Chapter 7

Update on Decision Support 2000+

Sarah L. Minden, M.D.; Hugh McDonough; Susan Schwab
Abt Associates
Cambridge, Massachusetts

Overview

Decision Support 2000+ (DS2000+) is an initiative of SAMHSA’s Center for Mental Health Services (CMHS) designed to improve the quality of information in behavioral health and, as a result, the quality of behavioral health care. The DS2000+ initiative seeks to advance the public health model, ensure stakeholder input, support quality improvement and accountability, and collaborate with allied fields (Substance Abuse and Mental Health Services Administration, undated). It provides tools and services to support national, State, county, and local informational and clinical activities.

DS2000+ involves a number of projects and activities that fall within two domains: standards for collecting and reporting behavioral health data and an online information system for collecting, analyzing, reporting, and disseminating data. DS2000+ Data Standards provide uniform criteria for defining, collecting, and reporting data that are both Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant and behavioral-health specific. DS2000+ Online provides tools for conducting surveys, recording health and personal data, finding services, measuring outcomes, evaluating performance, enhancing communication, sharing data, and disseminating information. These tools will make available data to describe the mental health system in the United States; evaluate the accessibility, appropriateness, and quality of care; facilitate stakeholder decision-making; and guide transformation efforts across the Nation (Powers, 2005). This chapter provides an update on DS2000+ activities, with a special focus on information technology.

Background

The intense debate over the past decade regarding problems in the financing and delivery of health and behavioral health care services has produced not only trenchant summaries of the problems, but also specific recommendations for improvement. Among these, there is clear consensus on two issues: First, improvement in quality of care involves substantial changes in the way the Nation handles health-
related information; second, all health-related care should be consumer- and family-driven. For behavioral health, there is, in addition, growing agreement on a recovery-oriented approach to care.

Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 1999) noted, for example, that “many who seek treatment are bewildered by the maze of paths into treatment; others in need of care are stymied by a lack of information about where to seek effective and affordable services.” Moreover, “public and private agencies have an obligation to facilitate entry into treatment, [but to do so, they need] to know what resources exist.” Among the six rules and ten goals for the new health system outlined in Crossing the Quality Chasm (Institute of Medicine, 2001), the Institute of Medicine (IOM) called for a consumer-centered system in which knowledge is shared and information flows freely. The President’s New Freedom Commission on Mental Health (2003) further affirms the special complexities, needs, and problems of behavioral health in its report Achieving the Promise: Transforming Mental Health in America (2003). The commission not only reinforced the IOM’s position that “mental health is consumer and family driven” (Goal 2), but also, in its sixth goal, asserted that technology should be used to access mental health care and information. Two specific objectives were set for the field: to use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations, and to develop and implement integrated electronic health record and personal health information systems (Objectives 6.1 and 6.2). Indeed, as Daniels and Adams (2004) showed, an integrated electronic health and personal record (EHPR) fulfills not only the commission’s goals but also the IOM’s aims of efficiency and equitability.

The National Committee on Vital and Health Statistics (NCVHS) addressed the issue of information from the perspective of data content and standards in its report Shaping a Health Statistics Vision for the 21st Century (2002). The committee made the case that decision-making of all kinds could be improved with better coordination of data collection and analysis; more information on factors influencing population health; more timely access to data; and data standards that ensure comparability across regions, programs, and populations. NCVHS employed a person-centric and recovery-oriented approach, recommending that data be collected not only on disease, but also on functional status, well-being, and community and cultural characteristics; and that data be reported in ways that make the information easily accessible to all. The health statistics model for the 21st century, then, is one in which data collection, analysis, and reporting are coordinated, collaborative, standards-driven, timely, and relevant, with clearly enunciated policies and procedures for protecting privacy and ensuring data security and confidentiality. To this end, HIPAA has provided standards for transmission of electronic health data and regulations for ensuring privacy and data security.

