eHealth - Darlene Arseneau

HNHB CCAC & eHealth

November 18, 2008

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HNHB CCAC

Overview

HNHB CCAC & e-Health November 18, 2008

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What is HNHB CCAC?

• The Hamilton Niagara Haldimand Brant (HNHB) CCAC was established in January 2007

• Five CCACs became one (provincial process)

• The HNHB CCAC head office is located in Brantford

• Branch offices serve Hamilton, Niagara, Haldimand-Norfolk, Brant and Burlington


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Who We Are

• Services funded by the Government of Ontario

• Governed by a volunteer Board of Directors appointed by OIC

• Serve population of 1.3 million

• More than 650 staff located throughout HNHB CCAC

• Close to 34,000 clients receiving service at any given time

• 60% of admissions are from hospital

• Largest CCAC with over $220M in funding


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Mission StatementMission Statement

Our passion is health; our strength is our people and our partners; our promise is compassionate care.

On a day to day basis, we are:• an easy to use gateway to information and high quality health services;• an innovator seeking to optimize people's health, well being and

autonomy;• an integrator partnering with others to reduce the barriers to access,

respect diversity and improve the care experience of people across the health care continuum;

• an employer of choice who believes in the remarkable capacity of our people to continuously learn and make a difference;

• an open communicator who promotes positive relationships; and• a steward of public resources who is openly accountable and

contributes to a sustainable health system.

Vision StatementVision Statement

To be recognized across the country as Centres of Excellence for integrative community services and health information by 2017..


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What We Do

• Provide information about CCAC and community services to the public: Information & Referral Service

• Help people remain at home, or return there more quickly from hospital stay by arranging in-home health & personal support service

• Provide school health and support services for children


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What We Do• Manage admissions to long-term care homes and

refer clients to adult day programs

• Manage admissions to respite care and other supportive services (give caregivers a break)

• Participate in >130 local, LHIN, and provincial planning tables/committees

• Participate in research and training of regulated healthcare professionals

NB: A doctor’s referral is not required to access CCAC services


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Flow of CCAC Services


Hospital

21 Sites

(60% of referrals)

Community

•Family

•Individuals

Physicians

(40% of referrals)

HNHB CCAC

•55,000 assessments per year

•Case managers in home/hospitals/schools/family health teams

Information & Referral

•Other Support agencies

In Home/School Services

•Nursing

•P.S. & Homemaking

•Therapies

•Wound Clinic

Long-Term Care Placement

Hospice

100+ Community Programs

Meals on Wheels

Adult Day Programs

•34,000 on service each month

•58,000 nursing visits/month

•19,000 nursing hours/month

•200,000 personal support hours/month

•19,500 therapy visits/month

•Delivered through 40 service providers

85 Long-Term Care Homes

10,330 Beds

5 sites, 42 beds

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Who We Serve

• People of all ages: 34,000 clients on service each month

• 13% 0-19 yrs

• 29% 20-64yrs

• 14% 65-74yrs

• 26% 75-84 yrs

• 18% 85+


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Number of Home Care Visits/Hours

• Personal Support: 200,000 PSW hours per month

• Nursing: 58,000 visits per month

• Therapies: 19,500 visits per month

• Delivered through contracts with service providers

• Contracts determined through RFP process


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Case Management Role

• Confirm client eligibility

• Assess client, determine services needed

• Arrange care to be delivered (home, school, hospice)

• Monitor each client’s care plan

• Help clients “navigate” the health care system

• Located in hospitals; family health team offices

• Case managers are regulated health care professionals (e.g. RN, OT, PT, etc.)


