Magazine article Behavioral Healthcare Executive

Steps toward Standardization in Massachusetts: MSDP Effort Asks Providers, Vendors to Adopt Common Paper, E-Forms

Magazine article Behavioral Healthcare Executive

Steps toward Standardization in Massachusetts: MSDP Effort Asks Providers, Vendors to Adopt Common Paper, E-Forms

Article excerpt

Massachusetts is ahead of the game when it comes to health care reform, having instituted its own in advance of the federal Affordable Care Act (ACA). The same can be said for the state's electronic health record (EHR) system--even in behavioral healthcare. Led by the Association for Behavioral Healthcare (ABH), a trade group representing community-based mental health and addiction treatment organizations in the state, providers and payers are working together with the encouragement of the state to standardize reporting of behavioral healthcare information. But there are many bumps on the road, and it's not at all clear that all behavioral healthcare providers will actually be up to speed with EHRs by January 2014. The Massachusetts Standardized Documentation Project (MSDP) is a statewide integrated development effort supporting behavioral healthcare providers at the community level, so that they can integrate their EHR efforts with other electronic health initiatives in the state.

Created by providers, payers, and consumers, the MSDP focuses on federal, state, and accreditation requirements that support services that are recovery-oriented and person-centered. The Massachusetts Department or Mental Health participated in MSDP development, and requires that all CBFS (community based flexible supports) providers USC the standardized forms. The ABH runs the program that certifies EHR vendors to work with behavioral healthcare providers in the state (see Figure 1).

Figure 1: MSDP-certified electronic health record (EHR) systems certified in Massachusetts (as of 1/24/13):

MSDP Certified (full certification unless noted)

ClaimTrak Systems

CoCentrix, Inc.

Defran Systems



MindLinc--Duke University

Netsmart Technologies

System Q (level-of-care specific certification)

Every state's problem

Systems can't communicate when everyone enters different information--whether it's on paper or electronically, explained Ben Jacoby, marketing coordinator for Defran Systems, an EHR provider which is one of the handful certified by the MSDP. The information, and the fields--locations on the electronic form where the information is entered--must be standardized, Jacoby told Behavioral Healthcare, "Standardization is a problem on many levels--among different states, within states among different agencies, and even within agencies themselves," he said. But without this standardization, there can be no coordination of care.

The best standardization involves using an electronic health record, said Jacoby. Whether the patient goes to his primary care physician, or to a behavioral health agency, the continuity of care document goes with that patient.

One state's solution

The solution is two-part: standardized forms, which can be on paper, and within EHR systems. Standardizing the language on paper is the first step, but there also has to be a second--adoption of EHR systems. That's where the MSDP is working hardest to facilitate the transition.

Currently, the MSDP is finalizing its first review of the electronic forms, said Vicker V. DiGravio III, ABH president and CEO. Because payer requirements are not static, the forms have to be continuously updated. Running in parallel to the forms standardization effort is the accreditation process for EHR vendors, also managed by the MSDP. Once accredited by the group, EHR vendors are free to adapt the MSDP forms for operation in their EHR products and to market their products with an MSDP logo.

DiGravio noted that the MSDP's process is "much less onerous" than the federal certification process for EHR vendors run by the Office of the National Coordinator at the Department of Health and Human Services.

Paper vs. EHR

Ironically, although the MSDP forms were designed to be used within EHRs and are much more cumbersome to use on paper, most providers are using them on paper, said DiGravio. …

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