Helen Jarvis, Program Manager, Central Intake Referral Team, Ballarat Health Services delivered the presentation at the 2014 Discharge Planning Conference. The 2014 Discharge Planning Conference - Assisting health services to adopt an integrated and consumer directed approach to discharge planning. For more information about the event, please visit: http://bit.ly/dischargeplan14
Text of Helen Jarvis, Ballarat Health Services - The Role of e-Referral in Discharging
Electronic Tools to Assist with Discharge Planning Helen Jarvis Program Manager Central Intake and Post Acute Care 24th July 2014
BALLARAT Ballarat is one of Australias fastest growing cities with more than 2,000 people moving to Ballarat each year.
Ballarat Health Services is Victorias second largest regional health service, providing a comprehensive range of general and specialist care across key medical and healthcare disciplines including acute care, sub- acute care, residential aged care services, community care, mental health, dental and rehabilitation services. In 2012/13 there were 32,355 inpatient separations and 53,308 attendances at the Emergency Department. BALLARAT
Central Intake and Post Acute Care Central Intake Central Intake is an access and referral management service providing consumers/carers/patients with a single point of entry to those programs within the scope of Community Programs as well as facilitating navigation of the broader community service system Central Intake Referral Sources Email Fax In Person Internal Mail Phone Total Community Programs 5098 1881 16 958 133 344 8430 Allied Health 654 3577 8 4291 898 36 9467 GRAND TOTAL 5752 5458 24 5249 1031 380 17897 Post Acute care The Post Acute Care (PAC) program assists patients to recuperate following an acute hospital admission, sub acute admission or an emergency presentation and to facilitate their independence or transition to continuing care.
E-Referrals What do we want in a E-Referral System? Easy access Improve efficiency of referral procedure Eliminate duplicate data entry Minim Data Set should be transferred from one system to another without the clinician keying anything in You should be able to confirm that the referral has been sent and acknowledged Rely on minimal training & expertise Provide statistical information Simplify transfer of information
Electronic Referral System Referral Information Management System (RIMS) The RIMS electronic referral system was initially trialled in the sub acute sector of Ballarat Health Services and was formally adopted mid 2005 System for collecting, sending & storing referrals electronically Primarily based on SCTT tools Supports secure email, Autofax & printing Pop-up calendar function on all date fields Auditing at the referral, provider and form level Facility to flag forms intentionally not completed Lock down facility to restrict forms to read only after sending Facility to supersede forms to generate a duplicate for editing after sending Facility to transfer form definitions between RIMS installations
RIMS Patient management System PAS Connecting Care Service Provider Pathway
Key Benefits Streamlined data entry and better data quality Linked to patient management system to provide demographic and episode data and integrated with Connecting Care. The forms required by each agency are automatically generated by the system, Referrals are stored electronically to enable analysis of referral activity; The user interface guides users to complete relevant fields based on the information needs of the receiving service provider; Forms can be emailed to agencies using Public Key Infrastructure (PKI) encryption capability through the Connecting Care system, otherwise they are able to be automatically faxed through a standalone electronic fax management system, or printed and manually faxed or mailed out.
