caredove

A Blueprint for an Effective Central Intake Hub in Healthcare

Thu, 27 Jun 2024 16:15:18 GMT

A truly effective central intake hub is not merely a team of staff manually routing referrals behind a veil of complexity; it is an integrated system that dynamically combines public accessibility, algorithmic precision, real-time capacity management, and seamless communication to ensure patients receive timely and appropriate care.

What is a Central Intake Hub?

Central Intake Hubs play a critical role in the healthcare referral process, particularly for lead agencies managing regional health services. They serve as a coordinated point of entry for referrals, ensuring that patients are efficiently and effectively directed to appropriate services. The Hub collects patient information and either uses algorithms or personnel to analyze and route the referral to the appropriate service.

Over the hundreds of deployments of Caredove across regions, key features of an advanced Central Intake Hub have been identified.

Key Features of an Advanced Central Intake Hub

1. Scaling the Network

Feature : The network of agencies can grow significantly and rapidly after a Central Intake Hub system has been established.
Example : In Ottawa, a Central Intake Hub receives and disseminates referrals for 50 organizations. As the hub gains recognition, over 100 additional agencies join, expanding the network to 150+ organizations. This growth allows for a more comprehensive range of services, from counselling to assertive community treatment, meeting diverse patient needs.

2. Adapting to Capacity Changes

Feature : The hub adapts to changes in capacity, such as fluctuating wait times due to new funding.
Example : In Oakville, a seniors’ day program receives new funding, increasing its capacity. The program quickly updates its availability to reflect shorter wait times, allowing for more timely referrals from the Central Intake Hub, thus reducing delays in care.

3. Simplifying Participation for Organizations

Feature : Organizations can participate easily without hassle or financial barrier.
Example : One local clinic decides it wants to create a secure account to receive notifications of new referrals and handle referrals. They can do so, freely. Another local mental health clinic joins the central intake network with a connection through an API, handling referrals in their existing case management system, on an advanced paid subscription. These methods encourage more organizations to participate, enhancing the range of available services, taking advantage of features that meet their workflow needs.

4. Efficient Staffing and Navigation

Feature : Efficiently supports staffing for the central intake, recognizing that navigation is a service, but not the primary service.
Example : Central intake staff are trained to use an intuitive interface that reduces the time spent on administrative tasks, allowing them to focus on patient interaction and navigation.
Example : In Mississauga, an algorithmic routing form allows patients or caregivers to answer a series of questions, which are then scored by an algorithm. The form deterministically matches patients to the right services within the trusted collection, saving navigator time to support patients with higher needs.

5. Collaborative Staffing

Feature : Staff from different organizations can contribute part or all of their time to the regional central intake hub.
Example : A nurse from a local hospital spends two days a week remotely supporting the central intake hub, providing specialized knowledge and ensuring smooth referrals as part of a regional collaborative. These workers can login to an account to manage referrals specifically related to the central intake hub, separate from their other hospital duties, ensuring client data remains secure. A central intake supervisor or supervisors can have oversight over all full-time and part-time central intake staff.

6. Booking and Appointment Management

Feature : Ensures patients know who will help them and when through effective booking systems.
Example : A senior requests help from a central intake navigator and books a time via web interface. The navigator subsequently books the senior with a community agency. All throughout this process, the senior receives appointment confirmations and details about who will be helping, reducing anxiety and improving the patient experience.

7. Simplified Navigation and Service Matching

Feature : Simplifies navigation across the trusted network for navigators, enabling effective service matching.
Example : A social worker navigator working within the central intake hub matches a senior going home from hospital with a volunteer transportation service that goes to her home, using a custom search interface designed to check geographic service eligibility.
Example: The system’s algorithmic forms streamlines the process based on information in the form from the patient, presenting the relevant service result(s) without need for the navigator.

8. Integration with Care Coordination Systems

Feature : Integrates referrals with regional care coordination systems to improve care planning and delivery (e.g., HL7 eReferral interoperability).
Example : A patient’s referral by the central intake navigator is received by a home care agency directly into their case management system, eliminating rekeying of information.

9. Rationalized Forms and Information Sharing

Feature : Ensures that central intake forms populate any forms at the services to which the patient is routed, reducing the need for repeated information.
Example : A central intake form for a client with diabetes populates necessary information into the service forms required by a nutritionist, and a diabetes educator, streamlining the process and preventing the patient from repeatedly sharing the same details.

10. Expert Assessment and Triage

Feature : Can include an assessment step where expert personnel can conduct triage when necessary.
Example : A client is referred through a post-surgical clinic that functions as a centralized follow-up service post hip replacement. An advanced practice physiotherapist assesses the client and determines which type of community services, from nutrition support to transportation and medical equipment, would be optimal. The accurate assessment ensures the patient receives comprehensive community care and is referred accordingly.

11. Transparency in Referral Routing

Feature : Provides visibility to referring individuals about where the referral was routed.
Example : A primary care clinician can see that her patient’s referral was received by the central intake hub and routed on to a dietician, allowing for better followup and care coordination.

12. Low Barrier Public Access and Centralized Intake

Feature : Balances public access to low-barrier services with central intake for other services.
Example : Public can easily access basic services like flu shots, screening, walk-in service, meals and transportation, through a public self-serve search and request interface, while more complex needs are managed through the central intake process, ensuring appropriate triage and care coordination.

It might seem contradictory to have a single point of entry for referrals while also enabling public search and request directly to trusted services. However, these functionalities are designed to be complementary.

A well-designed Central Intake Hub efficiently manages the healthcare referral process. The right balance of navigator-enabled service matching, algorithmic routing, and direct public booking changes over time, based on service availability and seasonal demands. By leveraging a fully featured referral management platform like Caredove, with dynamic methods to integrate all these various components, Central Intake Hubs can live up to their promise of providing unparalleled value to healthcare networks, funders, and clients.

Rethinking Referrals: Embracing Direct Access for Community Health Care

jeff@caredove.com (Jeff Doleweerd) — Tue, 14 May 2024 16:15:59 GMT

Access to community healthcare is paramount for individuals across various stages of life — from seniors desiring to age gracefully in their own homes, to new parents seeking care for their infants and individuals in need of mental health and addiction support. Traditionally, when we mention referrals, the image of a physician sending a document to a specialist comes to mind. However, the landscape of healthcare referrals is evolving, and it's time to redefine our approach.

Gone are the days when referral management systems solely relied on healthcare professionals. Take Caredove, for example. What was once considered a referral management system has transformed significantly to a multichannel access management platform. Surprisingly, 43% of referral activity now stems from direct public sign-ups. This shift is monumental, with a staggering 70-fold increase in public service requests compared to pre-pandemic levels in 2019. Clinician referrals will be the minority of service requests activity in our platform by the end of 2024.

Why this paradigm shift?

During the pandemic, communities learned the importance of direct access to essential services. The notion of gatekeeping community services in any manner like specialist services became obsolete. The crisis strengthened the muscles of direct access, emphasizing the significance of preventive health through social and other services that keep people out of hospitals and other care facilities. Moreover, primary care is under immense strain, with 15% of Canadians lacking consistent access to ongoing primary care. In such a scenario, burdening already stretched healthcare professionals with more referral duties is not sustainable.

Accessing services directly not only expedites the process but also empowers individuals to take charge of their own health journey. It signifies readiness for change and recovery, without the artificial requirement of seeing a physician solely for a referral.

Primary care remains crucial, and it's imperative to equip them with resources available at their fingertips, enabling them to navigate the healthcare landscape autonomously. After all, patients trust their primary care providers, and we should harness this trust. We also need to foster a culture of self-advocacy and consumer empowerment as part of a broader solution.

Community agencies are champions of a healthcare system where individuals are empowered to take control of their health, supported by a network of trusted professionals. In an era of putting patients before paperwork, it is time to embrace direct access and take every bit of unnecessary administrative burden off family doctors and nurse practitioners, in the process.

10 Reasons Rapid Access Low-Barrier Walk-In Counseling Shines!

Fri, 10 May 2024 16:24:55 GMT

In the landscape of mental health support, a new trend is emerging: rapid access low-barrier walk-in counseling. This innovative approach is reshaping how individuals access mental health services, providing immediate support without the traditional hurdles of scheduling. At Caredove, we're witnessing the transformative power of collaboration among organizations delivering these services. Let's delve into why this trend is not just groundbreaking but essential.

Immediate Suppo rt : Imagine being able to get the help you need right when you need it, without waiting weeks for an appointment. That's the promise of rapid access low-barrier walk-in counseling. It ensures that no one falls through the cracks during times of crisis.
Reduced Stigma : By offering low-barrier access, we're sending a powerful message: seeking therapy for mental health concerns is not only acceptable but encouraged. This approach helps break down the stigma surrounding mental health, making support readily available and easily accessible.
Increased Accessibility : Not everyone has the means to access traditional counseling services. Some regions have been able to eliminate cost barriers, thereby ensuring that everyone, regardless of financial situation, can access the support they need to thrive.
Community Building : Low-barrier walk-in counseling centers can become community hubs, fostering a sense of belonging and support.
Preventative Approach : By addressing mental health concerns early and proactively, these services can prevent more serious issues from developing later on.
Empowerment : Rapid access low-barrier counseling empowers individuals to take charge of their mental health. By providing immediate support and resources, we're giving people the tools they need to overcome challenges and live fulfilling lives.
Cost Savings : While offering these services may seem like a costly investment, it can actually save money in the long run. By addressing issues early, we can reduce the need for more expensive interventions down the line.
No physician burden : Rapid access counseling requires no physician referral so does not tap the resources of overextended primary care, or present barriers for unattached patients.
Progressive Approach : Embracing rapid access low-barrier walk-in counseling reflects a progressive mindset in healthcare. It's about prioritizing the well-being of all in the community.
Stepped Care approach : Rapid access can operate in a stepped care model. During the session, if more specialized services are identified as necessary, individuals can be seamlessly referred to these services by their therapist.

Rapid access low-barrier walk-in counseling represents a seismic shift in how we approach mental health support. By embracing collaboration, we can amplify its impact, ensuring that everyone has access to the help they need, when they need it. Together, we're not just changing lives; we're changing the conversation around mental health..

The Danger of Shared Email Accounts in Healthcare: Avoiding Legal Risks and Building Patient Trust

Wed, 17 Apr 2024 17:35:45 GMT

Imagine a healthcare agency dedicated to serving its community, yet unknowingly putting patient privacy at risk with each click of 'send' to an email account. In today's digital age, safeguarding sensitive health information isn't just a legal obligation—it's the cornerstone of trust and integrity in healthcare.

Let's explore why relying on 'shared@communityhealthcare.ca' for referrals could be a costly oversight, jeopardizing both patient confidentiality and the agency's reputation.
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Email and Referrals… a bad match

Using email for sending and receiving referrals is a poor practice that can lead to significant privacy, security and compliance issues.

Inadequate Security Measures: Standard email lacks robust security measures. Most email services do not provide end-to-end encryption, making the content vulnerable to interception during transmission. This inadequacy exposes sensitive patient information to potential breaches.

Potential for Human Error: Emails can be easily sent to the wrong recipient, leading to unintentional disclosure of PHI. Such errors not only breach patient confidentiality, but also open up the organization to legal liabilities and loss of trust.

Challenges in Auditing and Monitoring: With email, it is difficult to maintain a comprehensive audit trail. Healthcare agencies need to track who accessed specific patient information and when. Emails, especially those sent from shared accounts, do not provide the necessary level of detail to maintain a reliable audit trail.

Record Keeping : Proper documentation and tracking of referrals are essential in healthcare for continuity of care and legal reasons. Secure systems designed for healthcare referrals often have features that ensure proper tracking and logging of communications, which standard email systems lack.

Lacking Consent Interface: Email has no specific method, such as a click-through agreement, for ensuring consent is actively collected before proceeding with a referral. Such a consent interface establishes a clear record and helps protect confidentiality by ensuring all parties involved understand and agree to the referral process before information is shared. Furthermore, such an interface can enable revocation of a referral, and deletion of patient health information, if consent is later withdrawn - something that cannot be done with email.

Simply put, your standard Outlook email inbox is not PHIPA or HIPAA compliant.

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Example: Eastern Ontario Data Breach

Incident : In 2016, an Ontario Hospital experienced a data breach when emails containing sensitive patient information were sent to incorrect recipients.

Details :

Human Error : Staff at the specific hospital mistakenly sent referrals containing personal health information (PHI) via email, to the wrong recipients.
Lack of Encryption : The emails were not encrypted, making the information vulnerable to interception and unauthorized access during transmission.
Inadequate Security Protocols : The hospital lacked adequate security protocols and training to prevent such errors and to ensure that sensitive information was sent securely.

Consequences :

Patient Privacy Compromised : The breach compromised the privacy of numerous patients, exposing their sensitive health information to unauthorized individuals.
Regulatory Scrutiny : The breach prompted an investigation by the Information and Privacy Commissioner of Ontario (IPC), which scrutinized the hospital's email security practices and compliance with privacy regulations.
Public Trust Eroded : The incident was damaging to the hospital’s reputation and undermined patient confidence. The hospital had to undergo significant remediation efforts.

Lessons Learned:

Standard email services lack encryption necessary to enable interorganizational referrals.
Secure online forms , either on the organization website, or for facilitating system to system referrals, are a necessary alternative to email.

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Going from Bad to Worse - Shared Email Accounts

Shared email accounts, such as 'navigators@seniorhealthcompany.com' or ‘intaketeam@hospital.com’, allow multiple staff members to access the same inbox using the same credentials. Unfortunately, this seems to be common practice when multiple staff share a role. This further exacerbates the problems of email.

Lack of Accountability: Sharing an email account makes it nearly impossible to track who accessed or sent specific emails. Without individual accountability, it becomes very challenging to audit actions and ensure compliance with privacy regulations.

Healthcare agencies need to track who accessed specific patient information and when. Emails, especially those sent to or from shared avcounts, do not provide the necessary level of detail to maintain a reliable audit trail.

Individual accounts are a precursor to enabling Role Based Access Controls (RBAC) which further can restrict access to what is necessary for a person’s specific role.

Security Vulnerabilities: Using shared email accounts increases the risk of unauthorized access. For example, if an employee leaves the organization but still knows the shared email password, they could potentially access sensitive patient information. Also, setting up two factor authentication for email becomes problematic with shared email accounts, as 2FA relies on a unique access point, like a mobile device, to receive an authentication code. This lack of control over email access poses a significant security threat.

Regulatory Compliance Issues: Regulations like HIPAA in the US and PIPEDA in Canada mandate strict controls over who can access personal health information (PHI). Shared email accounts often fail to meet these requirements, leading to non-compliance. Healthcare organizations could face hefty fines and penalties for failing to protect PHI adequately.

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Example: West Ontario Data Breach

Incident : In 2018 an Ontario Hospital experienced a data breach due to inadequate email security. It was reported that unauthorized emails containing sensitive patient information were sent from a shared email account.

Details :

Commissioner Investigation : Office of privacy commissioner conducted an investigation.
Inadequate Controls : Shared email accounts were found to lack proper access controls, and there were insufficient safeguards to prevent unauthorized access and use of the account.
Inadequate Security Protocols : There could be no effective security audits given the lack of control on system access.

Consequences :

Patient Privacy Compromised : The breach may have compromised the privacy of numerous patients, exposing their sensitive health information to unauthorized individuals. The extent of the breach was difficult to assess.
Orders by Regulator : A series of recommendations and orders were issued, covering email administration, security, encryption, training and auditing.
Public Trust Eroded : The incident harmed the hospital’s reputation and undermined patient confidence. The hospital had to undergo significant remediation efforts.

Lessons Learned:

A system of unique user accounts , for email and any other systems of record containing sensitive information, must be implemented and managed at a healthcare organization to maintain regulatory compliance.

In summary, the use of email accounts to send or receive healthcare referrals poses substantial threats to patient confidentiality, organizational integrity, and legal compliance. The examples of data breaches highlight the vulnerabilities and consequences of inadequate and insecure email-based referral practices.

To safeguard sensitive health information, healthcare organizations must implement secure, individualized referral systems, like Caredove's access management solution, to ensure robust security measures, strict access controls and PHIPA/HIPAA compliance. By adopting these measures, healthcare providers can protect sensitive patient information, comply with regulatory requirements, and foster a trusted environment for patient care.

Community Paramedicine: Embracing a Digital-First Approach to Care

rob.babos@caredove.com (Rob Babos) — Thu, 05 Oct 2023 16:34:42 GMT

In the traditional model of primary care, physicians provide health services to their patients in their offices, in nursing homes and in hospitals. This role is increasingly being shared with nurse practitioners and other health care professionals who work together to deliver care and provide referrals to other supportive community based healthcare services. These primary care teams typically operate in clinics such as Family Health Teams or Community Health Centres, which can be inaccessible to underprivileged populations due to the increasing shortage of family doctors who can take on new patients, or simply because transportation barriers to get to a clinic, exist.

