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OWITS/EHRWhy is AMH changing their reporting system and adding additional data elements?
The current data that is collected through Client Process Monitoring System (CPMS) does not meet the needs of AMH, especially when it comes to tracking and paying for performance and outcomes. The phasing out of CPMS allows AMH to comply with Federal Block Grant Reporting requirements. Also, the US Department of Justice requires AMH to collect certain data items to ensure treatment is provided appropriately. More importantly, this change will allow AMH to track the performance and outcome measures associated with the AMH System Change Initiative, and the larger Oregon Health Authority Health System Transformation. These initiatives allow us to pay for services in a different manner via flexible funds. However, greater attention to outcomes is required with these flexible funds. While every data item in the Data Submission Guide is necessary, we did eliminate many of the old CPMS data fields. The outcome measures require that any change during treatment to the status data be sent to AMH on a regular basis. AMH proposed monthly updates, but based on feedback from the Association of Oregon Community Mental Health Programs (AOCMHP) Technology Committee, AMH decided to go with quarterly updates. AMH needs to have better data on the outcomes that occur during treatment.
OWITS/EHRWhat type of stakeholder feedback has AMH initiated from Providers prior to moving forward with  the new system?
AMH has been working over the past two years with the AOCMHP and the AOCMHP Technology Committee, as well as meeting directly with various CMHP and provider representatives. AMH has also met with various workgroups including the CMHP Addictions Core Group, the AMH System Change Implementation Advisory Group, and the Addictions & Mental Health Planning and Advisory Council. The feedback has been very helpful and we continue to welcome it.
OWITS/EHRWhat's the Community Mental Health Programs (CMHP) role with subcontractors?
The role of the CMHP will be to review their subcontractor’s data at a high level and make sure the data is complete. AMH is in the process of determining what data CMHPs will review. CMHPs have interest in data related to new admits, services, latency time between new admit and getting data submitted, active clients, etc.
OWITS/EHRWill AMH be able to give service providers any data back?
AMH will be setting up a web based reporting system for our counties and providers to access, run reports and view data. It won't be fully operational until late 2014, but it is definitely part of the plan.
OWITS/EHRHow is the new data reporting system “streamlining”?
In an effort to “streamline,” AMH is doing away with the multiple provider numbers each provider has with the current system (CPMS). AMH is also removing the need to submit two admissions if the client is dual diagnosed. Additionally, we are eliminating the need to close and reopen a client every time a client moves from one level of treatment to another within the same provider. Also, if a client returns to treatment, it is not necessary to do a complete re-enrollment in the system. Finally, discharge or termination forms are no longer necessary.
OWITS/EHRIs the Measures and Outcomes Tracking System (MOTS) completely replacing CPMS?
Yes, the MOTS data collection system will completely replace CPMS. COMPASS is the name of the project, which has many components, however, once all components have been implemented, the term COMPASS related to this project will no longer be used.
OWITS/EHRWhen is the CPMS system going to stop accepting new data?
The CPMS system will stop accepting data once we have implemented the new MOTS data collection system and all providers have moved over to the new system. We know that not all providers will move from CPMS to MOTS at the same time; however, a policy is in place on how and when providers will transition and become fully implemented into the new system. The policy is located at: http://www.oregon.gov/oha/amh/mots/internalresources/Fully%20Implemented%20Policy%20for%20OWITS,%20MOTS%20Client%20Entry%20and%20EDI%20Users.pdf. The policy is divided by data submission method.
OWITS/EHRAre the Data Submission Guide and Data Dictionary finalized?
They are finalized and on the web at: http://www.oregon.gov/oha/amh/mots/Pages/index.aspx. Occasionally, minor updates are made from new information that we have received, however, when changes are made, they will be indicated and the date of the change is included in the document activity log at the beginning of the document.
OWITS/EHRRight now, we have 2 different CPMS forms for adult and youth Addictions treatment. Will these  continue to be separate?
In the new system there will no longer be forms. You will enter client information similar for youth and adults, however, some data points may not apply to all populations. Instructions on how to complete and submit the required fields is include in a MOTS Reference Manual located at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf and trainings/webinars will be available in the future to assist with data collection.
OWITS/EHRWe have 2 Medicaid provider numbers (mental health and addictions). Will we be able to consolidate  this?
The goal is for each agency to have one Medicaid Provider number for both mental health and addictions treatment services to submit the status and non-Medicaid service data, however, we have given entities the option to use two numbers if they would like.