RIMS Referrer Statistics Department Referrals Post Acute Care 1128 Social Work 876 Emergency 838 Central Intake 634 HARP 609 3 North 467 2 North 271 4 South 259 Hospital in the Home 244 ACAS 217 Inpatient Rehabilitation 186 Occupational Therapy 178 Gandarra Palliative Care 158 3 South 157 Transition Care 157 4 North 100 Geriatric Evaluation & Management 67 Rehab in the Home 67 Cognitive Dementia & Memory Service 21 Diabetes 21 Domiciliary OT 20 Jim Gay Unit 20 2 South 17 Wound Care CNC Team 16 PDPU 14 Midwifery 4 Clinical Services 3 Dialysis 3 Outpatient Department BH 3 Information Technology 2 Psychiatric Services 2 Acquired Brain Injury Clinic 1 Total 6760
Provider Referrals Ballarat District Nursing And Healthcare Inc. - Nursing 912 Ballarat Health Services - Community Programs - Central Intake 902 Ballarat Health Services Post Acute Care 694 City of Ballarat Council - Home Care 654 Ballarat Health Services - Base Hospital - Respite care - Aged Care Assessment Service 561 Ballarat Health Services - Hospital Admissions Risk Program 371 Ballarat Health Services - Continence Resource Centre 365 mecwacare 207 City of Ballarat Council - Home Maintenance 173 Ballarat Hospice Care Inc - Palliative Care 166 Ballarat Health Services Carers Choice Grampians Region 157 Homecare Plus 108 City of Ballarat - Meals on Wheels 92 East Grampians HS Post Acute Care 76 Ballarat Health Services -TCP & RC 74 Maryborough District Nursing Service 69 Moorabool Shire Council - Home Care Assistance 64 Hepburn Shire Council - Home Care (Housekeeping Assistance) 55 Maryborough Post Acute Care 54 Ballan District Health and Care - Support groups - District Nursing Services 53 Djerriwarrh Health Services District Nursing 52 Hepburn Health - Daylesford District Nursing Services 48 Ballarat Health Services - Central Intake for Community Programs - Dietetics 45 Golden Plains Shire Council - Home Care 36 East Grampians - District Nursing Service 35 Beaufort District Nursing Service 28 Ballarat Health Services - Central Highlands Coordinated Community Care Linkages 27 Stawell Regional Health - Post Acute Care 27 Stawell Regional Health - District Nursing Service 23 St John of God Hospital Ballarat - Home Nursing Service 22 UnitingCare Ballarat - Do Care 22 RIMS Provider Statistics
Issues Varied computer skills Computer access Currency of PAS information Confirmation of e-referrals Policies & Procedures in place for receiving e-referrals Cost of Discharging Problems Readmissions For the person to be referred to the right program: - Hospital admission risk program - Hospital in the home - GITH - TCP - Restorative Care - HACC services - District nursing
Easy access Improve efficiency of referral procedure Eliminate duplicate data entry Minim Data Set should be transferred from one system to another without the clinician keying anything in You should be able to confirm that the referral has been sent and acknowledged Rely on minimal training & expertise Provide statistical information Simplify transfer of information What do we want in a E-Referral System? E-Referrals
Has been in use across Victoria for over 14 years as an online Service Directory and secure referral and messaging solution. Is now using the National Health Services Directory (NHSD) as its source of agency, site and services information. The NHSD is national asset content managed by a range of organisations and is used by a wide range of applications for definitive information. Now sends to and receives secure messages from Argus using sites. Argus is a major secure messaging system used by thousands of GP, Specialist and Private Allied Health practices. Will soon be launched nationwide, allowing a much wider range of medical, primary care and community services organisations to use secure messaging to better coordinate care across the spectrum of Spectrum of Services. Has adopted the national eHealth standard called SMD (secure message delivery) to allow this messaging to and from GPs. Connecting Care
RIMS Patient management System PAS Connecting Care Service Provider National Health Services Directory (NHSD) Pathway
Referral Information Management System
Referral Information Management System
Referral Information Management System
1. Drivers for change Identified need to reduce the burden on the ward staff making referrals A review of RIMS found that over the last 3 months ward staff completed 489 referrals to PAC and Central Intake alone. This is conservatively estimated at 80 hours of data entry. Our Health Independence Programs, which include HARP, PAC, Centre and Home Based Rehabilitation programs and Specialist Clinics, need to streamline intake in preparation for Activity Based Funding and to meet the requirements of the Department of Health. Central Intake Screening Tool
2. Aims Introduce a system that: - Requires ward staff to identify patient needs rather than specific funding and program requirements - Allows the Referral Team to screen patients and complete referrals - Supports expansion to remaining Health Independence Programs. Simplify the referral process and provide additional resources to complete referrals into PAC and HARP. Reduce the