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The Victorian ACAT’s Journey towards a paperless Environment

The Victorian ACAT’s Journey towards a paperless Environment. Presenter: Moyra Kwan Manager of Central East ACAT Burwood East, Victoria . From less to more to less. 137 Data Items. EACH 2004. 42 Data Items. EACHD 2005. 166 Data items. 1997 Aged care Act. TCP 2006-07. 17 Data items.

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The Victorian ACAT’s Journey towards a paperless Environment

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  1. The Victorian ACAT’s Journey towards a paperless Environment Presenter: Moyra Kwan Manager of Central East ACAT Burwood East, Victoria

  2. From less to more to less 137 Data Items EACH 2004 42 Data Items EACHD 2005 166 Data items 1997 Aged care Act TCP 2006-07 17 Data items CACPS 1992-93 2009 • ACAP Guidelines 1987 • ACAP Guidelines 1999 • ACAP Operational Guidelines 2002 • ACAP Guidelines 2006 • Transition Care Program Guidelines 2006 • National Delegation training 1985 NH5-2pages Local Summary

  3. The beginning of our Journey 1985 • NH5 ( 2 page approval document) • ACAP MDS( 17 MDS Items) • Manual collection of data/assessment information on paper. 1992-93 • 197- (2 page approval document) • DOS data base • PAPER: 5-8 pages NH5, SUMMARY PAGE + Assessment notes.

  4. EU Data Recording sheet- 1985!!!!!!

  5. AGS -1993 MDS v142 Items .

  6. ACAT’s MDS sheet

  7. Aged Care Evaluation Data Base (ACE V 2) • ACE V2 2002 ( 137 MDS Items) PAPER 10-15 pages: Application and Approval Form 2624, Assessment notes

  8. 2003 - ACE V 3 • ACE V3 2003 The Minimum Data Set version 2 (MDSv2 166 MDS Items) PAPER: 12-20 pages: ACCR, Assessment notes.

  9. ACE V3

  10. ACE Overview • Funded by the Commonwealth • Developed collaboratively by the evaluation units from NSW, WA and Victoria. • Victorian Evaluation Unit. (Australian Institute for Primary Care; La Trobe University) supports Victorian, Tasmanian & ACT • ACE User Group in Victoria • ACE Executive Committee • ACE Help Desk

  11. ACE as a Facilitator • 2004 - Mobile enabled ACE hardware • Documents generated from ACE V3 5.2 • Care Plan letter • E-ACCR • Official DoHA Approval letter • Service Coordination Tool Template (ScTT) • Clinicians entering information directly into ACE

  12. Projects- 2007-08 Vic Dept of Health (COAG initiatives) provided funding for : • Mobile Computers. • Evaluation of mobile computing • InterRAI HC assessment tool pilot and evaluation • eACCR demonstration project & evaluation • Mobile ACE development

  13. Mobile Computers (Nov 2007) • 250 (205 FTE) clinicians at eighteen ACAS teams • 203 laptops and tablets. Evaluation • Field tests, on-line survey & process mapping. • Benefits • Risks & Challenges • User response to mobile devices

  14. InterRAI HC Assessment tool pilot- (2006-07) • 5 Teams, 16 assessors • 355 InterRai HC Assessments Oct-Nov 2007 • Evaluation: • not ideally suited to the ACAS • strong support for a consistent assessment approach and a common assessment application in ACE with necessary domains. • Site visits, forums, questionnaires, client survey, data analysis, observations.

  15. InterRai HC embedded in ACE

  16. E-ACCR & e-Delegation High Level Process Case conference- care plan confirmed Assessment documented. ACCR Data entered into ACE ACAT Delegate digitally signs ACCR on ACE and sends it securely to Medicare Client signs hardcopy ACCR Statement of Application- assessed by ACAT File validated by Medicare -ACAT is advised via ACE of status and processed by Aged Care Systems 2008

  17. E-ACCR • Introduced March 2008-staged roll-out • By June 2009 all Victorian ACATs electronically Delegating all ACCRs. • Total ACCRs Delegated electronically at 18th March 2010: • Vic: 56,128 • Nationally: 97,640 Paper: 5-7 pages- Electronic ACCR (potential to be stored electronically), local Electronic assessment forms, CACPS/EACH/DEACH E-waiting list, electronic referrals.

