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I-Smart - Project Plan

Current factors influencing health care in general (HIPAA) and substance abuse treatment in particular (PPG's, GPRA) require entities to re-examine and in most cases re-design technology used for collecting and managing administrative and clinical information about clients and services.

The Iowa Service Management and Reporting Tool (I-SMART) project applies new technologies using the Internet to help solve these problems while creating a collaborative process to improve services.

The I-SMART system utilizes hardware (web servers, database servers, communication equipment, etc) that will be upgraded centrally at the Iowa Department of Public Health for all users.

System administration, which includes code table updates, user access management and general maintenance on the application, is done centrally thus standardizing administrative data content.

The web services infrastructure was created to meet HIPAA and other transaction processing and security requirements.

The application modules allow states and the providers they support to perform role-specific functions such as managing contracts, documenting client services, and being paid for services. A key to the design is that practitioners (clinicians) and other provider staff can input relevant data into a centrally hosted database using just a browser and an Internet connection.

Some of the advantages of a centrally hosted, integrated, web-accessed system that does not reside on a provider's network are:

  • Capturing data as it is created
  • Minimizing the burden for that data creation
  • Single entry of data
  • No need to hire an Information Technology person
  • Access to technical support on the state level
  • Minimal equipment needs for providers
  • Improving the quality and availability of data for all parties
  • Promoting best practice on a much wider basis than is generally possible with non-integrated systems
  • Improved clinical practice

There are benefits for all providers in such a web-based system:

  • Practitioners: less burden, more help and support functions, better access to client data
  • Providers: less burden reporting to the state and less cost in complying with HIPAA and other state reports, better business management

Because of its flexibility, the future of I-SMART will ultimately rest in the hands of the State and its providers that implement and use it. I-SMART is designed to include a repository of infrastructure and application module enhancements that can be shared with other system users on terms specified by the creators. Therefore, the I-SMART project could, in fact, be easily adapted for other providers such as mental health and/or gambling.

Providers will be required to utilize the modules that capture the administrative and Iowa Reporting data, but they can choose to use or not use all other modules. Some of the modules are:

  • Intake
  • Assessment
  • Treatment Planning
  • Progress Notes

I-SMART Planning Structure

IDPH utilized administrative and clinical staff from Substance Abuse Services Center in Dubuque and Center for Family Resources as its first test pilots to assist in customizing the basic system for Iowa. In the process, IDPH took into account lessons learned from the TOPPS II assessment project (utilized by 8 Iowa agencies) and the need for the system to be workable with Iowa's required use of the ASAM Patient Placement Criteria.

In December 2004, additional pilots were introduced: United Community Services, Bernie Lorenz, ZION and Area Substance Abuse Council.

  • Our implementation plan is composed of several stages that will begin allowing all interested providers to use the entire I-SMART clinical system.
  • The second stage will then add on those providers who only plan on doing web-based Iowa reporting.
  • The final stage will consist of adding on those providers who have existing clinical systems and only need to do an electronic data transmission. Our goal is to have all providers on the I-SMART system by January 1, 2007.