Successes & Projects


Electronic Health Records (EHR) Project


Signal Provider Performance Monitoring System (PPMS) Project
SWS Re-investment Funds
NIATx recognizes Signal's QI award

Signal’s Electronic Health Records (EHR) Project

In an effort to help its network of Substance Use Disorder (SUD) Providers meet the ever changing requirements of Health Care Reform, in 2009 Signal began a long term project to bring affordable Electronic Health Record (EHR) technology to its network. The project aimed to initially use Signal’s vast network of providers to create a ‘consortium’ of SUD providers thereby leveraging a larger user base to bring down the cost of a fully functional EHR system.

After intense research into EHR Vendors and in consultation with two of Signal’s network providers, an RFP process chose Qualifacts as the vendor to bring such a solution to Signal’s network.

In the summer of 2011, implementation of Qualifacts’ CareLogic EHR system began for two of Signal’s providers: Addiction Research and Treatment Services (ARTS) and Crossroads’ Turning Points (CTP).

ARTS and CTP represent the first two providers in Signal’s network to join the consortium. Other providers will be added over time to allow the consortium to benefit from a lower cost-per-user model while simultaneously allowing smaller providers to afford a fully-functional EHR system.

Signal’s role is to serve as overall manager of the consortium as well as providing implementation oversight and Information Technology expertise.

Signal is excited to be partnering with Qualifacts, a leading vendor in behavioral health EHR software using the Software as a Service delivery model, and equally excited to be able to offer this service to its network of providers. As Health Care Reform continues to evolve one thing is certain: the ability to share data amongst providers, payers, and the health care system as a whole will become paramount. With this project, Signal hopes to help those providers who otherwise could not afford a robust, meaningful-use-compliant EHR system, the availability of state of the art technology to continue their vital work of treating those with substance use disorders.

Signal Provider Performance Monitoring System (PPMS) Project

In 2007, the Joint Budget Committee, on a 6-0 vote, approved funding for Signal to develop performance-based contracting requirements as well as the software necessary to support a fundamental change in the way the substance abuse treatment services are reimbursed.

It is generally acknowledged that reduced recidivism translates into concrete cost savings, given that the cost of a prison bed approximates $27,000 annually.

The PPMS vision is that addiction treatment providers can be incentivized to adopt more effective practices, which will translate to more positive client outcomes and ultimately reduce costs.

The primary goal is the creation of a provider contracting structure in which financial incentives for successful client outcomes are an integral component of provider reimbursement. Providers would then be reimbursed for quality services producing positive client change rather than reimbursed only for service delivery. A secondary goal of PPMS is to demonstrate that providers are able to improve the quality of services by combining performance feedback and the process improvement approaches developed by the Network for the Improvement of Addiction Treatment.

The initial phases of the project included three areas. The first was a Detox Continuation Project in which three detoxification facilities participated in an active process improvement change process. Providers, with assistance from Signal, used rapid cycle Plan, Do, Study, Act (PDSA) cycles to change agency procedures and improve the rates at which clients moved from detox into treatment.

Another phase consisted of a Strategies for Self-Improvement and Change [SSC] continuation project which focused on an increase in retention rates for offenders enrolled in SSC. Crossroads’ Turning Points (CTP) was selected for this change project because its retention rates were lower than other Signal providers who offer SSC. The average provider retention rate for the baseline period was 62%; the CTP retention rate for this same period was only 53%. Following the change project, CTP increased retention by 15 percentage points to 68%, a change that was sustained for the following two quarters.

The third phase was a study to determine recidivism rates among clients who have completed the SSC program.

Following these three phases, Signal developed a customized software system (Signal Beacon Software System) which allows Signal to better capture data from its network of providers, monitor performance across various levels, measure that performance against incentives both at the statewide and regional levels as well as at a provider level, and ultimately change reimbursement towards quality of services rather than simply for service delivery.

Additionally, the Beacon software was developed with enhanced reporting capabilities to allow Signal, as well as providers, to more readily analyze data in real time.

Beacon also allows Signal enhanced data communication capabilities with the State of Colorado in providing up-to-the-minute data on provider performance across a variety of measures.

The Beacon system was fully implemented in September 2009. The following graphic shows some of the incentive measure improvement following the implementation of PPMS.

Outpatient Continuation over the lifetime of the program.

SWS Reinvestment Fund

Signal supports the tremondous efforts of our provider network to provide excellent services to vulnerable populations. Towards these efforts, Signal reinvested $19,500 to providers who demonstrate inovation and commitment to serving women.

NIATx recognizes Signal's QI award

You can view the full article here on NIATx's website.