with applicable laws;

be assured that their PII is consistently and accurately matched when electronically exchanged (i.e., patient matching).

Privacy & Consent

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• Patient must OPT OUT

• Otherwise, they are Opted IN by default

Opt Out

• Patient must OPT IN• Otherwise, they are

Opted OUT by default

Opt In

Opt In vs. Opt Out

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The state of Arizona is an “Opt-Out” state. BHINAZ operates under an “Opt-in” model

requiring the client to specifically agree to share their protected data from one provider to another.

The BHINAZ model ensures that data protected under 42 CFR part 2 is not redisclosed without proper consent

Privacy & Consent

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In Network 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

* No detox data can be viewed by any other agency on the network

Opt Out

Opt-In

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Viewing Out of Network data

Participant receives services at BHINAZ Agency A

Provider determines need to access out-of-network data and logs into portal through the EHR

Provider searches for data from outside network

Provider views and imports data to their EHR

BHINAZ Agency A

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Questions?

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