RPMS Behavioral Health System v4.0

1. RPMSBehavioral Health System v4.0 RPMS Bootcamp IHS Office of Information Technology

2. Objectives Identify the functionality available in the RPMS Behavioral Health System (BHS) v4.0 to support the delivery of integrated behavioral health care.  Generate workload, prevalence and other provider- and patient-specific reports. Utilize the RPMS Suicide Reporting Form and associated reports to collect and analyze suicide data.

3. Why Use RPMS BHS? Supports integration of BH and Primary Care Interfaces with Patient Care Component (PCC) and other RPMS applications: Health Summary and Problem List Medication History Patient Education Measurements and Screening Health Factors Facilitates Practice Management Patient Registration Scheduling Package Third Party Billing Contributes to National RPMS Database IHPES BHS Database NDW Database

4. RPMS BH Applications Released Applications BHS v3.0 Data Entry, Reports and Manager Utilities BH GUI/Patient Chart Data Entry In Development BHS v4.0 Client – Server application like BH GUI/Patient Chart Graphical User Interface version  Data Entry Roll and Scroll version  Reports and Manager Utilities Benefits of v4.0 Streamlined data entry Electronic Signature Improved performance Easier installation

5. Data Entry Features Clinical Activities Individual Patient Encounters Group Encounters Intake Documentation Case Management Information Treatment Plans Suicide Reporting Forms

6. Visit Encounters –Individual Entry Individual Visit Entry captures: DSM IV Axis 1 – V Progress Notes Intake/Assessment – initial and updates Medications Screening, Health Factors and Measurements Depression – PHQ-2, PHQ-9, Screening Exam Code Alcohol – CRAFFT, AUDIT, AUDIT-C, CAGE Health Factor, Screening Exam Code Tobacco Use Health Factor Domestic Violence/Intimate Partner Violence Screening Exam Code Patient Education Multiple codes specific to BH and access to entire code set Provider, Location of Encounter, Clinic, Community, Type of Contact, etc. Billing Information – CPT codes, Activity codes, etc.

7. Visit Encounters –Group Entry Group Data Group topic and duration (for ex., 60 minute Sobriety Maintenance group) Standard Group Note Populates standard note for each patient in the group Patient Education Patient Data Entry Document progress of each individual in the group Record how much time each individual spent in the group On-going groups can be duplicated to minimize data entry

8. Clinical Activities Cont’d. Case Management Case Status - Opened, Closed, Disposition Designated Providers Personal History Factors Treatment Plans Date Established, Reviewed, Resolved Details of review – participants, progress, next scheduled review

9. Data Entry Features Administrative/Community Activities Supports the documentation of non-direct patient care activities Community Prevention Location, Topic, Number Served Health Fairs Committee activities Training received/provided Clinical supervision Client transportation

10. BHS Data Exports BHS has a separate export process Not part of the PCC National Data Warehouse (NDW) export Typically done on a monthly basis by designated BH program staff person or facility RPMS/IT staff BHS export contains: Encounter Information (excluding clinical notes) Suicide Reporting Form (SRF) data BHS data contributes to the national aggregate RPMS data and is mined by HQE to: advocate for services and programs provide prevalence and outcome data for Agency Initiatives (Behavioral Health, MSPI, Suicide Prevention, Etc.) Congressional testimony

11. Reports Capabilities Patient Listings Treatment Plan and Review Reports Identify treatment plans that need to be reviewed or closed Case Status Reports Identify cases that need to be closed Screening Reports Generate lists of patients who have been screened for alcohol, depression and DV and results Behavioral Health Record/Encounter Reports Customizable Patient List reports Workload/Activity Reports Frequency of services provided Problem Specific Reports including local SRF Reports Abuse Suicide

12. Security Features RPMS Access and Verify Codes Security keys restrict access to application and to select features (reports) Only BH providers are given BHS security keys Access to data within BHS can be restricted Clinical notes (progress notes) and treatment plans do not pass to PCC and are not visible on the Health Summary Electronic signature prevents editing of visits and intake documents

13. Pre-Implementation Examine business process and work flow Does the BH Program use the RPMS Scheduling package to schedule and check-in patients? Does the Program bill for BH services? Will providers be expected to enter CPT codes? Documentation practices Discuss appropriate codes to use to fit your program Type of Contact, Activity Codes, POV, etc. Consistency among providers is important

14. Application Set-up • Installation • RPMS Site Manager is responsible for installation; users should be notified of impending installation • Server-Client application means that the GUI “client” will have to be installed on each PC • Security Keys • RPMS Site Manager assigns security keys per direction of the BH Program Manager • Can limit or grant access to certain functions, i.e. delete and reports • Site Parameters • Can be set by the BHS Clinical Application Coordinator (CAC) or RPMS Site Manager per direction of BH Program Director • Can limit or grant access to certain functions • Defaults • Certain fields can be auto-populated by the default settings – saves times • Defaults can always be overridden

15. RPMSSuicide Reporting Form Supports Agency Suicide Prevention Initiative by improving data collection Standardized and systematic method for documenting incidents of suicide Accurate and timely suicide data at the point of care GPRA SRF Performance Indicator Measures the use of the form, not the number of suicide incidents

16. What Data Does the SRF Capture? Based on existing local data collection tools and informed by subject matter experts and providers in the field. Data elements include: Provider who completed the SRF Patient demographics Type of suicide incident and date Ideation with intent and plan Attempt Completion Attempted/Completed suicide with homicide Standard suicide epidemiological data Method Substances involved Contributing factors

17. SuicideData Collection Recent changes: Lethality Deleted Suicidal Behavior Additional options

18. RPMS EHR and BH BH providers who are located at facilities that use the RPMS EHR can also use the EHR to: Enter individual patient activities Visits Chart Reviews Phone calls Electronic Order Entry Meds, lab and radiology Notifications, Alerts, Consults BH Specific Functionality Note templates, Diagnosis (ICD9) and CPT pick lists Programs can use the EHR for individual visits and BHS for group entry and admin/community activities

19. Resources Download the latest BHS software & documentation: http://www.ihs.gov/Cio/RPMS/index.cfm?module=home&option=index RPMS Training: http://www.ihs.gov/Cio/RPMS/index.cfm?module=home&option=OITTrainingLinks Further Information about BHS: http://www.ihs.gov/cio/bh/

20. BHS v4.0 Demonstration