Community Care Information Management Using OCAN Reports to Support Quality Improvement

1. Community Care Information Management Using OCAN Reports to Support Quality Improvement

2. Agenda

3. Objectives • Understand how OCAN reports can contribute to quality improvement efforts to enhance client outcomes • Understand the types of standardized reports available to the LHINs and HSPs • Hear from HSPs and LHINs about how they are using reports to inform service planning and measure quality improvement goals

4. OCAN: Continuous Quality Improvement

5. Early Stages: OCAN Data & Reports Experience with Data and Reporting Knowledge and Use Advanced Reports and Use  We are here Data Completeness Confusion A Westartedhere We’re here

6. What are the most prevalent areas of need for the client population we serve? What service activities should we focus on? Is the service we provide contributing to positive outcomes for consumers? Are we using a client-centred approach? Is the information going into OCAN accurate? How many clients are living in hostels and shelters? Questions OCAN Reports can Help Answer

7. Research Findings What this means for services

8. HSP OCAN and IAR Standardized Reports

9. HSP Standardized Reports HSP Reports: 1. Software generated: • 4 reports generated within the HSP’s own software • CCIM developed the software specifications for 4 reports • Reports are built into HSP’s source system 2. IAR generated: • 6 IAR standardized reports generated from aggregate OCAN data uploaded to the Integrated Assessment Record (IAR) *HSP reports can be used to inform direct service delivery, strategic planning decisions and quality improvement strategies

10. Software Generated Report: Needs Over Time • Report about an individual consumer • Shows changes in needs over time • Identifies domains where progress has been made (converting unmet need to met need or no need) • Shows domains that remain an unmet need • Identifies new unmet needs to focus on as a person goes through their recovery journey • Specific time frame and domains are selected by the staff to generate a tailored report that can be reviewed with the consumer and staff team

11. More Software Generated Reports • Individual Need Rating Over Time • Summary of Comments and Actions • Staff Workload Report

12. OCAN IAR Standardized Reports • How are reports produced and accessed? • Transform Shared Services Organization (TSSO) is the Health Information Network Provider (HINP) that produces and manages “Infoview”, the online reporting portal • The portal enables you to securely access reports specific to your HSP • Each HSP uploading OCANs to IAR can get access to the portal by completing a “Reports Recipient Form”“ • The reports are produced monthly • They will be available through the reporting portal towards the end of each month

13. OCAN IAR Standardized Report • What do the reports contain? • De-identified aggregate data - no personal health information • The most recent OCAN of every consumer that has been active in your HSP within the previous 12 months (with the exception of Report #6 – refer to slide 20) • For example, a report that’s generated at the end of October, 2015 has the most recent OCANs completed for each client between October 1, 2014 and September 30, 2015 • This provides a recent picture of your HSP’s client population • The report does Not contain all of the OCANs submitted to IAR because it only includes one OCAN per client • Reports #1-3: represents total client population of the HSP • Reports #4-6: broken down by functional centre

14. OCAN IAR Standardized Report Examples • Provided by the Canadian Mental Health Association (CMHA), Sudbury/Manitoulin • THANK YOU! • Used to illustrate ways you can use the reports for service planning and quality improvement activities • Some of the sample numbers are low and therefore, should be used to explore issues rather than to draw firm conclusions

15. Report #1: Aggregated Assessment Response specific symptom of serious mental illness? = 43% What percentage of consumers have a family doctor? 53% *HSP can set a target and measure progress e.g. increase percentage to 65% by 2016 What is the most common presenting issue reported among my organization’s client population?

16. Report #1: Aggregated Assessment Response What is the most common medical condition reported among my organization’s client population? Arthritis = 17% What services are we offering or linking with to help address this identified physical health issue?

17. Report #2A: Need Analysis company, psychological distress, • What are the top 5 areas of unmet need? • Are we focusing our services on the most common unmet needs identified by the consumers we serve? • What are the implications for programming and training? daytime activities, sexual expression and intimate relationships

18. Report #3: Need Agreement • Is the overall level of agreement in the moderate to high range? Yes • Are there domains with low alignment that should be explored? No

19. Report #4: Need Analysis – Met & Unmet Needs What are the domains in this functional centre where the consumers we serve have identified the most need? (combined unmet and met need) psychological distress, daytime activities and physical health How can we use this information to inform funders as to where we are meeting needs and where we could meet more need with more resources?