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In an ever-evolving healthcare landscape, innovative models of care are emerging to address the diverse needs of communities in ways that will increase efficiencies and reduce costs. One such nontraditional and direct-to-consumer approach is community paramedicine, a concept that is transforming the way healthcare is delivered and is proving to be a lifeline for underserved and remote populations. The community paramedicine model is bridging the gap between emergency medical services and primary care, ensuring timely and personalized interventions that enhance the overall health and wellbeing of communities.

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Understanding Community Paramedicine

Community paramedicine is an extension of traditional emergency medical services (EMS), but with a broader scope that goes beyond their traditional 911 emergency services role. Alongside their essential emergency medical services training, community paramedics are taught to provide care coordination, preventive care and health education to patients within their communities. This shift from a reactive to a proactive approach empowers paramedics to play a pivotal role in disease prevention, chronic disease management and overall health promotion, thus reducing unnecessary hospitalizations and improving patients’ quality of life at home.

The Growth of Community Paramedicine

Over the past decade, the concept of community paramedicine has gained significant traction both here in Canada and across the globe. As healthcare systems face challenges such as overcrowded emergency departments, limited access to primary care in rural areas and the rising burden of chronic diseases, community paramedicine offers a scalable solution. Many healthcare organizations, governments and EMS providers have recognized its potential and have begun implementing community paramedicine programs, leading to an increasing number of emergency hospital diversions, reducing the strain on an already limited health care system.

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Community Benefits:

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Enhanced Access to Care: Community paramedics bring healthcare services directly to patients' doorsteps, especially in underserved or geographically isolated areas. This eliminates transportation barriers and ensures that individuals receive timely medical attention, preventing health issues from escalating to an emergency status.

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Preventive Care and Health Education: Paramedics are well-equipped to offer preventive care services such as immunizations, health screenings and chronic disease management. By educating patients about healthy lifestyles and disease management strategies, community paramedicine promotes overall wellness.

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Reduced Healthcare Costs: By addressing health concerns before they become emergencies, community paramedicine helps reduce the burden on emergency rooms and hospitals. This leads to cost savings for both healthcare facilities and patients.

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Personalized Care Plans: Community paramedics work closely with patients to develop personalized care plans based on their specific health needs and goals. This patient-centered approach fosters better outcomes and empowers individuals to take charge of their health.

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Integration with Healthcare Teams: Community paramedics collaborate with primary care physicians, nurses, social workers and other healthcare providers. This integration ensures a holistic approach to patient care and facilitates the coordination of services, promoting smoother care transitions and timely referrals to other community based support services, such as Meals on Wheels or Friendly Visiting.

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Case Study: Eastern Ontario Community Paramedic Program (EOCPP)

EOCPP is the result of a collaborative effort involving 11 paramedic groups covering a large part of Eastern Ontario. The website, communityparamedics.ca , launched in 2022 and has redefined healthcare access in rural areas by focusing on delivering crucial community paramedic services to underserved communities. Through this website, any caregiver, hospital staff, physician or patient can enter a home address and find the community paramedicine program that delivers in-home care where they live. Service requests can be made directly through the website, immediately and securely connecting the patient with the right community paramedicine team that will follow up with a phone call to confirm their eligibility and get them signed up to the program.

Craig Jones, Deputy Chief Community Programs and Emergency Management for Peterborough County/City Paramedics and a staunch advocate for this digital approach, emphasized the program's success in eliminating the need for time-consuming faxes and underscored the importance of ensuring compliance with the Personal Health Information Protection Act (PHIPA). "We elected to be digital only. The reason we did that is to be PHIPA compliant, and I would hazard to guess that my fax machine is not PHIPA compliant."

In his role as Deputy Chief, Craig also understands that enhancing efficiency means enabling interoperability. “The integration between platforms like Caredove, Epic, and Ocean now allows for the referral process to be as easy as a single click.” This digital transformation has enabled the acceptance and completion of 729 referrals between October 1, 2022, and August 7, 2023, demonstrating the program's effectiveness in rapidly connecting patients with the care they need.

Technology at the forefront

In a digital age, initiatives like communityparamedics.ca , have proven that embracing technology not only ensures compliance, but also expedites access to healthcare. By making public service requests easier with secure online booking through Caredove, community paramedicine programs like EOCPP are significantly increasing access to essential healthcare services, ultimately improving the lives of those with barriers to traditional care.

From Warm Transfers to Booked Referrals: Empowering Community Navigators for Better Healthcare Outcomes

jules@caredove.com (Jules Roebbelen) — Tue, 23 May 2023 17:38:54 GMT

Community navigators are playing increasingly crucial roles in the Canadian healthcare landscape, and are key for improving service access for individuals looking for care. Community navigators, or care coordinators, are highly skilled in connecting clients with the resources they need to keep them healthy, independent and socialized in their communities. These navigators also often become a valuable resource for busy physicians who need help arranging community support services or social prescriptions for their patients.

Community navigators are required to have a deep understanding of the available local resources that address the social determinants of health and can help reduce hospital visits. Historically, navigators have kept binders of community service information at their desk, filled with pamphlets and notes about local providers. The knowledge of what services are available where, who is eligible and how to access the service, only came from experience. Digital service navigation tools are now providing navigators with a wealth of information at their fingertips, and the ability to easily search for local services from a predefined set of service categories, such as Meals on Wheels, Adult Day Programs, Counselling or Social Activities. Relevant search results can be automatically updated by the community providers, so the information available to navigators never gets out of date. These living service directories are providing Ontario Health Teams with 24/7 patient navigation resources, ensuring that community members are also able to self-navigate across local services from a public facing website.

But service navigation is just one part of the role of a community navigator. True and valuable navigation also includes connecting the client with the chosen service, through a transfer or referral. There are several ways transfers can be transacted, including warm, hot and booked transfers.

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During a warm transfer, a navigator provides the client with the contact information for a recommended service. If the navigator is speaking to the client on the phone, the navigator may route the call and connect the client to the service provider’s phone line. This often results in the client being put on the spot to leave a voicemail where they briefly outline their request for service and await a callback.

Some warm transfers may include a workflow where the navigator can send a referral to the community service provider, either via phone, fax or other means of communication. In these cases, clients are still uncertain about who is going to contact them and when. For example, if a referral is faxed, there’s no way of knowing it has been received by the right person at the service organization.

In contrast, a hot transfer is when the community navigator has the ability to send an electronic referral to the target service provider on behalf of the client. The navigator can complete an eReferral form that collects the required information on the client at the time of the referral. This ensures that the provider has exactly what they need in order to proceed with the intake process for this client. When a navigator has access to an eReferral system, they can also receive updates on the client’s referral outcomes, helping to close the loop on the client’s care journey. By connecting clients with the right service provider in a timely manner, community navigators can help improve health outcomes and follow up if more action is needed.

At Caredove, we believe that an eReferral system paired with online appointment booking offers the hottest transfer method possible. A booked transfer allows the navigator to easily schedule a client intake appointment with receiving healthcare providers, reducing the burden on referring healthcare providers to schedule appointments on their behalf. This can streamline the referral process and lead to better client outcomes. By enabling online appointment booking at the time of the eReferral, clients can select an appointment at a time that is convenient for them, which ensures that clients know exactly who is going to help them, and when, improving satisfaction and reducing barriers to access.

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By utilizing hot transfers, eReferrals and online appointment booking, community navigators can help to ensure that clients receive the care they need in a timely and efficient manner. These systems provide improved efficiency, enhanced collaboration and communication between healthcare providers, increased accessibility to relevant client data and improved security and privacy. As healthcare technology continues to advance, eReferral systems paired with online appointment booking will likely become an increasingly vital and popular part of the referral process in healthcare.

Want to learn more about how Caredove improves access to health care services in Canada?

Building digital maturity through virtual networks

Mon, 30 Aug 2021 14:16:08 GMT

The challenges currently facing Ontario Heath Teams are unprecedented. Many OHTs are still in early development, and in the midst of recovering from the COVID-19 pandemic they must also launch themselves into a new digital health world. They are tasked with improving clinical outcomes for patients and local populations and enhancing the operational efficiency of the workforce. New integrated care delivery systems must be designed with improved access in mind, while also leveraging existing digital and virtual tools among networks of local health care providers. It’s difficult to know where to begin on a journey towards digital maturity.

What is Digital Maturity?

Digital maturity is the degree to which technologies are used to enable high-quality service delivery. A digitally mature organization will use multiple technologies harmoniously, each improving a specific part of a workflow or patient journey, to provide the best possible care and service access. When best-of-breed digital tools are used together, they enhance and compliment each other, rather than creating silos of duplicated data. There are many models of digital maturity, as maturity might look different in varying health care settings. These models act as a roadmap for organizations to understand gaps and set goals for improvement.

For Example:

The Measure Evaluation Interoperability Toolkit identifies major components of interoperability for health systems and lays out paths to meet goals.

HIMSS has a suite of maturity models that cover domains like analytics and continuity of care.

Knowing where to start a digital transformation can be overwhelming. It can be helpful to perform a digital maturity self-assessment to help you understand how ready your organization is to leverage digital technologies. In the meantime, here are some can’t-go-wrong starting points for your digital health journey, and where Caredove can help:

1. Ensure Interoperability

Strong transfers of care between organizations requires that digital systems be interoperable, that is, able to share information. This benefits clinicians, who perform less data processing, and patients, who can be confident information flows among providers without hassle or error. A strong interoperable digital ecosystem is one where the technologies work behind the scenes to send and receive data seamlessly and without duplication.

Ontario has an eReferral interoperability specification, based on the HL7 FHIR standard. Systems like Caredove adhere to this standard ensuring information is not siloed into one system and accompanies the patient on their journey.

2. Provide patients with more choice & improving access to care

Providing public access to your network of trusted services means giving your patients control over how and when they navigate the system and access their care. One of the most effective ways to accomplish this is with online service search and service request resources:

Add a public facing website to help patients understand what your OHT does, with a built-in search for available OHT services.
Enable patients to electronically request service , book initial assessments and provide consent to share information. Provide in-person and virtual options.
Provide patients with alerts and reminders so there is no mystery about who will be helping them, or when.

Caredove provides the ability to build a patient facing homepage to market OHT services, with built-in search, electronic service requests and booking, enabling the patient to choose their service provider, appointment time, location, language and more.

3. Increase access to community mental health and addictions services

With sensitive services such as counselling, it is vital for prospective clients to be able to choose the provider, time and delivery method of their session so they can ensure they are in a safe place to talk. This can be facilitated by regional collaborative networks of counselling organizations, which provide a shared virtual front door for patients to access services, while still enabling patient choice.

Referrals to mental health and addictions services through Caredove grew an astonishing 827% since the beginning of the COVID-19 pandemic. Caredove is the service access platform for brief counselling initiatives like Counselling Connect , which enable a coordinated response across more than 20 mental health organizations virtually or in person. Caredove can also help build central intake systems for a stepped-care approach, like AccessMHA , ensuring that every door is the right door.

4. Rapidly enhance care for other priority populations

Caredove has been helping improve access to care in Ontario since 2013. With accelerated adoption during the pandemic, there now are over 800 organizations in Ontario actively receiving referrals in Caredove, with services discoverable in other systems like CHRIS, Ocean and Careteam. Whatever the priority population of your OHT, Caredove has trusted local community agencies in many important sectors - seniors, children, mental health and addictions - already onboarded to receive referrals.

These organizations can be swiftly assembled into virtual care networks for any OHT to improve access and navigation. By leveraging the existing natural network within the Caredove platform, networks can be deployed at a rapid pace and are easily scalable. Caredove has deployed 25+ large networks in Ontario and has a proven deployment playbook that makes it easy to launch an Ontario Health Team network, geared toward any patient priorities that are a Year One focus.

5. Leverage past technology investments

The Ontario Digital Health Playbook encourages OHTs to build-on existing infrastructure standards that respects the investment in existing taxpayer-funded provincial digital assets.

One such asset is the provincial CHRIS system, used by thousands of care coordinators around the province. Caredove has collaborated with CHRIS to streamline care transitions to community services. Today, a care coordinator using CHRIS can search and book eReferrals through Caredove, without leaving CHRIS or needing to copy client information to a new system. It is easy and confusion-free, and thereby demonstrates a system that is better integrated, navigable and more digitally mature. This innovative solution is already deployed in several regions across Ontario.

Caredove has helped over 500,000 Ontarians navigate and book into community services and continues to help health care organizations implement, enhance, and scale virtual care programs and services to support integrated care delivery and reach digital maturity. By leveraging existing technologies and focusing on patient choice and digital access, Caredove helps to enable the exchange of data between health information systems and eliminate barriers to data accessibility and streamlined patient care.

‍ Schedule a chat with us about your Ontario Health Team.

Two Kinds of Networks That Mental Health Providers Should Join

Tue, 17 Aug 2021 18:32:02 GMT

Therapists working in the mental health sector have unique challenges from other health providers. They often work in small, local, private practices or non-profits where local advertising and word of mouth historically could drive a successful business. They are increasingly challenged from a growing set of online alternatives, often venture-backed startups, looking to “uberize” counselling.

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So what can these counsellors do to maintain their local business presence? Firstly, they need to be concerned about business oriented issues like marketing and lead generation. They need to understand how to create and manage their online presence so that they can promote their services effectively.

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Participating in an online network is a near instantaneous method to create a trusted online presence.

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A network is a collection of services from different organizations assembled to solve a problem. We cover two types of networks - associations and referral networks . If you are starting out as a therapist, you and your organization should be familiar with these network types, and ideally involved in both. They will increase your credibility locally and drive leads to you and your organization.

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1. Associations

Virtually every health care discipline, whether it is nursing, medicine, dentistry or psychotherapy, has an association that provides services to its members. Associations are membership-focused organizations. Revenue comes from membership fees in exchange for solving sector-wide problems where a collective approach is more effective. Advocacy is best done as a group, for example. Mental health practitioners could be advocating for improved tax treatment on services or better funding for underserved groups. Professional networking is, by definition, a group activity. Organizing regular events both online and in person is a mainstay of trade associations.

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Benefits of Joining a Mental Health Association

Mental health associations and their members can create a mutually beneficial online relationship where their websites link to each other. When these crosslinks lead to other value-added sites that offer relevant information on mental health or counselling, it improves search engine ranking and can direct more potential clients to each site. It’s a natural network that should be leveraged online. Other search engine optimization benefits may include authority backlinks, topic clusters and boosted topical expertise. For a deeper dive into these concepts, read our post about how associations generate referrals for their members .

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This partnership benefits both the association and the mental health professional. For the professional, membership in the association confers a level of trust to the public that they meet a minimum standard of education and professionalism. Further, membership often provides many opportunities for professional development along with other perks. Some mental health associations such as the Ontario Association of Mental Health Professionals provide their members with access to certifications, insurance coverage, subscriptions to publications and even discounts for useful products and technology. These benefits add significant value to the practitioners, and encourage greater participation within the association.

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The “find a member” Test

If you are thinking of joining an association, take a look at the importance they place on lead generation for their members. Most association websites will feature a “find a member” tool, usually linked directly from the home page. If it is a clumsy interface that confuses the public with irrelevant, outdated results, that’s a sign that you should discuss their goals to improve lead conversion as a key member benefit. However, if the public can easily find a reputable agency based on address and limited other information collected, without scrolling through an alphabetical list, they are doing something right.

What truly creates trust between the public and an association is when the public can transact a request that goes securely to the receiving member organization. This means the association can demonstrate the value they offer to members, with hard numbers. For the association, analytics demonstrating strong referral volumes to members, will not only maintain, but grow the association membership.

Here is one example of how a Midwifery Association embeds lead generation within their website, effectively, using Caredove’s embedded search tool.

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2. Referral Networks

Referral networks are all around us, and a well marketed one should be easy to spot. A referral network is a set of services from different organizations, collected by one lead organization, to solve a community health problem. Your imagination is the only limit for what is possible. A few real examples are:

Meal & grocery delivery during the pandemic in Ontario (100+ organizations)
Transportation to vaccinations in Simcoe (4 organizations)
Preschool developmental services across Eastern Ontario (10 organizations)
Isolated seniors in New Brunswick (50+ organizations)

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Mental health counselling networks are increasingly common. These networks are a recognition that one agency cannot meet all of the demands in a region alone. The COVID-19 pandemic catalyzed this awareness, as a growing number of people across the country reported anxiety and depressive disorders, with limited access to online support. Clients presented with a vast range of issues and required modalities from counsellors with broader knowledge and skill sets than one organization could offer. Is the person looking for individual, group, couples or family counselling? What disorders are treated, and what therapies are offered? Referral networks offer the public a trustworthy solution by providing a single access point to access relevant counselling services from a variety of organizations across a region.

