In designing the 202 Medicaid Waiver, the Department of California Health Services (DHCS) noted: “Transforming the current health and behavioral health systems in California into a high performing, well-coordinated system requires a shift in the focus of data collection for the purpose of compliance to using data for quality improvement and evaluation. Current measurement practices do not produce sufficient data to assess and track overall population health and medical and behavioral health care system performance, which is essential for achieving the Triple Aim. Data also are not adequate to support decision-making by policy makers, public and private purchasers, providers, and other stakeholders. Developing a core measures set for integrated behavioral health will enable a common way of tracking medical and behavioral health performance in California. The performance measures are used to assess access, timeliness, quality, and coordination of care, and compare performance across payors and providers working with the target population.”
Data Requirements for Health Care System Improvement
A core principle of the Behavioral Health Integration Complex Care Initiative (BHICCI) is the recognition that population health and clinical data are the foundation of an integrated and effective health care system and are used to:
- Identify and stratify base and target populations.
- Facilitate patient engagement.
- Assess patient and provider experience.
- Conduct quality improvement activities.
- Assist managers and other clinical leaders in providing clinical oversight (e.g. assure program effectiveness and report benefits to regulators and key stakeholders, monitor service utilization and costs).
- Evaluate efficacy and impact of the BHICCI.
Data Requirements for Clinical Improvement
Real-time data is also critical to provide effective care at the point of service. Use of data in this way is relatively new to health providers and data-driven processes are used to:
- Track clinic and provider panels and coordinate patient engagement.
- Conduct medication reconciliation.
- Coordinate referrals.
- Manage care transitions.
- Share information between providers.
- Facilitate measurement-based clinical practices.
- Inform care planning.
- Provide patient education and empower self-management.
These many layers of data use require careful planning and coordination. On one hand it is important to make sure the right data is at the right place at the right time or else the data becomes meaningless, and on the other hand clinicians and leaders risk experiencing “data overload” if too much data is pushed out in an uncoordinated manner.