A View from the Desert

MHSIP TAKES A 20 YEAR LEAP WITH DATA STANDARDS

The Mental Health Statistics Improvement Program (MHSIP) is on the verge of leaping 20 years with the development of new and revised data standards for the mental health services system. Ten years after its publication of recommended national data standards, the MHSIP is participating in a major effort to develop data standards to take the mental health field, hopefully, at least to the year 2010. That is a 20 year leap----10 years catch up and 10 years forward.

The MHSIP Policy Group (formerly the MHSIP Ad Hoc Advisory Group) has been trying for several years to find resources to update and revise the MHSIP recommended data standards to meet the changing needs of the mental health services system. Now those resources are being made available by the Center for Mental Health Services (CMHS) through the efforts of Dr. Ronald Manderscheid.

Traditionally, the MHSIP modus operandi has been to convene experts from the MHSIP community to meet over time to work on the development of MHSIP products. As a result, these products have carried a sense of community involvement and a sense of ownership. The MHSIP data standards, published in AData Standards for Mental Health Decision Making@ (FN No. 10) in 1989, is a prime example of a product of the MHSIP Advisory Group and representatives from the MHSIP community. As such, it is a product that has been widely accepted and implemented, especially among publicly funded mental health agencies, service providers, and venders of mental health information systems and computer software.

Although the MHSIP Policy Group has long recognized the need to revise, update and expand the recommended national data standards that has resulted from major changes in the financing and delivery of mental health services, it has been unable to undertake the task of addressing this need for several reasons. Direct funding has not been available to the MHSIP Policy Group to support this major effort. In addition, growing needs and demands of mental health agencies for data and information have placed increased responsibilities on staff who develop, maintain, operate and use mental health information systems, so that the time of these experts can no longer be committed to work on the task forces or work groups that MHSIP would ordinarily convene to revise national data standards.

Recognizing the difficulties facing the MHSIP Policy Group and the need for updating MHSIP data standards, the CMHS has adopted a new paradigm for the support of MHSIP developmental activities. This approach has resulted in major contracts to develop data standards to meet the changing needs for information to support mental health decision making, clinical care, and reporting of national data. In 1997, CMHS contracted with Abt Associates, Inc. of Cambridge, Massachusetts to develop the functional requirements for a prototype information system built around the public health framework. The resulting draft requirements Alinks population, enrollment, encounter, financial, human resources, and organizational data with standards of practice data (i.e., clinical and system guidelines) and with instruments for evaluating care (i.e., consumer outcome measures, consumer-oriented report cards, and system performance indicators).@ The contract concluded that internal linkages among the data components and the external linkages with other systems (e.g., substance abuse, health, human services, justice, vocational rehabilitation, housing, and education) are critical to the success of the information system prototype. (The draft requirements have been posted on the MHSIP web site (www.mhsip.org) to solicit input and comments from the field.)

In 1999, CMHS negotiated a follow up contract with Abt Associates to continue work on the prototype information system. Marilyn Henderson of the CMHS is the government project officer for this contract; and Dr. Sarah Minden is the Abt Associates project director. The contract points out that a variety of organizational and financing arrangements are being developed and implemented to support a variety of mental health service delivery systems, and it is important to understand how these arrangements might evolve in the future and how they will impact on the proposed prototype information system. The contract, therefore, supports the development of a typology of the organizational and financial arrangements being developed within the behavioral healthcare field. In addition, the contract is to assess the fit between the organizational and financial arrangements and the information system prototype.

The current contract provides for Abt Associates to propose minimum data sets for each of the components of the prototype information system. In doing so, the contract has the potential of producing the next version of MHSIP recommended data standards.

To ensure that products of the CMHS contract are responsive to the needs of the MHSIP community, it is essential that the MHSIP community be involved in the development of the information system prototype and the recommended minimum data standards. To accomplish this the MHSIP Policy Group is formalizing a working relationship with the CMHS and Abt Associated to provide active participation in every step of the developments supported by the contract. This relationship will provide continuous liaison between MHSIP and the contractor, ongoing communications between the MHSIP Policy Group and the MHSIP community about the status of work on the prototype system, opportunities for the Policy Group and the MHSIP community to review and comment on product of the contract, and education of the MHSIP community about the prototype and its potential for meeting current and emerging needs for data to support policy and program decision making, clinical care, and services and systems evaluation.

The MHSIP Policy Group is appealing to the entire MHSIP community to support this important project, to communicate data needs and information that are required of a prototype system, and to review and comment on draft products as they are produced. By our involvement, we continue the MHSIP tradition of participation and, thereby, a sense of ownership of the resulting revised and updated MHSIP data standards and the new prototype mental health information system.