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Examples of Counselling Referral Networks

Here are a few examples of counselling referral networks that make it easy for the public to find and book services online.

www.communityconnectyyc.ca

Connecting Calgary's communities with affordable and barrier-free access to phone or video counselling sessions

www.counsellingconnect.org

Brief phone, video or in-person counselling, provided by more than a hundred counsellors of diverse backgrounds to residents of the Ottawa area ‍

www.counsellingconnectsask.ca

Offering quick access to brief mental health services for individuals, couples and families in Saskatchewan

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When organizations market their services together, they communicate a message to the public that they can not accomplish independently. They declare trust in each other. They convey that each network member meets a standard of service delivery that allows them to participate in the network. When a referral network is assembled, they can also present a unified case to the payer (e.g., charitable organization, insurer, government), making the whole network more investible. A network of organizations working together towards a common goal is greater than the sum of its parts.

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Therapists working in the mental health sector need to improve their web presence to be able to attract new leads. Look for provincial or state-level associations and local networks that use solid lead generation technology to drive referrals. If no networks exist in the region you serve, it could be the right time to start a conversation with like-minded agencies. Visit our Solutions for Mental Health & Addictions Networks page to learn more about how we help thousands of people access therapy and counselling every week, and book a demo with our team so we can get to know you. Accessing mental health services can be complicated. We help make it simple.

4 Ways to Monitor Network Health

jeff@caredove.com (Jeff Doleweerd) — Fri, 06 Aug 2021 18:59:47 GMT

Support for community-based population health initiatives has been growing and governments and grant-giving agencies are accelerating their investments. For example, Canada’s Intersectoral Action Fund and the Center for Disease Control’s Social Determinants of Health provide supportive grants. The awarded local lead agency will inevitably be charged with building trust, data sharing and creating cross agency referral relationships, or “networks”. Demonstrating success to the funder will require monitoring the health of the referral ecosystem.

Volume of referrals, over time, does not tell the whole story. There are usually multiple channels of access that need to be monitored and important metrics associated with each. Monitoring the right metrics can help lead agencies have trust that all the partners are providing optimal person centered care.

Referral Outcomes

Nobody likes a mystery, particularly when it comes to healthcare referrals. If a client requests service, or a clinician sends a referral, you want to know they were helped. Every referral should have an outcome whereby the service provider indicates what happened. Did they speak to the client? If so, when? Were they admitted, rejected, or waitlisted? When every referral is tracked, the network administrator has the opportunity to understand patterns of service delivery across the region. When referrals are not tracked, the health of the referral ecosystem is undiagnosed.

Goal: Percentage of network referrals with outcomes shared = 100%

Once referral outcomes are monitored, the network administrator can begin to understand patterns. For example, are there some services or regions with longer wait times? This might be a signal that new partners should be added to the network, or that additional service investments are required. Are providers frequently indicating that clients are ineligible for service? This may indicate that the service is poorly described in the first place and needs to be clarified. Are clients frequently not arriving for the intake appointment? Perhaps it is time to activate email or text appointment reminder notifications. Ideally, every referral leads to a timely admission to service.

User Experience

How likely are you to recommend this blog to a friend or colleague?

0 1 2 3 4 5 6 7 8 9 10

Not likely Extremely Likely

We have all seen these questions, and when we answer, we are helping a business gather valuable customer experience insights. This is called the Net Promoter Score (NPS), where the algorithm produces a user experience score between -100 and +100. It is a particularly great measurement tool precisely because it is used so often; there are many companies with whom you can benchmark. For perspective, here are some average scores across different industries and companies:

Facebook: -21
FedEx: +3
Healthcare companies: +27
Software companies: +30
Starbucks: +77

Caredove is able to provide network administrators with the net promoter score of their network. This will provide you specific insights into your clients’ experiences accessing service in the network. If they experience unresponsiveness, unclear processes or unbookable services, your NPS will drop.

Benchmark your network’s NPS against Caredove’s platform wide average of 74 to understand how well your network is performing in terms of user experience.

Website Metrics

If public access is a key referral channel, understanding your website’s performance can be a helpful tool to monitor the health of your network. Website analytics can provide you with statistics for the number of visitors to your website, where they came from and what they did while they were there. If you notice that you have a high volume of traffic leaving the site after a short period of time without booking a referral, it may benefit you to consider how you can change the flow of your website to make this process easier for potential clients.

Important website analytics to monitor include:

Conversions: A conversion occurs when a visitor to your website completes a desired goal. In the case of a network, this goal is likely a referral being transacted. Keeping an eye on the conversion rate of your website’s visitors is essential to ensuring the public facing side of your network is functioning well and can provide insights on where to make improvements.
Pageview : A simple but powerful metric, a pageview is counted when a user visits any page on your website. This allows you to see which content is being seen most often. If your primary call to action is hidden on a page that nobody is visiting, you are unlikely to get conversions.
Bounce Rate: This is the percentage of user sessions with a single pageview. This provides top-level insight on how your network website’s content is performing, particularly if your client’s journey should involve them visiting a subsequent page in order to connect to a service. This metric is less relevant on a single page website where all the information, including your call to action, is provided on one page.
Source: Reporting and analyzing how people found your website is important to understanding which channels are most effective at driving leads and growing referrals. If none of your traffic is coming from your network member’s websites, then you might have an opportunity to engage them in link building and cross-advertising to drive further growth.
Average Session Duration: This metric provides a top-level view of how long users spend on your website, and can be a good indicator of whether or not your customers are digesting the information provided. If most sessions are short, your message may need to be condensed to get your point across and increase conversions.

Providing your partner organizations, funders and stakeholders with a full picture of your network health will help influence decisions for the future of your network. Keep a close eye on these metrics and make small adjustments throughout the year to measure continued success across your network.

Client Reported Outcomes (CRO)

Once a client has been referred or signed up from a website, how do you know if the service actually helped? You could have a great referral process to a very unhelpful service. How would you know? Basic surveys of service experience conducted manually are common, and a good place to start. Administering these automatically by using a referral management system at predetermined intervals is next level. Ambitious network administrators can roll out something called a Client Reported Outcome (CRO) at a regional level, as a way to identify strengths and weaknesses in the network. A CRO (also known as a Patient Reported Outcome, or PRO) is a health outcome reported by the client themselves.

CROs evaluate one or more aspects of health. This could be physical, mental or social health in adults or children. They can be used in the general population or by people living with any chronic disease. Typically, a questionnaire is created that assesses the health status or symptoms, like pain. There is a burgeoning list of validated tools available, like what is shared by the Canada PRO initiative or the National Institutes of Health .

CROs also provide valuable insights to funders and network leadership. If you are running a pilot program to test a new service access process in a region, funders will want to know how the clients felt about the ease of accessing services and transitioning through various stages of care. If a client found it significantly easier to connect with care and achieve positive self-reported health outcomes, there is a high chance of your pilot program turning into a sustained regional network.

Referral management systems are optimally positioned to track CROs before and after service has started. This provides network administrators an understanding of the impact of services across the network, from a client perspective.

Collecting metrics and analytics on all aspects of your network’s health will help provide network leaders, funders, referrers and clients with confidence that your network is successful in providing timely access to quality services. Continue to monitor your network’s health on a regular basis to find ways to improve user experiences and streamlined intake processes.

4 ways associations can generate referrals for their members

rob.babos@caredove.com (Rob Babos) — Thu, 29 Jul 2021 19:40:10 GMT

Associations typically provide a similar set of benefits to Members. Collective representation for government advocacy, group insurance, training resources and networking opportunities like annual conferences are among the more commonly listed perks. Being a Member gives your organization added reputability over non-member organizations, as Members go through an application process, at minimum, and potentially a significant vetting process, before joining an Association.

As a provider of software solutions for both Associations and their Members across a wide range of health care disciplines, we’re seeing demand for an emerging and often overlooked membership benefit; lead generation . Service providers in the community health sector are asking their Member Associations to take a more active role in generating referrals from the public or other trusted sources.

The public sign-up renaissance

We’re seeing exponential growth in self sign-ups from the public as a source for referrals. The COVID-19 pandemic was a catalyst for providers to offer more virtual services and online registrations. Through self-directed care , clients are taking a more active role in managing their own health and wellness. Even older adults are bridging the digital divide and acquiring a wide range of technological skills, thanks in part to great programs offering age-appropriate training. These trends have many agencies rethinking their online presence and how people access their services and how their Associations might help them.

How Associations can help

Because of their extensive range of web content, the first place somebody looking for a community health provider might land is the website of an Association representing that particular sector of care. Here are four digital marketing ideas that can help an Association foster these initial points of contact and convert them into leads for their Members, helping their Members boost direct traffic and ultimately demonstrate ROI for the annual membership fee.

1. Backlinking with Authority

A backlink is a link created when one website links to another. Google uses backlinking as a method of ranking, and when one website links to another, it indicates that the content is noteworthy. Not all backlinks are created equal, however, so a high-quality backlink will do more to increase a site’s ranking position and visibility in search engine results. For example, a backlink to a Member’s website from the Association’s website is considered a high-quality backlink, given that it came from a leader in the same sector with strong domain authority . Comparatively, a similar link from somebody's Facebook post would be seen as a low quality link by Google because it is not coming from a relevant website that has the same area of focus.

Ideally, an Association should have backlinks to all of their Members' websites, and their Members should have a link back to the Association. A common strategy for achieving the latter is disseminating a Members badge with instructions to link it to the Association’s homepage. Strong backlinking strategies between websites can do wonders for organic traffic for both the Association and its member base. Capturing outbound links is a great way to show your Members the value provided by your Association through the traffic you are sending them.

2. Robust “Find a Member” Feature

When a visitor arrives on an Association’s website, it should be easy for them to locate and connect with a Member in a minimal amount of clicks. While this seems like a simple concept, a poorly designed "Find a Member" feature often means the difference between a strong lead generating relationship and a poor user experience. Here are some things to consider:

There should be a prominent call to action for users to “Find a Member” near them, immediately visible on the homepage.
Consider using an interactive search; simple directories or lists of Members are cumbersome and time consuming to search through. An alphabetized list is almost guaranteed to be the least helpful way to organize information for a user searching for a specific Member.
The Members search should be intuitive and easy to use; have somebody that knows nothing about your sector try to find one of your Members, and see where they may be getting stuck or frustrated.
Results should be relevant and accurate, only showing options that would meet this particular user’s eligibility criteria. For example, if your Members’s service has specific coverage areas, use a map-based search that collects the user’s home address, and only returns results that serve the location provided
If there is a range of services offered by the Members, allow for filtering so users can search for the specific service they need.

3. Enable Public Sign Up in Your Member Search

Ideally, the public should be able to transact a request from an Association's website that goes securely to the receiving member. Eliminating the extra step of leaving the Associations’ website to locate a service request on the Member’s website will greatly reduce user drop-off rates. For an Association, this is a great opportunity to show tangible value to your Members by sending referrals directly to them. Being able to report these successes will attract prospective members that are considering the perks of joining your Association.

When using a platform like Caredove to power public sign up , Members can have the option to receive referrals, or to simply have their information displayed in a Members search. A good platform will also allow Members to directly update their own service listings and company information, eliminating extra administrative work for the Association. With limited staffing, no Association wants to spend time keeping Member directory information up to date.

4. Establish a Content Strategy to Become an Authority

An Association representing a certain sector should aim to be seen as an authority on all topics related to it. A functioning backlink strategy will help, and complementing this with a strong content strategy is also important. Establishing an Association as a trusted provider of quality content, guidance and information in a particular sector can seem daunting. Content is likely already being created in the form of resources or webinars for Members, and this is a great starting point. Consider using a Topic Cluster approach, by creating clusters related to one key industry topic, developing a pillar page for that topic, and then further subpages. At the heart of a topic cluster strategy is strategic internal linking, offering multiple opportunities to keep readers on the Association site and explore related resources. Achieving status as an authority for search engine queries related to a specific sector will provide direct value to Members who have backlinks from the Association’s site.

In Conclusion

Engaging with the Association's Member base and encouraging them to become more accessible online can be a valuable service offering in itself. Depending on the sector, Members may be small agencies with limited marketing budgets. A good way for an Association to provide guidance on marketing and lead generation is to lead by example. Do some of the heavy lifting for Members by creating a strong online marketing strategy and begin driving referrals to Members. We are certain Members will appreciate the value provided come renewal time.

Community health agencies - Built for Innovation

Fri, 16 Jul 2021 20:20:32 GMT

Clayton Christensen, a thought leader on innovation states that it "sneaks in from below". Mainframe computers were replaced by smaller, faster and cheaper PCs, then replaced by smartphones. Simpler, convenient and less costly offerings to solve basic problems continue to improve, to the point that they appeal to the vast majority of users. [source]

In health care, nobody is better situated to drive innovation than a well-led community care agency. Community agencies have a pre-existing advantage in the fact they already use lower cost settings and less expensive professionals. Add to that technology, like telemedicine, online booking, other interoperable tools, and a good dose of patient empowerment, and the whole health care market can be disrupted.

Improving patient / public confidence in self-managing conditions is vital to driving innovation. This means easier access to a greater basket of services. Innovative community agencies are not relying on the traditional access processes built for a bygone age. The majority of traditional health care services are delivered for the most demanding patients who are complex and require repeated interactions over time. This is the "5%" who gain the attention of major institutions like teaching hospitals and specialist physicians. In the mental health sector, for example, these are people with severe mental illness requiring hospital inpatient beds or assertive treatment teams. Access to these services should be heavily prioritized, using needs assessments, triage tools and screening algorithms.

These services are not what most people need, and using these same complicated screening tools as a primary door to access for simpler problems is a waste of money.

Community agencies have the opportunity to deliver less expensive and more effective access processes than their complex, high cost institutional counterparts. For example, treatment for those with anxiety, mild depression or grief can be relatively simple and provided at a low cost. Virtual or walk-in single-session counselling is an economical, low barrier way to provide service to the many people who can benefit. Marketing this service so people can find and book it easily online, is vital.

The winning community health agencies will use their low cost advantage to focus on what they can do well, with simple and transparent marketing, access, and service delivery. Then they can add additional tools like remote client monitoring, so that their relatively less expensive professionals can do progressively more sophisticated things, ideally in the client’s own home. The same playbook can be applied in every sector of health care. Failing to do this means care is expensive, inconvenient and many people will simply not get the care they need.

What's too much? How to design a streamlined intake form

Fri, 09 Jul 2021 20:40:08 GMT

When improving access to a network of services like community mental health and addictions programs, you may be inclined to design a single intake form for all services. Creating “one form to rule them all” will require input from all of your partner organizations and can result in a lengthy form. Each organization might focus on different demographics, so a single form will lead to over-collection or under-collection of data, depending on the service. Further, asking too much information up front can become a barrier to access for many people. In many cases, this information is not required or necessary for a client to receive a particular service.

Instead of trying to control a single intake form across the network, use this guide to help design inclusive and streamlined online forms for each service type.

1. Ask the question at the right time.

How important is it that I know this information BEFORE the first intake appointment?
Will the answer to this question help me provide better care or service navigation?
Is this a sensitive question that might be better asked in person, once rapport is established?

2. Be succinct

Gather only the minimum required information for your intake team to conduct an accurate first assessment. A long, over-complicated form can cause stress or anxiety. If you need to collect cultural and demographic information for funding or reporting requirements, you can do so with a survey after the client has been provided service.
Format questions so they can be answered in the easiest way possible.
・ Use multi-select checkboxes if you are gathering information about related symptoms, risk issues or substances used.
・ Use dropdowns when only one answer should be selected (i.e., a preference of phone, video or in-person appointments)
・ Use radio boxes for binary questions (yes/no, true/false)

3. Avoid large free-form text boxes

A free-form question can lead to irrelevant information and the client may not provide you with what you are actually looking for. Normally, one open text box at the end of the form is enough for the client to share what they feel is important.

4. Consider relevancy

More is not always better when it comes to gathering information. Irrelevant information can distract from seeing what is important. Do you really need to ask the client’s gender or sex? It may be more relevant to ask their pronouns so you know how to address them in conversation. Do you actually require the client's health card number to deliver service? Ensure you know the purpose behind collecting each item of information, before you ask for it.

5. Avoid multiple consents

There is a difference between consent to share information and consent to treatment. Make sure you are only asking the client consent to share information with your organization, as the consent to treat should come after the intake appointment, when a treatment plan has been decided on.

If your network’s primary goal is to reduce barriers to access, design an intake form that is easy to understand and easy to fill out. Overcollection of information too early in the process will lead to higher drop-off rates and your intake team will waste time sifting through for important data. Take the time to ask the very sensitive or complicated questions in person, after rapport is established, to ensure that every person has equal opportunities to access services.

4 Ways to Kickstart a Regional Central Intake Project

Thu, 08 Jul 2021 21:17:31 GMT

A centralized approach to access is worth exploring, particularly when launching a mental health and addictions network. The concept is often raised because people accessing services are confused about what is available where, and what wait times can be expected. In theory, a single point of access can help streamline registration by ensuring that the client is connected to the right provider from the very beginning.

The idea of forming a central intake team to take on the task of navigating services for all inbound requests is great. This team would become ‘service experts,’ trained to quickly determine what client needs what service, and their eligibility. However, bringing a network planning committee to agreement on an actual process can be difficult. Enthusiasm is quickly replaced by analysis paralysis. Here are some actions that can kickstart a regional central intake project, and gain momentum towards coordinated service access.

