Innovative Technologies In Community Care - Allan Turner


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Innovative Technologies In Community Care - Allan Turner

  1. 1. Innovative Technologies in Community CareAllan TurnerCIO, Silver Chain GroupAustraliaNovember 2011
  2. 2. The Australian Landscape • The Productivity Commission Report; Caring for Older Australians, August 2011 notes; – Ageing of the Australian population—by 2023, 20% of the population will be over 65 years of age – Preference for independent living arrangements and choice – Increase in morbidity among aged and management of chronic conditions (diabetes, dementia, arthritis, visual and hearing impairments) – Reduced access to carers and family support – High and unmet demand for limited number of community care packages (of services) – Decline in demand for residential low care – Restriction of high care residential places to ‘extra service’ places that attract higher accommodation bonds
  3. 3. The Australian Landscape ACAA 30th Annual Congress (November 2011) • Productivity Commission Review and Reform – The release of the aged care report from the Productivity Commission raises the prospect of unprecedented reform of aged care. Will the Government take up this challenge? • Residential Care, Community Care and Retirement Living Interface – As is the case in many overseas jurisdictions Australia is gradually seeing a coming together of care and accommodation systems that had previously operated in silos. Will this trend continue? • Innovative Service Models – Will tomorrows consumer be happy to accept todays solutions? Will technology change the face of care options? Will future consumers take much greater management of their healthcare and health data? • Community – Australians are emphatic that they wish to stay in their own home and live independently for the rest of their lives. Is this aspiration sustainable?
  4. 4. About Silver Chain Group Our Purpose To create, build and sustain community capacity to optimise health and wellbeing for individuals in their homes and communities Statistics 2010:2011 Hours of care: 1,619,124 Clients assisted: 62,337 Clients visited per day: 4,943 Occasions of service: 2,271,426 Klms travelled : 20,797,206 Staff (Volunteers): 3,380 (411) Revenue $193 million
  5. 5. Silver Chain major programs • Health Care – Home Hospital, Hospital in the Home Program, Post-Acute Care, Community Nursing – Diabetes, wound and continence management and advice clinics – In-home palliative care – Remote nursing • Community Care – Home and Community Care (HACC) - personal care, domestic assistance, social support, respite – Community Aged Care Packages / EACH Packages – Independence Programs: Home Independence Program, Personal Enablement Program, Social Enablement – HACC Regional Assessment service – metro wide • Commonwealth Respite and Carelink Centre – Aged care information gateway and manage brokering of respite for carers • Training and Education
  6. 6. ComCare and ComCare Mobile
  7. 7. Patients/ComCare Client Clients Demographics, Alerts, Clie nt History, Previous Patient Diagnoses... RecordRecord source of referral and services requested Referrals Contract and Clinical Eligibility Patient Eligibility Assign client to a Round and Schedule Schedule Single/Group Assessments using “Questionnaires”; Care Plans generated Assessments and Care Plans Equipment Management Service Record of Deliveryservices, consumables, etc.. . Clinical Clinicalactions, indicators, diagno Record sis... Wound Management Discharge
  8. 8. Patients/ Commissioners/ComCare Client Clients Management Demographics, Alerts, Clie nt History, Previous Patient Diagnoses... RecordRecord source of referral and services requested Contract Referrals Management Contract and Clinical Eligibility Patient Block Eligibility Contracts/Fees for Service Assign client to a Round and Schedule Schedule Single/Group Assessments using Care Packages “Questionnaires”; Care Plans generated Assessments and Care Plans Equipment Management Service and Clinical Service Costs by Client and Record of Delivery Groupsservices, consumables, etc.. . Clinical Clinical Reporting toactions, indicators, diagno Record Funders sis... Management Reporting Wound Management Discharge Finance System
