Friday, March 6, 2009

Liveblogging CANS: Listening in on the CBHI

I have been wondering about the CANS instrument, so I listened in on today's call.  The training team is delightfully engaging, and quickly worked us through the logistics of the call.  They began by pointing out the the CANS is complicated, and their goal is to get people both at large practices and small practices to be comfortable using the instrument.  They pointed out that there are tutorials are available on the CBHI website, and they really want people to use the website to get information.   They reported that more and more providers are submitting their information through the Virtual Gateway, and are climbing up the learning curve pretty quickly.

Then they dug into the meat of the matter.  At the present time, providers are required to enter demographic information from the CANS assessment, including the determination of SED status  and to log the information into the Virtual Gateway.  Soon there will be an informed consent process that will allow all of the information from the CANS to be entered into the Virtual Gateway with the parent/guardians permission.   In order to do this, you need to register with the Virtual Gateway here.  Then you have to be trained in CANS-  that happens are UMass.  If you are a provider or a clinician who hasn't attended CANS training, they suggest calling the Massachusetts CANS Training Center at (508) 856-1016 or e-mail at  So far, about 7000 have been trained and 6000 have been certified in the system.   Listening to a description of the system, it sounds like there are a lot of "technical" components that make sense to computer people, but are confusing to us "mere mortals".  This sounds an awful lot like the process that I have to go through with my Electronic Medical Record.  I won't go into my long rant on the inefficiencies of our EMR, but listening to this talk, my sympathy for the Mental Health workers is greatly enhanced.   The system sounds quite complicated, and it sounds like it is changing pretty often.  On the call, both the providers and the CBHI folk have approached the process with good humor and a can-do attitude.

The questions were very practical:  Turns out that DCF has a CANS, that is subtly different.  So mental health providers can use the information from the DCF form, but it needs to be transferred into the MassHealth form and submitted separately at the present time.  They are working on developing ways to make that information transfer easier.  Several people had run into problems with the level of access that persons have on the system; the group reviewed the procedures for troubleshooting.

Again, I am impressed at the level of effort being made by the Commonwealth to support this transition.  At the same time, I understand why the agencies see this as an extra burden- mental health clinicians are traditionally not the sort of folks who spend lots of time navigating computerized record systems.  Needless to say, neither are doctors.  I suppose that they and we will need to get used to it.  The CANS is here to stay, and later today we will be hearing about the results of the RFP for CSAs, the next link in the process.  Stay tuned.

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