Well Family System as a Complete System of Care


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WFS is a powerful suite of tools and resources that manage multiple aspects of maternal child and family health programs and case management delivery systems in a drill-down capacity from a “lead” perspective to individual providers and case worker levels on any capacity.

Well Family System is a Birth Forward system that manages and tracks the interaction of individuals and families with programs and services over the course of their lives. Learn more at http://www.gobeyondmch.com.

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Well Family System as a Complete System of Care

  1. 1. Maternal Child - Family Health Information and Technology Company Since 1997
  2. 2. A Complete System Of Care Management The program and case management enterprise system forthe new generation of maternal child and family health programs.
  3. 3. Birth Forward ….system that manages and tracks theinteraction of individuals and families with programs andservices over the course of their lives.A single program can stand alone or coexist with other programs as a collaborativeenterprise while providing common intake paths, managing services and activitiesin complex family situations, common family support plans as a family-centeredprocess. WFS reduces duplication of services, increases knowledge of client risksand needs, reduces the chance of clients “falling through the cracks”, streamlinesthe process of delivering services and contributes to economy and efficiency. WFS is a powerful suite of tools and resources that manage multiple aspects of maternal child and family health programs and case management delivery systems in a drill-down capacity from a “lead” perspective to individual providers and case worker levels on any capacity.
  4. 4. Everything Can Be Connected 2 Families connect to POC, 1 Outreach, Groups WFS Program, Case and Family Management System Healthcare, Inter Agency EHR Operations 5 Information, Research, 3 Evidence Sharing & Policy 4
  5. 5. A Complete System of Care Provide Direct Services Manage Programs and Organizations Refer and Follow Up Services Central Referral and Intake Process Screenings, Tools and Assessments Manage Contacts, Outreach, People Direct Client or Group Participation Engagement, Home Invoicing, Billing, and Other Visits Time Management Reporting, Accountability
  6. 6. People, Program, Services and Communities What is the WFS equation? + relationships X programs + services TIME = WFS The total Well Family experience is: • The relationship of people and families • Their interaction with programs and services • Their interaction with the community OVER TIME!
  7. 7. It Is ALL ConnectedThere are “binders” thatconnect people, families andrelationships to each other BIOLOGICAL RELATIVES LEGAL CULTURAL
  8. 8. It Is ALL ConnectedAnd a community is the sum total of all of theprograms, services and resources available to people and families.
  9. 9. It Is ALL Connected A Family is a Social Network!A community is a network of families, programs and services!
  10. 10. WFS is activity, risk factor, event and timeline driven, offering interactive calendars,extensive ticklers and other tools that manage program requirements, benchmarks,milestones, services and significant events in care such as visits, developmentalaspects, immunizations, assessments, and more.WFS includes comprehensive contact and encounter management tools. WFS isideal for home visiting, clinical and other contact-based service programs.WFS assesses risks, builds a care plan and a customizable interactive familysupport plan.WFS includes many evaluation and assessment tools, surveys, home safetyinspections and unlimited measures, screening tools and other assets.WFS manages group activities and client participation in groups such as parentingclasses and other activities.WFS has an extensive services referral component that allows referred services tobe tracked and the ability for service providers to complete the referrals in WFS.WFS optional features include the ability for individuals to participate in profiles and“self refer” to WFS service providers. WFS can be connected to the FamilyResource Engine (FRE), a 211 style tool that connects a broad range of communityresources to the system. WFS is also a cost tracking system that connects servicesprovided to billing codes and payment systems. WFS Basics
  11. 11. Well Family System as a Single Program Workflow and process specific to program and users
  12. 12. Well Family System in aMultiple Program Environment Prevents duplication of services, increases positive economics, provides continuum of care
  13. 13. Multiple Program Model With MIECHVThe Virginia Model 72 RM sites statewide 3 Fed HS Projects MIECHV programs (NFP, PAT, HF, more to be added)
  14. 14. As a Continuous Care Management System WFS Navigates People Across Programs Over Time WFS smart intake process assesses the past and current client conditions.Who are you? I am a 24 year old married female with 2 children.Have you been in WFS before? Yes, I was in an ICC program in 2008.Why are you here today? I am pregnant Prenatal Intake & Directs the participation path based on CaseIntake Type and program requirements. Management
  15. 15. Each New Program Participation Places the Client on the Appropriate Path of Care and Management Women’s Health Questionnaire Case Management Prenatal Intake Prenatal Assessment Case Management Women’s Health Questionnaire Case Management Case Management Infant Screen Next step processing Infant Assessment Case Managementand care management is determined by specific program requirements.
  16. 16. The Continuing Plan of Care and Family Support Plan Are Built on Risks, Needs and Previous Services Info at intake and during risk assessment isanalyzed and triggers needs in several categories. Which automatically builds a POC & FSPPHYSICAL-MENTAL HEALTH CATEGORY ITEM ACTION Physical and Mental Health Dental Issues Refer to Dental Services No Infant Care Enroll with Pediatrician EARLY DEVELOPMENT Safe & Nurturing Environment No Permanent Home Housing Assistance SOCIAL - EMOTIONAL Economic Stability Father Not Working Refer to WIC Job Training SPIRITUAL FOUNDATION A Plan of Care is initiated and The SAFE ENVIRONMENT Family Support Plan provides a starting point for determining a path of care and ECONOMIC STABILITY can be shared across programs and can be part of the family history over time.
  17. 17. As a Complete System of Care Management WFS enables families, organizationsand communities to be more efficient, accountable and successful in delivering quality programs and services that make a difference. gobeyondmch.com email: info@gobeyondmch.com