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Information and Referral

• Provide information about CCAC and community services to the public

• Facilitate referrals to CCAC-funded services and other community supports and services

• Access us by calling one of our main phone lines soon to be one call number


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CCAC & LTC Placement• CCACs manage the application, waiting list and offer

process to LTC homes

• Our role:•Provide information about the process•Assess eligibility•Coordinate the application process•Manage the waiting list• Inform people when a vacancy is available•Manage out-of-province applications•# of placements per year – approximately 4,400


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CCAC Branch Specialty Services

• Pediatric and school care

• Palliative care (end-of-life care)

• Link with Family Health Teams

• Convalescent care

• Ambulatory nursing clinics


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A Closer Look at HNHB CCAC Partners

• LHIN

• 11 hospital corporations

• 21 hospital sites

• 16 emergency rooms

• 85 long-term care homes

• 100+ community support programs

• 8 ambulatory care centres

• 9 school boards and numerous private schools

• 5 hospices

• Physicians including 22 family health teams with over 200 physicians

• Service providers – 40 (72 contracts)


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CCAC and e-Health


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Flow of CCAC Services


Hospital

21 Sites

(60% of referrals)

Community

•Family

•Individuals

Physicians

(40% of referrals)

HNHB CCAC

•55,000 assessments per year

•Case managers in home/hospitals/schools/family health teams

Information & Referral

•Other Support agencies

In Home/School Services

•Nursing

•P.S. & Homemaking

•Therapies

•Wound Clinic

Long-Term Care Placement

Hospice

100+ Community Programs

Meals on Wheels

Adult Day Programs

•34,000 on service each month

•58,000 nursing visits/month

•19,000 nursing hours/month

•200,000 personal support hours/month

•19,500 therapy visits/month

•Delivered through 40 service providers

85 Long-Term Care Homes

10,330 Beds

5 sites, 42 beds

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What The CCACs Have Initiated in e-Health

Client Health Related Information System (CHRIS) & Health Partner Gateway• Foundational, provincial capability that significantly enhances the CCAC’s ability

to serve its clients

LHIN and Provincial wide Information and Referral capability (I&R)• Improves and simplifies navigation across the health system for clients• Creates a focal point within the health system that unifies and coordinates the

efforts of today’s individual I&R service providers

Standardized Client Assessments (Assessment)• Promotes uniformity in how clients are assessed for CCAC services, and promotes

equity in services provisioned for clients

Information Exchange and Positioning for Evidence Based Decision Making (IM)• Enhances the CCAC’s capability to access, manage, and analyze their data to

support evidence based decision making, and exchange their data with health sector partners to promote better health system-wide analysis and performance

Mobile, Productive Workforce (Telecom, and BTI)• Increasing ability for CCAC case managers to work productively with clients in

their homes, hospitals, or the community, through seamless access to CCAC telecom and IT services


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CHRIS & HPG

CHRIS is a multi-year, sector based initiative.

The CHRIS project will see the design and development of a comprehensive clinical case management solution for Ontario’s Community Care Access Centers (CCACs)

A secure solution that enables a CCAC to electronically exchange information with its Service Providers and Health Partners

Enables the consolidation of today’s gateway solutions onto a single platform (e.g. CHIN, CARE eCommerce, Hamilton Portal, etc.)


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HPG - Benefits

Benefits of Electronic Information Exchange• Improves Business Efficiency

• Eliminates manual procedures• Speeds up communication • Speeds up business processes• Eliminates redundant activities (e.g. re-sending failed faxes)

• Reduces Resource Usage Costs • Printer & fax resources (paper, toner cartridges, fax leased lines)• Printer & fax maintenance• Mail & Courier costs

• Improves Accuracy and Security of information• Reduces manual re-entry of data resulting in fewer errors• Reduces chance of sending information to incorrect destination• Enables better auditing procedures


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Information & ReferralBusiness Problem:

• Citizens and CCAC personnel cannot easily access quality information about services outside of their immediate geographical area

• CCAC Alignment has necessitated an alignment of I&R applications

Objectives:• Boundary-free, consistent access to health, community, and social

service information for all Ontario citizens, and CCAC employees

Deliverables (under development):• A search site that provides access to all approved provincial I&R

information (CCAC’s and approved partners)• A single published phone number that provides citizens access to

