Electronic Health Records

Organization Information:

Organization Name:
Miami Behavioral Health Center
City & State:
Organization Website:
Organization's Mission Statement

Miami Behavioral Health Center shall provide, to the extent of our resources, high quality, cost effective, mental health, substance abuse, and domestic violence services to the residents of Miami-Dade County. Our goal is to provide services: in an ethical and fiscally sound manner; without regard to sex, race, age, creed, religion, nation of origin, or sexual orientation, and in a culturally sensitive manner.

Submission Information

Impact Essay

MBHC is a non-profit Comprehensive Community Mental Health Center (CCMHC). Having served the Hispanic community of Little Havana in Miami Florida for 32 years, MBHC has forged strong links to the Hispanic community through churches, schools, and community agencies and is prepared to collaborate with grass roots Hispanic organizations to expand the agency capacity to provide community mental health, substance use treatment and HIV/ AIDS services. MBHC has provided the full range of culturally and linguistically appropriate substance abuse and mental health (SAMH) services to adults, children, and families who are indigent, severely and persistently mentally ill, substance abusing and/or dually diagnosed since 1977. MBHC prides itself in working collaboratively with other community providers to improve quality, accessibility, and effectiveness in its full continuum of care for all clients. Since the beginning, MBHC have served over 100,000 unduplicated clients. MBHC has a significant portion (over 80%) of Hispanic employees.

MBHC provides a wide array of services including: In-patient crisis stabilization unit (CSU); 24-hour walk-in assessment services through a single point of access (SPA); 24-hour mobile crisis response team (MCT); adult and child psychiatric care & treatment; adult and child mental health counseling and therapy; adult and child substance abuse treatment & prevention (residential and outpatient); adult monolingual (Spanish) substance abuse residential program; adult and child case management services; domestic violence services; drop-in center for the mentally ill; pharmacy services; and numerous culturally-specific programs designed to meet the needs of the community.

Notably, because of their immigration status, 94% of these clients are neither eligible for aid, nor legally employable (indigent and uninsured). In 2008 MBHC provided substance use and mental health services to more than 10,000 individuals, 78% of whom were Hispanic. Clients ranged in age from infants to 85 plus, the greatest numbers were youth age 6 – 17 and adults age 41 - 65. Most clients were referred by the criminal, juvenile, and family court systems for substance use and domestic violence treatment. Also, we received referrals from the Substance Use Newborn Program and the Department of Children and Families.

In 2007, MBHC began developing an Electronic Health Record. Specifically, modules for client intake and assessment, treatment planning, documentation of progress and discharge planning have been completed. Upon completion of the Health Record, it became important that our case managers and therapists working in the homes and communities of our consumers were able to access the health record remotely from laptops used in the field. In May, 2008, Miami Behavioral Health Center received a donation from Microsoft of 50 Exchange CAL , 50 Windows Serve CAL and 50 TS CAL. This allowed us to pilot the Health Record and clinician use of an electronic record with 50 of our workers in the field. The results have been astounding!

Prior to the health record implementation at MBHC, all required fiscal and service delivery for the State and Medicaid were entered by data entry clerks. With the implementation of remote system access from the field, the responsibility for the data entry of admissions, discharge, and outcomes data required by funders was transferred to the clinicians working in the field for the pilot project. This has resulted in the elimination of the data entry costs for the agency. This was 2 FTEs for a total savings to the infrastructure/administrative costs to MBHC of $60.00 per year. We are now able to receive daily reports on client utilization of services, waiting lists, staff productivity, and real-time prior authorization for client services from HMO’s. Additionally, the impact of having remote access to the health record has had on staff productivity and efficiency while working “in the field” has been remarkable. During the pilot project, we experienced a decrease in the time for the completion of assessments of 50%. Prior to the remote access capability, assessments took, on average, 90 minutes to complete. This was in large part due to the redundancy of completing the paperwork on the part of the clinician (e.g., writing the client’s name and ID number on the top of each page, repeating information on one form that was also contained on another required form, etc). Through the new access from the field, all the redundancy and writing time was removed and this reduced time by 50%. The assessments are all neat, legible, and much more complete than the hand-written ones. MBHC completes approximately 6000 assessments per year. With the complete implementation of just the assessment module of the EHR, we have demonstrated we are able to reduce the assessment cost by 50% thereby allowing us to provide services to 50% more or an additional 3000 individuals each year.

The access to this real-time data has greatly enhanced and facilitated our ability to make immediate changes to correct issues and to effectively manage the changing environment and most importantly, to serve more consumers in need of service. As a result of our successful pilot project, our hope is to provide remote access to all 250 of our case managers and clinicians working in the community.

Submission Category
Transformations to Maximize Impact
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