Riverside County Mental Health Implements Web-Based Consumer Outcome Data Collection System
The Riverside County Department of Mental Health provides effective, efficient, and culturally sensitive community-based services to the residents of Riverside County, the fastest growing and currently fourth largest county in the state of California. Its services enable severely mentally disabled adults, older adults, children at risk of mental disability, substance abusers, and individuals on conservatorship to achieve and maintain their optimal level of healthy personal and social functioning. The department serves approximately 29,000 residents a year.
The Challenge
In 1991 the state of California passed the Bronzan-McCorquodale Act, also known as "Realignment," which mandated that counties report data on client satisfaction and outcomes to the director of the California Department of Mental Health (DMH). The legislation was partially based in research showing that clients who are actively involved in the treatment and evaluation process generally fare better.
"Assessing consumer outcomes is about accountability and cost effectiveness, but it's also about helping people get better," said John J. Ryan, director of Riverside County DMH. "In addition to addressing state mandates, we wanted to implement a clinical feedback system that would survey a client and provide an immediate trend report, in graphical format, so that our service providers could see client progress from one visit to the next at the time that service was being given."
In addition, the solution would have to be one that the department's IT services could manage and modify on its own, explained Dr. Stephanie Oprendek, Supervising Research Specialist for the Riverside County DMH. "Cost effectiveness, timeliness, and flexibility were very important. We didn't want to have to rely on an outside vendor for modifications, such as producing custom reports. And we needed a system that our remote sites could afford, use and maintain themselves without special hardware or software and that would be able to keep up with our volumes and produce near instantaneous reports even from afar."
The Solution
After evaluating its legacy fax based data collection system and deciding it would be too costly to modify the system to suit its current needs, Riverside County DMH selected a solution from Cardiff Software and its longtime partner, Hershey Technologies based on their understanding of WEB Service oriented solutions. Hershey recommended Cardiff Software's TELEform™ product with the HTML eForm Option® for form design and data collection over the Internet, along with Hershey's WEB Validation and Image Management system, ImageNet. The solution allows agencies to easily collect patient performance outcome data required by the State, via hardcopy from remote Kodak scanners using ImageNet's Internet Scan application. The ImageNet Scan application saves the images to the central ImageNet server, which is integrated with the TELEform™ Reader for automated recognition on the saved images. After form processing by TELEform™, ImageNet's browser-based Validation module allows the remote departments to perform verification on the outcome data. Optionally, the outcome survey may be filled out and submitted online through Cardiff's Web-based HTML+Forms module, which eliminates the need for scanning or human verification of the outcomes data. Regardless of data collection source, the system provides clinicians with immediate feedback in the form of graphical, trend reports based on the outcome data.
"We had to work under a really fast turnaround requirement." Neal Fischer at Hershey Technologies explained. "The department wanted the data to be processed and a report generated within five minutes after turning the survey in, so that the counselor could respond appropriately as quickly as possible. So, we discarded several ideas, such as faxing forms and verifying the data centrally because we found that approach to be too slow and unable to handle the volume. Instead, we were able to integrate the ImageNet document management product to work with TELEform in a way that would allow for Web-based scanning, data collection, verification, integration of the clients reporting tool, along with an automated repository for completed digital forms and imaged documents."
At the time of treatment, clients complete a survey, called the Goal Attainment and Treatment Evaluation Survey (GATE). Developed by Oprendek and Dr. Larry Ogilvie, Program Chief of Riverside County DMH, GATE consists of questions designed to alert clinicians to potential areas of concern. At selected sites, clients can complete an electronic WEB version created in TELEform's Eform product. Due to user acceptance; the survey is also delivered in a paper format. The paper surveys are then scanned by clerical staff, which verify and correct them over the Web from the secure ImageNet Web site. "The recognition rate of the TELEform OCR engine is very good," Oprendek commented, "but occasionally we have to make corrections. The great thing about the system is that the client is right there, in the same office where the data is being verified, so we can be assured of 100% data accuracy."
After scanning and verification, surveys are automatically archived into ImageNet content management system and the data from the survey is submitted to DMH's main database, from which reports are generated immediately and presented over the WEB for use by the clinician during the visit with the client.
"All our patient visits start on the hour, which means that everyone is turning in surveys at the same time," Oprendek observed. "We're averaging as many as 250 simultaneous ‘hits' to the system, yet we're handling the volume and achieving the turnaround that we set out for."
The Results
With the new solution now in place, Riverside County DMH can assess client outcomes within five minutes, no matter where the client is being seen. This is especially important because many clients are being served at multiple venues. In addition, they've been able to push workload to the remote clinics instead of handling data collection centrally.
Oprendek expanded, "Most other systems have a centralized proprietary verification and reporting architecture. In these types of systems, you might have to wait days for a report, and then wait days again if an error were found and you had to correct the data. With the TELEform - ImageNet solution we have seen more accurate, timely data and enhanced workflow efficiency."
The efficiency of the final Web-based solution --which enables rapid deployment, WEB Form presentment, quick turnaround time for patient outcome reports, and will enable future capabilities such as input from new technologies like wireless Windows-based Tablet PCs -- Oprendek credits to Hershey Technologies. "Hershey made our requirements fit into their ImageNet solution. Thanks to Hershey's collaborative approach and Cardiff's open-system, easy-to-use product, we've achieved what we set out to do and are looking forward to using the system for other surveys and applications ".
