Prior to NYSCRI, the New York State Clinical Record Initiative, New York clinics filled out open-ended paper forms. With these forms, it was difficult to accurately track information and recordings were inconsistent due to the open-ended questions. It was a challenge for clinics to assess trends among their patients and to stay on top of the different types of paperwork that was necessary for various regulations.
New York is not the first state to go through this transition. This concept hopped across other states, including Ohio and Massachusetts, before landing in New York. Just as kangaroos move quickly through the Australian landscape, the clinical record initiative moved across multiple states and continues to improve.
Hopping Across Ohio, Massachusetts, & New York
Kangaroo Fact #1: Kangaroos live in a wide variety of habitats.
Just as kangaroos live in a wide variety of habitats, the clinical record initiative has been emphasized in multiple states. Clinics across the United States struggled to maintain adequate records with irregular forms. To combat this, Ohio and Massachusetts each sought to create a consistent form set. After seeing the strides these states made with their new implementation, New York took similar steps to create a form set that would help them streamline clinics’ documentation process. New York contacted MTM Services, a firm that helps behavioral health adapt their systems in a changing healthcare market, to assist them.
The process for NYSCRI began with the formation of a committee. The selected committee members were individuals in the field who would be able to offer insights into clinical operations. The committee sought to create forms and combine existing necessary regulations in the most effective way possible.
Originally coined the Long Island Clinical Record Initiative (LICRI), the form set was first introduced to clinics in Long Island as a paper system. This pilot program lasted between six months to one year depending on the clinic. The form set was also revised multiple times based on gathered feedback. After the pilot program, the new group of forms were then implemented on a voluntary basis throughout New York state.
The intended goal of the form set was to achieve compliance and efficiency in person centered/driven recovery oriented services. The NYSCRI form set allows clinicians to capture a more comprehensive view of the individual’s needs, goals, and treatment plan. The form set captures these important aspects, but is also fluid enough to accommodate the consistently changing behavioral health field. The clinician can work together with the individual to ensure that their treatment plan is being fulfilled.
Hopping From Paper to EMR Formats
Kangaroo Fact #2: Kangaroos are the only large animal to use hopping as its primary mode of locomotion.
The NYSRCI form set continued to improve, particularly in its format, after being made available statewide. Currently, the NYSCRI forms are available in paper (PDF), e-Word, or Electronic Medical Record (EMR) formats. Clinics can choose which format best suits their agency. The eventual goal of NYSCRI is to have a single set of statewide processes and data elements that can reflect changes made to the form set at the statewide level. The form can also be adapted based upon user feedback at this level as well.
Clinics who implemented the NYSCRI form set electronically experienced even more uniformity within their agency. When implemented properly into an EMR, the forms lend perfectly for a Golden Thread factor that allows clinicians to enter most treatment plan information only once. The clinicians can highlight the needs, goals and objectives of the client. That information will populate down from the assessments to the treatment plans, and the treatment plans down to the progress notes. Rather than entering the same information multiple times, well integrated systems like eCR™ creates a strong link between the assessments, treatment plans, and progress notes. This yields better results.
Learn more about the Golden Thread and TenEleven’s form library here.
There are specialized forms available through NYSCRI as well. The Office of Mental Health reviews these forms and the original NYSCRI form set on a regular basis.
Hopping Forward, Not Backward
Kangaroo Fact #3: Kangaroos are unable to move backward; they can only hop forward.
NYSCRI has moved the behavioral health field forward by improving the efficiency of multiple clinics. NYSCRI templates provide a mechanism for clinicians to document client visits easily and in detail. It also helps clinicians to view patterns in their client’s treatment plan or medical history. With this form set, the state’s behavioral health system functions better because everyone is on the same page. This consistency makes it easier to execute change based on new developments in behavioral health.
The NYSCRI form set is continually revised to ensure that it properly meets the needs of the current behavioral health market. The most recent revision included improvements to progress notes, treatment plans, and assessments/agendas and was released in 2016. The concept behind NYSCRI is one that has driven change in multiple behavioral health fields. Consistent forms improve clinic efficiency and compliance.