1. Map all the service assets

A strong network contains many organizations, each offering a different variety of services. It is important to clarify the services each agency delivers, where they are located and how people normally access these services. Overlaps and gaps will be evident. Decide as a group which types of services will be the primary focus of the network’s central intake and work to fully understand their intake processes.

2. Start with less complex health services

You don't have to streamline the access process for everything, all at once. This can be overwhelming. Rather, we recommend first tackling the least complex health care services first. For example, an intensive service that is provided to a patient every week over many months, with a several year wait list will have a more complicated path to access. Leave this for later, once you have some momentum from early successes. Choose to coordinate access to publicly accessible counselling before tackling referral based assertive community treatment programs, for example.

3. Don't over-collect information

Every agency has a service with its own referral form. When centralizing access to a specific service type, be ruthless about what should be included in any new form. Only include the minimum information required that the central intake team needs to successfully route the referral. The target service will require its own relevant information which comes later in the process, often with a different form.

4. Have clear routing criteria

The central intake team should have a decision support tool to ensure they have a clear process for determining which provider receives the next referral. Digitize this process and communicate it broadly across all partner organizations so they understand when and how they will receive referrals. This ensures buy-in from all partners. Ideally, each provider should be so familiar with the process that they are able to route referrals to other providers in the network, and if pressed, could actually work in the central intake area.

We all know what it feels like to get stuck in a planning process. A regional central intake process can feel enormous, and this feeling can deter the most well-intentioned from taking a first step. Taking small, measurable steps helps build momentum for more ambitious goals.

10 Tips for Picking a Good Domain

jules@caredove.com (Jules Roebbelen) — Thu, 10 Dec 2020 15:23:14 GMT

Having a hard time deciding on a website domain for your coordinated access initiative? Caredove’s marketing experts have come up with 10 tips to keep your team on track when brainstorming ideas.

As we build a health care system focused on sharing data and resources, groups of local organizations want to work together to improve access to services. Maybe it is to help people schedule virtual counselling appointments across multiple mental health agencies, or several community based organizations want to collaborate on the services available for seniors in a certain region. It’s hard enough to harmonize intake processes, and picking a domain name for your project website shouldn’t be the showstopper. Just because you named the initiative something at the start, in the early days of the committee’s founding, you don’t need to have that limit your project domain name options.

A domain name is the URL used for your website. Picking the right domain name can make a huge difference in how easy it is for people to access your project website. Your project name might be very long, but that does not need to be your domain name. For example, the project “North East Home Care and Community Support Services” uses the domain name northeastsupport.ca. This is a succinct summary of what their project is about, in a way that is easy to communicate without too many words.

Pick something easy to spell and type. It should be easy for someone to say, and for others to understand. Imagine trying to share the website domain with someone over the phone.
Avoid double letters - cypresssurfshop.com has three Ss in a row, which can easily be mistyped.
Keep it short, under 15 characters if possible.
No more than 3 words.
If you are using an acronym, keep it below 6 letters.
Avoid mixing spelled out words, with acronyms - gtaaccess.com mixes an acronym with a word, and has a double A, which is a recipe for many typos.
No symbols like ampersands, as they don’t function as part of a domain.
Hyphens are technically allowed, but discouraged as they’re often considered spam by search engines. Also, people may forget to include the hyphen and be redirected to a different website.
Ensure the domain and all the social handles are available to help achieve continuity for your brand.
Check what results currently are displayed when searching for the new domain. Anticipate misspelled words and view the related results.

It might be hard to achieve a domain that avoids all these common mistakes. These are guidelines, and one rule could be broken if it really makes sense for your brand (ie, you can have more than 3 words, if they’re short words). If you can do these things and find something memorable that captures your brand or project goal, you’ve got yourself a great domain!

Advanced tips:

When it comes time to check if your domain name is available for purchase, do your domain name research outside of GoDaddy or any other domain provider. It will increase the value of your domain if you don’t buy it right away.
Avoid creative domain name generators, because your keywords may be tracked by a third party domain provider that might snatch up whatever you’re looking at. Instead, research keywords using Google Trends for your region, or by testing domain names in your search bar to see if they’re already taken.
Buy multiple similar domains and point all of them to your website.

If you are using www.torontosupport.com, make sure that www.torontosupports.com is also available and have them point to the same location, to avoid confusion if someone adds, or removes the S at the end.
If you are purchasing the .ca domain, also purchase the .com domain.

5 Steps to a Secure Website

jules@caredove.com (Jules Roebbelen) — Tue, 04 Aug 2020 16:13:53 GMT

Please do not send any personal health information through this form.

Email communication is not secure. Do not share your health information via email.

No matter how it’s worded, even in giant blinking letters, whenever there is an opportunity to type text into a message area, people will, without fail, share personal information through website Contact Us forms. This likely triggers a whole process of information deletion at the receiving end, and is a constant privacy concern for security officers. It is the responsibility of health care providers to ensure that information is handled properly, even if it was improperly sent through your website.

There are hundreds of available website Content Management Systems (CMS), but few are optimized for displaying health care services or gathering Personal Health Information (PHI) from patients and clients. Caredove takes your website security seriously, and we have a few tips to help boost your site's integrity and improve the management and security of PHI.

1. Secure your website with an SSL certificate.

This turns the "http" at the beginning of your URL to "https" which encrypts requests and responses between your website and the website viewer. This also makes your website harder to hack, protecting your information and any client information that might be held in your website. Having a site secured with an SSL certificate is the bare minimum of security measures you should implement on your website, especially if you are promoting healthcare security and privacy standards in your workplace. It is the most standardized "stamp of approval" for a website's authenticity and trustworthiness. Depending on your website provider, you can get free or low cost SSL certificates that are simple to implement.

2. Remove your general inbox email address from your site.

‍ Hacker bots can scan thousands of web pages every day looking for an exposed email address. These email addresses are then victim to higher volumes of spam and junk mail, which can be an insidious way for hackers to gain access to your private information through a scam process called phishing. If a team of receptionists or front desk staff are sharing access to a general email inbox, any one of them could fall victim to a phishing scam, where they are tricked into entering passwords or credit card information into a fake form, handing over the keys to their virtual lives to an unknown hacker.

3. Secure your contact form.

‍ Contact forms are an excellent way to gather leads and handle incoming inquiries from your website. But there are several reasons why a contact form is NOT the best way to gather information about your clients. Contact form submissions likely land in a general email inbox for your organization, managed by multiple front desk staff. Overall, email is NOT a secure place to hold patient information.

Are you 100% sure that you know all the people that have access to that email inbox?
When was the last time the password was changed?
What country is your email server hosted in?
What if the email server fails? How do you access your messages?
Does your staff have access to this email from home?
What if their home computer gets a virus? Do they have proper malware in place?
How do you know that your staff aren't forwarding PHI on to other parties?
What sort of workflow do you have in place to action these inquiries to make sure they aren't being lost in the shuffle?
If PHI is sent through these forms, what steps do you take to destroy that information?

If your contact form is NOT going to a general email inbox, that means that the data is stored directly in your CMS. The top five website Content Management Systems under attack in 2018 were:

WordPress (while WordPress does offer a substantial security program, most breaches are because the WordPress website was improperly set up by the user, due to old plugins not being updated and missing SSL certificates)
Joomla
Drupal
Magento
Sharepoint
Source

These CMS are at risk of compromising any PHI you have stored in your website. Many CMS have servers all over the world, which means your client PHI could be travelling to countries with much less strict privacy standards than Canada. Storing PHI outside of Canada might be in breach of your organization's privacy and security standards.

4. Ensure any contact form integrations are compliant with your national healthcare privacy standards.

Contact forms can be integrated to lead pipeline software like Hubspot or Salesforce, making it easy for your sales team or intake staff to action leads without living in an email inbox. Even if you have an integration to one of these softwares, which ensures leads and PHI does not land in an email inbox, many of these lead tracking softwares are not PIPEDA and HIPAA compliant, meaning they do not meet Canadian and American healthcare privacy and security standards. If you are handing PHI in one of these systems, make sure that they are meeting the healthcare standards necessary to properly handle your client information.

5. Choose a contact form process that aligns with your organization's values to provide the best and most secure access to care for your clients and patients.

You will likely be able to make things clearer if you manage service requests in a compliant system like Caredove.

Caredove has a 99.9% uptime with AWS servers hosted in Montreal. No patient health information ever leaves Canada.
Caredove terms and conditions means we take responsibility for storing this information securely.
Our data is encrypted end to end.
We are experts in health information privacy and security, so you don't have to worry.

Caredove can embed a secure contact form on your site, or build and host your entire website if you are concerned about your site's overall security. We guarantee a secure, responsive and beautiful website, with all your Caredove services and contact forms seamlessly integrated, making it easy for patients and clinicians to send service requests from their computer, tablet or phone. Learn more about our WebBuilder, and how we can improve your website security and your client experience.

How 'Best of Breed' Digital Tools Increase Network Value

jules@caredove.com (Jules Roebbelen) — Wed, 03 Jun 2020 17:21:12 GMT

Click here for Part 1 of our Interoperability series.

When systems are integrated , each system builds connections to each other system to ensure that it can exchange, translate and interpret the data of the other systems. Integration usually requires the use of “middle-ware”, a third-party software in order to receive the sent data, interpret it and then transmit the translated data to the receiving parties. You see this often on a small scale within and between organizations. For example, a hospital might integrate its medical records system to its billing system, its admission/discharge system, its scheduling system, and maybe even some external partner organizations. With each integration, you have to translate the APIs (Application Programming Interfaces, or “languages”) of each system to each of the systems they are connected to. This becomes exponentially more complex as you add new systems. This often becomes so difficult, that many organizations give up and purchase monolithic systems that try to do it all. This strategy has many benefits, but you begin to sacrifice the ability to use best-of-breed solutions, limit access to new innovations in the marketplace, and often make inter-organizational integration even more difficult (because your monolithic system often wants to control your business partners’ processes too). In most cases, your monolithic system will not be greater than the sum of its best-of-breed competitor parts. It discourages the introduction of new technologies that would otherwise be beneficial to your organization. Your monolithic system ends up creating more limitations than possibilities.

The Art of the Possible

What is best of breed? These are digital tools that have mastered a solution to a few very specific problems. Each tool "stays in its lane" and perfects the solution in such a way that stands well above any other competitor that tries to "do it all". For example, a nutritionist will never recommend a meal replacement bar. Yes, it will keep you alive, and it is cost effective and convenient, but you are not getting all the nutrients your body requires from fresh fruits, vegetable and whole protein sources. Best of breed technologies works the same way. Best of breed solutions are always built according to the HL7 FHIR standard of healthcare data exchange. This means that any solution built to the HL7 FHIR standard can easily interoperate with any other HL7 FHIR system, because they communicate using a common language. A system built of best of breed solutions means that you are getting the most advanced features specific to that healthcare sector, without compromising any one system's ability to attempt to do everything, which often results in gaps in the functionality of the software.

Caredove is the only eReferral system focused on home, community care and mental health & addictions services. With complicated coverage regions, multiple referral forms and a desire to market services to the general public, Caredove's eReferral and service marketing platform provides all the tools your agency needs to advertise services, gather client information and schedule intake appointments. If you are a hospital network, being able to search for and refer to these types of services, directly from your EMR or HIS, is of incredible value to your patients who are confused about navigating the community care sector on their own.

By using an HL7 FHIR interoperable system, connecting to Caredove through your existing system is just a click away. To learn more, schedule a demo with the Caredove sales team.

Orillia company helping seniors across province get essentials during pandemic

jules@caredove.com (Jules Roebbelen) — Wed, 22 Apr 2020 12:24:26 GMT

By Nathan Tyler at Orillia Matters. See the original article here.

An Orillia company is using its online expertise to help isolated, low-income seniors get the essentials during the COVID-19 pandemic.

Caredove, a local software company, is already in the business of connecting health-care professionals and their clients with available resources. So, when it was asked by the Ontario Community Support Association (OCSA) to host a website to help out during the pandemic, “it made sense for us to do it,” said Caredove CEO Jeff Doleweerd.

“For people who are isolated, it’s more important now than ever that they remain in their homes, supported, because it’s the safest place for them to be. They need supplies and groceries to be able to do that,” he said. “Not everybody has the means or ready access to a social network that can help them remain in their homes.”

Through the new website, ontariocommunitysupport.ca — a partnership between Caredove, the OCSA and the province’s Ministry of Seniors and Accessibility — people can book deliveries of Meals on Wheels or other essentials, such as groceries and medication.

The service is available to people all over Ontario. The OCSA manages community support services for the province and works with about 600 organizations.

“With the help of the OCSA, we were able to reach out to all of the organizations they work with,” explained Jules Roebbelen, digital marketer with Caredove.

She echoed Doleweerd’s comment that it was a natural partnership for Caredove to get involved with.

“Our entire business model is about keeping people healthy and safe and independent at home. We do that by connecting people with community support services,” she said. “In line with COVID-19 and self-isolation, this was the perfect time for us to launch a provincial response.”

Caredove officials might not have expected a pandemic, but their software has made for a fairly seamless transition to assist during this type of situation.

“The platform was built to deploy at a rapid pace. We already had the software in place,” Roebbelen said. “This was not a position we ever wanted to be in, but we’re happy to be able to provide such a rapid response to something like this.”

Caredove, which has been in business for about six years, has approximately 20 staff members who have been helping with the latest project, and all of them have been eager to assist, Doleweerd said.

“It’s nice to be able to help out in a way like this,” he said.

More information about Caredove can be found on its website .

Caredove Business Continuity Plan

jules@caredove.com (Jules Roebbelen) — Thu, 19 Mar 2020 17:27:18 GMT

Caredove’s mission has always been to help people remain healthy and happy at home. Keeping true to that statement has never been more important than now.

The community support sector is quickly adapting to support seniors and other isolated people to ensure they are safe and well equipped at home. Some services are cancelled, while others are in more need than ever. For example, efforts are focussing on delivering nutritious food, prescriptions, essential supplies and vital transportation.

Let us reassure you that Caredove is here to help you as your priorities shift to respond to the COVID-19 pandemic.

All Caredove staff work remotely at this time, ensuring minimal exposure to COVID-19, and resulting illness. At this time we are fully staffed, and we are able to support existing customers while operating at as little as 30% staffing levels, as all staff are trained in providing operational support. As always, our operations team is available Monday-Friday, 8:30 am - 4:30 pm EST to help you manage program cancellations and notify your clients of changes to upcoming events or response times.

Please do not hesitate to reach out to us in this time of need. For all questions, please call 1 (833) 567-3683 , or speak with your existing Caredove representative.

10 Books to Support Alzheimer's and Dementia Caregivers

jules@caredove.com (Jules Roebbelen) — Tue, 17 Mar 2020 17:42:00 GMT

This is a subtitle for your new post

As health systems move away from healthcare access models that involve referral management shrouded in mysterious fax processes, caregivers and clients embark on a new path towards self-guided care. This is why we created Caredove in the first place. Our goal is, and has always been, to help people remain healthy and happy at home, by providing everyone with easy access to relevant local services through a network of quality community organizations.

We have spent countless hours designing and developing the right tools for the job. Over 700 organizations use our platform to receive streamlined eReferrals, allowing staff to spend more time with clients, and less time on faxes and phone tag. But how do we best help the client or caregiver, awash with the anxiety of a new diagnosis?

How might we help them learn to direct their own care?

Where do we start?

The best health care access processes involve clients directly in the selecting of services and convenient appointment times. We strive to eliminate referral confusion often associated with documents faxed to vague destinations, with unknown service wait times. When someone is newly diagnosed, for example, with Alzheimer's disease, the last thing they need is anxiety related to who can help them, and when. We believe a more informed health care consumer will experience better health outcomes.

As we support clients and caregivers with improved service access, they also need resources to better manage conditions like Alzheimer’s. Our friend Kathryn Harrison at AlzAuthors has provided helpful reading material. We hope that you may find a helpful book or two to help you on your journey, or to recommend to a friend caring for someone with Alzheimer’s or related dementia.

10 Essential Books About Dementia for Caregivers

1. A Pocket Guide for the Alzheimer’s Caregiver by Dr. Daniel C. Potts and Ellen Woodward Potts

Written by a neurologist and caregiver, this “how to” guide offers clear, concise, practical, and compassionate advice to help improve the lives of people with Alzheimer's and those who care for them. “In my writing, I often attempt to place myself in the shoes of the person with dementia and speak in what I perceive to be their voice.”

2. Caregiver’s Guide for Canadians by Rick Lauber

Specifically for Canada, this book gives readers valuable tips and advice to help them to provide the best elder care possible, while balancing their other demands. This comprehensive guide answers many common caregiver questions. Feedback on the book includes “superbly written”, “a lifesaver” and “a wonderful, concise, practical book.”