OWITS/EHRThere doesn't seem to be a definition of what "Treatment Completed" means. CPMS has a fairly clear  definition, even if not everyone liked it. But without a definition, does this mean each provider gets to  define what "Treatment Completed" means?
Definitions and clarity on how to interpret the data for your clinicians will be included in the MOTS Reference Manual, similar to the CPMS manual. It is available on the web at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf.
OWITS/EHRIf we don't have to do termination "forms", how do you know outcome information?
Within the Data Submission Guide is a data point titled “Client Treatment Status”. This information will provide us the status of the client and through status updates and non-Medicaid service data AMH will be able to generate information regarding outcomes.
OWITS/EHRWill we still get the CPMS MMRs?
No, Monthly Management Reports (MMRs) will no longer be necessary. The sender (provider) of the information will receive notification that the data did or did not successfully submit and why. Also, the sender will be able to review data to ensure it’s all there by viewing dashboard reports online (ready late 2014).
OWITS/EHRWhat particular non-Medicaid service data will need to be submitted?
Within the Data Submission Guide and spreadsheet are the required non-Medicaid service data elements and the services for which they should be submitted. Both documents are available on the web at: http://www.oregon.gov/oha/amh/pages/compass/electronic-data-capture.aspx. The non-Medicaid service data elements are required. Medicaid encounter data submitted to the MMIS system will be pulled by AMH. Non – Medicaid service data will need to be submitted to AMH. The data entry for non-Medicaid services is limited and is only eleven data fields. This information will assist us in capturing data that we currently cannot report to the legislature and federal government and to track outcomes on the clients. More information regarding non-Medicaid services is available within the document; “Policy on Non-Medicaid Service Data Submission to AMH” located at: http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf.
OWITS/EHRCan't you get the Medicaid encounter data from the CCO?
AMH will pull Medicaid encounter data on Medicaid clients from the MMIS system, which is the system that CCO’s will use. However, non-Medicaid client service data is not currently collected. Providers will now need to submit data on non-Medicaid services and will be required and tracked by AMH.
OWITS/EHRNon-Medicaid service data: What are the expectations for submission? Quarterly or when a service  is rendered?
AMH would like to see non-Medicaid Service data, services that are not funded by Medicaid, submitted shortly after the service is rendered. The data must be submitted every 30 days and is due by the 15th of each month for the non-Medicaid services provided during the previous month.
OWITS/EHRAs far as encounter data, will we continue to submit our Medicaid encounter data as we do now and  then submit the same data to another place?
The non-Medicaid service data that AMH will collect is for those services you provide that are not paid with Medicaid funds or through Medicaid billings, but are paid for with public funds. Your Medicaid claims would, however, continue to go to the same place as you do now and this information would not need to be submitted to AMH, as we can pull it from the MMIS system.
OWITS/EHRWill you want non-Medicaid service for grant specific services such as pre-commitment?
We have a spreadsheet that lists all the required data points AMH will collect. It provides you with the services that require non-Medicaid services data to be submitted. You will notice that pre-commit or involuntary services do not require non-Medicaid service data. The spreadsheet can be found at: http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf.
OWITS/EHRWho do you consider to be a non-Medicaid client and required to submit non-Medicaid service data  to AMH?
Actually, it's really non-Medicaid funded services. So, you might have a client that is OHP eligible, but some services that are provided aren't covered. These are the non-Medicaid service data we would like to collect. More information on the non-Medicaid service data can be found within the documents located on the web at http://www.oregon.gov/oha/amh/mots/Pages/resource.aspx. Such documents include the
OWITS/EHRHow do you submit a non-Medicaid service if there is no prime number for a client, because that  client is not Medicaid eligible?
How do you submit a non-Medicaid service if there is no prime number for a client, because that client is not Medicaid eligible?
OWITS/EHRWill the status data submission be quarterly? Meaning we would only send the data 4 times a  year? So it would be possible that a client was admitted, had a status change(s) and discharged in the  same period?
AMH is asking for data at admission (enrollment), and updates to that data to be sent to AMH at least on a quarterly basis. And yes, a client could be opened and complete treatment in a very short period of time. Status data can be submitted more frequently than every 90 days in order to show improvement over time.
OWITS/EHRWe were required to keep a copy of the CPMS form in our chart. We will be required to keep the  data in our chart to be able to recreate it or can we overwrite certain fields as they change?
If you are planning to submit data out of your existing EHR, then your EHR is the source of that data and the form does not need to be in the paper file. It would be great if your system tracked history so that if necessary, it would be possible to see changes to the client data. In the future, the Client Entry tool will allow you to print the status information that you have submitted to the system and one could put this in the chart, but it’s not necessary.
