LOUISIANA Community Mental Health Services Block Grant ...

eviews of proprietary and open-source systems, analyses of the pros and cons of various approaches
to an EBHR, consultations with other states and a readiness assessment of the human and technical
infrastructure needed to implement a system. Five approaches to an EBHR were reviewed: 1.) To
continue to build and to integrate state-custom built systems; 2.) to procure a commercial system; 3.)
to procure an open source system; 4.) to implement a hybrid of an open source and proprietary
system; 5.) to allow each region/ LGE establish its own system. The pros and cons of each approach
were reviewed in terms of cost of acquisition and implementation, the implementation timeline, and
important features such as interoperability, certification, and infrastructure requirements. Priority
system features were identified. It was determined that OBH should consider pursuing an open
source/ hybrid solution as the most cost effective approach. OMH participated in two national
meetings facilitated by NDIIC and dialogued with other states regarding implementation strategies in
coordination with a national SAMHSA effort to develop a model for an EBHR. Based on analyses,
NDIIC recommended that OBH proceed with establishing the necessary project staffing and conduct
a Request for Information (RFI) for candidates that fit the identified prioritized state needs. The
responses to the RFI will provide cost estimates to be determined that would enable OBH to prepare a
budget for the coming fiscal year and an RFP to procure the desired system. The LA EBHR initiative
is laying a firm foundation for the agency to make strides forward towards an integrated electronic
client record in the coming fiscal year as the Office of Behavioral Health is operationalized.
As information technology advances, OMH continues to operate several legacy systems until these
are systematically replaced by OMH-IIS or by an integrated electronic record system. These legacy
systems continue to provide needed performance data for service system planning and monitoring.
OMH legacy systems are largely custom-built, LAN-based, and compliant with national data
standards (e.g., Mental Health Statistics Improvement Program - MHSIP). These legacy systems
include:
PIP/PIF/ORYX. The Patient Information Program, implemented in 1992, operates in each of the state
hospitals and regional acute units, providing a comprehensive array of data on all inpatients served.
Together with OMH-IIS, it is the primary source of counts of persons served, diagnoses, lengths of
stay, and bed utilization. The financial module (PIF), implemented in 1994, supports billing and
accounts receivables, and the ORYX module, implemented in 1999, supports performance reporting
for Joint Commission accreditation. PIP has been upgraded to include collection and reporting of the
new Joint Commission core measures, for reporting of screening (trauma, substance abue),
medication management (antipsychotic monotherapy), and continuity of care (reducing the time for
needed care information to be sent to the aftercare service unit). The OMH-IT strategic plan
identifies PIP/PIF/ORYX to be the next legacy system to be integrated into OMH-IIS. The state
hospital and regional inpatient units are also included in plans for an integrated electronic behavioral
health record system.
MHR/ MHS & UTOPiA. The Mental Health Rehabilitation/Mental Health Services system,
implemented in 1995, supports client, assessment, and service data collection and reporting for
Medicaid mental health rehabilitation provider agencies (MHR) and for some OMH contracted
mental health service program providers (mainly case management) (MHS). The Utilization,
Tracking, Oversight, and Prior Authorization (UTOPiA) system supports prior authorization of
services and utilization and outcomes management at the state and area levels. The system is now
being utilized in OMH in the PASSR program providing data on mental health needs in the nursing
homes. MHR/MHS & UTOPiA both run in Visual Fox Pro. As of July 1, 2009, the Mental Health
Rehabilitation Services Unit has been transferred to the Medicaid Office in DHH. As such, the MHR
version of MHR/MHS is be maintained and further developed within the Medicaid Integrated Data
PART C LOUISIANA FY 2011 PAGE 225
SECTION III: ADULT & CHILD/ YOUTH PLAN – CRITERION 2
MENTAL HEALTH SYSTEM DATA EPIDEMIOLOGY - INCIDENCE & PREVALENCE ESTIMATES