3. Connecting in the Land of Dementia: Creative Activities to Explore Together by Deborah Shouse

“Across the globe, writers, painters, musicians, gardeners, dancers, expressive therapists, and other innovators were using the arts, creativity, and imagination to tap into the spirit that thrives in those living with dementia. I talked to dozens of creative experts, collecting their ground-breaking ideas, and translating them into easy, meaningful activities.”

4. Dementia with Dignity: Living Well with Alzheimer's or Dementia by Judy Cornish

This book details the often unmet emotional needs caused by dementia and provides techniques for responding to them. When the caregiver learns these techniques, it will help the loved one enjoy more peace and security in their home. This book is “filled with stories from my years with my clients—stories of their courage, wisdom and perseverance.”

5. I Care: A Handbook for Care Partners of People with Dementia by Jennifer A. Brush and Kerry C. Mills

“I wanted to write something that was hopeful and helpful, something that made life better and more manageable. There are so many ways that a person with dementia can still contribute to a relationship. Focus on what the person can still do, not what is lost.”

6. If Only You Would Ask: A Guide to Spending Quality Time with the Elderly by Eileen Opatz Berger and Joan Berger Bachman

With forty-two topics and over four hundred questions, this book provides a framework when visiting with the elderly for tapping into memories that may not have been thought about or talked about for years! “This resource has great potential as a way to encourage enjoyable visits.”

7. Managing Alzheimer's and Dementia Behaviors (Health Care Edition) by Gary Joseph LeBlanc

From decades of experience in caregiving and years of research, this book was created to help caregivers become more dementia-friendly. “I have truly learned that there is no greater “expert” than one actually living with the disease. We need to listen to these folks—and I mean, truly, listen.”

8. Meet Me Where I Am: An Alzheimer’s Care Guide by Mary Ann Drummond

This book leads caregivers to joy, while preparing them for the road ahead. “Caring for someone with Alzheimer’s disease requires an abundance of knowledge, patience and love. My goal was to give caregivers a tool that would teach, enlighten, and comfort while preparing them for the journey ahead.”

9. Minding Our Elders: Caregivers Share Their Personal Stories by Carol Bradley Bursack

“Through my book – a portable support group - I offer emotional support. Through my newspaper column, I give practical advice and resources. Through all of my work – my blog, column, caregiver’s forum, speaking, and my role as writer and moderator for major caregiving websites – I offer support from the caregiving trenches.”

10. The Alzheimer's Medical Advisor: A Caregiver's Guide to Common Medical and Behavioral Signs and Symptoms in Persons with Dementia by Dr. Philip Sloane

Written by a physician and researcher, this resource for caregivers of people with Alzheimer's disease or a related dementia, provides information about a variety of medical conditions and dementia-related behaviors. This book “was written to help share the practical knowledge that has accumulated during the past 40 years.”

‍

Kathryn Harrison is a director for the non-profit organization AlzAuthors , the global community of authors writing about dementia to light the way for others, breaking the silence and stigma that often accompanies a dementia diagnosis, one book at a time. Find more of their best Caregiver Guides and reading suggestions here .

Kathryn is also the co-creator of Flipturn Publishing , where you can find her children’s book about Alzheimer’s, Weeds in Nana’s Garden .

Caredove Integration Webinar

rob.babos@caredove.com (Rob Babos) — Fri, 06 Mar 2020 18:44:02 GMT

Thank you to everyone that joined our webinar on March 12. Stay tuned for more webinars from the Caredove team by following us on Twitter .

Integration vs Interoperability: The Definition

jules@caredove.com (Jules Roebbelen) — Fri, 06 Mar 2020 18:33:21 GMT

This is a subtitle for your new post

The terms integration and interoperability are often used interchangeably, but they are very different creatures, and understanding the impact of an “integration strategy” versus an “interoperability strategy” can have a dramatic effect on your product and business.

Let's start with some definitions:

Integration : A connection between two or more products or systems, enabling communication, usually with the use of “middleware” to translate each system’s data

Interoperability : A characteristic of a product or system to be capable of communicating with any other products or systems that speak the same language (i.e., have a common standards-based interface)

Imagine that you are visiting an international conference with people from across the globe, and that everyone speaks a different language. How do you communicate with everybody? There are three basic options:

Everyone learns every single language spoken at the conference
Hire a translator for every language at the conference
Everyone learns ONE common language

Options 1 and 2 are “integrations”, where 1 is a direct integration (everyone learn everyone else’s language) and 2 integrates via “middleware” (i.e., the translator). These options require a custom translation to each participant. Furthermore, each additional participant adds another translation that everybody needs to handle. If 10 people know all 10 languages to speak to one another, what happens when ONE new person joins the group? That one new person now has to learn 10 new languages, or, the translator now needs to learn how to communicate that new language into the 10 other languages. At a certain point, no new person is going to want to join the group, because of how many languages they have to learn. When the number of systems add up, this process is timely, and costly.

If you only ever want a few people at your conference, “integration” will probably work just fine. But, if you want a lot of participants that all interact with each other, “interoperability” is the way to go.

Option 3 is “interoperability” - everybody learns the same ONE common language. The benefits of interoperability in this scenario are clear:

You only need to learn ONE language, no matter how many people are at the conference
When a new person arrives, they only need to learn ONE language, and no one else needs to learn anything new

When systems have interoperability , they communicate via a common language with no translation required. Phones, faxes, railroads, AM/FM radio, the web, and email are all examples of technological interoperability. In the world of email, the different products Outlook, Hotmail and Yahoo all use a common data format to transmit emails from one system to another. When Gmail was introduced, it did not add more complexity to the network - and the other systems did not need to do any extra work, because the email ecosystem was interoperable with any platform that used published public email protocols and standards. The interoperability of faxes has incredible value, as every single fax machine is built to communicate with every other fax machine. Despite the method’s shortcomings, fax still dominates the healthcare industry as the preferred method for information exchange because the size and value of the existing network is so big.

In healthcare, there will never be a world where all agencies use all the same software. Primary care clinicians have a unique workflow of client profiles; specialists have specific technology to display their laboratory test results; nursing homes have bed matching algorithms, and home and community care agencies manage transportation and meal delivery requests for a growing number of billable patients across pre-defined coverage areas. But, they all might need to send pieces of client data to one another in the form of referrals. This is becoming increasingly clear as we learn what shape Ontario Health Teams will take, as each partner agency brings their existing systems to the table.

We need a new digital network to enable referrals. For this new network to fully succeed in displacing fax, it needs to be as interoperable as the fax machine. Integrations won’t get us there. The first step towards this goal is - agree on the language.

Fortunately, there is already a standard and flexible standard for health care data exchange, called HL7 FHIR . This standard provides the core building blocks needed to build a detailed interoperability specification (i.e., “language”) for a specific process such as eReferrals. Once this specification is defined and in use, any new system can simply “learn” this one language to easily join an entire network of eReferral enabled systems.

In Canada, the process of building this HL7 FHIR based specification has been ongoing, with participation from both government and industry. As various systems adopt this specification in full, true interoperability for healthcare referrals emerge from a dream into a reality.

If you are in the early stages of a digital healthcare referral strategy, choose interoperability over integration and ensure that all systems adhere to the FHIR standards, so you aren’t still faxing referrals like it’s 1999.

OHT Survival Guide: Part 1

rob.babos@caredove.com (Rob Babos) — Fri, 20 Dec 2019 19:22:20 GMT

How Caredove’s eReferral platform is helping Ontario Health Teams navigate the latest challenges of the province-wide health overhaul

Ontario’s health care system is in the midst of significant change, and while this transformation may seem difficult for the organizations involved, we are excited about the promise Ontario Health Teams (OHTs) offer. In this first part of our OHT Survival Guide, we’ve highlighted some key challenges that reform will bring and why we feel they present exciting opportunities to innovate and improve on how healthcare is delivered in the coming years.

1. The push towards community care

One of the earliest expectations outlined to Ontario Health Team (OHT) candidates was Community Engagement and the idea that in order to end “Hallway Medicine,” the responsibility of looking after our sick and vulnerable will need to be shared between the system and the community. Shifting the burden of care away from hospitals, managing patient transitions from hospital to community, and preventing readmissions are all part of the plan for a more sustainable healthcare system. This is the very space where Caredove thrives.

Caredove's digital tools were designed to help connect clients with local home and community care services. With 600+ organizations across Ontario using Caredove to create trusted networks of care, there’s simply no better tool for addressing the need to increase and improve access to community care.

2. Patient engagement

OHT applicants have committed to measuring and improving the patient experience with patient-centred care that is focused on treating patients with dignity, including assisting them with decision-making and ensuring proper care coordination. This patient empowerment will require more tools designed for patient engagement, including personal health records, patient portals and remote patient monitoring - all in a secure digital ecosystem.

Caredove’s secure cloud-based eReferral platform includes out-of-the box features that allow patients to choose their preferred service from a network of trusted providers, book their own appointments and even complete their own intake assessments. Enabling patients to play a more active role in managing their personal health will ease coordination of care and OHT workflows.

3. Supporting our clinicians

As OHTs accelerate down the path of digital transformation, making it easy for clinicians to access the data they need remains a top priority. Clinician burnout is a significant problem, and there have been links to the administrative burden of electronic documentation and data handling across multiple systems, as a contributing factor. Burnout in healthcare providers reduces outcomes and patient satisfaction while increasing healthcare costs.

The time is now for interoperable digital health solutions that reduce clinician data over-processing. Caredove’s integrations are optimized for the smooth flow of data from sending systems, like EMRs and the provincial CHRIS system, to receiving community case management systems, such as AlayaCare.

We are excited with the early progress we’ve made with Ontario Health Teams, and look forward to working with many more to help integrate the health care system, the community sector and the clients they serve.

Success Story: Infant Hearing Program

rob.babos@caredove.com (Rob Babos) — Wed, 02 Oct 2019 19:37:43 GMT

Caredove’s eReferral platform is helping shape the way we screen newborns for life-altering diseases

Since 2016 Caredove has connected over 50,000 newborns with Infant Hearing Programs. These tests play a vital role in the early detection and treatment of a number of life-threatening or life-altering diseases. Our secure eReferral software allows clinicians to book, track and follow-up on these tests instantly and accurately.

With a philosophy to innovate and empower patients, Caredove introduced self-booking functionality. New parents now have the flexibility to schedule and manage their own screening appointments online without having to wait for phone calls to be returned. This feature increases efficiency, ensuring more newborns are receiving screening quicker and the chances of early detection and prevention are improved.

We always love a good success story that reminds us why we do what we do; and this note from our client is as good as they get:

I wanted to thank you and your team for all of the work you continue to do to support our Infant Hearing Program and our partnership with Newborn Screening Ontario (NSO). As you know, our famous "Phase 2" of the risk factor screen launched July 29th.

What the launch of Phase 2 meant for families across the province was that they would now have the option of consenting to the Hearing Loss Risk Factor Screen. When parents in our region consent to this additional testing, we then flag NSO (via Caredove) to go ahead and test the same sample NSO collected at birth for certain risks associated with hearing loss. (When babies are born, hospitals or midwives collect a blood sample from the infants' heel - NSO automatically tests this sample for approximately 30 life-threatening or life-altering diseases - but the risks for hearing loss are only tested once they receive our separate consent via Caredove).

This risk factor screen looks for congenital Cytomegalovirus (a virus which can cause progressive hearing loss in early childhood) as well as some common genetic mutations (also increasing the likelihood that the child will have PHL). While there's no way for us to change one's genetic make-up, knowing about these babies means that we can offer support to these families right away. In the case of cCMV, many of these babies will have no visible signs or symptoms at birth - but CMV can have very serious life-changing effects on hearing, eyesight and brain development. When symptoms are identified under the age of 4 weeks, babies may be eligible for antiviral treatment. We believe this antiviral treatment may be able to stop the progression of Permanent Hearing Loss in these infants.

Since the launch of Phase 2, our region has been able to identify 3 infants via the risk factor screen - 2 with cCMV and 1 with a genetic marker. The first baby identified to us was born on July 29th - the first day of the launch. Had this child been born even one day sooner we would never have known.

The second CMV baby we found was symptomatic. With permanent hearing loss identified, this infant was able to start antiviral treatment by 20 days of age!

Though we don't know the impact these viruses will have on our babies and families, we do know that the work we all continue to do to ensure accurate, reliable and timely transmission of our information to NSO via Caredove has been a great value to our program. Caredove has also allowed us to more easily manage the referrals we receive and to track which families require follow-up, while booking them into appointment spots that will be accessible to them.

Because the timing of when we obtain and share consent with NSO is so crucial, our IHP also anticipates that the work you're now doing to further customize the self-booking option will have yet another positive impact on our families. Self-booking will allow new parents, who are struggling to juggle life with a newborn, the convenience of booking their appointment any time of day - without having to work around our business hours or lose precious time playing phone tag.

On behalf of our team and our families, Thank You for the work that you do - know that you're making a difference in the lives of these babies!

Caredove’s collaboration with the Infant Hearing Program is a shining example of implementing an eReferral solution customized to meet the unique needs of a workflow. We look forward to many more success stories in the future as we continue to develop our platform and partner with other Infant Hearing Programs and community agencies.

Spontaneity as a Prescription

jules@caredove.com (Jules Roebbelen) — Tue, 09 Jul 2019 15:23:42 GMT

Bill Thomas started a new job at a nursing home. He soon identified the “Three Plagues” of nursing home existence as boredom, loneliness and helplessness. Not long after he started his job, staff were encouraged to bring their children to the nursing home after school, and soon they built a garden and a playground in the backyard. They introduced 2 dogs, 4 cats and hundreds of live plants. Soon, they had 100 birds with cages delivered to the home. Every senior who wanted a bird in their room could have one. The changes they saw in the residents were incredible and unprecedented. Residents who hadn’t spoken in years began talking again, first to their birds and then to other people. They offered to take the dogs for walks. People volunteered for plant watering duty. Everyone would share their bird-raising stories at meal times. It was spontaneity, it was out of the routine, and it was working. Life was breathed back into the home. Prescriptions were reduced by half, particularly drugs to help with agitation. Death rates reduced by 15%.

Thomas believed "that the difference in death rates can be traced to the fundamental human need for a reason to live.”

Spontaneity. Breaking the routine is one of the most fundamental points of alleviating isolation and loneliness.

While most nursing homes cannot (or should not) commit to hundreds of plants and animals, there are much more manageable ways to introduce spontaneity to the lives of the residents.

Seniors with dementia have scheduled “play dates” with a children’s day care program in the same building. This offers respite for the day care workers (on both sides) and allows the seniors to exercise their minds, stave off loneliness and just have some fun. Fostering relationships and spontaneity is simply life-giving to the residents who may not have regular visitors. For many, it is the highlight of their week to have a conversation with a silly, energetic three year old. Other programs encourage seniors to read to kindergarten students. Connecting seniors with young children provides health benefits beyond mental stimulation. Not only are the children learning how to read, the seniors truly feel like they have something to look forward to in the day beyond meal times and movie night. They’re given a newfound purpose. A fundamental human need for a reason to live.

Our seniors deserve a greater level of care and connection with other programs. Having a network of care organizations can encourage these beautiful and unconventional partnerships. Organizing a senior’s group to participate in a young children’s program will likely improve the mental, social and physical well being of the residents. Spontaneity, responsibility and general lack of boredom can do a world of difference. We dare you to be spontaneous, and to prescribe it daily.

8 Questions About Your Referability Score

jules@caredove.com (Jules Roebbelen) — Wed, 29 May 2019 20:13:51 GMT

Providing you with a trusted network of referrers is Caredove’s number one job so you can serve more clients and streamline your intake process.

Your referability factor, however, is up to you.

What is referability?

We think of referability as how easy it is for clinicians to refer their patients to your organization, and how well you handle those incoming referrals.

Does your organization make it a pleasant process, a process that referrers would like to do again for future clients?
Do you respond quickly and effectively to each incoming referral?
How many referrals lead to failure, where the client never gets started with service?
Do you even get referrals from clinicians?

If the answer to the last question is, no, then chances are your referability score is very low.

What makes a service more referable? Think about these questions as you aim to improve your referability score.

Search-ability: How easy is it to find your services?

1. Do you have an SEO optimized website that is easy to navigate, where each service is clearly described?

2. Do you clearly state program eligibility, cost and wait times to avoid getting ineligible referrals?

People looking for care will most often head to the internet before the phone book. Make sure your website is always up to date with your current information and instructions on how to access the service.

Availability: When can you see the client?

3. Do you know when your staff do their intake appointments?

4. How long does each intake appointment take?

5. Can your reception book appointments when people call in asking about services?

6. Can anyone else book your intake staff for a call back (or home visit, or whatever the first step is)?

If you think that your staff are always available, think twice. Your staff are dealing with other clients, volunteers, on the phone with others, or taking their much needed breaks. Ask them how often they check for new referrals left in their voicemail or email inbox.

Dependability: How quickly do you close the loop on your appointments?

7. Do you let referrers know the outcome of their referral?

8. If so, how? A phone call? A fax? An email? Is this a reliable process?

Greater referability means closing the loop on all referrals, so clinicians continue to refer to you and more patients experience better transitions of care.