OWITS/EHRSuppose somebody is being treated by a provider in county A because they live there, but they work  in county B and want to take a class in county B for convenience. How does this get submitted?
If services are being paid for with public funds, the entity (CMHP or provider) that is responsible for making sure those services are provided must make sure those services, where ever they may occur, are reported. Use of the County of Responsibility field will help AMH better understand who’s paying for those services.
OWITS/EHRAre we required to submit data if Medicaid is not primary, but secondary payor?
Status data is required for all clients whose services are paid for with public funds, including Medicaid. If a service is provided, and it is paid for with public funds other than Medicaid, please submit non-Medicaid service information as well.
OWITS/EHRStatus data is required for all clients whose services are paid for with public funds, including Medicaid. If a  service is provided, and it is paid for with public funds other than Medicaid, please submit non-Medicaid  service information as well.
Non-Medicaid services are any publicly funded services that aren’t funded in any way by Medicaid. So this would include grants, contracts with AMH, write offs, etc. The only thing that’s not included is if a client is fully self-pay or has private insurance. For those, you do not need to submit that data (status or non-Medicaid service data), unless they are a required reported service such as methadone or DUII.
OWITS/EHRDo foster care services need to report status data?
Yes, similar to what is expected today in CPMS.
OWITS/EHRDo "Out of Network" providers need to report services or does the CMHP do that?
A policy has been developed that will state that in these cases, “out of network” and CMHPs do not have to report status or non-Medicaid service data. See the Who Reports in MOTS Policy located at http://www.oregon.gov/oha/amh/mots/internalresources/Who%20Reports%20in%20MOTS%20Policy.pdf.
OWITS/EHRHow do we know if a client is a PSRB client? Is it just the referral code?
This will be picked up from the Legal status data element.
OWITS/EHRHow does MOTS track multiple admissions? For example, if a client comes in through outpatient,  then has a crisis, then an involuntary commitment, all within the 90 day period, how would AMH know?
New admits, crisis and involuntary commitments events must be submitted within 7 days of event. This information is not considered a status update, but rather an event. This is defined more clearly in the MOTS Reference Manual located at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf.
OWITS/EHRWill CMHPs be able to see dashboard reports with clients they serve or clients they pay for or both?
As a CMHP, if you are paying for services you will be able to see the service details, because the county of responsibility data field will allow this. You will also be able to see the services you provide as a CMHP. Reports will be available in late 2014.
OWITS/EHRIn the Service data, are entities supposed to submit the full usual and customary charge? Or the  UCC minus the client’s adjusted fee schedule?
Submit the full amount charged.
OWITS/EHRCan a provider submit data under multiple provider IDs?
Each provider will register within the MOTS system with up to two Oregon Medicaid Provider IDs. These IDs are the number you will use to submit your data and by which your data will be tracked.
OWITS/EHRWe have 2 Medicaid numbers (one MH and one AOD) and then other provider numbers for different  services (child MH, adult MH, AOD, DUII, ICTS). Do these go away?
We are now only requiring one Oregon Medicaid Provider number, however an entity can submit up to two. Provider numbers for different services will no longer be necessary or used. We will track service using different data elements and information on how we will track these services is available within the MOTS Reference Manual located at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf.
OWITS/EHRWhat is the utility of having DUII completion date without having corresponding DUII completion  outcome? eg: a client who does not complete DUII but continues in treatment in a different level of care  would have a DUII completion date but would not have
We have added a DUII completion date to our data elements to ensure we are capturing this data. Update other data items as needed. At this time, we are not getting DUII completion outcome data from the ADES, so it will need to continue being submitted to AMH from the DUII treatment provider.
OWITS/EHRIs the frequency of data submission every 90 days?
Status update data submissions are required at least every 90 days and non-Medicaid data is required monthly. Timeline information can be found on the COMPASS web page and within the MOTS Reference Manual located at http://www.oregon.gov /oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf
OWITS/EHRCurrently we need to submit a separate CPMS enrollment for A&D services and a separate  enrollment for MH services. Will we still need to do this for MOTS or is one general enrollment  sufficient?
One general enrollment will be sufficient.
OWITS/EHRWhat providers/practices are required to submit to MOTS? If a practice is not currently submitting  data to CPMS, will they be required to submit data to MOTS?
Providers who currently submit CPMS data will be required to submit data to MOTS. These are providers that are receiving public funds or under contract and rule to report services. See the Who Reports in MOTS Policy located at http://www.oregon.gov/oha/amh/mots/internalresources/Who%20Reports%20in%20MOTS%20Policy.pdf.