The vision of a National Health Information Infrastructure (NHII) that will “connect all health decision-makers [including consumers] to sound information and to each other” is beginning to take shape through development of “technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health; [that will] deliver information to individuals—consumers, patients, and professionals—when and where they need it, so they can use this information to make informed decisions about health and health care” (NCVHS, 2000 and 2002). For example, through Connecting for Health (2004a, 2004b, 2005), public and private stakeholders have reached initial consensus on a set of health care data standards and recommended strategies to promote electronic connectivity in health care; the departments of Health and Human Services, Defense, and Veterans Affairs have agreed upon standards for exchanging clinical health information electronically for surveillance and health care at the Federal level (the Consolidated Health Informatics [CHI] initiative); the Centers for Medicare and Medicaid Services (CMS) are developing standards for electronic prescribing and interoperability of electronic health records and are piloting the Medicare Beneficiary Portal for secure access to health information; the Centers for Disease Control and Prevention (CDC) are working toward electronic laboratory reporting and information exchange; Health Level 7 (HL7) has created standards and a functional model for electronic health records (EHRs); the Health Resources and Services Administration (HRSA) is supporting regional health information organizations (RHIOs) to develop information exchange at the community level; and the National Coordinator for Health Information Technology is developing a strategic plan for nationwide implementation of interoperable health information technology (HIT) (Thompson & Brailer, 2004).

The NHII plan for “consumer-centric and information-rich” health care is taking shape through four goals and attendant strategies: (1) to inform clinical practice by incentivizing adoption of EHRs, reducing investment risk, and promoting use in rural and underserved areas; (2) to interconnect clinicians by fostering regional collaborations, developing a national health information network, and coordinating Federal health information systems; (3) to personalize care by encouraging consumers to use personal health records, enhancing informed choice, and promoting telehealth; and (4) to improve population health by unifying public health surveillance architectures, streamlining quality and health status monitoring, and advancing research and dissemination (Thompson & Brailer, 2004). Implicit in the plan is collaboration between the public and private sectors; across Federal, State, and local governments; and among stakeholders.

Model programs exist to guide vision and planning. For example, the Veterans Health Administration’s (VHA’s) fully integrated EHR connects all VHA medical facilities and provides beneficiaries with access to information on benefits, services, and Web-based enrollment; supports electronic provider credentialing and education; enables telemedicine visits and consultations; and can be used for screening, prevention, and quality measurement. Similarly, the Department of Defense (DOD) has developed an EHR, telehealth services, personal health records, and online provider education. In San Diego, the Network of Care for Mental Health program has a user-friendly, replicable Web site to help consumers and families find services and other community-based resources and information about conditions, insurance, and other mental health-related matters.

The Decision Support 2000+ Initiative

DS2000+ is another of these model programs. Informed and driven by the same vision, DS2000+ can provide the NHII with a critical behavioral health perspective through its data standards and online information system.

DS2000+ Data Standards

Building on a long tradition in the development of data standards for mental health (National Institute of Mental Health, 1989), DS2000+ recommends standards for collecting, recording, and reporting population, person/enrollment, encounter, financial, human resources, and organizational data as well as standards for measuring fidelity to evidence-based practices at the clinical and systems levels, outcomes of person-level treatment and interventions, and performance at the system level. For each substantive area, there are core and stakeholder-specific data standards. The core standards reflect the common data requirements of all behavioral health stakeholders—consumers, family members, public mental health agencies, providers, and managed behavioral health organizations—and incorporate applicable HIPAA standards. The stakeholder-specific standards were designed to meet the needs of particular stakeholder groups for specialized information. Since the data standards have been described previously (Manderscheid & Henderson, 2004), this chapter focuses on the online DS2000+ decision support tools.

