PBHCI Grantee Technical Assistance - Physical Health Indicator Data Jam Session

Friday, February 11, 2011 1:00 PM - 2:00 PM EST

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Purpose

Describe collection of physical health (PH) indicatorsPH Indicators are specific to the PBHCI program

i.e., not relevant to your other SAMHSA grants

SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Data Requirements*

PBHCI-related Information/Data

Clinical Registry Quarterly ReportsIPP and NOMs

(to include physical healthcareindicators by March 2011)

RAND PBHCI SharepointSite** TRAC Website***

*Contact Emma Green at the SAMHSA/HRSA Center for Integration Health Solutions (CIHS), emmag@thenationalcouncil.org, with questions.**The RAND PBHCI Sharepoint Site is a secure, HIPAA-compliant, project-specific web-site via which de-identified, patient-level health care utilization data from your local community behavioral healthcare center will be uploaded. In addition, we ask that you submit your Quarterly Reports (for review by your SAMHSA GPO) to this site. **The TRAC system is a web-based data entry and reporting system that provides a data repository for CMHS program performance measures. Performance measures are collected as part of CMHS effort to promote accountability within its programs. This effort is mandated by the Government and Performance Results Act (GPRA) and the Office of Management and Budget’s (OMB) Program Analysis Review Tool (PART).

What are PBHCI PH indicators?Required Recommended

Mechanical MeasuresHeightWeight

Body Mass Index (BMI)Blood Pressure (BP)Waist Circumference

Breath Carbon Monoxide (CO)Blood Work

Fasting glucose / HbA1cTriglycerides

HDL CholesterolLDL Cholesterol

Total Cholesterol

Why are some items recommended?

Your contract with SAMHSA requires that you collect some PH indicators

Recommended items are consistent with good clinical careWaist circumference: Metabolic syndromeBreath CO: Tobacco smoke exposure

Recommended items help you / SAMHSA monitor the health of your consumers

PH Indicators FAQs

Q: What is the difference between “lipid panel” and “blood work”?

A: Lipid panel is a blood test that includes triglycerides, total cholesterol, HDL, and LDLLipid panel does not include glucose or A1cBlood work refers to any diagnostic testing performed on the

fluids or cells of peripheral blood, including lipid panel, glucose and A1c

PH Indicators FAQs

Q: Which is better to collect: A1c or glucose?A: A1c

A1c is the standard tool to monitor sugar control in patients with diabetes

A1c is becoming the new standard for screening patients for diabetes

– More convenient than glucose test

PH Indicators FAQsQ: Why collect waist circumference?A: Although waist circumference and BMI are related,

waist circumference is an independent predictor ofType 2 diabetes, dislipidemia, hypertension, and

cardiovascular disease over and above BMI

This is especially true for patients who are normal weight or overweight according to BMI, Asians, or older adults

Collecting and Reporting PH IndicatorsNext slide has a timeline for collecting and reporting PH

indicatorsTiming of collecting and reporting is not the same

Mechanical indicators need to be collected more often than they are entered in TRAC

– Per specifications of your contract with SAMHSAReporting of PH indicators coincides with NOMS interview

MC = Mechanical indicators: Collect and store in medical recordsMT = Mechanical indicators: collect, store in medical records, and enter in TRAC BT = Blood work: collect, store in medical records, and enter in TRAC NOMS = NOMS survey, enter in TRAC

Collecting and Reporting PH Indicators

Intake3 Months

6 Months

9 Months

12 Months

Discharge

MTBT

NOMS

MC MTBT

NOMS

MTBT

NOMS

MCMTNOMS

same pattern continues

until…

PH Indicators FAQsQ: When can I start entering PH indicators into TRAC?A: End of March, 2011

Pending: (1) the TRAC system is fully functional, and (2) data collection is approved by OMB

TRAC Help will notify you when you can begin entering PH indicators in TRAC. TRAC Help will also send explicit instructions about how to enter and edit PH indicators data

PH Indicators FAQs

Q: Where do I enter PH Indicators in TRAC?A: Section H

Section H is for individual programs to collect program-specific data.

In the future, other grants may include a Section H that contains different data items

PH Indicators FAQs

Q: When should I start collecting PH indicators?A: As soon as you start enrolling patients into your PBHCI

programYour contract with SAMHSA stipulates that you will collect PH

indicators for all PBHCI clients quarterly (mechanical measures) and annually (blood work) throughout the life of your grant

PH Indicators FAQsQ: How should I collect (and maintain records) of PH

indicators before the TRAC system is ready?A: Use the form on the next slide as a guide

Use the forms directly or build a database to house the information.

PH indicators data will ultimately be entered into TRAC by hand. Your data collection and storage system should facilitate easy data entry once the TRAC system is ready.

When TRAC Section H is ready, you will be able to edit old interviews and add the PH indicators data

Missing PH Indicators Data

Missing PH indicators data can be marked in TRAC in two ways:

1. Refused2. Missing

Don’t forget to note missing data on your forms/ database for later entry into TRAC!

PH Indicators FAQs

Q: If the consumer does not fast for 8h, should we still obtain the blood sample?

A: Yes.Note on the form that the fast wasn’t completed and record the

value of the non-fasting glucose test

PH Indicators FAQs

Q: Do all PH indicators data need to be entered at the same time as the NOMS?

A: NoPH indicators data is often collected at the same time as the

NOMs (see timeline) but blood work might not be back from the lab right away

Unlike other data, you can enter blood work data into TRAC at a later date.

Help?Q: Who should I contact for help with PH indicators? Contact Emma or Jeff at the Center for Integrated Health

Solutions for questions about content or collection.emmag@thenationalcouncil.orgjeffc@thenationalcouncil.org

Contact TRAC Help for questions about data entry for section H and all other sections of TRACTRAC Help Desk, TRACHelp@westat.com 1-888-219-0238 Hours: M-F 8:30 AM - 7PM (ET)