GeneralWhen will the MOTS Client Entry web tool be available to use?
The web based MOTS Client Entry system is up and running. The website address is: https://mots.oregon.gov/MOTS. You will need a login and password. Information on how to get a login and password is located on our website: http://www.oregon.gov/oha/amh/mots/Pages/index.aspx.
GeneralIs there a limit to the amount of staff that has access to the Client Entry online application?
No, there is no limit. It will be up to your organization on how many staff will have access. Each organization will have an Agency System Administrator to determine this and set up access for the staff. Each staff with access will be assigned a secure access ID, etc. with roles and responsibilities assigned to them to determine how much access they will have to the system.
GeneralWhy do I see people outside of my agency when I am setting up users in my agency?
When a System Administrator enters in a user, but doesn’t give them access to an agency and facility the user will be visible to all System Administrators. This allows a System Administrator to find and correctly assign users to the agency/facility, if any steps were initially missed in the process of assigning access to their users. If you see people who are not in your agency or facility, you can ignore them. They do not have access to any data in MOTS.
GeneralWill clients enrolled in CPMS be rolled over to the new system or will they have to be entered in  again?
We will not be converting the CPMS data into MOTS. We want to improve the data quality. It is important that you make sure everyone that is no longer in treatment is closed in CPMS. We have a fully implemented policy that instructs providers on the transition and it is located on the web page at: http://www.oregon.gov/oha/amh/mots/internalresources/Fully%20Implemented%20Policy%20for%20OWITS,%20MOTS%20Client%20Entry%20and%20EDI%20Users.pdf. Also, you can request a list of open CPMS clients in spreadsheet format to assist you in entering your current active caseload into MOTS client entry. The spreadsheet lists all open clients and all the data that needs to be entered in the correct order to make it easier for you. Some new fields will not be on the spreadsheet and you will need to enter “Unknown” or “N/A” until you gather the data. This way you would not need to pull all client charts. To request the list, please contact mots.support@state.or.us.
GeneralCan we use the OWITS EHR, and not MOTS Client Entry?
Yes, if you will be using the OWITS EHR, you do not need to use Client Entry. Your OWITS data will transfer to MOTS. However, all providers will need to register with MOTS in order to submit their data. In MOTS you will let us know which method of data submission you will use. In the future, you will use MOTS to review reports. To register in MOTS, please see: http://www.oregon.gov/oha/amh/mots/Pages/index.aspx
GeneralI was attempting to access the MOTS Client Entry system today, but it told me that it did not  recognize my username in the system. I used the same info from the training class. Can you let me know  if I need to use a different USER/PASSWORD combination?
The username and password you received at the training is for the MOTS Test/Training Site only. You will have a different username and password for the live/production site. It should be a P# with a unique password.
GeneralWhere do I register my Oregon Medicaid Provider numbers? Do I need to register both of them or  just one? If just one, should it be MH or AD?
Please follow the instructions on our web page: http://www.oregon.gov/oha/amh/mots/Pages/index.aspx. You will need to fill out the MOTS Registration Form to get a User ID and Password to MOTS. There is a Video you can watch on how to do this on the web site, as well. In the registration screens, you will enter your Medicaid Provider Numbers. Thank you for taking care of this important task.
GeneralI wanted to clarify that our EHR status file which we will be sending via EDI will replace an entry in  the MOTS Client Entry system.
Yes, if you submit your status and service data via Electronic Data Interchange or EDI (sending from your existing EHR), then you do not need to submit your status and service data via MOTS Client Entry. Make sure you indicate in MOTS that you will be sending your data via EDI.
GeneralHow will MOTS Client Entry work with existing EHRs?
MOTS Client Entry is one data submission method. If you already have an EHR and can generate a file to send to us from that EHR that contains all necessary data, you do not need to use MOTS Client Entry. When you register in MOTS, tell us that you will be using EDI.
GeneralHow is it all going to come together between clinical and clerical in entering the MOTS client entry  data?
Some agencies are going to have their clerical staff enter the administrative information, then Save as Draft, and have their clinical staff enter the clinical info afterwards and then submit. If you are going to have just one person enter all the information into MOTS Client Entry from the counselors, you might use the MOTS Client Entry Cheat Sheet which is available on the COMPASS website. It’s available in PDF or Word format, so that you can modify it as needed. Some agencies have chosen to let the counselors enter the data into MOTS Client Entry. Which method you decide to use in your agency depends on your current and future business processes.