DS2000+ Online

DS2000+ Online is a Web-based information system that began with a requirements analysis derived from information provided by multistakeholder focus groups, expert panels, and site visits to public and private entities with exemplary behavioral health information systems (Minden et al., 2000). On the basis of this input, the development team specified the key functionalities for a second-order distributed information system (Phillips, Mindent, & Dunworth, 2002) and built a functioning prototype, DS2000+ Online, to facilitate data collection, analysis, and reporting.

Following a positive response from the field, the team added functionalities and capacity to transform the prototype into a fully functional system based on four basic principles: (1) development is guided by the expressed needs of consumers and other stakeholders; (2) security and privacy are ensured because users retain control over their own data; (3) user-friendly tools are in the public domain; and (4) the architecture is modular and expandable.

Stakeholder-driven Development

Throughout the development of DS2000+ Online, consumers, family members, and other stakeholders—public mental health agencies, providers, managed behavioral health care organizations, behavioral health software vendors—shaped the overall design of the system and the content of its modules by participating in focus groups, work groups, and expert panels and by responding to numerous requests for feedback. As a result, DS2000+ Online is easy to navigate and its modules serve the needs of a wide and diverse user community.

Security and Privacy

DS2000+ Online is a secure distributed network through which users control, analyze, and report their own data and design and manage their own operations within the site. As figure 7.1 shows, data remain “outside” the system and beyond its “control.” Those who “own” the data choose whether to provide any of their data and whether to provide an entire data set or an extract. To protect privacy, data owners remove identifiers before providing data and assign any new identifiers that might be required; they keep the “keys” to identifying their own data. Data are transformed according to Simple Object Access Protocol (SOAP) and Extensible Markup Language (XML) standards, loaded into analytic databases with customized online analytic processing (OLAP), ready for analysis and reporting in various formats.

User-friendly Tools

DS2000+ Online has a number of generic tools. They are listed in table 7.1 and include a Web page builder with a document upload tool and text editor; extraction, transformation, and loading (ETL) software; a survey builder with survey-specific databases and automatic scoring; database-specific OLAP; report builder; and a database mapper. These tools can be used for a wide variety of purposes as summarized in table 7.2 and described in detail in the descriptions of the DS2000+ Online modules.

Architecture Is Modular and Expandable

DS2000+ Online has a modular and expandable framework that begins with a stable, basic platform and allows rapid addition of new components at users’ request; expansion of capacity as user interest and participation increases; and prototyping, piloting, and refinement of components without disruption of the basic system. Taken together, the modules listed in table 7.2 will help users understand the mental health care service system and evaluate its performance; measure outcomes to improve individual care and recovery and contribute to the evidence base for determining best practices; record and access health and personal data through standardized, uniform, and distributed processes; find and give feedback on local services; share information across and among clinical and administrative systems; and disseminate information. In the following section, we describe selected modules that are in operation or development.

DS2000+ Modules

This section describes in detail selected modules.

The presentation of modules is organized by the general purpose they serve. Modules were selected to demonstrate particular characteristics of the DS2000+ Initiative and DS2000+ Online:

• Anticipating field needs: the MHSIP-DS2000+ Consumer Survey module created to help consumers voice their concerns about mental health services and help States report URS data in fulfillment of their data infrastructure grant responsibilities;


• Responding to users’ requests: the Federal EAP and NACBHD surveys developed in response to requests by these programs to survey their constituencies and improve their services;


• Meeting government mandates: The CPSS, designed to provide more complete, reliable, and continuous data collection than possible with traditional paper surveys;


• Facilitating quality improvement: The consumer outcomes and the system performance measurement and reporting modules intended to make widely and economically available instruments that will produce uniform and comparable data on treatment outcomes and system performance;


• Supporting mental health service delivery: The modules for recording health and personal data, finding local services, and managing clinical and administrative communication fashioned to support providers, consumers, family members, and administrators in their efforts to improve the quality of care;


• Supporting the field’s need to know: The document and data library structured to help users find the information they need quickly and accurately;


• Piloting new technologies and procedures: The NJAMHA pilot study to test software and processes needed by a distributed network of agencies to share de-identified data from claims and other administrative databases.