1 Easy Way To Increase Password Security [Infographic]

jules@caredove.com (Jules Roebbelen) — Thu, 11 Apr 2019 15:37:26 GMT

You are only as strong as the weakest link. The weakest team member, the weakest city gate, the weakest beam in a house.

The same goes for passwords.

Caredove is vigilant about security. We use password managers, API encryption and have staff testing for weaknesses on a regular basis. We use 2 factor authentication (2FA) on applications, on every device. No two passwords are the same, and no password could ever be guessed.

Despite all our security, we’re only as strong as your password.

Let’s be clear. Passwords with your mom’s maiden name or the address of the house you grew up in, are not secure. Passwords like misterfluffy123! Are. Not. Secure.

Unless you’re using a password manager and a random password generator like 1Password, your password is guessable and that is a massive weakness. If you’ve written your password in a notebook, that is a massive weakness. If you use the same password for everything, that is a massive weakness.

Be better.

To start, try using a password strength tester to see how strong your password is.

If your password is crummy, use a password generator. Get that and added password security at 1Password . We also encourage 2 factor authentication on all your devices. 1Password can help with that too.

Don't be the weakest link.

Beauty in Health Care Processes

jeff@caredove.com (Jeff Doleweerd) — Sun, 07 Apr 2019 15:53:03 GMT

Fyodor Dostoevsky , the Russian writer, once said: “Beauty Will Save the World!”. This is a provocative statement. With health care in what seems perpetual crisis, it might be worth asking – can beauty can save health care? This is not about being pretty. If beauty saved health care it would be about artful service design. Service design that brings joy to health care providers and patients.

Processes are the things that weaves people, tools and information together in health care. Health care process design is, to a manager, what a paint brush is to an artist.

What are you doing when you are changing your health care processes? Are you improving them? Maybe you’re streamlining them, making them more efficient or more value adding?

Or do you try to make them beautiful?

Other ways of thinking about processes can fall short:

Making processes efficient: Efficiency is a dirty word in some circles, and can be used to justify all kinds of nasty things. Some invoke efficiency in the name of firing staff, cutting budgets or making something better for one person at the expense of another. A single minded focus on efficiency is cold. In health care, most processes are about the flow and experiences of people rather than movement and assembly of parts without waste. People deserve something more than an efficient process. A beautiful process is probably less efficient, but more valuable to the client.
Process Improvement : Improvement is a better term, it teases at the idea of building on past success, and that we should be continuously getting better at what we do. The saying “Improvement is a journey, not a destination” is the strongest element of the “improvement” concept. However, the term “improvement” is often incorrectly used in place of the word “change”, which may or may not yield any improvement at all. Furthermore, a process can be improved … but remain a poor experience for patients and contain tremendous amounts of waste. Aiming for an “improved” process often isn’t enough. Make sure improvement goals are client value oriented.
Making the process lean : This term is great with people and organizations that have embraced and understand the concept. The reality is, the typical staff member doesn’t immediately know anything more about lean than a penguin knows about pineapples. Lean contains vital ideas for the quality improvement practitioner like making value flow at the pull of the customer, reducing waste, etc. People can be taught, and integrating this type of knowledge is the essence of management, but it takes time. Don't be afraid to slow down and examine the process. Give it the time it deserves.

Your clients interact with you through your processes. Your staff spend most of their working lives in your processes. Is it possible to make a process fun, a pleasure to be a part of, an experience to look forward to, joyful, to make it … beautiful?

I don’t think we strive to this level of achievement with processes, but we should.

No health care process is too mundane to beautify. Phone calls can be a pleasure, forms can be satisfying and communication can be enriching. Making a health care process beautiful respects the impact that it has on people and their lives. A beautiful process would deliver what people need, is not wasteful, and would be uplifting to experience.

Isn’t beauty – the experience of pleasure and satisfaction often in the presence of another – what makes life worth living? Save some room for considering beauty when designing a health care process.

Senior Social Engagement

jules@caredove.com (Jules Roebbelen) — Tue, 05 Mar 2019 14:21:22 GMT

Your grandma is on Facebook. She's always posting cat videos and commenting on your photos. It's cute (and maybe a little embarrassing) and it makes you smile because you know she's staying connected. The more comfortable seniors get with social media and technology, the more opportunities there are to keep seniors involved in their communities. Research has shown that social engagement tools for mental and emotional health are just as important as physical health: this study shows that seniors engaged with social technology are happier, have better self-rated health and fewer chronic illnesses. Being able to FaceTime with a grandparent who cannot make it to a wedding or holiday gathering is incredibly fulfilling and life giving for the entire family. Social engagement tools can also help financially; seniors can rent out bedrooms with AirBnB and gain extra income with little effort or overhead costs. Uber drivers are increasing in age as seniors become more comfortable with technology, with more Uber drivers now being over 50 years old than under 30.

Transportation for seniors should not be a barrier.

With the help of technology, seniors are able connect with community programs to get escorted, wheelchair-accessible transportation to medical appointments, social outings and shopping trips. Many of these programs are volunteer-run, reducing the cost of each ride and making trips more affordable than a taxi. And it definitely is more than a taxi service; seniors transportation programs will often provide an escort physically to and from the appointment, without a meter running outside. Having access to safe and reliable transportation reduces medical appointment no-shows and keeps seniors engaged in their communities.

Empowering seniors to maintain their independence through technology is a practice we should continue to develop. Does your organization offer an Adult Day Program, Group Dining or Friendly Visiting service? Make suggestions to your seniors about using social engagement tools to increase their connectivity to friends and family. Offer an hour introductory course to FaceTime, Uber or AirBnB to get them started. Finding more ways to improve seniors' independence will improve their mental health and will likely reduce the need for doctor and hospital visits.

Elder & Financial Abuse

jules@caredove.com (Jules Roebbelen) — Tue, 05 Mar 2019 10:18:00 GMT

It’s an ugly topic. We hate to think of seniors in our community being affected by elder abuse. We want to believe the best in everyone. But it’s not unwise to be prepared. Recognize the signs and know what to do if you suspect elder abuse.

Elder abuse affects between 4% and 10% of seniors in Canada , but only 20% of those cases are addressed. People with dementia and Alzheimer’s are at a higher risk of all forms of abuse compared to those with sound cognition. Seniors living alone or recently widowed are much more likely to be financially abused, whereas those living with their caregivers are more often physically or emotionally abused. Abuse can quickly lead to a downward spiral of other health risks such as depression and isolation.

The most common form of elder abuse is Financial Abuse . The elder will be pressured into giving money to a friend or younger relative, and will be bullied if they ask for the money to be repaid. Because the abuser is often a loved one, the elder may feel guilty for asking for the money back or saying no to the person. It could be as small as a few dollars every week, or as serious as signing over a Power of Attorney and losing their home. Complicated by the close relationship between the abuser and the abused, the elder feels hopeless to find a solution.

As a caregiver, learn the signs of financial abuse.

Things going missing from the home or possessions being "given away"
Overdue bills, despite having a nice home
Poor or changing living conditions, despite financial stability
Sudden changes in the living situation under the pretence of needing more help (e.g., moving to a long term care facility, or family members moving in)
Off hand remarks regarding money confusion, stress, or giving money to a family member

The key is awareness. If you suspect one of your clients is experiencing elder abuse, ensure them that speaking to you is safe and that you want to help. Ask if they have signed any documents they didn’t understand or were forced to sign. Ask if money has been taken or borrowed and not returned. Ask if there have been any changes to the home made without their permission, such as someone moving in, or possessions being taken or sold. There are excellent resources such as CASE and BASE screening tools to help you determine whether or not someone may be abused. If it is clear that the elder is being taken advantage of, you can encourage them to speak to the police or a lawyer to get help.

Here are some tips and tricks to to help avoid financial abuse before it starts.

Keep financial information such as cheque books, PINs and passwords safely stored.
Keep a record as to whether money you have given out was a loan or a gift.
Have a lawyer look over any legal documents that someone may want you to sign.
Do not give Power or Attorney (POA) or a joint bank account to someone you suspect may take advantage of the situation, even if they are pressuring you to do so.
If you are worried about another family member, make sure the POA you assign understands the threat that any specific persons may pose to your finances or wellbeing.
Include a clause so that the POA must continue to use your same financial adviser (someone you already know, trust and who understands your intentions).
Empower your lawyer, bank manager and accountant to all speak to one another to discuss the POA's actions to ensure everything is always in good standing and to share suspicions. A collective set of “red flags” regarding the POA from different perspectives makes a stronger case to point out abuse.
Ask for help! Always! Calling 911 is always an option if you feel threatened or mistreated.

Frauds & scams are also serious threats to seniors. You can learn more here . Further resources are elder abuse can be found at CNPEA and INPEA .

Don’t forget: you can always refer your patient to an Elder Abuse Consultation clinic through your Caredove network.

A.I. In Elder Health Care

jules@caredove.com (Jules Roebbelen) — Sun, 03 Mar 2019 10:24:03 GMT

Technology advances more every day. Ways to stay connected, ways to do things faster, easier, cheaper. You can order toilet paper right to your door just by asking Alexa (and probably for less money than at your local shopping centre). You can share your computer screen in real time with someone halfway around the world. Going in to the office is often optional. Technology improves our lives so we have more time to exercise, socialize, travel, play. It can also improve the lives of seniors by allowing them to more safely age in place at home.

Today's healthcare system is preparing for the world’s rapidly growing senior population. As the baby boomers age, we have increasing numbers of seniors needing access to care. Introducing specific technologies into the healthcare process can alleviate strains on administrative teams, doctors and nurse practitioners by avoiding unnecessary hospitalization or institutionalization. EMRs have been around for years, and we have finally found a way to stop faxing referrals to specialized service providers ��

Yes, we always need more doctors, but we also need better solutions to keep seniors well and out of hospital, to prevent doctor visits in the first place. The growing field of gerontechnology is aimed at reducing the use of health care and community care resources as well as admissions (and re-admissions) to hospitals and long term care facilities. The main goals of gerontechnology are to increase autonomy, self-confidence and mobility through the maintenance of health and active lifestyles. While gerontechnology encompasses everything from anti-aging medical research to social engagement tools for seniors, a major part of gerontechnology is also the development of ambient assisted living technologies (AAL). Here are some innovative examples of how technology can be used to help keep seniors safe, active and healthy at home to age in place by reducing the risk of injury and isolation.

Personal health monitoring systems can alert emergency or other care services of a sudden change in someone’s health, such as a drop in blood pressure, temperature or heart rate, or even track abrupt movements like a fall. These can be as simple as the classic LifeAlert, or as complicated as a custom bracelet like a FitBit or Apple Watch.
Smart phone alerts can be set to remind seniors to take specific medications, eat a meal or have a glass of water. Prompts can even be set to suggest taking a walk, having a shower, or calling a family member. Virtual home companions are robots that learn the user’s habits and can customize daily reminders or suggestions, much like the smart phone alerts. Two great examples are Mabu and ElliQ .
Motion sensors can be positioned in the home to alert when someone has not been active for an extended period of time. They can also alert services in the case of a senior with dementia leaving the house with Wander Prevention Devices.
The number one cause of fires in a senior’s home is unattended cooking equipment. Home modifications can be made to turn off taps or the oven if they’ve been left on for an extended period of time. Alerts screens can be installed near the exits to remind you if one of these things has been left on when you open the door.
Many people living with Alzheimers, dementia or mental health differences do not often notice a change in their environment, for example, if the air conditioner stops working on a hot day. Smart temperature controls can alert the senior if the room is getting too hot, cold or humid, as well as the obvious smoke, gas and CO detectors.

These are just a few examples. You can learn more about the ways AAL technologies are improving the lives of seniors here . By implementing some of these AAL device integrations into already existing at-home care services, aging in place can now be easier, safer and more fulfilling for both the seniors and the health care providers.

Alzheimer's Awareness

jules@caredove.com (Jules Roebbelen) — Fri, 22 Feb 2019 14:45:23 GMT

After a diagnosis, connecting to individual and family counselling resources is just as important as working with a clinician to become familiar with the disease. Make sure that patients are given information and access to services such as adult day programs, support groups and counselling to provide the most support possible. At-home care such as Meals on Wheels and housekeeping are great ways to delay the urgency for a nursing home. Make sure to also remind your patient about writing an updated will and assigning a Power of Attorney before the disease progresses.

Remind your patients that they are not alone on this journey. Beyond the regular informative brochures and websites, here are some movies that feature Alzheimer's and dementia.

What They Had (2018)

Glass (2016)

Still Alice (2014)

Away From Her (2007)

The Savages (2007)

Aurora Borealis (2005)

The Notebook (2004)

A Song For Martin (2001) - Swedish with English subtitles

Iris (2001)

Firefly Dreams (2001) - Japanese with English subtitles

Age Old Friends (1989)

Loneliness, the Silent Killer Among Seniors

jules@caredove.com (Jules Roebbelen) — Wed, 30 Jan 2019 16:04:01 GMT

Loneliness can be as unhealthy as smoking 15 cigarettes a day.

It’s a shocking statement, and maybe not true in the way you might think. According to Ami Rokach , loneliness itself does not cause health issues, but rather it is an “intervening variable” and can cause a myriad of physical and mental health problems.

Loneliness will not directly increase your risk of lung cancer, but it may encourage unhealthy habits, such as excessive smoking, drinking or substance use. It also increases the risk of depression, which is often linked to insomnia and not taking medications. People who lack social interactions often have compromised immune systems; the germs we come in contact with on a daily basis from others helps us build up our immunity to things like colds, flus and other viral infections. A compromised immune system can lead to greater risks of chronic conditions including heart disease.

Imagine being diagnosed with early onset dementia or Alzheimer’s. Imagine you share the news with your friends and family to gain support and comfort. As social creatures, this is only natural. Imagine that a week later, a month later, you haven’t heard back from anyone. According to the UK Minister of Loneliness , 38% of people lose friends after they have been diagnosed with dementia. "People who are 80 years and older say that up to 80% of the time they feel lonely." Rokach tells The Current's Anna Maria Tremonti.

This is devastating.

This is not OK.

As health care professionals, we need to do better. Staving off loneliness actually keeps people out of hospital. ‍ Lonely people tend to make more trips to the doctor or emergency departments in an effort to feel better by experiencing social interaction and human contact. This is a strain on the health care system, and is not the right solution for those looking to alleviate their feelings of loneliness. According to Statistics Canada, 20% of seniors don’t participate in regular social events, and can often go over 4 weeks without socializing with others. In fact , people who experience isolation are 50% more likely to die prematurely than those with social relationships. Loneliness is the psychological state most associated with suicide, according to this article.

So, what do we do?

England is ahead of the curve after appointing a Minister of Loneliness to address this issue head on. After their GPs noted that 1 in 5 patients suffer from loneliness, they have taken to “social prescribing” which gives the doctor the ability to direct patients to community care organizations that have daily social programs such as cooking classes, walking groups and art clubs. They have partnered with the Royal Mail service and have their postal workers check in on isolated people during their daily mail delivery routes. This can help the government connect people with social activities and provide safety check-ins if they haven’t been to a doctor lately.

How cool is that?

There’s more.

A loneliness helpline has been created in the UK. Silver Line is a free phone service where people can call in and chat, 24 hours a day, if they are feeling lonely. Users say that this is a great service when they cannot sleep at night, but don’t want to bother their adult children or friends with a phone call at 2 am. They get around 1600 calls a day. Don’t like phone calls? Silver Line does more. They have a “pen pal” service called Silver Letters for those who prefer handwritten correspondence. They also have Silver Circles which are group phone calls, and Silver Connects helps the users find local services to help with housing, health and financial issues.

Programs that excel at helping with loneliness are Friendly Visiting, Meals on Wheels, Group Dining and Senior Exercise. By recommending a service like this to a patient who may be feeling loneliness, you may doing more than getting them out of the house. You may be saving their life.

Students & Seniors: A Solution to Canada's Housing Crisis

jules@caredove.com (Jules Roebbelen) — Tue, 29 Jan 2019 17:07:05 GMT

* Caredove is a health care software provider that focuses on improving access to home care and community support services. This blog is an opinion piece on ways to keep seniors healthy, safe and independent while remaining at home. We do not provide any student and senior matching services at this time.

With a rapidly growing elderly population, Canada is working hard to encourage independence in seniors through new intergenerational and social initiatives. While Canada remains one of the best and safest places to live in the world (5th best and 6th safest in 2018), problems continue to arise among two major demographics striving to maintain the “best and safest” housing situations.