GeneralI have questions about the Non-Medicaid Services portion; what counts as non-Medicaid?
Please see the policy on Non-Medicaid Services at: http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf for help on deciding which services should be entered into MOTS Client Entry.
GeneralI don't understand why it is being left up to the agency to determine how we set ourselves up (re:  agency/facilities). It seems that this choice will ensure inconsistency.
We are asking for each Agency to have a System Administrator who will set up the Agency and its facilities, as well as enter the users for each. AMH wants to give providers the ability to add users, remove users, assign users to certain facilities, add new facilities, etc. This gives the providers more control over how their data is entered.
General Can we start with manual entry (Client Entry) and move to EDI submission later?
Yes, you can use MOTS Client Entry for now, until your EDI submission process (sending electronic data from your own EHR) is ready. When you are ready to change your submission method, you will need to contact your system administrator and have them make the request in MOTS Admin.
GeneralWhat date do I use as the Admission Date in MOTS for the active clients in CPMS?
You will use the original CPMS open date as the Admission Date in MOTS.
GeneralWhy are there no business rules to prevent discrepancies between non-Medicaid services provided  and the assigned diagnosis codes. Ex: A Methadone maintenance service can be submitted for a client w/o  opiate diagnosis.
As we continue to use the new MOTS Client Entry system, we want to hear from providers using the system. We want to hear your ideas on how to make it better. Please send your suggestions to mots.support@state.or.us. While we want the system to be easy to use and have as few restrictions as possible, we will be adding more business rules over time to deal with any inconsistencies or discrepancies we notice. Thank you for your help.
EDIWhat are the ramifications if an agency is not able to meet the deadline of August 1, 2014 for new  submission, specifically for those with existing EHRs that will need to be updated?
If a provider is not able to meet the deadline, AMH will handle those on a case by case basis.
EDIOur agency is concerned about the financial burden it may cost to upgrade our existing EHR to meet  the new data element requirements and transmission.
AMH understands that this change to the data and the way data is collected will take some effort by the provider and CMHP. COMPASS staff is willing to meet and discuss any concerns regarding these efforts. Remember, there are three different ways to submit data, including a low cost Electronic Health Record. AMH wants to work with providers to ensure they choose the best method and that the method has limited impact on the business. Incentive payments are also available to CMHPs that meet the reporting requirements.
EDIIs the EDI (batch) submission similar in structure to the HIPAA 5010 formats such as 837, 835, 270,  271, etc.?
Both the status and non-Medicaid service files need to be delimited flat files. Information on the file extracts are available within the AMH File Transfer Specifications for Electronic Health Records document located on the MOTS web page at: http://www.oregon.gov/oha/amh/mots/internalresources/EDI_Batch_File_Specifications_and_Certification.pdf
EDIDo you have requirements for the text like client name, etc. For instance I understand that All Caps  was required at some point.
The Data Dictionary provides you with the specification and rules for submitting data. The document can be found on the MOTS web page at: http://www.oregon.gov/oha/amh/mots/internalresources/Data_Dictionary_and_Business_Rules.pdf
EDIAre openings to be reported separately from status updates?
Yes. New enrollments (openings) must be submitted within 7 days of the first active treatment episode. You would then be required to submit a status update on this client at the end of the quarter. Status updates are required quarterly on all clients receiving services for the quarter.
EDIOn the status updates, what EHR data changes constitute the need for an update? When we do  report changes, will we just report the values that changed, or do we resubmit the whole file and your  system will tease out the changed values?
Just re-submit the whole file and we can tease out what has been changed. Files can be reported at the end of each quarter or as often as your organization would like.
EDICan we use the Client Entry web data submission method until we can get the EDI up and running?
Yes, you may use the Client Entry web tool until you get your electronic health record system implemented and the EDI submission process is successful.
EDIDo existing clients need to be re-opened in the new system?
No, when a client returns for services, you would just reactivate them within your systems, using the data field of “Client Treatment Status” as active. Hopefully, all the past demographic information on the client is still within your record system and the provider would just update any of the data fields that have changed and submit a status update.
EDIRelated to a person's specific case number that we are supposed to use when they return, can the field  be moved to have 7 (or 8) digits? We are trying really hard to not duplicate numbers, with changes to  EHR, this is very hard.
Related to a person's specific case number that we are supposed to use when they return, can the field be moved to have 7 (or 8) digits? We are trying really hard to not duplicate numbers, with changes to EHR, this is very hard.
EDIShouldn't you have MH only, Addictions only, and MH and A&D options?
