CareRight Clinical Solution for Health Funds

Case StudyQLD_COUNTRY.PNG

Queensland Country Health Fund - Care Navigation and CareRight clinical solution

 

Overview

Queensland Country Health Fund was established in 1977 in Mount Isa and has expanded across the state and now insures more than 54,000 people. Queensland Country has a regional focus and provides service to Members in most regional towns and cities in Queensland. 

At Queensland Country Health Fund their Members come first, with lower premiums, improved benefits, and genuine personal service.

Purpose

Queensland Country is part of a Member owned group and therefore one of its objectives is to improve the health and wellbeing of their Members.  An area of concern is the growth in non-communicable diseases such as heart disease and type two diabetes in Queensland communities. Therefore Queensland Country sought ways to assist Members suffering from chronic disease to better manage their health.

It was also identified that there are significant costs associated with chronically ill Members requiring a high level of hospital and specialist treatment. If these Members could be assisted to better manage their health, their quality of life would improve and this would result in lower hospital and medical costs which would lead to lower premiums for all Members.

Solution

To achieve this, Queensland Country Health Fund realised they would need to develop a program of coordinating healthcare for Members outside the hospital environment. As a result they formed Queensland Country Care Navigation(QCCN), consisting of a small number of clinically trained and educated staff who could focus on the health of these Members.

Queensland Country Care Navigation staff:

- identify Members who could benefit from educational programs

- communicate with these Members and conduct regular health assessments

- monitor the Members health and provide assistance where required through allied health

services

- report back to the Member and fund on the Member’s progress

To handle the record of Member interaction with staff, clinical information and reporting, QCCN required an electronic clinical health solution that was flexible, easy to use, affordable and could be used by staff in the field.  After a thorough selection process, they chose CareRight as the solution to meet their needs.

Proven Practices

Once a Member has been identified and engaged with, QCCN use CareRight to track the individual Members from initial contact through their journey to improved health.

CareRight has the ability through Intelligent Forms, to gather information specific to the Member’s condition. This information is immediately available throughout the client record, date stamped and audit ready, if required.

CareRight also allows for workflow, specific to QCCN, throughout the solution, which can be configured and altered as required.

Reporting against key information for staff is paramount to the success of QCCN and CareRight has inbuilt reporting that can be easily adapted by staff to generate the ongoing and ad-hoc reporting required.

These features, combined with the best practice clinical modules within CareRight, allows QCCN to develop their processes in the future, when required.

Outcome

QCCN has reported significant improvements in the way they interact with Members and the assistance they can provide their chronic Members to better manage their health.

The financial benefit to the fund now and importantly in the future, will see the service grow to assist more Members and reduce premiums for Members in the future.

Kindee Lawty, QCCN Manager explains the benefits she has seen from using CareRight:

CareRight provided QCCN with a solution to manage recently discharged and chronic disease support for our clients. The system is flexible and highly configurable allowing us to mirror our work flow and therefore provide a more timely and professional service to our clients.

CareRight provides first class reports which in turn, provides better individual care-plans and an overall picture of individual and service caseloads.

The Clintel team have been responsive with implementation and ongoing support and have provided valuable advice in using CareRight to streamline workflow and processes.

 

QCCN are continuing to adapt CareRight for new and evolving improvements in the way they operate, including integrations with other software solutions.

 

 

For further information regarding this Case Study:

Andrew Bennett - National Client Services Manager

Clintel Systems

08 8203 0550

0438 100 126

 

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