Skyrocketing housing prices make it almost impossible for a single person to live on their own. With a current 3% rental vacancy rate, the number of apartment and housing rentals continue to decline, and new builds are far out of budget for most single and young people. This is especially difficult for international students who may not have friends or family to live with, and who often default to unsafe neighbourhoods due to their affordability.
Elders and seniors living alone. While many want to maintain their independence and remain living at home for as long as they physically can, sometimes it no longer makes sense for single or widowed seniors to live alone. They can still drive, cook and look after themselves, but there is the all too real possibility of a slip on icy steps, a mild stroke or a sudden heart attack. Routine maintenance costs of a house and everyday chores often become too much for a single person living off a retirement fund. It pains us to see elders in our community moved into semi-assisted nursing homes or retirement homes when they are capable of taking care of themselves, but feel they should not live alone for safety and financial reasons. While they aren’t physically or emotionally ready to give up on the home and community they have lived in for decades, they so often find themselves without other options. Safety is the top issue for seniors living alone, but there are also increasing reports of the negative effects of loneliness on the aging population.

A CBC article states "In Ontario, more than half of residents — and three-quarters of those over the age of 65 — live in houses that are bigger than they need, leaving five-million spare bedrooms across the province, according to a 2017 report by the Canadian Centre for Economic Analysis.”

5 million spare bedrooms. It is logical for the single homeowner to put their 4 bedroom home up for sale in this housing market, but what if they’re not ready to move into a semi-assisted care facility? The term “nursing home” may feel like the inevitable death sentence to an able-bodied but financially strained senior. The stress of being put on a waitlist for a long term care home, added to the stress of selling their family home can be overwhelming, and quite often unnecessary for another decade.

So here is the problem. An increasingly aging population with room to spare, and an increasing number of young and single people hard-pressed for affordable accommodations. Addressing the housing needs of seniors without compromising their independence has called for some creative solutions.

A beautiful and genius solution has been created through the idea of home sharing. These programs connect a young or single person in need of accommodation with a senior in need of a little bit of care at home. This provides affordable housing for a person while allowing the senior to remain living at home, maintain their independence and get help around the house. Suddenly, a 95 year old woman has a roommate who is a 26 year old grad student. By helping with cooking, cleaning and other household duties, she can live at home without fear of forgetting to take her medication or falling without someone coming to her aid. In many cases, they become friends. They run errands together. They watch movies together. They laugh together. Not only is there now a peace of mind financially and physically, seniors are presented with more opportunities for social interaction, something that all too often decreases over time, leading to unhealthy levels of isolation.

The Netherlands are seeing the benefits of intergenerational retirement homes , where students can live rent free in exchange for 30 hours a month of “hanging out” with the seniors, a task that the staff and professionals may not have time for. Seniors can learn computer skills or play games together, and while students are able to pay off tuition without incurring large amounts of debt, they are also learning invaluable lessons about life from the elders in their community. In a similar vein, Alberta's Mount Royal University has an English program partnered with a Calgary retirement home. The university elects a “writer in residence” from the young students to live among the seniors for a semester, documenting the life stories of the residents. The student receives free rent as well as a university credit, and the families of the seniors are gifted with a beautifully written biography of their loved one.

Trial student & senior housing programs have sprung up all across Ontario. Each party experiences reduced feelings of loneliness and increased levels of security and companionship. Students have a safe, quiet and affordable place to live and study while the senior has companionship and help with daily chores. There are many cases where the two continue living together for many years and consider one another as part of his or her family. These are beautiful success stories of helping seniors maintain their independence while they are still able to almost fully take care of themselves.

Of course, this isn't the solution for everyone.

A senior may not be willing or able to invite a student to rent a room in their home. Still, there is a growing trend of seniors expressing a desire to stay in their homes rather than moving into long term care homes. With the help of community services such as Meals on Wheels and Friendly Visiting, seniors can maintain their independence while getting a little help with housekeeping, food preparation and social visits.

Your Wait List Should Be Getting Longer

jeff@caredove.com (Jeff Doleweerd) — Thu, 17 Jan 2019 15:20:41 GMT

Do you have a wait-list? If you do, then it should be getting longer.

Let's say your organization provides autism assessments, and you can provide 10 assessments a week. However, you are getting requests for 12 assessments per week.

Therefore, each week, you provide 10 assessments and 2 more people get added to the waitlist. Every week, the wait list gets longer by +2 people, and every new applicant has to wait longer than the previous one for an assessment.

Your wait list will keep getting longer and longer until you:

a) can provide 12 or more assessments per week

b) the number of people asking for your service reduces to 10 or less

However, many organizations have wait lists of 2 weeks, or 2 months, that essentially stay at this level for months and years. This means that demand = supply (i.e., 10 new clients requests each week, 10 clients served each week). These organizations have the capacity to serve each client as they arrive with minimal waiting time, yet still they wait 2 months.

Why?

If your wait list is not getting longer, it is something else.

It is a backlog.

The solution is simple: eliminate your backlog by temporarily applying extra resources to clear them out. Then, proceed to serve your clients in a timely manner within existing resources and make sure you don’t get a backlog again. Match the demand that comes in today with staff available to do the work, today. Add 1-2 more appointments to your calendar each day for a week or a month to reduce the backlog and get your system back on track.

You will also save resources in the long run because you won’t be wasting time triaging a wait-list. Every client deserves to be assessed on a first-come, first-serve basis without the need of triage, because you have available appointment times and a minimal wait list. By using booked appointment times without the time consuming phone tag of an old referral system, it's easy to increase your assessment volume each day or each week.

Caredove offers streamlined waitlist management tools as part of its out-of-the-box eReferral solution for both community based organizations and family health teams. Contact us to learn more.

It Takes a Village to Raise a Child, and a Community to Keep Them Well

jeff@caredove.com (Jeff Doleweerd) — Thu, 01 Nov 2018 16:27:02 GMT

It takes a village to raise a child. This is not a new idea; it’s common knowledge that multiple resources are imperative for a child’s development. Coaches help develop physical agility and team-building character. Parents provide a moral compass and the essentials of care. Teachers cultivate learning, patience and explore a student’s potential passions. Each of these avenues trains and matures the child through their early years into adulthood and provides them with the necessary knowledge, tools and skills to empower them to be strong, capable and contributing members of that village.

So it takes a village to raise a child. But it takes a community to keep them well.

A patient enters the acute-care system, and after being discharged, the aftercare needs are often forgotten or fall through the cracks as phone calls, faxes and referral information goes missing between the discharge administrator and the community health care program. This often leads to unnecessary re-admittance to acute-care, costing hospital dollars and precious bed space.

By streamlining the referral process to ensure that the referrals never fall through the cracks, patients receive better care at home at a lower cost than hospital re-admittance. With at-home care visits being booked before the patient even leaves the hospital, there is no chance of someone falling under the radar of the discharge administrator or the family doctor. By finding the right services through the proper local health care networks, we can help people stay in their homes healthier and longer. Managing improved care, wellness and outcomes for a community population benefits everyone from the hospital administrator to the patients and the families of the patients.

We have the potential and the responsibility to be a better community of care. Let’s be the community that our community deserves.

Caredove Partners with Canadian Frailty Network

jeff@caredove.com (Jeff Doleweerd) — Tue, 30 Oct 2018 20:10:59 GMT

The Canadian Frailty Network (CFN) and The Geriatric Health Systems Research Group (@University of Waterloo), have collaborated with investigators across the country to support stronger primary care for older adults living with frailty. Caredove is proud to be a partner in this research initiative.

Our referral management platform will be used by primary care clinicians to connect older adults with the community care they may need. Primary care networks and practices in Alberta and Quebec will engage with Caredove’s platform to send electronic referrals.

Your agency is a vital part in caring for at-risk older persons. Join us, it’s easy, and start receiving referrals. There is no charge to be part of this initiative.

Visit our home page and select "Get Started" to request an account.

Secure Email

Mon, 01 Oct 2018 19:34:10 GMT

How awesome would it be to receive your referral information directly to your email the moment you receive it?

Caredove now supports Secure Email, which utilizes end-to-end encryption to allow for safe & secure transmission of personal health information that only your mail client can view. Note that your organization must still have the appropriate policies in place to ensure that your email environment is secure once it’s arrived, but Caredove will make sure it’s secure in transmission to your inbox.

Learn more about setting up Secure Email

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We take security seriously at Caredove which is why this was such an important update for us. We want to ensure you feel secure at every step of the process within the Caredove platform. Securing email was our newest element involved in that objective.

If you have a feature request, please send us a message via our chat box.

Invite Registrants to Self-Book

Wed, 12 Sep 2018 19:13:29 GMT

Have you ever had the Registrant on the phone and they just aren’t sure when they are available for an intake appointment? Why not invite THEM to book the appointment themselves? All you need is an email address!

This handy new feature is located within the Referrals module - so if you haven’t been spending a lot of time there recently, now is the time to start. Learn how !

If you have a feature request, please send us a message via our chat box.

FAQ

Wed, 29 Aug 2018 18:38:23 GMT

What is Caredove?‍

Caredove is an eReferral management Software-as-a-Service platform designed to transform how access to home care and community services works for everyone involved. We believe that everyone should be able to easily connect and engage with the care that helps them remain independent, supported, and healthy at home. We are committed to improving connections across all health care transitions.

Caredove builds delightful software that helps community health agencies promote their services, onboard more new clients, and organize a network of agencies to respond to a local health challenge.

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What can I do with Caredove?‍

Organizations Can:

Curate service listings to advertise services and receive quality referrals
Allow the public to request service using embedded website buttons
Streamline intake & receive booked appointments
Manage all incoming & outgoing referrals in a unified referral inbox
Report on inbound referrals activity over time and audit coverage area gaps
Build a new website with Caredove's WebBuilder , seamlessly linked to Caredove services
Use other Developer Integrations to receive referrals directly in a Client Management System or EHR

Learn more about our organization features

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Networks Can:

Build a referral network of trusted local agencies to enable referral sending among partners
Use advanced marketing tools to promote a suite of organizations or services with a custom WebBuilder site
Invite clinicians to send referrals to trusted partner organizations
Track network health and referral activity with robust reports across all organizations

Learn more about our network features ‍

Who uses Caredove?‍‍

Service Providers who want to capture high quality referrals, streamline their intake processes and connect clients with home care and community support services (Meals on Wheels, Personal Support, Counselling, etc.)
Referring Sources who want to connect clients with care outside of their own organization (discharge planners, social workers, GPs, etc.)
Caregivers & Clients who want to connect with care
Networks that want to connect multiple organizations and services to each other to allow easy referring and outcome tracking ‍

‍

‍Why Caredove?‍

‍Goodbye messy forms, faxes and phone tag. Hello referral simplicity. ‍

When a caregiver, client or clinician can send a referral with an appointment date and time, there is no mystery about who is going to help, and when. Caredove works with over 800 community health agencies in Canada, and we bring that experience to every new organization looking to streamline their intake processes. By leveragine Caredove's natural network of community support services, you're not only sending and receiving eReferrals, you're also improving your entire workflow and making it easier to connect with similar local organizations. ‍

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Is Caredove Secure?‍

Absolutely. Our security and privacy policies can be found at caredove.com/legal .

Make a Death Plan

jules@caredove.com (Jules Roebbelen) — Sat, 18 Aug 2018 17:32:48 GMT

Palliative care can be done well at home with the proper resources. At-home care is an excellent alternative for many hospice-bound seniors with added emotional, physical and financial benefits.

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We prepare for the birth of our children. Parents have a carefully drawn out, memorized and practiced “birth plan”, ready to spring into action the moment labour commences. We prepare for our deaths, often as early as in our thirties or forties. We make wills to ensure our worldly assets are distributed to the right people: our family, friends and charities. Some people select flowers to be placed on their coffin and songs to be sung at their funerals.

So we prepare for what happens when we are gone; we make sure our spouses and our children are taken care of and that our legacy will be remembered. But who of us has prepared for what should happen while we are going? Why do we not better prepare for our own dying? Why don’t we have a “dying plan” in place for ourselves and for our loved ones? Some people sign DNRs, or “Do Not Resuscitate” forms so that heroic measures will not be taken near the end, so that they may let nature take its course, but many decisions must be made in the season of dying before coming to the point of enacting a DNR. These decisions are often left until the last moment, leaving family members, doctors and caregivers scrambling to find the proper care and resources when they should already be in place.

Dr. Denise Marshall of McMaster University sheds light on our fears: “Our society is not against death, but against dying. We are a dying-denying society; we want death without dying.” This “invisible death” is a new phenomenon in western culture, only widespread after WWII. We hide the dying in solitary hospital rooms, tucked away in palliative wings, so we do not have to see the ugly uncomfortable side of dying. Death is not always dignified, but we can revive the dignity in it by continuing to care for the dying at home. They’re dying; it seems only fair that they do it on their turf, on their terms.

There are many cultures around the world where dying at home is commonplace. Grandparents, parents and children all live under the same roof, and often spend their dying days together, being cared for by younger family members. This may be because of lack of access to health care or money for hospital bills, but there is something beautiful and profound about dying at home, surrounded by family.

According to Cardus , More than 70% of Canadians who died in 2014 did not have access to palliative care. Residential hospice beds (home-style hospices with a comfortable community environment) are non-existent in the territories, and as of 2014, three provinces also had zero residential hospice beds. This means that most of Canadians who died were actually tucked away in lonely hospital rooms. Residential hospice beds cost about 60% of a bed in a palliative care bed in a hospital. Dying at home can cost less than 10% of what it does in hospital. So not only could we be caring for the dying in a space they feel most loved and most comfortable, we can save precious government dollars allotted to palliative care in Canada to ensure that more residential hospices can be opened and that acute palliative patients are provided with the most attentive care.

Dying at home enlists friends and family as caregivers to completely surround the dying with love: people who will shovel the driveway, bake cookies, share stories and laughter, read aloud, offer dignity and respect to each other and to the one dying. This can bring the caregivers a sense of peace, being part of the gift to the dying in their final days. Being in community with the dying at home makes the loss bearable for the caregivers, because it is a loss that is mourned together. The social benefits for the elderly are unmistakable as well; isolation can lead to serious health problems in aging populations, worsened in lonely hospital rooms. Read more about the risks of loneliness here .

But this is no easy task. It takes a lot of courage. Henri Nouwen reminds us that caring for the dying should not be done alone. It is extremely likely that neither you nor your family members can afford the time off work to commit to the full-time care of a parent or grandparent. You may need the proper medical equipment and a nurse professional to help administer medication. You will likely need the guidance of a palliative doctor. With resources through your local Community Care Access Centre or Local Health Integrated Network, services like Meals on Wheels, housekeeping and at-home nursing care can be easily booked. These services take the burden off the hospital resources by reserving hospital rooms for urgent care patients. These services are built around the idea that living and dying at home are healthy, and good.

So think now about your death plan. What would you hope for your loved ones: a sterile death in a hospital ward, or a warm and loving death, surrounding by family and caregivers in a home? What if we said “she died well”, not because a doctor told us she peacefully died in her sleep in a hospital room, but because she died surrounded by the ones she loved, holding the hands of the ones she loved? And for a fact, we would know that there was life in their season of dying, because we were there.

Florida Association of Accountable Care Organizations Partners with Caredove

jeff@caredove.com (Jeff Doleweerd) — Mon, 13 Aug 2018 16:19:08 GMT

JACKSONVILLE, FL: The Florida Association of ACOs (FLAACOs), the premier professional organization for Accountable Care Organizations and value based healthcare leaders throughout Florida, announced today a strategic partnership with Caredove, Inc. to provide its Statewide ACO membership with access to Caredove’s advanced, online e-Referral platform which focuses on making it easy to transition patient care into home care and community services. Under the agreement, Caredove will work with FLAACOs and its ACO members to establish and build out trusted networks between its ACO members and the organizations and agencies providing home care and community support services in the communities they serve.

Nicole Bradberry, CEO of FLAACOs, states “Our partnership with Caredove shows our continued commitment to bring additional value to our members and to take a leadership role in helping to address those aspects of care needs to help our member’s patients stay healthier in their homes and communities and to avoid costly readmission into the Acute care system”. It is anticipated that over 1000 home care and community agencies will be implemented on the platform, serving some 40+ ACOs across the state. Caredove’s CEO, Jeff Doleweerd, said “We spent thousands of hours examining how patients access different home care and community services. We saw the same problems over and over. Clinicians couldn’t locate helpful services, patients didn't know what would happen next, intake staff were overwhelmed while triaging referrals, voicemails would pile up, and patients wouldn't get connected with the care they needed. We created Caredove to solve these problems”. The development of the initial e-Referral networks in Florida under this agreement will pave the way for additional parties to join the platform. We’re happy to be working with FLAACOs to bring Caredove to benefit the patients of their ACO members.”

Richard Lucibella, CEO of Accountable Care Options (Boynton Beach Florida) and FLAACOs Board member, is an early adopter on the Caredove platform. “As we’ve extended our Chronic Care Management efforts, we’ve gained a better understanding of the extent to which behavioural health and community social services can impact our patients' health status. We’ve all known this to be an issue, particularly in the Medicare population. Our CCM teams at Accountable Care Options continue our leadership position here on behalf of our patients, and are excited about the very real promise of the Caredove platform to support and potentially multiply our current efforts.” “Overall, we’re seeing great interest and excitement about the platform in Florida and elsewhere”, says Jim Atkinson (Chief Growth Officer at Caredove), “and, we are working to expand the network through Community & Public Health groups as well as to bring Payers and Health Systems into the trusted exchange.”

