A case study of Tablet PC use by allied health

therapists

Leading the Way

Louise Schaper

19th July 2007

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• Importance of health-ICT and e-health issues for allied health

• The case study:• Who are KaK

• Project background

• About the project

• Project outcomes & benefits

• Key success factors

• Implications of this work to other stakeholders

Topics to be covered

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Importance of ICT & E-health for allied healthIn 2020 …• The health system will have to • … treat proportionately more people• … with proportionately more illness• ... with relatively fewer tax dollars• … and proportionately fewer workers

How?...

• We need to reinvent healthcare!

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The Future is Now

Australian health sector will continue to see a rise in the use of ICT due to:

• Information needs of health care professionals• Information overload • Reinvention of healthcare • Global trends

• Effective and efficient use of health information will optimise resource use, improve health outcomes, act to inform and empower consumers to participate in the healthcare process and improve continuity of care

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100%100% Healthy, Healthy, Independent LivingIndependent Living

Chronic Chronic Disease ManagementDisease Management

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Community Community ClinicClinic

HOMEHOME CARECARE

Assisted LivingAssisted Living

Skilled Skilled NursingNursing FacilityFacility

RESIDENTIAL CARERESIDENTIAL CARE

CommunityCommunityHospitalHospital

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Specialty Specialty ClinicClinic

CLINICAL CARECLINICAL CARE

COST of CARE/DAYCOST of CARE/DAY

QUALITYQUALITYof LIFEof LIFE

The Continuum of Care

SHIFT LEFT

Acute CareChronic CareHealthy Care

Slide courtesy of Intel

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Importance of ICT & E-health for allied health

• For this to occur many challenges need to be overcome & many changes need to happen

• Allied health are well placed to do this…

• Because we are an intelligent and creative lot !!

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• Provide professional therapy and education services for children and families

• Independent, not-for-profit, community based• 10 staff - 5 FTE• Staff include, occupational therapists, speech

therapists, physiotherapists & a behavioural consultant

• DSC funds 17 places in the KidStart Early Intervention Program.

Who is Kids Are Kids?

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Staff

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Clients

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• 3 years ago almost no IT• 2004 successful LotteryWest submission to fund

new IT equipment• New IS = transformation• HUGE success

• In 2006, in response tostaff interest & motivationwere given a Tablet PC.

Background to the Project

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• A Tablet PC is a computer shaped in the form of a laptop computer which also allows the user to take notes using natural handwriting with a stylus or digital pen on a touch screen.

• Tablet PCs are intended to function as the user's primary personal computer as well as a note-taking device.

Some information on Tablet PCs

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Aim• To trial the use of Tablet PCs in place of handwritten

documentation

Project Objectives• the development of electronic templates for recording

client records• staff training and experience in the use of the Tablet PC • an improvement in the quality of documentation• an improvement in the efficiency of work practices• collection of information regarding the cost effectiveness

of implementing such technology

Project: Tablet PCs at KAK

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Methods• One Tablet PC

• 3 therapists – physiotherapist, occupational therapist, speech therapist

• Focus on the KidStartprogram clients - 17 children

• Used the Tablet wheneverpossible

Project: Tablet PCs at KaK

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In place of handwritten documentation, created templates for…• Intake form – start of electronic client record• School/community visit checklist• Comprehensive assessment – one combined report for all disciplines

(an achievement in itself!!)• Related reports• Activity sheets• Therapy Plans• Progress notes

• 14 clients have had comprehensive assessments• 6 school/community visits• Record client voice / language samples as part of notes

What KAK used the Tablet for:

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Example of Use

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Examples of Use

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Individual Family Intervention Plan (IFIP) meetings• Increased professionalism• Parents and therapists work on the therapy plan together

in the meeting• Better, more comprehensive reports PLUS less time to

do them!• Positive response from parents

- parents get the report andfeedback immediately, not 10 weeks later

What KAK used the Tablet for:

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Individual Family Intervention Plan (IFIP) meetings• “When we used the Tablet in the IFIP parents were blown away, they

were so impressed.. They took it much more seriously … they feltmore part of the process of planning care and therapy for their children; they could see that we were writing in exactly what they were saying.”

• “Parents have said how impressed they are with the report, as it’s very extensive. We are able to give them the report immediatelybefore they leave the building and ensure they have a high quality, comprehensive report. It allows us to cover it ALL, whereas previously it was too time intensive and excessive to write such a long report”.

