Texoma Community Center

Transcription

1 Texoma Community Center Request for Proposals EHR Platform Technology and Infrastructure Issued: September 12, 2016

2 Infrastructure and Technology Texoma Community Center (TCC) manages its own infrastructure and hosts its critical applications with an IT Unit that currently is staffed by 4 skilled individuals who cover networking, desktop services, helpdesk, EHR infrastructure support and server managed services. Wide Area Network TCC sites are connected by fiber via an AT&T Multiprotocol Label Switching (MPLS) network managed by Network Services Solutions (NSS). TCC facilitates connectivity between 12 sites in this manner, primarily set up in a hub and spoke architecture. The network has a 250MB internet connection into the main hub with a 250MB link to the main office and data center. The rest of the sites are supported by either 20MB or 50MB connections. TCC supports remote users via Cisco AnyConnect technology. Network Devices and Solutions Network Devices include network printers/multifunction devices, desktop computers, and VOIP phones. TCC clerical staff have personal scanners connected to their PCs and can scan directly into Cabinet Paperless, which serves as the document management solution. Clinical staff use network scanners to scan to protected folders on a file share. Interfaces In addition to our local system, iserv, staff in multiple programs at TCC perform direct data entry into State of Texas HHSC supported systems, including the Clinical Management for Behavioral Health Services System (CMBHS), a web-based clinical record keeping system for state-contracted community mental health and substance abuse service providers; TKIDS, a tracking system for the Early Childhood Intervention (ECI) Program maintained by the Texas Health and Human Services Commission (HHSC) (formerly Texas Department of Assistive and Rehabilitation Services (DARS)); and the former Texas Department of Aging and Disability Services (DADS) supported Client Assignment and Registration System (CARE) system. TCC additionally pushes data into the State of Texas MBOW data repository on a regular basis. TCC uses Claim-MD as our clearinghouse for billing our Medicaid managed care and other 3 rd -party insurance. Infrastructure The TCC Team supports approximately 12 servers, primarily Dell and HP physical servers running Windows Server 2008R2 and We are about 80% virtualized using VMware. The TCC network currently does not include any SANs. All storage is local to the servers, but TCC does provide a file server with shared drives for staff use in addition to cloud storage through Mircosoft s OneDrive service. Applications running on this infrastructure include iserv, Cabinet SAFE, and Sharepoint. bases run on physical servers running MS 2008 R2 Server, supporting Live and Test instances of MS 2008 SQL Server Enterprise. TCC IT supports over 100 desktops that are are primarily Dell or HP workstations, over 100 Microsoft Surface Pro tablets, 25 HP and Dell laptops, and a few Apple ipads. Other than the ipads, the remaining computers are running Windows 10 professional OS. Telecommunication TCC utilizes Mitel as our primary telephone vendor and outsources Crisis Call Center and Patient Navigation services to the Avail service. 1

3 Applications and iserv TCC is currently part of a six center cooperative that owns and maintains a proprietary solution targeted specifically for Texas based community behavioral health centers. The software is built off of a Visual FoxPro database and covers the following areas of our key business areas: Outpatient Physician-based mental health services Field Based Case Management Services for multiple departments Therapeutic Services (including but not limited to Counseling, Applied Behavioral Analysis, and Rehab Services) Inpatient Crisis Units Scheduling of Appointment based services Financial Assessments and Billing for Services State Reporting Usage Current user counts are as follows: 180 active users w/ dedicated accounts Features As iserv is owned by the co-op, TCC has direct access and support for customization and specialized reporting. The centers also fund staff to maintain and support iserv, allowing for very quick response times to changing state requirements. iserv has been described by state staff as being the only EHR in the state to correctly report on some of the more difficult and convoluted reporting requirements. Some key features of iserv include: Module based Allows for customization of forms and data tables by trained staff and by dedicated iserv staff Cabinet SAFE While iserv functions as the data portal, TCC uses the Cabinet Paperless SAFE software as our document management solution to provide an electronic chart. Currently TCC is in the process of migrating all paper charts into SAFE. At the time of this RFP we are about 75% complete with approximately 2 million pages scanned into the system. TCC expects to be completed with this migration before moving to any new EHR solution. The software is built off of an SQL database and covers the following areas of our key business areas: Client charts for all client services HR Training and staff credentialing Payroll Usage Current user counts are as follows: 180 active users o 30 dedicated accounts (mostly clerical and medical staff) o 45 concurrent accounts 2

