Health care goes high-tech
The Orange County, Fla., Health and Family Services Department has begun using Web-based software to track the services it provides residents and to plan each clients’ program of care. Already live in two divisions, the software is helping the department provide medical care more quickly and ensure that families receive all the services for which they may be eligible.
With a population of 980,000, Orange County is one of the largest counties in Florida. The county’s Health and Family Services Department has nine divisions that offer a variety of services for children and families, including medical care, crisis assistance and foster care services. Many individuals and families interact with several of the department’s programs. Each program traditionally has kept its own records of clients; however, the department did not have a way to track all the care individuals and their family members received.
A few years ago, the inability to track services and clients became a problem for the department’s Health Services Division. From 1999 to 2001, the division’s client base grew rapidly, from 5,000 to 30,000 patients. It received a federal grant from the Health and Human Services Department’s Health Resources and Services Administration to support the rapid growth. Part of the $1.2 million grant provided a medical case management system to manage referrals for services and track medical care for clients.
The division began searching for a case management system that would be secure enough to protect health information and to comply with the Health Insurance Portability and Accountability Act of 1996. However, it also needed a system that would let it share information over the Internet with its multiple service providers, many of which are private contractors in remote sites.
In late 2001, the department contracted with Wayland, Mass.-based Softscape to provide its Web-based case management and client tracking information system, CaseOne. The department began rolling out its intranet-based software in the Medical Clinic, which provides medical care to low-income, uninsured residents through a network of primary, secondary and volunteer services, in February 2003.
Caseworkers enter information about residents visiting the Medical Clinic into the system to determine which medical and social services they are eligible for. Using the software, caseworkers can issue referrals to physicians electronically. Additionally, the software generates full-service plans for the clients with instructions for steps they should take to receive services from other programs. The department automatically can generate reports to monitor caseloads, the number of medical referrals that have been issued and the number of residents that visit the clinic daily.
Shortly after the county began using the software in the Medical Clinic, the Youth and Family Services Division installed the software. The division provides services such as crisis assistance to residents who are in jeopardy of being evicted, losing their homes or having their utilities turned off; juvenile justice programs; and shelter for children and teenagers. Using the software, the division can track the financial assistance it is providing, the education progress of foster children and case plans for juvenile justice clients.
Because the software combines all clients’ information in one database, the department can evaluate all the services that it is providing each client and each client’s family members. “We’re getting a good picture of how many times a family might receive our services,” says Megan Cassidy McGee, monitoring and evaluations coordinator for the Youth and Family Services Division. “It’s given us some insight for planning for the future and funding issues.”
Although information about clients can be shared, it is not available to all users. The department can grant the levels of access users have to information, down to individual fields in the database.
Currently, the department is continuing to roll out the software to other divisions, including its Ryan White program, which provides services to HIV-positive residents, and its Citizens’ Commission for Children, which funds private contractors that provide counseling services, after-school programs and computer labs in 13 local neighborhoods. Soon, the department plans to integrate the software with the Medical Examiner’s Office as well.