CCAC I&R personnel for support• An improved method of measuring and reporting on use, to inform

program evolution


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AssessmentBusiness Problem:

• Standardizing how clients are assessed for health services, is a critical step in ensuring consistent quality and equity in health service delivery

Objectives:• MOHLTC, via CCeH, undertook a program to standardize client assessments for the

Continuing Care Sector, based on the InterRAI assessment standards• For the CCAC Sector, CCeH has created and deployed a Long Stay Assessment tool called

LSAS, and is in the stage of rolling out a Client Intake Assessment tool called CIAT

Deliverables:• LSAS ongoing support and enhancement (current)• CIAT rollout, and ongoing support and enhancements to address CIAT adoption gaps

(current)• CIAT and LSAS integration with CHRIS to ensure that assessment tools are properly

integrated with the prime client management tool used by the CCACs (current)• Ongoing assessment of other instruments for use by CCACs (planned)• Better leverage of Assessment data by CCACs and by health sector agencies (InterRAI,

CIHI, etc) (planned)


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Information Management

Information Management is critical to the health system transition to evidence based decision making, and system performance measurement

The CCAC IM programs create a solid CCAC foundation through• Standardizing Data Definitions• Improved access to critical CCAC data for analysis• A comprehensive data sharing agreement to allow secure data

sharing among CCACs, and between CCACs and other health partners (in compliance with PHIPPA)

• An emerging knowledge center to enhance the sectors health informatics capabilities


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Information Management - Vision

External Data Sources *

PHPDB CIHI

Internal Data Sources

CHRIS

HCD

Demographic

LSAS

CIAT

Other dataSources(CPRO,

MIS,ODB)*

ServiceCatalogue

ClientRegistry

ProviderRegistry

Community CareIntegrated Reporting

Environment Pre-defined reportsAd-hoc data access

Analytical tools

Validation

Validation

Validation

integrated data access

Enterprise Data Warehouse(aggregated, summarized data)

Center of Excellence

Operational Data Store(consolidated transactional data)

Stats

Can

CIAT

Others

HCD

CHRISCIHI

LSAS

MISPostal Codes

refresh

refresh

transform

* To Be Verified Through Analysis


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VOIP Business Enablement

Client experience• Improved reachability of Case Managers

o mobile extensions o accessibility in remote offices, hospitals, and their home offices

• Improved accessibilityo Hours of operations; Language support

• Improved Client Servicingo Warm call handoff; CTI application value-adds; etc

More flexible business operations• Improved mobility of staff• Organizational flexibility• Resilient, alternate site back-up; easier to respond to weather situations, emergency

situations as pandemics (business continuity/disaster recovery)• Facilitate movement of staff within the CCAC• Allow for more skills-based call routing

VOIP is not about phone substitution – it is about supporting CCAC business transformation


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CCAC IT Enterprise

• Base Technology Infrastructure

• All users and IT products and services in all CCAC main and satellite offices across Ontario

• 3 data centers

• All users and IT products and services in OACCAC

• That is…

• 14 main offices, 56 branch offices, 170 Satellite offices

• 6000 computers; 200+ servers/routers, 7300+ users

• 3 Data Centers + OACCAC lab

• All the technology to support CCAC users and Applications (printers, routers, switches, servers, storage, email, etc)


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E-Health projects with LHIN Partners and CCAC


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Projects with LHIN Partners

• HHS and Hamilton CCAC joined together to share data using the HHS data warehouse.

The data sharing used data from 2004/05 forward

The project has produced quality data that is now starting to be used to assist in decision making and care management.

• CCAC data being linked to a LHIN clinical viewer for physician viewing.


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Questions?


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Contact Information:

Darlene Arseneau, C.A.

Senior Director Corporate Services

HNHB CCAC

[email protected]


mailto:[email protected]

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eHealth - Darlene Arseneau