20. Report #5: Need Analysis by Age Range • For clients ages 25-34, is psychological distress an area to focus services on? • yes – 64% • Relative to our total client population, do clients ages 35-44 have a very high percentage of unmet need in psychological distress? • no – 24%

21. Report #6: Change in Unmet Need Over Time • What does report #6 contain? • The number of consumer OCAN sets • OCAN set: two assessments of the same individual at different stages along their assessment cycle • The two assessments are the “most recent” OCAN and the “previous” OCAN six months earlier • This report includes OCANs that have been submitted over the past 18 months

22. Report #6 Change in Unmet Need • Accommodation • 100% progress - conversion from unmet need to met need and no need • Looking After The Home • Highlights that there has been significant conversion from unmet to met need - 67% • Demonstrates the effectiveness of services delivered to address these need • Daytime Activities • Highlights that the conversion from unmet need to met need is lower -14% • Identifies an area to monitor and explore service planning activities • HSP can set a target and measure progress. e.g. increase percentage to 40% by 2016

23. LHIN Clinical and Operational IAR Standardized Reports

24. LHIN IAR Reports • LHINs have access to two types of reports based on aggregate data from common assessments uploaded to the IAR from Community Mental Health, Community Support Services, Community Care Access Centre, Inpatient Mental Health and Long Term Care sector • 3 LHIN IAR Operational Reports • These reports enable LHINs to monitor HSPs participation in IAR and common assessment. Eg. upload activity • 3 LHIN IAR Clinical Reports • These reports can be used to better understand the needs and characteristics of client populations to inform service and systems planning

25. Introduction to LHIN Clinical IAR Reports • Purpose of the reports • To help better understand client populations served • To explore issues related to client needs and health service planning • To monitor HSPs use of OCAN and IAR in order to identify effective practices and strategies to overcome challenges

26. LHIN IAR Clinical Reports

27. Introduction to LHIN IAR Operational Reports • Purpose of the reports • To monitor common assessment sharing and IAR activity • To explore issues related to HSP activity in the IAR • To work with the HSPs to identify good practices and strategies to overcome challenges

28. LHIN IAR Operational Reports

29. LHINs’ use of Clinical and Operational IAR Standardized Reports

30. Champlain LHIN’s use of Reports OCAN Presenter Kevin Barclay Date: October 2015 Location: Webinar

31. Why does Champlain LHIN support the principle of Common Assessment and the platform of the Integrated Assessment Record (IAR)? • Promotes a client centered approach to care • Clients don’t need to repeat their stories • Enables faster care planning and easier collaboration • Providers can access information about common clients from other partners more efficiently • Provides a standardized approach to identify needs and trends across a client group • Facilitates system level dialogue needs planning

32. Champlain LHIN’s use of OCAN – IAR reports • LHIN Clinical Report #2 : Extent of Unmet Need in OCAN • Look at most common needs identified • Explore priority opportunities to address gaps • Look for trends across past and present reports • Explore potential hypotheses to explain the change • LHIN Clinical Report #3 : Incidence of Common Health Indicators in Community Care sectors by Age and Gender • Look at common conditions within OCAN population • Explore potential partnerships to collaborate on care.

33. Champlain LHIN’s use of OCAN – IAR reports cont’d • LHIN Operational Report #1 : IAR Upload Summary • Identify which agencies are successful at uploading and which agencies are facing challenges • Explore what’s working and how to spread good practices • LHIN Operational Report #3 - IAR Assessment Summary • Identify variance in consent proportions • Explore what’s working and how to spread good practices

34. Process for using reports and working with the sector • Convened an OCAN working group amongst providers, lead by representatives who work with OCAN and IAR regularly • Initial focus was to develop approaches to collaborating on OCANs for common clients • Renewed focus to explore IAR usage and dialogue about needs identified through OCAN • LHIN review reports as they are provided • Working group reviews highlights of reports as a group to identify opportunities to collaborate on improvements