MHSIP-DS2000+
Consumer Survey Module

Purpose

• Improve ease, response rate, and cost-effectiveness of MHSIP consumer surveys


• Enhance utility and value of MHSIP consumer survey data



Tools

• Web page builder


• Survey builder (with database and scoring software)


• Data upload tool


• Online analytical processing


• Report builder


• Permission granting tool



Products

• Web-based MHSIP consumer surveys for direct online entry by adults, youth, and families


• Web-based MHSIP consumer surveys for data entry by staff from paper surveys


• Database for storing MHSIP consumer survey data entered by respondents, data entry staff or uploaded in aggregate format


• Automatic scoring to produce domain and item scores


• System-generated benchmarks and data tables


• User-generated ad hoc analyses and data tables


• Fixed data tables from system and/or users

A Module for Consumer Assessment
of Care and State Reporting

MHSIP-DS2000+ Consumer Survey Module

With the Idaho Department of Health and Welfare (IDHW), the DS2000+ team built and pilot tested the MHSIP-DS2000+ Consumer Survey Module. This module provides tools for administrators to set up and manage survey processes for their State or organization; respondents to complete the adult, youth, or child and family surveys online; staff to enter data from surveys completed on paper; and users to see item and domain scores for an individual or a group and to compare them to appropriate benchmarks (see figure 7.2).

The DS2000+ team used the survey builder tool to construct the basic online questionnaires (see figure 7.3) as well as the database and scoring procedures; the IDHW staff then used it to customize the surveys by adding questions of local interest (see figure 7.4).

IDHW also used the Web page builder to host the surveys on an Idaho-specific site and create a private area where administrators could assign permissions to their staff to perform various functions (e.g., enter data, change the survey) or access certain information (e.g., anonymous raw data, item and domain scores, summary reports).

When consumers took a survey online or staff entered data from paper surveys, responses were immediately encoded in a database, scored, and available for viewing as item and domain scores for each individual or aggregated across many individuals.

Individual scores could be compared to previously established benchmarks for respondents with similar characteristics (e.g., demographics, diagnoses, treatment, location, service site), and aggregated data could be sorted by the same characteristics to produce a wide range of reports.

The IDHW-DS2000+ pilot study had two goals: first, to test the DS2000+ survey, scoring, report building, and OLAP tools; second, to evaluate the capacity of IDHW staff, local providers, and consumers to use the survey module. IDHW set up computers in three private provider organizations, which, in turn, invited consumers to complete online surveys when they came for their appointments. IDHW trained a consumer advocate to provide technical assistance to consumers. The study showed that the survey, scoring, OLAP, and reporting tools worked well and that having consumers complete the surveys online reduced the burden and cost of data entry and analysis. IDHW also learned that access to the scoring software and a database made it cost-effective to use the module to enter data from paper surveys.

The pilot demonstrated the logistical challenges associated with providing Internet access in clinical settings and the technical challenges involved in tracking survey completion while maintaining privacy. Methodological challenges, such as sampling strategies, respondent tracking, and service site identification, exist whether the surveys are administered on paper or online.

Three Modules for Describing and Evaluating the Mental Health Care System

Client/Patient Sample Survey Module

CMHS’s CPSS produces national estimates on treatment satisfaction and outcomes for adult consumers who receive services in specialty mental health outpatient programs (State and county mental hospitals, private psychiatric hospitals, non-Federal general hospitals, VA medical centers, multiservice mental health organizations, and freestanding outpatient clinics and partial care organizations). The DS2000+ and CPSS project teams worked closely together to create a module that could host the survey through the DS2000+ portal and provide a seamless interface with all other CPSS operations.