ABOUT FLAACOs

FLAACOs, also known as the Florida Association of Accountable Care Organization, has a mission to provide members a vehicle to collaborate, ensuring that each healthcare organization grows and thrives. The Florida-based association aligns goals to help member ACOs shift physician incentives and improve health-care outcomes across the state. FLAACOs provides a voice for the accountable care marketplace and its participating providers, payers, and individual physicians. The goal of FLAACOs is to provide advocacy and support to all Florida accountable care organizations so that together they can become the health-care models of the future. To learn more visit www.flaacos.com

ABOUT CAREDOVE

Caredove is a healthcare solutions company providing its online platform to make it easy for patients to gain access to home care and community services. Providers and care coordinators, as well as patients and family caregivers, can Search for geo-available home care and community services, Book appointments and e-Referrals directly into those services, and Connect through secure data communication and organization-specific referral and intake workflows. Caredove is a true healthcare platform that builds trusted webs between Referrers (Providers/Care Coordinators), Service Providers and their mutual patients. Caredove currently covers over 80 categories of Home Care and Community Services. On the platform referrals are always free and it’s easy to invite referrers and service providers to the network so there is no impediment to its growth in serving each local community. www.caredove.com

Aug 2018

Nobody Likes a Healthcare Mystery

jeff@caredove.com (Jeff Doleweerd) — Sun, 02 Jul 2017 16:56:50 GMT

Mysteries are fun to watch in the movies, but mysteries are rarely fun in real life.

It’s 4:00pm and your cable guy was supposed to show “sometime between 8am – 5pm”…
You ordered food at a restaurant 30 minutes ago and haven’t seen the waiter since…
You sent in an application months ago and were supposed to hear back by now…

Often the mystery while waiting is worse than the waiting time itself. It makes us anxious and angry. Our imaginations fill in the blanks with all kinds of worst-case scenarios (I’m going to have to wait at home again tomorrow for the cable guy … I’m going to get home really late after our meal, I’ll be tired at work tomorrow … I’m not good enough to get accepted to that program or ANY program).

In health care, mystery while waiting is routine:

You have been sitting in the ER for 3 hours due to a burn on your arm, and told there’s no way to know how much longer you will have to wait…
Your family doctor sent a referral to a cancer specialist 2 weeks ago because of concerning lab results…

The worst case scenarios get amplified when it’s related to our health. (I’m going to have a burn scar for life on my arm … I have cancer, and it’s getting worse while I wait. That referral must have gotten lost…).

Patients should not be burdened with this kind of stress-inducing mystery.

Are your patients experiencing mystery in your processes? What type of mystery?

1) Shrouded in obscurity – The patient knows next to nothing about who they will see next and when.

2) Some clues are provided – The patient is provided an “educated best guess” about who they will see next and when, but will have to wait for more details.

3) Mystery solved – The patient knows exactly who they will see next, and when.

We have observed a lot of health care processes, and unfortunately 1) Shrouded in obscurity is the norm – even when 2) or 3) are viable options.

Moving from 1) Shrouded in obscurity to 2) Some clues are provided , is easy. Simply tell the patient what you know (e.g., How long did the last person like you wait? How many people are on your wait list? How many people do you see a week/day/hour? What determines how fast you will go through the line? etc.). Health providers often leave wait information shrouded in mystery because they don’t have the exactly correct information or they have information that the client might not like. However, something is better than nothing, even if the information is not exact or not what the patient wants to hear. Give a reasonable, conservative range based on experience and facts when you can’t be exact (1-2 hours, 2-3 weeks, etc.). If something highly unusual happens and you expect to go past the upper range, proactively let your patients know.

Moving from 2) Some clues are provided to 3) Mystery solved requires a strong process built on the quality improvement principles such as value flow and pull . An example would be a referral process where you directly book the first appointment for a patient with the referred service, providing the name of the person providing the appointment, the date, time, and location.

Solve your patients mysteries whenever possible, and they will have a much less anxious health journey.

35 Questions to Improve Your Health Care Access Process

jeff@caredove.com (Jeff Doleweerd) — Sat, 11 Mar 2017 14:42:47 GMT

When trying to improve your health care access process, you’re best to first understand your current process. The most effective way to understand is to go find out. This means watching the process as it happens and gathering the facts.

After 10+ years of studying health care access processes, we have learned what to look for. Use these questions when investigating your access process to set a strong foundation for improvement work.

Patient Group

1) Which client/patient group’s access process are you investigating?

Referral Reception

2) What documentation did the patient receive when they were referred?

3) How do you find out about new clients/patients (phone, voicemail, fax, visit, electronic, etc.)?

4) Where do referrals come from?

5) Who are your most trusted referrers?

6) What volumes come from each referral source?

7) By what method do referrals arrive, for each referral source?

8) How are your referrals prioritized?

9) Where do you store received referrals?

10) Do you receive and process referrals on behalf of other agencies? If so:

How many referral destinations do you have?
Do you process referrals differently depending on the agency they are for?
How long does it take to process a referral for another agency?
Do you contact the client directly, or does the other agency?
What types of assessments, if any, are done?

Referral Forms and Ancillary Documentation

11) What form(s) are used for received referrals?

12) What information does the form show/collect?

13) How often is the form filled out incorrectly?

14) What ancillary documentation do you require from the referrer? Does it get sent consistently?

15) If the referral form or ancillary documentation is incomplete, how long is spent remedying the situation?

Patient First Contact

16) How do you first contact the patient (phone, voicemail, fax, visit, etc.)?

17) Who performs the first contact?

18) How long does the first contact last?

19) What information is gathered at the first contact?

20) What information & documentation is provided to the patient on the first contact?

21) How long was the wait since the referral (min/max/average)?

22) What is the referral backlog on average? (i.e., How many people are waiting to be contacted)?

Registration and Scheduling

23) After you make first contact with the patient, how long is the wait for their first appointment (min/max/average)?

24) What electronic system, or non-electronic method, is used to schedule patients?

25) How long does the scheduling and booking process take?

26) What electronic system, or non-electronic method, is used to register patients?

27) How long does registration take?

28) What useful statistics are available from the scheduling & registration systems/methods?

Appointments

29) On average, how many patients have their first appointment with your service per day/week/month?

30) Is the first appointment to begin service, or to perform intake/assessment? If the first appointment is to provide intake/assessment, how long does the patient wait from intake/assessment to first service appointment?

31) How many patients miss their first appointment due to communication errors?

32) Do you provide feedback to the referrer regarding the appointment outcome? If so, how?

Overall

33) What are your biggest headaches with the current access process?

34) Does batching (waiting for a certain number of tasks to build up) occur at any stage in the process?

35) Write a brief description of the service provided, the number and type of people providing the service, the hours of service availability and the service capacity (e.g., maximum caseload, visits per day, etc.).

Discovery of access processes isn’t limited to these questions, but they are a good start. Follow the rabbit down the hole when you stumble on something interesting with more questions and more observation.

Once you have collected this information, make the process visual by including all of your findings on a process map, which will help to clearly communicate your observations with others. Then, you will be ready to begin a truly informed discussion about improvement.

What Nature Taught Us About Health Care Networks [Infographic]

jeff@caredove.com (Jeff Doleweerd) — Fri, 18 Nov 2016 15:24:38 GMT

Health networks battle with questions like, “should we put all patients through one wait list?” or “should we have one single phone number for patients to call?”. Otherwise put, should we centralize referrals for service, or decentralize? Stories frequently appear in the media, often after an effort to centralize referrals fails to bring the desired results. Centralized intake departments often “go under the knife” like in this Ottawa example or with Fraser Health’s centralized flu shot booking.

Can nature teach us a better way?

When birds flock in a V formation, it appears as though there is a “lead” bird controlling the direction and speed. In fact, none of the birds “lead”, but rather each bird interprets what to do based on the movements and sounds of other birds right near them. It is a coordinated , decentralized , decision making system. The result is a beautiful migration pattern with birds maintaining strong interactions to keep their formation. Insect behaviour is similarly decentralized, where decisions are distributed across the colony, rapidly and accurately.

Patient Transitions Today: Referral Chaos

Unfortunately, handling patient transitions between services isn’t like a flying V, it’s more like herding cats – chaotic, with little synchronization ( even the MythBusters can’t herd cats ).

Here is how transitions currently (don’t) work:

When clinicians refer today, first they have to find the right service in a confusing ocean of information. Then they have to find the right form, fax it, and wait. Nobody knows when the patient will be served. Referrals get backlogged, phone tag begins, and some referrals never get completed. Confused patients adapt by seeking out alternatives, often resorting to costly hospital emergency department visits.

Referrals can feel chaotic and unorganized. A common solution is to centralize the transition process, but can the solution also incorporate the benefits of informed coordinated decentralized decision making?

Centralized Chaos?

“Centralizing intake” typically means that all referring clinicians in a region direct referrals of a specific type to one spot, using one form, or through one phone or fax number, with one central agency “triaging” the referral before it is routed to the final provider agency. The key benefit of this approach is that it makes life simpler for the referrer.

The main problem with a central referral process is that the quality of the interaction between the referrer and the patient doesn’t fundamentally improve, as the patient still doesn’t clearly know the next step in their transition.

In fact, there is often weaker interaction and less connection using the traditional centralized referral processes because there is less available information to convey to the patient. The referrer usually doesn’t even know what organization the referral will land at. The message to the patient becomes a variation of “someone will be in touch with you, sometime”.

Once the central referral department receives the referral, they often have to apply the same referral procedures that the original referrers once used. Centralized intake, without a fundamental process change, is still confusing for the patient (also, it can be quite costly).

Coordinated Transitions

Referring clinicians can improve the quality of interactions with patients when they book referrals for patients. A booked referral is where front line clinicians directly provide patients with appointment time options, and book them into a preferred time slot with the referred service. Patients clearly know the next step in their care.

Health system planners often feel that they need to decide between a costly centralization agenda or a decentralization agenda. With Caredove, this becomes a false dichotomy. Both models co-exist in a coordinated access model with booked referrals . Referrals to most services can be handled by directly booking the right service for the patient, or enabling patient to directly sign up. For situations where an intermediary would provide additional value (e.g., early assessment of patient needs for a service with a long waitlist), clinicians can refer to a centralized intake function which, itself, performs a booked referral to the required service.

Caredove provides the information and tools necessary for a health system to behave like a coordinated flying V, with the benefit of a single control centre, using both decentralized and centralized approaches to improving patient transitions.

Contact Caredove to start a conversation about affordable e-referral today.

Care Coordination Should Be As Easy As Booking A Hotel

tim@caredove.com (Tim Berezny) — Thu, 28 Jul 2016 20:08:04 GMT

Good care coordination helps patients easily navigate the health care system.

Countries care about care coordination. A recent Commonwealth Fund international survey asked seniors how they felt about their transitions in care. United States, Switzerland, Netherlands, Canada and a number of other countries funded and participated in the survey. All 11 countries found they have coordination problems associated with a lack of information and communication among providers.

Clinicians care about care coordination. Helping patients get the care they need as they transition settings is a vital role for many health professionals:

You have a regular doctor but also receive care from other doctors and medical professionals. Family doctors and nurse practitioners helps make these arrangements.
You are at home but need care from some place else. Community care coordinators are there to help you get this additional care.
You are leaving hospital and you need follow-up. Discharge planners help you get connected.

In the Commonwealth Fund Survey, 79 per cent of Canadians reported that follow-up care was arranged after their hospitalization. With thousands of discharges every day, that is a lot of clinicians caring, a lot, about care coordination!

A lot of patients care about care coordination, although they might not say this outright. Few patients say “I want care coordination”, just like few travellers express they want on-time connecting flights with “I want vacation coordination”. Care coordination is the kind of thing that, done well, can feel almost invisible to a patient. However, when we hear expressions like “I want to know what will be happening next”, or “I want my appointment in a timely manner”, we know patients want care coordination. Yet we also know that coordinating transitions to community health services is a challenge for patients.

There are many ways we can make care coordination better:

Make it easy for clinicians to search for and find the most relevant community service
Involve patients in choosing the right service
Ensure everyone is clear about who will be helping next, and when, with booked referrals and email confirmations

Focus on solving these three problems to build a care coordination approach that patients will appreciate.

Reduce Re-admissions by Improving Hospital-to-Home Transitions

jeff@caredove.com (Jeff Doleweerd) — Wed, 06 Apr 2016 20:44:02 GMT

In the US Medicare population, up to 76 percent of rehospitalizations occurring within 30 days of discharge are avoidable. Rehospitalizations represent a significant source of waste and harm in the healthcare system.

Research shows that enhanced care and support during transitions is an effective method to reduce rehospitalizations. This is because newly discharged patients are vulnerable to adverse events while they wait to learn about the next steps in their care.

The Institute for Healthcare Improvement (IHI) has published a helpful How-to Guide for improving transitions from the hospital to community settings to reduce avoidable rehospitalizations. One of their key recommendations involves scheduling the next steps in care, before the patient leaves the hospital.

“Key Change 3B – Prior to discharge, schedule timely follow-up care and initiate clinical and social services.” – Institute for Healthcare Improvement

Clinicians can ensure that, before the patient is discharged, patients have the help they need by booking directly into appointments with trusted services in the community. This reduces avoidable readmissions, diminishes potential harm and alleviates caregiver and patient stress.

Booking the next appointment before discharge may seem ambitious. However, when hospitals work together with their community health service provider agencies, the discharge process can actually be simplified.

“Teams have succeeded in successfully scheduling appointments by partnering with providers to create a simplified process, and by getting patient input regarding the best times for them to arrange transportation” – Institute for Healthcare Improvement

At Caredove, we provide the online platform that enables health care organizations to partner together to create a simplified transition process with scheduled appointments before hospital discharge. The result is that hospitals can reduce readmissions, discharge planners can better coordinate care, and patients know they will get the care that they need.

caredove

A Blueprint for an Effective Central Intake Hub in Healthcare

What is a Central Intake Hub?

Key Features of an Advanced Central Intake Hub

1. Scaling the Network

2. Adapting to Capacity Changes

3. Simplifying Participation for Organizations

4. Efficient Staffing and Navigation

5. Collaborative Staffing

6. Booking and Appointment Management

7. Simplified Navigation and Service Matching

8. Integration with Care Coordination Systems

9. Rationalized Forms and Information Sharing

10. Expert Assessment and Triage

11. Transparency in Referral Routing

12. Low Barrier Public Access and Centralized Intake

Rethinking Referrals: Embracing Direct Access for Community Health Care

10 Reasons Rapid Access Low-Barrier Walk-In Counseling Shines!

The Danger of Shared Email Accounts in Healthcare: Avoiding Legal Risks and Building Patient Trust

Email and Referrals… a bad match

Example: Eastern Ontario Data Breach

Going from Bad to Worse - Shared Email Accounts

Example: West Ontario Data Breach

Community Paramedicine: Embracing a Digital-First Approach to Care

Understanding Community Paramedicine

The Growth of Community Paramedicine

Community Benefits:

Case Study: Eastern Ontario Community Paramedic Program (EOCPP)

Technology at the forefront

From Warm Transfers to Booked Referrals: Empowering Community Navigators for Better Healthcare Outcomes

Building digital maturity through virtual networks

What is Digital Maturity?

Two Kinds of Networks That Mental Health Providers Should Join

1. Associations

Benefits of Joining a Mental Health Association

The “find a member” Test

2. Referral Networks

Examples of Counselling Referral Networks

4 Ways to Monitor Network Health

Referral Outcomes

User Experience

Website Metrics

Client Reported Outcomes (CRO)

4 ways associations can generate referrals for their members

The public sign-up renaissance

How Associations can help

1. Backlinking with Authority

2. Robust “Find a Member” Feature

3. Enable Public Sign Up in Your Member Search

4. Establish a Content Strategy to Become an Authority

In Conclusion

﻿

Community health agencies - Built for Innovation

What's too much? How to design a streamlined intake form

1. Ask the question at the right time.

2. Be succinct

3. Avoid large free-form text boxes

4. Consider relevancy

5. Avoid multiple consents

4 Ways to Kickstart a Regional Central Intake Project

10 Tips for Picking a Good Domain

Having a hard time deciding on a website domain for your coordinated access initiative? Caredove’s marketing experts have come up with 10 tips to keep your team on track when brainstorming ideas.

5 Steps to a Secure Website

1. Secure your website with an SSL certificate.

2. Remove your general inbox email address from your site.

3. Secure your contact form.

4. Ensure any contact form integrations are compliant with your national healthcare privacy standards.

5. Choose a contact form process that aligns with your organization's values to provide the best and most secure access to care for your clients and patients.

How 'Best of Breed' Digital Tools Increase Network Value

Click here for Part 1 of our Interoperability series.

The Art of the Possible

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By Nathan Tyler at Orillia Matters. See the original article here.

Caredove Business Continuity Plan

Let us reassure you that Caredove is here to help you as your priorities shift to respond to the COVID-19 pandemic.

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