35. Example Highlights that are used for exploration

36. Example Highlights that are used for exploration cont’d

37. Next Steps • Promote the benefits of exploring client identified needs as a way to improve services and systems • Explore with individual agencies the barriers to upload • Support the development of improvement plans to assist agencies in meeting MSAA obligations

38. Central LHIN IAR Adoption Project Karen Blackley, eHealth Program Manager Central LHIN CCIM Data Quality Webinars – Using IAR Standardized Reports Fall 2015

39. Central LHIN IAR Adoption Project – Why? • In 2014/15, a 2-day workshop with Central LHIN Community Health Service Providers (HSPs) identified gaps with the use of both common assessments and the Integrated Assessment Record. • Both the Central LHIN and our HSPs wanted to increase the use of the Integrated Assessment Record to: • Reduce number of times clients have to repeat same information • Facilitate collaboration between community sector providers which is becoming increasingly important as: • more care is shifted to home and community • more complex clients with multiple needs being seen in the community sector • Reduce duplication and allow for access to assessment data to help identify client needs and put services in place to meet those needs.

40. Central LHIN IAR Adoption Project – Why? • In 2014/15: • Central LHIN issued a survey to Community Sector HSPs which validated the gaps in the use of common assessments and IAR and the need for training and education to support use. • Central LHIN started to receive the IAR Operational Reports which validated the inconsistent use of the IAR in the sector: • Less than 50% of CSS HSPs had an active IAR User Account • Less than 40% of CSS HSPs were uploading assessment to the IAR • Less than 30% of OCANs being uploaded had consent to be viewed • IAR Adoption was included as a priority in our Central LHIN eHealth Plan.

41. FY 15/16 Targets Increase % of CMH HSPs uploading Assessments to over 80% Increase % CSS HSPs uploading Assessments to over 75%

42. FY 15/16 Targets Increase # of CSS HSPs with minimum of 1 user account active to 75%. Increase # of CMH HSPs with minimum of 1 user account active to 90%.

43. FY 15/16 Targets Increase % of OCAN Assessments with Consent Granted to and average of 50%. (baseline 32%)

44. Central LHIN IAR Adoption Project – What we have put in place. • Standardized Assessment & Eligibility Workgroup (co-chaired by LHIN and CSS HSP) • RAI User Group (chaired by CSS HSP) to support the use of AIS (interRAI web-based training and testing tool) which was purchased last fiscal • IAR Trainer for the community sector to support education and training for both the common assessments and the IAR and will lead the RAI User Group • Included the use of common assessments and the IAR as eligibility criteria for new initiative funding

45. Central LHIN IAR Adoption Project – Where to go next. • Continue to use reports the IAR Operational Reports to show progress and areas for improvement in the use of common assessments and IAR. • For the Collaborative Home and Community-Based Care Coordination policy guidelines implementation, information in our IAR reports will be used support our planning (understanding our current state). • As uploading of assessments increases, see if there is opportunity to use the more clinical LHIN reports to support program planning.

46. Thank you Questions? Comments? Central Local Health Integration Network 60 Renfrew Drive, Suite 300Markham, ON L3R 0E1Tel: 905-948-1872 or 1-866-392-5446 Fax: 905-948-8011Email: central@lhins.on.ca www.centrallhin.on.ca

47. HSPs’ use of OCAN Standardized Reports

48. Algoma Public Health Community Mental Health Support Services Alana Brassard Client Care Coordinator

49. Benefits of using the OCAN reports Encourage staff to follow the standards of completing OCANs at the reassessment time frame. Helpful in understanding the needs of the client population – and do program planning based on high need areas Because OCAN is an evidenced based tool, the result is better planning for clients served Measure how services are contributing to positive outcomes for clients – changes from unmet need to met need or no need

50. Report #2B – Need Analysis-Most Recent Staff Assessment of Unmet Need • We do not use #2A: • difficulty with getting self assessments completed • Two of the highest areas of unmet need • daytime activities and physical health e.g. diabetes, complications from smoking Focus Service Planning on Identified Unmet Needs Developed groups partnering with the Chronic Disease Programto address both domains Examples: Community Kitchen and Walking Group with health teaching as a component.