Submitted by Cardiff Software.
The Challenge
In 1991 the state of California passed the Bronzan-McCorquodale Act, also known as "Realignment," which mandated that counties report data on client satisfaction and outcomes to the director of the California Department of Mental Health (DMH). The legislation was partially based in research showing that clients who are actively involved in the treatment and evaluation process generally fare better.
"Assessing consumer outcomes is about accountability and cost effectiveness, but it's also about helping people get better," said John J. Ryan, director of Riverside County DMH. "In addition to addressing state mandates, we wanted to implement a clinical feedback system that would survey a client and provide an immediate trend report, in graphical format, so that our service providers could see client progress from one visit to the next at the time that service was being given."
In addition, the solution would have to be one that the department's IT services could manage and modify on its own, explained Dr. Stephanie Oprendek, Supervising Research Specialist for the Riverside County DMH. "Cost effectiveness, timeliness, and flexibility were very important. We didn't want to have to rely on an outside vendor for modifications, such as producing custom reports. And we needed a system that our remote sites could afford, use and maintain themselves without special hardware or software and that would be able to keep up with our volumes and produce near instantaneous reports even from afar."
The Solution
After evaluating its legacy fax based data collection system and deciding it would be too costly to modify the system to suit its current needs, Riverside County DMH selected a solution from Cardiff Software and its longtime partner, Hershey Technologies based on their understanding of WEB Service oriented solutions. Hershey recommended Cardiff Software's TELEform™ product with the HTML eForm Option® for form design and data collection over the Internet, along with Hershey's WEB Validation and Image Management system, ImageNet. The solution allows agencies to easily collect patient performance outcome data required by the State, via hardcopy from remote Kodak scanners using ImageNet's Internet Scan application. The ImageNet Scan application saves the images to the central ImageNet server, which is integrated with the TELEform™ Reader for automated recognition on the saved images. After form processing by TELEform™, ImageNet's browser-based Validation module allows the remote departments to perform verification on the outcome data. Optionally, the outcome survey may be filled out and submitted online through Cardiff's Web-based HTML+Forms module, which eliminates the need for scanning or human verification of the outcomes data. Regardless of data collection source, the system provides clinicians with immediate feedback in the form of graphical, trend reports based on the outcome data.
"We had to work under a really fast turnaround requirement." Neal Fischer at Hershey Technologies explained. "The department wanted the data to be processed and a report generated within five minutes after turning the survey in, so that the counselor could respond appropriately as quickly as possible. So, we discarded several ideas, such as faxing forms and verifying the data centrally because we found that approach to be too slow and unable to handle the volume. Instead, we were able to integrate the ImageNet document management product to work with TELEform in a way that would allow for Web-based scanning, data collection, verification, integration of the clients reporting tool, along with an automated repository for completed digital forms and imaged documents."
At the time of treatment, clients complete a survey, called the Goal Attainment and Treatment Evaluation Survey (GATE). Developed by Oprendek and Dr. Larry Ogilvie, Program Chief of Riverside County DMH, GATE consists of questions designed to alert clinicians to potential areas of concern. At selected sites, clients can complete an electronic WEB version created in TELEform's Eform product. Due to user acceptance; the survey is also delivered in a paper format. The paper surveys are then scanned by clerical staff, which verify and correct them over the Web from the secure ImageNet Web site. "The recognition rate of the TELEform OCR engine is very good," Oprendek commented, "but occasionally we have to make corrections. The great thing about the system is that the client is right there, in the same office where the data is being verified, so we can be assured of 100% data accuracy."
After scanning and verification, surveys are automatically archived into ImageNet content management system and the data from the survey is submitted to DMH's main database, from which reports are generated immediately and presented over the WEB for use by the clinician during the visit with the client.
"All our patient visits start on the hour, which means that everyone is turning in surveys at the same time," Oprendek observed. "We're averaging as many as 250 simultaneous ‘hits' to the system, yet we're handling the volume and achieving the turnaround that we set out for."
The Results
With the new solution now in place, Riverside County DMH can assess client outcomes within five minutes, no matter where the client is being seen. This is especially important because many clients are being served at multiple venues. In addition, they've been able to push workload to the remote clinics instead of handling data collection centrally.
Oprendek expanded, "Most other systems have a centralized proprietary verification and reporting architecture. In these types of systems, you might have to wait days for a report, and then wait days again if an error were found and you had to correct the data. With the TELEform - ImageNet solution we have seen more accurate, timely data and enhanced workflow efficiency."
The efficiency of the final Web-based solution --which enables rapid deployment, WEB Form presentment, quick turnaround time for patient outcome reports, and will enable future capabilities such as input from new technologies like wireless Windows-based Tablet PCs -- Oprendek credits to Hershey Technologies. "Hershey made our requirements fit into their ImageNet solution. Thanks to Hershey's collaborative approach and Cardiff's open-system, easy-to-use product, we've achieved what we set out to do and are looking forward to using the system for other surveys and applications ".
Submitted by Cardiff Software.
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