The procedure page aims to outline guidelines for the implementation of Interoperability FHIR standards (as defined by DHCS/CalAIM initiatives) within San Mateo County’s BHRS system. The adoption of FHIR is crucial for enhancing interoperability, data exchange, and communication among various stakeholders within the behavioral health domain.

This document outlines guidelines for the implementation of FHIR standards within the San Mateo County Behavioral Health and Recovery Services (BHRS) system in compliance with CMS Interoperability Rule. These guidelines ensure the secure exchange of patient data across various healthcare entities, including healthcare providers and third-party applications.

Interoperability Objectives 

1. Facilitate seamless data exchange: FHIR implementation will enable the secure and efficient exchange of patient data between different healthcare entities within the county behavioral health system.

2. Improve care coordination: By standardizing data formats and protocols, FHIR will support better coordination of care among behavioral health providers, primary care physicians, social services agencies, and other relevant entities.

3. Enhance patient outcomes: Access to comprehensive and up-to-date patient information through FHIR will enable providers to make more informed decisions, leading to improved patient outcomes and quality of care. 

4. Ensure data privacy and security: The policy emphasizes compliance with relevant privacy and security regulations, such as HIPAA, to safeguard patient information during its exchange and utilization.

Infrastructure and Framework (FHIR) 

The document outlines a structured approach for implementing FHIR standards within the county behavioral health system, including technical specifications, data mapping, and integration with existing health IT infrastructure.  San Mateo County BHRS Infrastructure for FHIR is provided through our primary health care system: Netsmart. 

• Technical Specifications: The FHIR API will follow v4.0.1 standards and implemented via Oauth 2.0 standards
• Data Mapping: Data from claims, encounters, and provider directories are integrated into the API in real time.

Governance and Oversight 

County understands that establishing governance structures and oversight mechanisms is crucial for managing FHIR implementation projects, ensuring compliance with policies, and resolving any issues or disputes that may arise.

In observance of that need, San Mateo County relies on the guidance provided by state regulators, DHCS, county health division leadership, and county health governance committees.  San Mateo BHRS is also fully engaged in adherence to the privacy policies parameters outlined by DHCS and SUD privacy policy directed by 42 CFR Part 2.

Link to San Mateo County BHRS: General HIPAA, Privacy and Security control/release of information release pages