  18. Current and proposed ACE COAG projects 09-10 • Development of ACE Net ( June 2010) • Embedding ACAS Common Assessment Form (Victorian Comprehensive Assessment Record) • Further development of Super User process • Quality Framework • Further enhancement of Help System for ACE. • Scoping for Client Management System

  19. Victorian Comprehensive Assessment Record (VCAR) Purpose: • collect the common, core information required to provide a comprehensive ACAS assessment • information to auto-populate the eACCR, ACAP MDS and SCTT tools. • Facilitate take-up of mobile computing. • Reduce duplication • Consistent assessment information/practice.

  20. Victorian Comprehensive Assessment Record (VCAR) for Vic ACAS Consultant’s methodology • Collection and analysis of existing ACAS assessment forms • Consultation with key stakeholders, including all Victorian ACAS teams • Identification of common assessment information • Trial the common assessment form Next step • Embed the VCAR into ACE.

  21. VCAR in ACE.NET for Vic ACAS

  22. Other IT Developments • Electronic referral process • Electronic CACPS, EACH and EACHD waiting list • HealthSmart

  23. Adoption of E-Referral- Background • Better Access to Services (BATS) Strategy 2000 • Primary Care Partnerships (PCPs) • Service Coordination Victorian State Government, Department of Health, Australia http://www.health.vic.gov.au/pcps/publications/access.htm

  24. Service Coordination • Review of Intake & referral processes. • made changes to systems, processes and practices to achieve requirements of Practice Standards • Implementation of e-referral. • implemented the DHS requirements: Service Coordination Tool Templates (SCTT) and Consent

  25. E-Referral • PCP act as platform for change • Secure Electronic Referral and acknowledgement system Main providers in Victoria • InfoXchange-Information stored in secure repository • Connecting Care- Messaging system.

  26. ACATs E-Referral activityInfoXchange Data

  27. % of E-Referrals by service type made by ACATs (EMR Jan-Dec 09)

  28. State-wide CACPS, EACH AND DEACH Electronic Referral and Waitlist • All ACAS teams (exception of two) • 1214 Users & 207 services. • Web-based • Accessed through a secure online portal • Clients listed for their preferred provider/s. • Priority mechanism & tool developed (2009) • State-wide Steering committee • Continued enhancements and reports

  29. Other projects utilising E-Referral /Service Coordination • General Practitioners E-Referral Interface Project in EMR of Melbourne. • Direct2Care : • part of Way Forward reform • Utilising E- referral • 2 Demonstration Access Points in Victoria (Eastern Metropolitan Region and the Grampians Region)

  30. Victorian State Government Developments • HealthSMART is a seven-year $360 million strategy to modernise and replace ICT systems throughout the Victorian Public Healthcare Sector. 2009 • Patient and Client Management System (PCMS) • The Clinical Systems. • The Resource Management Systems (completed) Victorian State Government, Department of Health, Australia http://www.health.vic.gov.au/healthsmart/

  31. Clinical Patient Folder (CPF)

  32. Coming soon!!! • Electronic Medical record • Common UR Number within Health Services • Interface with auspice client management system • Interface with electronic referral system • Interface with electronic waiting list Result: ZERO PAPER!!

  33. Thanks and acknowledgments… • Department of Health and Ageing http://www.health.gov.au/ • Victorian Department of Health-http://www.health.vic.gov.au/ • Janette Collier and the ACE support team. • ACAS Victoria. • Lincoln Centre for Research on Ageing; Australian Institute for Primary Care; La Trobe University, Bundoora Campus, Victoria http://www.latrobe.edu.au/aipc/lincoln.htm

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