Federal Employee Assistance Programs Module

This module was developed at the request of SAMHSA/CMHS to collect data from administrators and counselors of Federal EAPs and users of EAP services to guide efforts to improve program management and quality of care. The administrator survey will address utilization by Federal employees and their families of individual services, support groups, workshops, and educational programs; extent of information seeking and participation in online services; proportion of mental health and alcohol/drug problems; percentage of referrals by supervisors compared to percentage of self-referrals; and demographic characteristics of service users compared to eligible beneficiaries.

The data will be reported at the system level (the Federal Government), department level (Health and Human Services), and division level (SAMHSA). Both administrators and service users will be able to compare their own department’s data to the system-level data that includes all departments, although individual departments will not be identified. Similarly, they will be able to view division-level data within the departments—again, with the identity of the division protected.

Federal Employee Assistance Programs Module

Purpose

• Determine the organizational characteristics, types of services, and utilization of Federal EAPs


• Evaluate satisfaction among users of EAP services

Tools

• Web page builder


• Survey builder (with database and scoring software)


• Data upload tool


• Online analytical processing


• Report builder


• Permission granting tool

Products

• Web-based surveys for direct online entry by EAP administrators and service users


• Web-based surveys for data entry by staff from paper surveys completed by EAP administrators and service users


• Database for storing survey data entered by respondents or data entry staff


• Automatic scoring


• System-generated benchmarks and data tables


• User-generated ad hoc analyses and data tables


• Fixed data tables from system and/or users

NACBHD Module

NACBHD has begun to use the DS2000+ survey-building and reporting tools to periodically canvass county commissioners and executive directors of county or local government sponsorship authorities. The survey will define the network of government entities overseeing, managing, and financing behavioral health and developmental disability services; characterize the services provided; and map these services, resources, and expenditures of county communities to the populations served. Currently, no national picture captures delivery of county or local government-sponsored behavioral health and developmental disability service. With data produced by this survey, NACBHD will be able to supplement Federal and State data to create a more complete understanding of the current system of care.

NACBHD Module

Purpose

• Define the network of entities delivering behavioral health and developmental disabilities services at the county and local levels


• Describe the services, and the county resources and expenditures for these services


• Supplement State-level and national surveys to provide a national picture of county behavioral health care delivery to help Federal and State governments target resources to counties



Tools

• Web page builder


• Survey builder (with database and scoring software)


• Data upload tool


• Online analytical processing


• Report builder


• Permission granting tool



Products

• Web-based survey for county commissioners and executive directors of county or local government sponsorship authorities


• Database for storing survey data


• System-generated benchmarks and data tables


• User-generated ad hoc analyses and data tables


• Fixed data tables from system and/or users

Modules for Measuring Consumer Outcomes and System Performance

Outcomes Measurement and Reporting Module

Development of the Outcomes Measurement and Reporting Module is guided by an Oversight Group consisting of representatives of organizations with experience and interest in outcomes measurement and reporting, with a small steering committee of experts. The module will consist of recovery-oriented questionnaires and rating scales completed by consumers and clinicians at specified points in time to determine current status and change over time associated with treatment and other interventions. The module will reflect and can be used to collect data on SAMHSA’s National Outcome Measurement (NOM) system. The core set of measures can be supplemented to address the assessment needs of particular groups. With built-in scoring programs, individual scores, comparison with benchmarks, and comparison with previous scores will be available immediately to users.

Outcomes Measurement
and Reporting Module

Purpose

• Build, test, and implement a recovery-oriented outcomes measurement and reporting module


• Analyze person-level and aggregated data to determine outcomes associated with treatment interventions and consumer characteristics



Tools

• Web page builder


• Survey builder (with database and scoring software)


• Online analytical processing


• Report builder


• Permission granting tool



Products

• Outcome measurement and reporting software


• Database for storing outcomes data


• System-generated benchmarks and data tables


• User-generated ad hoc analyses and data tables


• Fixed data tables from system and/or users

Stakeholder work groups recommended the content (i.e., domains and data elements) of the measurement system, and a technical expert work group advised on methodology, instruments, and technological approaches. Both groups offered suggestions for implementation.

