For TenEleven, updating electronic Clinical Record (eCR™) for the Home and Community Based Services (HCBS) roll-out has been about understanding root causes, not about applying quick fix upgrades. We are not just simply converting a list of requirements into software changes, but rather, we have taken the time to truly understand what the true operational and business needs for HCBS service providers are. Understanding the reasons behind the changes has enabled TenEleven to incorporate software changes that are enhanced by our understanding of the true nature of the needs.
Now that HCBS has been rolled out in New York City for adults participating in Health and Recovery Programs (HARP), state and local agencies are working to ensure that the electronic clinical record industry is providing the core functionality necessary for designated providers to be successful in implementing HCBS during the transition to managed care.
HCBS Software Requirements
In order for agencies to successfully provide HCBS, New York State has determined that there are minimum technology components that will ensure those providers remain viable during the transition to managed care. According to the NYS Office of Mental Health, the critical electronic clinical record functionality needed by HCBS providers is as follows:
- Input data into Electronic Health Records (EHRs)
- Access data from EHRs
- Share health information among providers to improve integrated services, sustain financial viability, and reduce health care costs via reduction in Emergency Room/Inpatient services
- Align with:
- Delivery System Reform Incentive Payment (DSRIP) Performing Providers System (PPS)
- Health Homes (HH)
- Regional Health Information Organizations (RHIO)
- State Health Information Network of New York (SHIN-NY)
You can read more on the NYS BH-IT program here https://www.omh.ny.gov/omhweb/bho/bh-it.html
What's so different about HCBS anyway?
Within the scope of all the capabilities New York State is looking for, the second bullet point gets at the main source of change that HCBS brings for both technology and providers. The need to "share health information among providers to improve integrated services," is really what the introduction of HCBS is all about.
HCBS says good bye to the days of one patient, one chart, and one provider; and instead creates a collaborative work-space for multiple providers to collaborate on different aspects of a client's care in order to establish a 360° degree care coordination concept that will provide the timely interventions necessary to reduce hospital emergency visits.
What software changes are needed to accommodate this new service type?
The basic needs still apply; the appropriate billing rules, alerts, outcome reports, and day-to-day functions like scheduling and checking-in/out, are all still there and need to accommodate the correct business rules. But in addition to new forms for HCBS, the new forms need to behave differently. They need to accommodate the concept of bringing a larger number of providers into the client's care plan both in the physical world, and also in the electronic record. This requires clinical record technology to be smarter and more interactive than ever before.
While eCR™ has already been performing for HCBS providers in New York, we are working with the State to ensure our software will give HCBS providers what they need to be successful now, and throughout the transition to managed care.
Find our current HCBS capabilities here.
As we continue to work toward joining the New York State OMH Approved Vendor List for HCBS, we are confident that understanding the root causes instead of employing quick fixes, will enable TenEleven and eCR™ to provide the best possible solution for HCBS providers to succeed.
You may also want to learn about the challenges to documentation time that face community based mobile programs that experience long gaps between visits and completed progress notes. Learn about it in the White Paper Combating Progress Note Float.