For Mental Health only clients, complete the client profile and Behavioral Health detail. For Addiction only clients, complete the client profile, Behavioral Health and Addictions Detail. For Dual Diagnosis clients, we will use all three.
EDIIf the system will not accept EDI data until early 2014, will we continue to use CPMS system until the  cutover?
Yes.
EDIAre Crisis and Involuntary records additional to the behavioral health status record which may be  already existent for some clients who are engaged in BH outpatient treatment and require either or both  of these services?
If an existing client is seen for a MH Crisis or Involuntary Service, a MH Crisis record or Involuntary Service record will need to be submitted. Both records are considered as separate events from regular treatment.
EDIIn these instances, are you expecting providers may include 2+ status  records in a file?
No, only one status record would be submitted within a file for a client. However, if a client is seen for a MH Crisis and/or Involuntary Service, then a provider would need to submit a record on these events also.
EDIWill subcontractors set up EDI interface directly or do they submit to Mental Health Provider/CCO?
Subcontractors of the CMHPs/CCO’s are required to interface directly with AMH. CCOs/CMHPs will have access to their subcontractor’s data.
EDIDo we have to use other methods if EDI is not available or will all start together?
All will start at basically the same time. We request that you use the data submission method that works best for your organization in the beginning and recommend that you do not change methods later on.
EDIRegarding Diagnosis - The guide states that you want DSM IV. Are you planning to require or allow  DSM V once that is available? OR will the State be moving to just capturing ICD-9 and then ICD-10  when it is available? For billing we currently send ICD-9
AMH will be moving to ICD-10 in October 2015, the same time as MMIS. As for DSM V, an AMH workgroup has formed to discuss this and we will provide communication on decisions once these are known.
EDICan an agency submit data more often than 90 days and will AMH capture information each time?
Yes.
EDIWill some valid Behavioral Health entries be restricted by AOD or MH admission? For example, if a  client is enrolled in Mental Health services, would a Legal Status of “DUII Diversion” be accepted? If so,  when will the Submission Guide be revised to ind
The MOTS Client Entry Business Rules document is posted on our web page at http://www.oregon.gov/oha/amh/mots/internalresources/Data_Dictionary_and_Business_Rules.pdf This lists all the edits we are building into our EDI tool. You are welcome to use the document as a guide for your own EHR.
EDIIf a client has a crisis and is an existing client, can they be treated like regular treatment and the  provider would not have to submit a crisis record?
We need to capture separately and outside of regular treatment the crisis event. AMH receives and distributes funds for crisis services and needs to track by county where crisis events are occurring to help us better plan for service coverage. We recommend that you either update your system to do this or use the MOTS Client Entry tool to capture MH Crisis events.
EDIIn our current system, only Axis I and Axis II have any data entry fields we can capture. Axis III and  Axis IV are free-form text entry fields in the progress note. We don't have a good way of extracting those  comments from that entry form.
At least one diagnosis is required, so if you can provide Axis I and II, that will be fine. All we need is the ICD 9 code.
EDIDUII was being tracked for last 5 years and now is being tracked for last month. We capture this in  AD, but not in MH. If we are not presently capturing this data can we use NULL for now. Anticipate  implementing this in next version.
Yes, you can do NULL on MH, as this is not a required data field for MH.
EDIAs soon as we are able to complete the new MOTS data in our EHR reconfigured, can we close out  CPMS and stop submitting in old format, then hold the MOTS until you are able to take it? We want to  discontinue duplicate data entry in two systems.
Yes, if you contact AMH at MOTS.support@state.or.us and get approval, this will be acceptable.
ICD-10 and DSM-VWhen will the MOTS system be transitioning to the ICD-10 and DSM-V?
For ICD-10 we are aligning with the effort by the Medical Assistance Programs (DMAP) who has an implementation date of October 2015. The American Psychiatric Association (APA) has published its fifth update to the Diagnostic and Statically Manual (DSM). Addictions and Mental Health (AMH) leadership has reviewed the timing for implementing DSM-V changes within our data collection system, MOTS (Measures and Outcomes Tracking System) and have concluded that we will align our efforts with that of the Oregon State Hospital. We intend to implement the DSM-V changes no sooner than March of 2015.
ICD-10 and DSM-VHow will the changes from DSM-V and ICD-10 affect the data collection for MOTS?
