We've all heard of the many uninsured Americans who don't get the health care they need because they simply can't afford it.
For many pregnant women, young mothers and children however, health care services are in fact available through state or federal programs. They may simply not be aware of the programs, realize they are eligible, or even know how and where to apply.
Colorado’s Healthy Communities Program
The State of Colorado has more than 600,000 children ages 20 and under currently enrolled in medical assistance programs - including both Medicaid and Child Health Plan Plus (CHP+), Colorado's CHIP program. All of these children are entitled to well-child screening, diagnosis and treatment services.
The State of Colorado’s Department of Health Care Policy and Financing (HCPF) created the Healthy Communities Program to make sure that these children receive the well-child visits they need to stay healthy, and can easily access any necessary treatment services. Routine preventive care not only helps keep communities more healthy, it also preempts costly emergency care services.
Healthy Communities Reporting
There are 25 Healthy Communities programs throughout the state, providing services for all 64 counties in Colorado. Each program is administered by a local county health department, a human services office, or a nonprofit organization.
Until 2013, each program was responsible for developing and implementing their own business procedures, and reporting their results back to the state. Some programs were keeping paper-based records, some were using Excel spreadsheets, while others had independently developed their own databases to record client information.
Every month each program unilaterally submitted reports to HCPF. The reporting was cumbersome for the individual programs – particularly those who had to tally data from paper records - and even more tedious for HCPF, who had to cobble together information from 21 programs into a coherent set of statewide results.
Outreach and Case Management System
Late in 2012, HCPF contracted Upleaf to work closely with all 25 programs across the state to standardize program procedures and create one unified HIPAA-compliant system, built within Salesforce.
The new system was crafted with a vision of efficiency (saving time at HCPF headquarters and at the counties) and quality (improving data quality and the capacity to analyze program results).
Upleaf designed the new Outreach and Case Management System around nine core goals:
- Automated Reporting - to streamline the monthly reporting process and save everyone's sanity. No more painstaking consolidation of Excel spreadsheets or waiting for monthly reports from the counties—reports are updated in real time. The State’s program managers now access the latest results anytime with just one click.
- Client Retention - Keeping clients in the program is key to improving overall health in the state. A set of real-time monitoring dashboards and reports enable the State’s program managers to detect issues and help ensure measures are stepped up to retain clients.
- Faster Data Entry - Faster data entry means higher productivity for everyone. Recent records are always one click away. Fields are programmed to auto-complete and all client information is available in one page, so managers can quickly scan and glean what they need.
- Mobility - The system is web-based and mobile device ready. That means managers can go to an outreach event or home visit with a tablet or even a smartphone, and collect potential client information directly into the system.
- Security / HIPAA Compliance - A combination of access controls, data segmentation and procedures training for all users makes the whole shebang HIPAA compliant.
- Improved Data Quality - Robust search functionality and ‘search first’ training helps reduce duplicate records. If duplicates are created, the system flags them for staff to correct. Real time data validation rules prevent users from entering data with errors (e.g. incomplete phone numbers, addresses that are not mail-ready, misconfigured email addresses). Social Security Number and State IDs are validated by the system so the same client can’t be created twice.
- Better Customer Service - When an agent has all of a client’s information at their fingertips, they can respond to any question faster and process applications swiftly. Agents are automatically reminded when it is time to follow up with each client/potential client. Clients are grouped into households so an agent can quickly get all information regarding a mother and her three children.
- Scalability - Each contractor has access to virtually unlimited storage capacity. New contractors or new contractor staff can be easily added by program managers.
- Team Collaboration - State program managers and contractor managers can manage their team workflow and assign and delegate tasks. An online reference manual assists users with questions. Internal Q&A section called ‘Answers’ allows Family Health Coordinators (FHCs) from anywhere in the state to ask questions. The entire community of users can respond, helping create a knowledge base that serves all FHCs and reduces support costs.
This consolidated system now ensures that overall service quality levels and client follow-up effectiveness can be accurately measured and improved upon. Data is more accurate, and HIPAA compliance is embedded in the way data flows both within the system and out of it.
Upleaf consolidated, cleaned and migrated all existing client records to the new system, and provided extensive training and support to ensure that each program manager had the knowledge and skills necessary to effectively use the system. All 25 programs across the state are now using the system as intended, and collaborating closely with each other to continually improve the program.