• Used in IFIP to review previous assessments – “we could show them how much their child had achieved. It was really good for them to be able to see just how much progress had been made”

What KAK used the Tablet for:

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Main outcome - achieved the stated project objectives:

• development of electronic templates for recording client records

• staff training and experience in the use of the Tablet PC• an improvement in the quality of documentation and

efficiency of work practices• information on cost effectiveness

of using this technology

Project Outcomes

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• Acceptance and use of the Tablet PC by therapists• Enhanced communication & collaboration amongst

the team• Efficiency gains & significant time saving through

reduced time spent on administrative and non-client contact tasks

• Significant cost saving• Improved documentation quality and

comprehensiveness of reporting• Increased professionalism of services provided

“It’s been revolutionary!”

Key Benefits

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• More time for direct client contact• Limit problems associated with legibility of handwriting• Improved security of client records• Increased ability to record, compare and analyse client &

service data

Other Benefits

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Time Savings• Scoring of assessment - at least 1 hr• Report writing – at least 1.5hrs per

therapist• IFIP meetings – at least 2 hrs

(documenting)• Interventions - 30mins per intervention for

progress notes & activity sheets“It saved us hours and hours of time”

Cost Effectiveness

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For just the comprehensive assessment, report & IFIP meeting for each KidStart client:

• 1.5 hrs per therapist for Ax & report• 2 hrs per IFIP meeting

Assuming 3 therapists and one appointment with each therapist -

• Total saving of 6.5hrs per clientAssume funding rate of $56/hour

• Total saving of $364 per clientYearly calculation - ~20 comprehensive assessments per year

• Total saving of $7280/year (conservative estimate)

Cost Effectiveness

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• Focus is on the quality of service they provide to clients and their families

• Could visualise the benefits to themselves, their clients & the organisation– Frustration with paper-based records & systems– Focus on efficiency (limited $$, so must be efficient)– The technology is compatible and supports their practice

goals

“If something is going to save me time and help me to do a good job then I’ll go with it”

Key Success Factors

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• Management support “we feel very supported here”

• Staff motivation and commitment to organisation, its mission and goals (agreement to work together)

• Recognised need & value for use of ICT as part of their job “You have to be computer literate to keep working. It’s a necessary part of your job.”

• Staff involvement - all staff involved in the process, they owned it

• Technical support on hand

Key Success Factors

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• Unique on a global scale

• First of its kind

• Showcases the use of Tablet PCs by allied health therapists

• Demonstrates the potential of this technology and how allied health can lead the way in the use of Tablet technology within the health and disability sectors

Project Uniqueness

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• More efficient communication between Kids Are Kids! and other organisations such as DSC, particularly in regards to reporting requirements

• System plagued by waitlists, busy therapists, not enough therapists, system inefficiencies

• Need further investment in use of technology which can assist us to deliver a more cost efficient service

Benefits to the Sector

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• In 2005-06 6,861 people received a therapy service,–funded by DSC Individual Family Support Service*

• If we assume similar costings but HALF the savings as was experienced at KAK

• = $1,248,702 total saving per year

*Disability Services Commission 2006. Annual Report ‘Making a Difference’ 2005-06. www.dsc.wa.gov.au

Benefits to Sector

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• The success of this trial will lead to further opportunities to continue to explore how the use of technology could be used throughout the organisation to improve work practices and deliver a more comprehensive and quality service to clients.

• As a mobile solution when providing services in the community (allows therapist to have complete access to all client documentation and resources without needing to carry around boxes of paper records).

Where to from here

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• Unique• Trial was a success & ongoing• Benefit to clients, therapists, the organisation

and the disability and health sector. • Of interest to wide range of stakeholders – DSC,

funding bodies, employers, State & Commonwealth Govts, allied health professionals, technology vendors, researchers

• Significant return on investment• Numerous benefits: cost savings, efficiency

gains, improved productivity, better & higher quality service to clients, more time to see clients

In Summary…

Kids Are Kids! Therapy and Education Inc.Tablet PC Use at

Louise Schaper

l.schaper@curtin.edu.au

a BIG thankyou to:DSC for their support and interest in this project

the therapists for their enthusiasm & for leading the way

Ian, the tireless volunteer who always has a smile on his face

Intel, for sponsoring the sork