The domains shown in table 7.3 as well as the data elements and instruments to measure them are under consideration for inclusion in the module. Following psychometric refinement and field testing of ROSI and RMT, these instruments along with others will be piloted in several States to evaluate consumer and clinician responses to measuring outcomes, the feasibility of incorporating outcome measurement into customary clinical practices, and the technological features of the module. It is anticipated that the final module will allow users to add instruments of their own choosing. Reports will show current status and change over time in both item and summary scores. Basic demographic and treatment data will be collected to allow for analysis of independent and dependent variables.

Modules to Support
Mental Health Service Delivery

Electronic Health and Personal Record

There is a plethora of EHR systems, ranging from simple software that enables one practitioner to record limited clinical data, perhaps with some scheduling and billing capability, to comprehensive systems that serve large numbers of providers distributed over many different clinical and administrative settings. EHRs may be text-or image-based and may or may not provide processable data to assist decision-making and guide improvements in the processes of care.

EHRs typically contain the following kinds of information: identification numbers (e.g., medical record number, social security number); personal information (e.g., name, address, demographic characteristics, emergency contact information); health insurance and billing information; historical data (medical/surgical history, family history, social history, past treatments and procedures); current clinical data (dates of and reasons for visits/admissions, problem lists, clinic and operative/procedure notes, hospital summaries, laboratory tests, radiological and other procedure results, medications, allergies, immunizations); clinical management tools (reminders and alerts, computerized order entry and prescribing, clinical practice guidelines); provider identification and contact information; and treatment plans and instructions. EHRs may also have correspondence, instructions concerning and an audit log of access, advance directives, and other legal documents (NCVHS, 2000; President’s New Freedom Commission on Behavioral Health, 2003).

However, there are additional special requirements for behavioral health records based on the unique needs of mental health consumers and their families. For example, a behavioral health electronic record should include information about functioning and recovery and accommodate data sharing across various provider types (e.g., health and behavioral health professionals, peer providers, and staff of programs in allied fields), service settings (e.g., outpatient or inpatient, partial hospital, residential, peer-run, home), and health care delivery systems (e.g., general health care, corrections, housing, child welfare, education). Furthermore, behavioral health care requires a multifaceted record that incorporates not only the standard data collected in the general health care system but also the personal, functional, social, and interpersonal data critical to comprehensive, coordinated, long-term care. Access to and sharing data must also be determined by the role of the user to ensure appropriate levels of security and confidentiality.

In addition, a behavioral health record should have tools for mental health assessment that are both generic and condition-specific and that can be used to record a consumer’s status at the beginning, middle, and end of treatment. These tools should fit seamlessly into providers’ and consumers’ customary activities and automatically generate information on how the consumer has changed over time. Other tools should help providers and consumers develop, monitor, and modify treatment plans; access evidence-based practices; and measure fidelity of treatment to these standards. Finally, since a behavioral health record is a personal as well as a medical record, it should be accessible to consumers and those to whom they permit access and include personal progress logs and other consumer-maintained trend monitoring tools as well as a clearly defined permissioning system.

As with other modules, the DS2000+ team is collaborating with initiatives that have already faced many of the functional and technology challenges of a distributed intra-organizational health care system to define the standards and specifications for a behavioral health and personal record.

Tools for Managing Clinical and Administrative Communication and Navigating and Evaluating Local Services

High-quality care requires effective communication between and among clinicians and administrators. Tools developed for other modules, such as the ETL, document and data upload and download tools, and permissioning mechanisms will be adapted to streamline data sharing in clinical and managerial settings. Quality care also depends on easy access to appropriate services in the community. Existing technology will be tailored to the needs of consumers, family members, and providers to identify local services and make decisions based on feedback provided by their peers.

