The Psychiatric Services
and Clinical Knowledge
Enhancement System
(PSYCKES)
Molly Finnerty, MD
Director, OMH Bureau of Evidence Based
Services and Implementation Sciences
Fall 2011
Overview
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Introduction to PSYCKES
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Using PSYCKES
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QI Reports
Clinical Summary
Data access & the Consent Module
Next Steps
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PSYCKES Access
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Technical Assistance
What is PSYCKES?
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Secure, HIPAA-compliant portfolio of Web tools
PSYCKES – State hospitals (2003)
 PSYCKES – Medicaid (2008)
 MyPSYCKES for consumers (2010)
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Developed by OMH to support quality
improvement and clinical decision-making
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Calculates performance on quality indicators at
state/regional/agency/site levels
Provides treatment history across settings over time
MyPSYCKES allows consumers to enter data on treatment
process, outcomes and goals
Client Records Accessible in
PSYCKES-Medicaid
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NYS Medicaid enrollees
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Behavioral health population, i.e., at least one of
the following:
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Fee-for-service claims
Managed care encounter data
Dual-eligible (Medicare/Medicaid): includes Medicaid
data only
Mental health or SUD service
Mental health or SUD diagnosis
Psychotropic medication
Currently over 2.5 million individuals
Data Available in PSYCKES
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All Medicaid-reimbursable services for which a
claim was submitted, across treatment settings
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Behavioral health (outpatient and inpatient)
Pharmacy (psychotropic and medical)
Medical (services, lab tests, and procedures)
Living supports (if Medicaid-billable)
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Up to 5 years of data
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Currently does not include data from Medicare
or private insurance
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For dual-eligible clients (Medicare and Medicaid),
includes services but not pharmacy
PSYCKES Implementation
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State hospitals (2003): 27 hospitals
Mental health clinics (2008): 340 clinics
NYC Hospital affiliated clinics (2010): 25 clinics/
CDTs
LGU pilot (2010): NYC, Erie
ACT Transitions Project (2010): 27 teams
MyPSYCKES pilot (2010): 2 clinics
ER pilot (2011): 4 ERs
Access for OMH and OASAS licensed hospitals
and detox programs (2011)
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Support goals of Phase I – Learning to use data
6
USING PSYCKES
PSYCKES Homepage
(www.psyckes.org)
Logging in to PSYCKES
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From PSYCKES Homepage, click “Log into
PSYCKES
At Login Page, enter:
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User ID (first box)
Password + token code (2nd box)
Your PSYCKES Homepage:
QI Overview Screen
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Hospital/ ER related measures
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High utilization (4+/yr): BH, Medical, any cause
Readmission: 7 days, 30 days
Preventable admissions: Diabetes, Dehydration, Asthma
High need ineffectively engaged
Medication related indicator sets
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Psychotropic polypharmacy (by class and over all)
Dose (by class of psychotropic)
Cardiometabolic (high/moderate risk AP +
cardiometabolic condition)
Youth (“too many, too much, too young”)
QI Overview Screen:
Performance on measures with regional & state comparators
Drill Down on Indicator Set (e.g. 4+
Inpt/ER)
to Individual Measures (e.g. BH,
Medical, All)
Quality Indicators Link to List of
Flagged Clients
Recipient Search:
Find an individual (search by name, ID)
Find a cohort (search by demographics, diagnoses,
physician, medication or services received, MCO, or QI flag)
Search Results
Click on Recipient Name >> Clinical Summary
Mapping
Clinical Summary
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Header
Integrated view of all services (graph and table)
Service Summary Tables by category
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Medications: BH, medical
Outpatient services: BH, medical
Inpatient/ER services
Dental and Vision
Living Support
Lab/ Xray
Transportation
Summary Table links to individual claims/encounters
(“See All Data”)
Can print or save as PDF or excel
Clinical Summary Header:
Report date, level of access, select time frame,
Name, DOB, Age, MCO, Quality Flags, Diagnoses
Clinical Summary:
Integrated View of All Services
Graph allows for rapid identification of utilization patterns,
including medication adherence, outpatient and inpatient services.
Zoom on Period of Interest
Hovering the cursor over an individual record will show
date and place of service.