  9. 9. Patients/ ComCare Modules and Commissioners/ Care Process FlowsComCare Client Clients Management Providers Demographics, Alerts, Clie nt History, Previous Patient Organisation(s), Position Continuous Diagnoses... Record Organisation s, postings and Improvement Chart employees...Record source of referral and services requested Contract Candidate Referrals Record of employment Management (recruitment) Tracking applications... Contract and Clinical Care Provider Employee details, service centre, hours of Eligibility Patient Records work, classification, qualifications Block Eligibility Contracts/Fees for Scheduled/ Service Messaging Assign client to a Round Training completed, position/emplo and Schedule yee... Schedule Rosters Assign Care Providers to Rosters; GeoCode Single/Group Assessments using using Google Mapping... Care Packages “Questionnaires”; Care Plans generated Assessments and Care Plans Occupational Equipment Incident, accident Safety & recording etc... Management Process Health Mapping Service and Clinical Service Costs by Client and Record of Delivery Groups Car Fleet Vehicleservices, consumables, etc.. Allocations allocation, Maintenance, . Accidents Mileage etc Clinical Clinical Reporting toactions, indicators, diagno Record Timesheets Automatic Completion using Mobile Funders sis... Management Technology and Google Maps Reporting Wound Management Nursing Procedure manuals... Manuals Discharge Finance System Payroll System
  10. 10. The Mobile Application• Large and mobile workforce – need to be able to provide and capture up to date information 24/7• Enables our nurses to be able to access information about clients such as their details, referrals, diagnosis, alerts, contacts and services.• Enables nurses to record in real time the clients assessment details and information about wound care.  Clients  Assessments  Admission wizard  Contacts  Clinical details  Messages  Access comments  Wound management  Alerts  Service details  Schedule/roster  Maps and GPS tracking  Task details  Timesheet  OSH checklist  Client equipment  Manuals (nursing & quality)  Continuous Improvements
  11. 11. The (WA) Mobile Users (total group mobile users 2,000+)
  12. 12. The Mobile Devices
  13. 13. The Mobile Benefits Clients Staff Organisation Better care Greater safety Reduce overheads Increased privacy Better information Improve unit costs Reduced errors Feel connected Efficient processes Less hospital visits Reduce travel time Increased productivity Improved quality of Reduce paperwork Reduce travel time life Better information
  15. 15. ComCare
  16. 16. Random pieces of available information
  17. 17. Mobile Timesheets DATA • Auto download of care workers ACTION workload / timesheet INFORMATION • Updated daily for today and 4 days ahead • Data recorded in real time and submitted daily • 600 mobile timesheet users COMMUNICATION “Oh no something else I have to KNOWLEDGE learn and worried that it was going to that will take up time……. “But now yeah it great, its been very easy to learn” UNDERSTANDING
  18. 18. Mobile Timesheets Total savings Savings Project (est.)* Timesheets (TS) - messaging $60,000 TS - Carrier voice contract $180,000 TS - Calls to Customer Operations $620,000 TS - Remove paper system $500,000 TS – Total estimated savings per year $1,360,000
  19. 19. Wound Care • 16,784 wounds total DATA • 2,456 active wounds • 20,316 assessments • 21,551 treatment plans ACTION INFORMATION • 14,469 treatments • 353,071 dressings • 5,943 Notes COMMUNICATION KNOWLEDGE“With the phone we can bring wound care in real time with real data.”………“We can now prove the worth of the work our nurses have been doing for years.” UNDERSTANDING
  20. 20. Wounds
  21. 21. ComCare Travel Smart Stay Safe
  22. 22. Travel Efficiencies • A days nursing activity at a location after optimisation: 62 hours of travel reduced to 27 hours and 3708 kms reduced to 1620 kms • A nursing round after sequencing: Saving = 1 hr 42 mins & 53 km • Savings potential $6,000,000 per year
  23. 23. Route Optimisation and Visit Allocation (ROVA) ROVA considers Travel distance to first client. Travel distance between clients. Travel distance home from client Time provider is early for a visit Time provider is late for a visit The preferred provider Visits occurring outside of shift Providers identified not suitable The provider ideally suited Uses genetic algorithms (mimics natural evolution) Potential savings ≈ $millions
  24. 24. A Connected Workforce
  25. 25. ComCare Process Flows
  26. 26. ComCare Reporting
  27. 27. KPI Reporting• Directs peoples behaviour• Makes performance visible and focuses attention• Clarifies expectations and provides objectivity• Improves execution and promotes consistency• Country nursing unit cost fell by 40% in 3 months• Central assessment recording saving $250,000 per year• At one centre cost per 1 direct hr fell by 11% saving $24,000 per month
  28. 28. KPI Reporting
  29. 29. TelehealthHospital admissions of Silver chain clients over 5 ½ yrs 67,674 individuals 286,185 admissions Average LOS 7.6 days Any one day Silver chain clients use 1,085 beds 51% had a diagnosis of chronic diseaseRandomised control trial 120 chronic heart failure 80 chronic obstructive pulmonary diseaseFindings Per person cost savings = $2,931 per year High level of Client satisfaction Increased self confidence, control and awareness Improved sense of security and reduced anxiety
  30. 30. Telehealth
  31. 31. Summary Improve client care and increase capacity Drive down Logistics costs and reduce inefficiencies E: M: +61 419 907 357