Modules for Enhancing
Communication and Sharing Data

ETL for transfer of encounter data:
A Pilot Study of the Distributed System
with the New Jersey Association of
Mental Health Agencies

A partnership consisting of the NJAMHA, individual provider agencies, behavioral health software vendors, and the DS2000+ team is pilot testing the ETL device that lies at the heart of the DS2000+ Online distributed system (see figure 7.1). The ETL software will be installed on the agencies’ computer systems and transfer to DS2000+ Online anonymous data in selected fields from the agencies’ HIPAA Health Care Claim: Professional Transactions (837) for Medicaid beneficiaries. Agencies that do not submit HIPAA-formatted electronic claims will submit data collected on Health Care Finance Administration (HCFA) 1500 claim forms. The agencies will provide additional race and ethnicity data not available through either claim format.

The data will be stored in an analytic database that can also be populated by uploads of de‑identified aggregated data. The data will be used to determine the number of people served by the agency over a specified period of time, their demographic characteristics and diagnoses, the services provided, and the types of clinicians providing services. Comparisons across agencies and within an agency over time will be made to address issues of access, appropriateness, and quality of care.

NJAMHA Data Transfer
Pilot Study

Purpose

• Test the extraction, transformation, and loading device to transfer data routinely from local providers to DS2000+ Online


• Transfer administrative data and use them to determine key characteristics of service provision by NJAMHA providers



Tools

• Web page builder


• ETL software


• Online analytical processing


• Report builder


• Products


• ETL


• Database for HIPAA health care claim: professional transactions (837)

State Uniform Reporting System Data Sharing Project

States with CMHS Data Infrastructure Grants (DIGs) are required to submit data annually as specified in the URS. Data are received, cleaned, analyzed, and reported by the DIG Coordinating Center. States in the northeast region asked CMHS for permission to share data among themselves to define analyses, benchmarking procedures, and sharing rules. The DS2000+ team created a module for the private use of these States, and data were transferred from the Coordinating Center. Once feedback is received from these States, the module will be finalized and made available to others who wish to share data.

Modules for Disseminating
Information

Document and Data Library Modules and Links to Relevant Web Sites

Through the Document and Data Library Modules and links to many relevant Web sites, DS2000+ Online offers users easy access to the information they need to remain up-to-date and make critical decisions. The Document Library stores articles and reports on the DS2000+ Initiative, its components, and on topics of more general interest to the field (see figure 7.5). Documents can be downloaded as Portable Document Format (PDF) files, printed, or e-mailed.

The links to relevant Web sites are continually expanded to give users a growing body of information. The links are shown in figure 7.6; the last link is to a Web site that provides numerous fixed data tables on Medicare, Medicaid, and private insurance information. The Web site is configured to look like DS2000+, although it is housed on another organization’s server (see figure 7.7).

User-Designed and Operated Pages: The Adolescent Wellness Portal

The Adolescent Wellness Portal (see figure 7.8) was created to help schools and parents find resources related to adolescent mental health and wellness: a guide for parents when a child is referred for psychiatric hospitalization; a starter kit  for school leaders to implement a preventive mental health program for students in grades 7 through 12. The Adolescent Wellness Program is a collaborative effort of Children’s Hospital and McLean Hospital in Boston, and the Sidney A. Swensrud Foundation. The module was developed and is maintained entirely by a consumer and family advocate volunteer using DS2000+ tools and minimal technical assistance from the DS2000+ team.

The Adolescent Wellness Portal

Purpose

• Facilitate communication and information sharing


• Work group builds its own private, secure Web page for posting, downloading, reviewing, and revising documents



Tools

• Web page builder



Products

• Customized private Web pages

Conclusion

By empowering consumers and family members, working closely with other stakeholders, using and disseminating DS2000+ data standards, and collaborating with allied fields, DS2000+ Online provides comprehensive, accurate, and accessible information to assist decision-making for clinical, administrative, and policy purposes.

References

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