Integrated View as Table
Medications: Psychotropics
Drug, dose, duration, start date, last pick up, prescriber
Pharmacy Data: Medical
Drug, dose, duration, start date, last pick up,
prescriber
Drill Down from Medication
Trials to Individual Prescriptions:
Dose, Quantity, Tabs/day, Days supply, Route,
Prescriber, Pharmacy
Outpatient BH Services
Summary:
Type of service, Provider, Date of First and Last,
# of visits, Diagnosis, Procedures, Practitioner,
“See all Data” > Links to each invoice/claim
Outpatient Medical Services
Type of service, Provider, Date of First and Last,
# of visits, Diagnosis, Procedures, Practitioner,
“See all Data” > Links to each invoice/claim
Inpatient and ER Services
Service Type (ER or Inpt, BH or Medical), Hospital Name,
Date of First and Last ER/Inpatient Admission,
# of Admits, Last Diagnosis, Procedures,
“See all Data” > Links to each invoice/claim
Labs, Dental & Vision, Living
Support
Export Data to PDF or Excel
All reports, all screens can be exported to PDF or excel
Benefits & Uses of PSYCKES
Data: Clinical
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Evaluation and treatment planning
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Medication reconciliation
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Coordination of care across clinical settings
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Assess medication compliance
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Identify utilization patterns (high use, readmission)
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Discharge planning
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Timely – weekly updates
Benefits & Uses of PSYCKES
Data: Quality Improvement
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Performance on measures – can select comparators
Transparency – all stakeholders see the same
information
Meaningful and Actionable Data - link to individual
clients
Flexible – an expanding array of quality measures,
and capacity to search for cohorts of interest
Timely - updated monthly
Limitations of PSYCKES Data
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Accuracy dependent on coding and billing
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Data elements limited to what is shown on claims
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Time lag between services and billing is variable
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e.g. See labs/ x-rays but without results
Service data may lag by weeks or months
Client data affected by changes in eligibility,
moves, hospitalizations (bundled services).
Accessing Client Data:
PSYCKES CONSENT MODULE
Which Clients Can Be Accessed
Through PSYCKES?
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Two ways clients are “assigned” to you:
Automatically: Clients you billed in the past 9
months
 Manually: through the Consent Module
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Clients you consent
 Clients you attest you are serving in a clinical emergency
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Who is available for consent?
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All Medicaid enrollees in the NYS BH population
MH or SUD diagnosis or service
 Psychotropic medication
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Client Level Data Access
Context
Quality Flag
Clinical
Emergency
Consent
(PSYCKES,
RHIO)
Data includes
Duration
SUD, HIV, Family
Planning?
No
As long as flag is
active; up to 9
months after last
service
Yes
72 hours
Yes
3 years after last
service
What is an Emergency?
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Can occur in any setting
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New York State Public Health Law Section 4900.3
"Emergency condition" means a medical or behavioral condition,
the onset of which is sudden, that manifests itself by symptoms of
sufficient severity, including severe pain, that a prudent
layperson, possessing an average knowledge of medicine and
health, could reasonably expect the absence of immediate
medical attention to result in (a) placing the health of the person
afflicted with such condition in serious jeopardy, or in the case of
a behavioral condition placing the health of such person or others
in serious jeopardy; (b) serious impairment to such person's
bodily functions; (c) serious dysfunction of any bodily organ or
part of such person; or (d) serious disfigurement of such person.
Consent Process in
Hospital Workflow
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Hospital staff obtain written consent from clients
OR determine that it is a clinical emergency.
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PSYCKES consent
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RHIO consent (if Medicaid data used/ addressed)
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Clinical emergency
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Registrar uses Consent Module in PSYCKES to
attest to rationale for access to client data (consent
or emergency).
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Any PSYCKES user at the hospital can then
access client data.
Registrar Menu
 Consent Module is accessed through
the
Registrar Menu in PSYCKES.
 Registrar Menu tab only appears if the user has
been granted PSYCKES-Registrar access.
 Clicking “Registrar Menu” tab opens a new row of
tabs.
Consent Forms Menu
PSYCKES Consent Forms available in English and
Spanish.
Using the Consent Module
From Registrar menu, go to Medicaid Consent
Menu and click on “Grant Consent”
Step1: Find the Client
Enter client’s Medicaid ID number, and click “search.”
AA19 386GAA
Confirm Search Results
Correct name, age, gender, address?
AA19 386G
Mouse Minnie
7 Goofy Lane
Warnerville
NY
13456
05/15/1969
42
F
05/15/1969
42
F
Step 2: Attest to Right to Access Data
consent or clinical emergency
Step 3: Confirm Client Identification
Select forms of ID from drop-down list, or if known to setting
can attest to identity without ID
Submit then Quit or
Go to Clinical Summary
Search for Consented Recipients
Once a client is consented, any hospital staff with
PSYCKES access can view the client’s clinical data.
Steps for Setting up PSYCKES
Access for Hospitals/ Detox
Programs
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Complete PSYCKES Access Packet (emailed to Hospital CEO)
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Contact Sheet
Data Sharing Agreement (Note: GNYHA/PSYCKES Quality Collaborative
participants have completed already)
CNDA - Confidentiality and Non-Disclosure Agreement (Note: agencies
participating on OMH PCS have completed already)
CEO assigns local Security Managers
Security Managers use on-line Security Management System
(SMS) to enroll PSYCKES users and registrars
OMH sends tokens to Security Manager
Security Manager activates tokens and gives to staff
Training and Technical
Assistance
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Webinars beginning in November
On Access to PSYCKES
 On Using PSYCKES PSYCKES website
materials
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www.PSYCKES.org
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Users’ Guide, recorded Webinars, FAQs
Helpdesk assistance via
PSYCKES-help@omh.ny.gov
Next Steps
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PSYCKES Access Packet will be sent
out to all OMH or OASAS licensed
inpatient or detox programs (Nov 2011)
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Training Webinars (Nov 2011-April 2012)
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Questions
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www.psyckes.org
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PSYCKES-help@omh.ny.gov