A new examine has discovered that though California’s state companies have created sturdy IT techniques that function the system of document for community-based service suppliers, these techniques don’t readily interface with EHRs to facilitate cross-sector care coordination.
Information alternate capabilities amongst conventional healthcare organizations grew considerably with the enactment of the HITECH Act, which dedicated greater than $47 billion in grants, loans, and incentives to speed up EHR adoption. Nonetheless, the information alternate capabilities of behavioral well being and social service suppliers not noted of HITECH funding proceed to lag considerably behind.
In 2022, the Division of Well being Care Companies (DHCS) engaged the College of California’s San Francisco (UCSF) Medical Informatics Enchancment and Analysis group to conduct analysis on a subset of California’s psychological well being, substance use dysfunction, and social service organizations to assist assess their fundamental knowledge alternate capabilities.
The state techniques that have been included within the evaluation embrace:
• The Little one Welfare Companies-California Automated Response and Engagement System (CWS-CARES), which helps youngsters within the foster care system;
• The Case Administration Data and Payroll System, which helps older adults who could also be susceptible to institutionalization; and
• The Correctional Well being Care Companies’ Digital Well being Data System, which manages folks transitioning out of incarceration.
The California Advancing and Innovating Medi-Cal (CalAIM) was a key issue motivating DHCS to conduct this analysis. Because the report notes, CalAIM is a multiyear initiative to enhance the Medi-Cal program by integrating healthcare service supply with psychological well being, substance use dysfunction, and social companies. This system is meant to help advanced affected person populations served by many native organizations with distinct priorities, monetary incentives, and technical capabilities.
Listed here are a couple of snapshots of how leaving these suppliers out of HITECH funding could have hindered their EHR use and data-sharing capabilities:
• Solely 18% of substance use dysfunction remedy (SUDT) services report utilizing “solely digital” strategies to retailer and keep well being information.
• Nearly all of expert nursing services (SNFs) reported “all the time” utilizing non-electronic strategies to obtain details about incoming sufferers from discharging suppliers, together with cellphone conversations with the discharging hospital (71%), faxes despatched by the discharging hospital (65%), and information bodily introduced in by the affected person (65%). Amongst SNFs that reported having an EHR, lower than 30% reported interoperability with their native hospital EHR.
However many of those organizations are making progress. The report notes that service suppliers are turning to shared companies and techniques to help scale and interoperability. For instance, many county behavioral well being organizations are collaborating with the California Psychological Well being Companies Authority to make use of the SmartCare EHR platform.
Some organizations even have set requirements and processes for knowledge assortment. Continuum of Care Organizations use the Homeless Administration Data System and should acquire “Common” or “Widespread” Information Components to qualify for federal funding, the report mentioned.
The most typical knowledge components captured throughout companies supplier sorts are race/ethnicity, housing standing, language spoken, and make contact with info. Different info, akin to meals insecurity or behavioral well being diagnoses, is collected whether it is core to the service being offered.
The report means that to successfully set up dependable and safe knowledge alternate capabilities at scale, a complete mapping of the expertise techniques and knowledge assortment practices inside the behavioral well being and social companies sectors is essential. This foundational step will allow these sectors to combine extra seamlessly into broader knowledge alternate networks, finally enhancing coordinated take care of these with advanced wants.
