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Better Together: Integrated Service Solutions' High-Tech initiative
What began as a cooperative effort among four Maine nonprofit behavioral healthcare agencies has become a blueprint for other organizations looking to increase effectiveness, share costs, and foster a sense of trust and partnership. The group – comprised of Crisis & Counseling Centers (C&C), Day One, Aroostook Mental Health Center (AMHC) and Youth and Family Services (YFS) – began looking at how to streamline processes in 2003, when they formed as Integrated Service Solutions of Maine (ISS). The group decided that one of their major projects would be an intra-agency electronic health records system. Better Together “Alone, we didn’t have the fiscal resources to get the system we needed, we were able to take that next step by coming together as a collaborative and pooling resources,” said Greg Disy, Treasurer and CEO at AMHC. “This is a step we’ve wanted to take for at least the past eight years,” Disy said of the group’s decision to purchase and implement the ClaimTrak system. The groups decided to purchase and implement an electronic records system as a team in order to standardize data and forms and increase shared knowledge of how the records system works. (YFS was unable to join the project in the initial development, but two other agencies, Charlotte White and OHI, have been part of the developmental phase.) “It turned out to be even more of a challenge than we imagined, and we thought it would be a significant challenge to begin with,” said Lynn Duby, with a chuckle. Duby is CEO of C&C and President of ISS. Square Pegs and Round Holes Analyzing the services (more than 40), and forms (more than 1,100) and data fields (a seemingly countless number) that all the partners represent, all of which are governed by nine MaineCare regulations, the group realized the task before them was greater than they had originally thought. “It was a little difficult getting everyone on the same page, but the project has been unbelievably good from the beginning,” said David Faulkner, Vice President of ISS and Executive Director of Day One. Keeping everyone on the same page was vitally important to the group. Duby says she repeatedly heard about groups who had bought an electronic records system collectively, but decided to implement it individually. “Very quickly they didn’t have the same system at all,” she said. In making the system their own, they had built compatibility issues into their projects. Many of those groups had tried to reintegrate data and forms to share resources later on, but faced obstacles every step of the way. “It’s much more complicated to undo these sorts of things than to design them with compatibility in mind from the start,” Duby said. Letting Go and Getting More “As separate agencies within the collaborative, we hold our practices and forms near and dear to our hearts and going into this process we recognized that we were going to have to give something up,” Disy said. “They might have served us well as individual organizations, but they wouldn’t work within the context of the collaborative, and we wanted the end product to be a single product.” Sharing the Load Purchasing the system and consolidating forms was only the beginning. The cooperative was also committed to equal responsibility and resource sharing. “Everyone has an equal share of the cost burden and everyone has an equal share of access to resources,” Duby said. This means that there is no single individual in overseeing information technology (IT), for example, but instead five technology departments working together on the project. “This is the model. Our billing people work together as a team. Our clinical staff works together as a team. And they started doing that in the very beginning,” Duby said. The cooperative is more resilient than it might otherwise be because when the project is completed it will be the same record system for everybody. Staff at different agencies are cross trained in the system and can pitch in, should the need ever arise. “We can support one another in circumstances where one of us might need a little more,” Duby said. “We see each other as a resource.” A Clear Alternative Duby calls this collaborative model a “clear alternative to mergers and acquisitions.” Whereas many mergers and acquisitions fail due to a clash of culture and because people feel like they’re dominated or domineering, this IT collaborative allows all partners to maintain their identities. “This kind of effort gets you the outcomes you want – more efficiencies, lower costs – without going through all that. All partners retain their corporate culture, name, and approach, but they also gain what can only come from working jointly.” The cooperative has worked closely with Maine Health InfoNet, the state’s existing health information exchange, which is currently solely comprised of medical records. It is hoped that the customized ClaimTrak system will provide the first behavioral healthcare “module” to plug into the Health InfoNet system. Duby is co-facilitating with the state’s health information technology coordinator to streamline the data the state collects from agencies and that process is being informed by all of the work currently being done by the Collaborative. “Hopefully our work will help inform the state about what data elements need to be collected for what types of clients,” she said.
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