CCA tracks clients for Texas Departmentof Mental Health and Mental Retardation

The Texas Department of Mental Health and Mental Retardation (TDMHMR), headquartered in Austin, Texas, is a state agency that runs over 20 inpatient facilities for the mentally ill and the mentally retarded. TDMHMR also has contractual arrangements with over 50 outpatient programs state-wide, directly overseeing 10 such programs.All of the agency's mental health professionals and administrators access vital patient continuity-of-care records, Medicaid reimbursement, and high-level diagnostic information which is stored and tracked on TDMHMR's computer systems. The systems also store employee and personnel information including salary and vacation time. These systems are completely integrated and support more than 250 concurrent users daily. Model 204, a high performance, high capacity database management system from Computer Corporation of America (CCA) is the heart and soul of these complex systems.

Historically, the majority of Texas' mental health clients were cared for as full-time patients at hospital facilities across the state. During the late 1960s and throughout the 1970s, mental healthcare institutions in the United States began a process known as "de-institutionalization," which shifted the vast majority of clients from inpatient to outpatient care. The shift was designed to reduce the high cost of inpatient care while maintaining the best supervision possible for clients on an outpatient basis.

TDMHMR needed to develop a system to store and track all the information required to serve both inpatient and outpatient clients across the state. Tracking and recording accurate histories of mentally ill and retarded clients proved to be a particularly daunting task. The clients often moved without notifying anyone, and many provided false information which resulted in incorrect histories and duplicate client records. As client numbers grew and the complexity of information required to provide care increased, TDMHMR needed a new high performance, high capacity database management system that could manage the vast amounts of client and administrative information. They also required flexible indexing and search parameters so that duplicate records could be identified, even if they weren't identical matches. TDMHMR found all those capabilities in Model 204.

The agency chose Model 204 after an extensive evaluation of five other database management systems. CCA and Model 204 provide TDMHMR with an open, flexible information management solution that has enabled the organization to successfully track thousands of clients.

"We need a database system that provides both the flexibility and performance to accommodate constant changes to client records," states Julie Bonner, senior programmer for TDMHMR. "Model 204 data structures are easily changed and many database attributes can be modified in-flight which makes it easy to update and change systems and applications without having to reconfigure the entire database. In addition, the native User Language supplied with Model 204 has increased programmer productivity multifold over the old 3GL language we used to use. Using Model 204, tasks that used to take months are now completed in weeks, days and sometimes even hours."

Model 204 maintains a high level tracking system with sufficient data to report on work loads and manage contracts across the agency's many operations. Model 204 also manages all state personnel, inpatient and client information systems. In total, the system tracks approximately 1 million patient records and stores over 30 million total records, with an average response time of less than 1 second per transaction. It also uploads 25 million Medicaid eligibility records weekly. Model 204 simplifies administrative processes and provides TDMHMR with the capability to keep costs down and service standards high.

"Model 204 gave us technology in the early 1980s that, even today, continues to increase our productivity and keeps costs to a minimum," continues Bonner. "Model 204 was one of the first database technologies to have inverted list indexing technology and record-level locking - there are more ways into Model 204 than any other database out there. I don't think our organization could have survived with as small an IS department without Model 204."

Due to Model 204's success and Year 2000 capabilities already in place within the organization, TDMHMR plans to take over the long-term care program for the Texas Department of Human Resources for mentally retarded patients. CCA's technology will continue to support TDMHMR in its efforts to keep costs down and its patient care standards high, all while managing a complex yet efficient statewide healthcare organization.

Texas Department of Mental Health and Mental Retardation Contact:

Julie Bonner

Senior Programmer

(512) 206-5144

julie.bonner@mhmr.state.tx.us