1. Integrating Behavioral and Physical Health Data Napa County Health and Human Services Agency March 21, 2013

2. Napa County HHSA Vision  Integration of services  “Social determinants of health” model

3. Why Share Health Data?  Improved health outcomes for clients  Expectations of recent health care legislation

4. The County Campus Clinic Integrated HHSA and Community Health Clinic Ole program on HHSA campus Coordinated care for primary care, mental health, and substance use clients Targets clients with co- occurring chronic illnesses 2 4 3 p a t i e n t s C a r e c o o r d i n a t i o n t a r g e t p o p u l a t i o n : 9 0

5. Our Challenge Communication across agencies and disciplines Two EHRs – EClinical Works and Anasazi cannot communicate or effectively store information from other providers Keep it compliant with HIPAA and Mental Health and Substance Use privacy requirements Keep information off personal computers and out of paper files

6. Ways We Share Information Client release Faxed progress notes Landline telephone Face-to-face consultations Warm handoffs Case conferences

7. What Information to Share? Need to know basis…depending on what is needed Psychiatrist Therapist Case manager Care coordinator Peer support Primary care provider Nurse Medical assistant

8. Communication Form Contact information, demographics Providers Client goals Joint problem list-diagnoses Medication lists, allergies and adverse reactions, medications reconciled Conference actions Health indicators Social needs

9. Anasazi Data Anasazi Gateway HHSA Interface Clinic Ole Interface ECW Gateway ECW Data Possible Next Steps  Encrypted e-mail – secure e-mail from Dr. A to Dr. B or from lab to doctor  Interface pilot project between Anasazi and EClinical Works

10. Privacy Issues  HIPAA  42 CFR Part 2  California laws