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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

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
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

the beginning of our journey
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.

aged care evaluation data base ace v 2
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

2003 ace v 3
2003 - ACE V 3
  • ACE V3 2003 The Minimum Data Set version 2 (MDSv2 166 MDS Items)

PAPER:

12-20 pages: ACCR, Assessment notes.

ace overview
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
ace as a facilitator
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
projects 2007 08
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
mobile computers nov 2007
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
interrai hc assessment tool pilot 2006 07
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.
e accr e delegation high level process
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

e accr
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.

current and proposed ace coag projects 09 10
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
victorian comprehensive assessment record vcar
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.
victorian comprehensive assessment record vcar for vic acas
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.
other it developments
Other IT Developments
  • Electronic referral process
  • Electronic CACPS, EACH and EACHD waiting list
  • HealthSmart
adoption of e referral background
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

service coordination
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
e referral
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.
state wide cacps each and deach electronic referral and waitlist
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
other projects utilising e referral service coordination
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)
victorian state government developments
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/

coming soon
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!!

thanks and acknowledgments
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