In the future state we will be collecting diagnosis and will not be focusing on the Axes. We will allow for multiple entries, but only one is required to satisfy MOTS requirements. DSM-V combines the first three DSM-IV-TR axes into one list that contains all mental disorders, including personality disorders and intellectual disability, as well as other medical diagnoses. Contributing psychosocial and environmental factors or other reasons for visits are now represented through an expanded selected set of ICD-9-CM V-codes and, from the forthcoming ICD-10-CM, Z-codes. These codes provide ways for clinicians to indicate other conditions or problems that may be a focus of clinical attention or otherwise affect the diagnosis, course, prognosis, or treatment of a mental disorder (such as relationship problems between patients and their intimate partners). For billing or non-Medicaid services, these conditions may be submitted along with the patient’s mental and other medical disorders if they are a focus of the current visit or help to explain the need for a treatment or test. Alternatively, they may be provided as a general diagnosis for the client data submission as useful information on circumstances that may affect the patient’s care. Only DSM diagnosis and ICD codes (V or Z codes) will be accepted into MOTS. Text fields will not be accepted.
ICD-10 and DSM-VDSM-V is doing away with the 5 Axis which includes the GAF score, what impacts will this have on  MOTS?
AMH will still continue to ask for GAF scores in the future as a separate data field. This may change to the WHODAS in 2015.
OWITS/EHRWho is required to use OWITS?
Use of OWITS is encouraged, but not required. Mental health and substance abuse providers who receive public funding or who administer state monitored programs (such as DUII services) are still required to submit data. OWITS is one tool that will be made available for recording and submitting that data. Providers who do not wish to use OWITS may use a different EHR (OHA will work with those providers to develop a method for extracting the required data), or they may use alternate data submission methods, which will be made available.
OWITS/EHRCan OWITS be accessed from any computer with internet access?
OWITS can be accessed from any computer connected to high speed internet and using Internet Explorer version 6.0 or higher as the browser. OWITS will also be compatible with any other web browser by the summer of 2014.
OWITS/EHRAre you aware of any problems running OWITS on the Windows 7 operating system? What  about Windows 8?
There are no known issues with Windows 7. OWITS also works with Internet Explorer 9. For Windows 8 and Internet Explorer 10, it does present a few problems out of the box, but if you tell it to run everything in the witsweb.org domain in compatibility mode, everything works fine. It even works with touchscreens. An architecture change being made in the summer of 2014 will make OWITS compatible with other browsers and operating systems, including smartphones with web browsers.
OWITS/EHRIs the access secure even when using a computer outside of the office?
Yes, OWITS is accessed through a secure and encrypted portal. The security is at the same level as that of your bank. For OWITS you will have to use a user name, password and a PIN to access the secure website. Even though the system is secure, we still recommend that providers adhere to HIPAA standards regarding accessing patient data outside the office.
OWITS/EHRHow does a user get access to their clients’ information in OWITS?
OWITS uses role based access to limit and allow access to the data you will need for your job. A system administrator will work with you to be sure you have the access you need.
OWITS/EHROur agency has several facilities, but staff should only be able to view information in their  facility. Is it possible to limit access to one facility?
Yes, staff can be limited to data in one facility.
OWITS/EHRCan a system administrator log you out?
Yes, if necessary the system administrator can log you out. This is necessary if you close the browser before logging out and then try to log in again from another computer or after resetting a Wi-Fi connection because OWITS sees the user as still logged in and will not allow you to log in again.
OWITS/EHRWho is FEi?
FEi (Focused eHealth Innovations) is the contractor for the OWITS System. FEi is a leading IT company specializing in Federal and Local Government data system solutions. For the past decade they have maintained a leading position in providing programming and consulting services in their primary areas of expertise—Behavioral Health Data Systems, and Clinical Trials Software Solutions for institutional systems of care. For more information, visit the company web site at http://www.feisystems.com/.
OWITS/EHRHow does OWITS benefit providers?
Mental health treatment and substance abuse counseling providers who choose to use OWITS will benefit because OWITS: - Is free until July 1, 2015. - Contains a behavioral electronic health record (EHR). - Is proven current technology. - Offers the ability to collaborate with other states. - Includes HIPAA compliant security and privacy notifications. - Is flexible and modifiable. - Is interoperable with other systems. - Will allow providers to stop submitting data through CPMS and avoid duplicate MOTS data entry. - Data can be used to improve outcomes. - Offers improved efficiency in tracking patients and services. - Is capable of budget tracking. - Improves data integrity. - Can improve billing processes. - Provides secure access to personal health records. - Is web–based. - Offers one-source reporting. - Contains a voucher system for the ATR3 grant. - Meets current federal minimum user guidelines.
OWITS/EHRWhat are the primary OWITS modules?