4 Features TCC uses SAFE for storing both client charts and controlling administrative paperwork. Some key features of SAFE include: Ability to directly import all types of documents (images [gif, jpg, png, tiff, etc.], PDFs, all office documents [Word, Excel, Powerpoint, Viso, etc.], s with attachments, etc.) Ability to scan or print directly into the system Ability to create fillable forms directly in the system and pre-populate fields Versioning, history, and tracking functions Internal workflow, routing, and messaging Internal tasks, reminders, alerts, and ticklers Report engine and detailed audit trails Other Systems Used at Texoma Community Center Telemedicine TCC uses Secure Video, a HIPAA compliant, Vsee based video conferencing technology that allows providers in any remote location with internet access to participate in camera based private sessions with their patients and families. CMBHS Clinical Management for Behavioral Health Services (CMBHS) is a web-based clinical record keeping system for state-contracted community mental health and substance abuse service providers. The system was deployed December 14, 2009 and has been implemented across the state to DSHScontracted substance abuse and mental health treatment service providers with rollout concluding in September In addition to an electronic health record, CMBHS also serves as a clinical tool which includes diagnostic and treatment plan capabilities. CMBHS supports data exchange across contracted substance abuse service providers and between DSHS and other state agencies to coordinate care. The CMBHS system combines the electronic health recordkeeping requirements for both mental health and substance abuse treatment providers in a single system. CARE, MBOW The Client Assignment and Registration (CARE) System was originally developed to support the State s resiliency and recovery with respect to mental illnesses. The Resiliency and Disease Management (RDM) approach to mental health treatment uses focused, evidence-based treatment, which is intended to lead to better outcomes for the greatest number of clients. RDM is a DSHS mental health program for children and adolescents. an effort to redesign the way public mental health services are delivered to adults with severe and persistent mental illnesses and children with severe emotional disturbances. A primary aim of RDM is to ensure the provision of interventions with empirical support to eliminate or manage symptoms and promote recovery from psychiatric disorders. Key to this effort is Management. Numerous changes were made to provide data support for the RDM initiative, including the creation of WebCARE and enhancement of the Mental retardation and Behavioral health Outpatient Warehouse (MBOW), which allows for extensive monitoring of data for decision-making. Analysis of cost information is provided through the Cost Accounting Methodology (CAM). Recently, the Texas Department of State Health Services (DSHS) conducted a focused desk review of the New Generation Medication program to ensure compliance with the Performance Contract requirements, to verify accuracy of data in CARE and to support Local Authority quality. 3

5 TKIDS TKIDS is a tracking system for the Early Childhood Intervention (ECI) Program maintained by the Texas Department of Assistive and Rehabilitation Services, a department with the Texas Health and Human Services Commission. The system is used to collect and report data on services provided to children, birth to age 3 with disabilities or developmental delays, and their families. ECI services, which have a strong case management component, are available to Medicaid and non-medicaid children. is also entered into the Cerner Behavioral Health solution to generate billing data and for internal reporting. State Reporting TCC has extensive State reporting requirements, much of it coming from our EHR System. The following diagram depicts the main flow of data to state systems: SAFE TKIDS (State base) State SFTP site And Other Reporting sites Client Encounter Reports iserv TRR Assessment CMBHS (State base) Care (State base) TRR Assessment Encounter MBOW (State data Warehouse) 4