Implementation of Behavioural and Medical Health Management Applications: Reducing High Intensity Medicaid Services Utilization for Individuals with Serious Mental Illness

Provider supporting, dynamic, self-service applications may deliver actionable information to support care management, quality of care, best practices, value based purchasing, and cost control for persons with Serious Mental Illness (SMI). Health analytics as a self-service (AaaS) can be provisioned in a streamlined way in LAN/WAN and cloud environments. These platforms can support Health Level 7, Version 3 (HL7 V3) CDA (Clinical Document Architecture) implementation guides and FHIR (Fast Health Interoperability Resources) for clinical documentation, messaging, and interoperability. Specifically, these can be implemented with Apache Spark® and Hadoop®, Google BigQuery®, Amazon Cloud MapReduce®, Microsoft SQL Server® with Azure®, IBM DB2® with Websphere®, Oracle RMDBS® with Cloud Applications/Platform Services, and many other platforms. Availability, functionality, and usability of such systems are critical for chronic care management for clients with SMI and chronic comorbid medical conditions. An application suite to improve behavioural and medical services was deployed in the community services division of South Beach Psychiatric Center (SBPC), a large state-run facility in New York, USA. As an exemplar of application effectiveness analysis, the association between the use of a Medicaid utilization application and changes in the use of two high intensity Medicaid-paid medical services, inpatient hospitalization and emergency room services, by a balanced panel of 416 patients, over a five-year period, was evaluated.

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