OWITS offers all of the essential modules for collecting client demographics and administering clinical services. Here is a snapshot of the more frequently used modules, however many more are available within OWITS. - Client Profile - Intake - Screenings and Assessments - Admission - Program Enrollment - Progress and Encounter Notes - Discharge - Consent (ROI) and Referral - Treatment Plan - Progress Notes - Group Notes - Drug Test Results
OWITS/EHRWhat if providers want a new module or a system change?
Providers are encouraged to make requests and suggestions regarding adding new modules or making useful changes to OWITS. Change requests should be submitted to the state via email (owits.support@state.or.us) or the OWITS Forum (http://owits.boards.net). The state will implement some changes. If it is determined that the change would not be widely beneficial or is not cost-effective but would otherwise not cause any problems, then providers have the opportunity to volunteer to pay for the change themselves, individually or collaboratively. Providers also have the opportunity to work through the OWITS Users Group (OWUG) to discuss proposed changes.
OWITS/EHRIs there a warning or flag to show that users are in a non-production site, so they don’t  inadvertently key in protected health information (PHI) in the test/training site?
The training environment displays “Training” in the upper left corner (the production environment does not). Production and training sites require a different user name. Due diligence will have to be used at all times to ensure users are in the appropriate site and do not key PHI in the test/training site.
OWITS/EHRDoes the system track deletions from the electronic health record? Is there the ability to  review audits or history of those changes?
Yes, deletions, changes, additions, and views to all of the modules are tracked, in addition to what user made the changes.
OWITS/EHRCan certifications and licenses be tracked by the facility?
Yes, certifications and licenses can be tracked at the Agency level within OWITS.
OWITS/EHRCan you search for clients through the scheduler?
Yes, you can search for clients through the scheduler.
OWITS/EHRIs there longitudinal checking of chart reviews to remind staff when reviews are due?
Yes, there is the ability to have staff reminded that a specific review must be done.
OWITS/EHRCan you add issues to the list of reasons a person is seeking services?
Yes, you can add to the list of issues that a person is seeking services.
OWITS/EHRAre all five axes included for diagnosis?
Yes, all five axes are included on the diagnosis screen.
OWITS/EHRWill the EHR move to ICD-10 and DSM-V?
Yes, the EHR will move to ICD-10 and DSM-V. FEi expects the changes to be ready for review in the summer of 2014 and implemented by the end of September, 2014.
OWITS/EHRIn the Progress Note, is time included for the service provided?
Yes, there is the option of adding the time but it is not a required data element.
OWITS/EHRCan the drop-down menus be changed for specific program or provider only or will all users see  the same drop-down options?
Changes made to drop-down menus are seen by all users. However, many changes can be made that do not adversely affect (and may benefit) other users.
OWITS/EHRCan clinicians write progress notes if the treatment plan has not yet been signed off?
Yes, progress notes can be created prior to the treatment plan being signed off.
OWITS/EHRIs there a flag in the system if a client is noted as an IV drug user and/or pregnant?
Yes, there are queries already set up to pull and report this information.
OWITS/EHRIs the consent in the EHR a consent-to-treat form?
No, there is no consent-to-treat form in the EHR.
OWITS/EHRWhat about billing?
OWITS contains a billing module that works for Medicaid, self-pay, and private insurance, using the CMS1500 form and/or 837/835 file transfers.
OWITS/EHRHow much will OWITS cost after July 1, 2015?
Exact amounts have not yet been determined, but based on current usage, it is estimated to cost $660 per agency per month.
OWITS/EHRWhat if I want to switch from OWITS to MOTS Client Entry or to another EHR?
AMH staff will work with your agency to facilitate any such transition.
OWITS/EHRIs OWITS limited to use only by publicly funded treatment providers?
t was limited at its initial implementation, but that limitation has recently been removed. OWITS is available for any mental health or substance abuse treatment provider in Oregon as long as that provider is will and able to pay the support and maintenance costs that will be required after July 1, 2015.
OWITS/EHRWhen noting an individual’s strengths are the drop down list and description required?
No, the drop down list is not required. The description field is a required data field and must be completed before going to the next screen.
OWITS/EHRIf there is an assessment missing from the EHR can it be added?
Yes, assessments can be added; however, there may be an additional cost to do this.
OWITS/EHRCan providers scan current paper records into OWITS?
OWITS can accept up to two documents (of any file type), up to 10mb each, per client. They are securely stored and available for download. This capacity may be expanded in the future.
Client EntryShould we complete the Involuntary Service form for PSRB clients?
Involuntary Services are not for PSRB clients. It is only used for civil commitments.
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