Agency develops program to support long-term care

More than 20 years of experience aid planning

Connecticut Community Care Inc. (CCCI) in Bristol is an established name in long-term care. With more than 20 years of long-term care management experience, the agency decided to rely on its own resources to develop a care management software product when available programs failed to fit the agency’s delivery model.

"We spent more than a year researching available case management software. CCCI needs to track ongoing service authorization and service utilization on a long-term basis. Most available systems seem suited to a strictly medical, short-term, acute case management, and nothing seemed to meet our needs," says Sue Walker, MSN, vice president for operations for CCCI. "We wanted to create a paperless patient record incorporating all our current data, and be able to analyze that data on an individual and aggregate level. We have a holistic model that includes social support as well as medical models of care management."

The agency built a multidisciplinary team of nurses, social workers, and technicians that spent six months developing the system requirements for CyberCAM. The agency then contracted with LINC Systems in Bloomfield, CT, to develop the CyberCAM software system that was launched in March at the American Society on Aging’s National Conference in Nashville, TN. "The system uses laptop computers to help care managers quickly gather patient information and monitor the delivery of care services. It’s designed to help us guarantee consistency and continuity," Walker says.

CyberCAM allows CCCI to collect and analyze client data in seven separate domains essential to comprehensive long-term care management, she says. Those include: health status, functional status, support systems, cognition, psychosocial function and needs, finance, and environment.

A foundation for outcomes management

The agency’s client assessment is now built into the CyberCAM system. For each of the seven areas of assessment, care managers select responses that lead to a professional analysis of client status for each domain, Walker says. This information provides the foundation for future outcomes measurement. For example, for questions relating to health status, the choices are: stable, unstable, unstable but improving, and unstable but deteriorating.

"Our clinical process assures that our client assessments and care management interventions are quantifiable and available for analysis. The reporting and management of information is demanded of us as we practice in the changing health care environment," Walker says.

Throughout the development and current use of CyberCAM, maintaining client confidentiality is a priority, she says. There are multiple levels of confidentiality built in the system. "We looked at confidentiality in stages. The first thing we insisted on was that we would be the ones to determine who would have access to our records."

A secure system

Data entered on laptops by care managers in remote locations is both encrypted and protected by password, therefore preventing unauthorized interpretation of the data, Walker says. In addition, when data are sent over the Internet, the agency’s Internet server has built-in "firewalls" that protect and secure transferred information.

"The system is designed to limit access to those involved with direct patient care on a need-to-know basis only. Care managers only have access to the files of their own clients and the clients of other members of their care management team. Care managers only have access to the files of their own clients and the client’s of other members of their care management team. We’re working hard to minimize the exposure of client information as we move into a paperless environment," Walker says.

CyberCAM also helps care managers track their time by activity. "In our current practice, care managers are manually accountable for their time in 15-minute increments, which is very tedious," she says. CyberCAM tracks each care manager’s time statistics which Walker anticipates will leave care managers free to do more important tasks.

[Editor’s note: For more details on CyberCAM, contact Mary Iannaccone, clinical supervisor, Connecticut Community Care, 43 Enterprise Dr., Bristol, CT 06010-7472. Telephone: (800) 972-3851. Fax: (860) 585-0858.]