March 23, 2006



Posted: 06.04

A Community Effort

With mobile solutions, Access Community Health Network’s traveling caseworkers are reaching Chicago’s underserved. Fast.
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By Phil Britt

Access Community Health Network, a Chicago-based operator of health clinics, is the largest private community health center organization in the metro area. It provides primary and preventive healthcare in underserved local neighborhoods through its 42 health centers and caseworkers in the field.

Access recently turned to a pen-based, wireless computing solution to get quicker, more accurate care for its clients. With the wireless computers, a customized software program, a wide-area network and cooperation from nearly 10 other social services agencies, Access is providing assistance and referrals in just a few minutes, rather than several hours or days, as was the case in the past.

At the Point of Care

Caseworkers typically visit communities in outreach vans, providing information on various programs, from AIDS awareness to women’s health services. During these outreach programs, which are publicized formally and through word-of-mouth, people in need of various social services can approach
caseworkers for assistance.

In the past, the caseworkers handled those situations they could, but would need to call other social services agencies if the person needed housing, drug rehabilitation, long-term healthcare or other services that were outside of Access’ specialties.

“We have patients who are at high risk for HIV, TB and other diseases,” says Abraham Miller, Access information services manager. “What we try to do is share key client information and help facilitate referrals for services. If someone had to wait too long, they’d usually leave,” Miller says.

People leaving without care was fairly common before the caseworkers had the new technology, because making referrals the old-fashioned way was a very time-consuming process, according to Miller. “We were always trying to contact people. Sometimes they would be out and wouldn’t return calls until the next day. By that time, the person needing care would be gone.”

Using the old method, the caseworkers asked a client questions to determine the appropriate agency that could help them. Once this was determined, the caseworker would try to reach the right contact, to ask if the other agency could aid the client. If the appropriate person was out of the office, the caseworker might wait hours or even as long as a day before receiving a response.

Now this is all done electronically, thanks to a $500,000 grant from
the U.S. Department of Commerce. Access worked with the other social services agencies to develop a list of 22 standard questions that would indicate whether a person qualified for care and what type of care they qualified for. The questions are included in Vancouver-based Cogent Integrated Solution’s Equicare case management software, which enables users to input client history, demographics and notes, as well as send text messages.

Once the caseworker inputs all of the answers to the questions, the software determines the social services agencies in a specific geographic region that can meet the patient’s needs. Using the stylus, the caseworker can immediately call an appropriate agency to find out if it has room to handle the client—and to avoid, again, a scenario of waiting for someone to retrieve and return a voicemail message, the new system sends a text message to the appropriate contact’s Skytel pager.

“Now we don’t have the communication barrier back and forth that we had before,” Miller says. Referrals can be made in as little as 10 minutes. If available, other agencies may even send a vehicle to pick up the referred client.

Helping Access Help Others

Besides breaking down communication barriers, the new system provides several other benefits for Access, the associated social services agencies and their clients.

“This also enables us to search for a client to see if they are already in the system,” Miller says. The recorded history provides a pair of benefits. If the client already exists, there’s no need to re-enter information, only to amend any details (such as address or phone number) that have changed. Additionally, the client may be seeking services that he’s received already and doesn’t qualify for again (e.g., methadone treatment), which prevents double- or triple-dipping.

Miller looked at a few types of mobile computers before choosing the Fujitsu P-1000 LifeBook with an integrated Sprint PCS Merlin 802.11b wireless network card.

The Fujitsu uses a power-saving Crusoe chip rather than a Pentium, so users benefit from a longer battery life of six to eight hours. That is critical, Miller says, because some caseworkers are out in the field all day before returning to an Access health clinic where the battery can be recharged.

Another advantage of the Fujitsu, according to Miller, is that it’s pen-based, enabling case workers to complete the yes and no answers by touching the appropriate box with the accompanying stylus, rather than using a more cumbersome touchpad. If necessary, the stylus also enables a caseworker to add notes more quickly than a keyboard. The Fujitsu is also a little smaller and lighter than the more traditional tablet PCs, so it’s easier to carry around.

Making the Connection

The choice of communications networks came down to Verizon and Sprint PCS, according to Miller. He chose Sprint because its CDMA network provides better, clearer signals than Verizon’s TDMA network. Communication speeds run from 128 kbps to as high as 200 kbps, depending on location. Sprint’s pricing was also preferable, according to Miller. Access pays $40 a month for 20 MB of downloads.

The government grant expires on Sept. 30, 2004, but the program has worked well enough that Miller expects to apply for new grants to extend the program. The next step will be to include even more social services agencies, which may work together to obtain grants for the wireless referral service.•

Phil Britt is a freelance writer who covers technology.
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