You could be forgiven for not knowing what services are available from your local Community Health Service, or exactly who they support with those services. When we think of healthcare, most of us think of our local GP, allied health provider, specialist, and of course for all cases except childbirth, we hope that we never end up in our local hospital.
These are all essential services that everyday Australians like you and me rely on for maintaining our health and wellbeing. However, the unsung hero of the Australian Healthcare crown isn’t any of the above, but in fact, your local Community Health Service organisation, and here’s why.
Our community health sector
The Australian Community Health sector is much larger than you might think. These organisations go about their business with a fraction of the fanfare and attention craved by other parts of our health sector, and the breadth of support they provide to some of our most vulnerable Australians is simply mind-boggling.
To name a few:
- General Medical Services
- Dental Services
- Addiction Recovery Services
- Allied Health Services
- Disability Support Services
- Care Coordination Services
- Victims of Domestic Abuse
- Refugee Healthcare and Support
- Rehabilitation
- District and Community Nursing
- Mental Health and Counselling Services
The list really does go on, and last year their support extended to include the roll-out of COVID-19 vaccinations across their local communities. In rural Victorian areas such as Sunraysia, their community health service has been charged with the task of vaccinating their entire community! These compassionate, not-for-profit organisations that plug all kinds of ‘gaps’ in our health and social support systems, make their services either for free or at an extremely low cost-base just to enable greater support for all Australians.
Our complex funding models
I have been working with these organisations for the best part of a decade, implementing electronic client management solutions that help them manage their clients, administration and reporting obligations. What I have found to be incredibly fascinating is the sheer volume and complexity of administrative and reporting tasks required to access the funding that makes these services available. Most of the services listed above can be funded by several different state and federal programs or claiming mechanics, depending on which individuals are presenting for their services.
Each of these mechanisms represents a bucket of funding provided by the state or federal government, made available for providing services to support client cohorts with a range of health issues. As an example, a single person could require services from several of these programs at the same time, each of which is reported to a different government department or entity.
All of this makes for an incredibly complex funding landscape for these providers, one that is in a constant state of change due to annual revisions and the introduction of new programs occurring on a regular basis. A typical client of our EMR solution will be required to collect and report on 6-12 different “Minimum data sets” to access funding, and are also required to support separate billing processes for claiming such as Medicare, NDIS, DVA, WorkCover and so-on. These obligations have impacts right through their business, from intake and assessment to the front desk and reception.
Here’s an example of the billing and reporting requirements for just one of our Community Health clients:
- PMHC (Primary Mental Health Care)
- VADC (Victorian Alcohol and Drug Collection)
- FMHiCH (Forensic Mental Health in Community Health)
- C&WH (Community and Women’s Health)
- CHSP (Commonwealth Home Support Packages)
- HACC (Home and Community Care)
- VINAH (Victorian Integrated Non-Admitted Healthcare)
- DVA (Department of Veterans Affairs)
- NDIS (National Disability Insurance Scheme)
- Medicare
- TAC (Transport Accident Commission)
- Private Health Insurers
There are also some really exciting national infrastructure initiatives that these organisations are expected to interact with. Namely: My Health Record, Secure Messaging, ePrescribing, the Australian Immunisation Register, and more. Adopting these initiatives requires careful change management and updated processes that take into account client consent and education. For these reasons, some initiatives (where optional) have fallen down the priority list, causing many of the benefits to remain unrealised.
Our technology providers
Technology stands as the greatest opportunity and enabler for these community health organisations to digitise their patient management processes, participate in the e-health evolution, and deliver an improved patient care experience. Standardising and streamlining the way they do business so that they can meet these disparate and fluid obligations is a challenge that we as technology providers need to take-on head first.
In our world, customer and user expectations are sky-high when it comes to intuitive and streamlined patient journeys, and consistent user experiences, and rightfully so. There’s constant pressure to improve the customer experience within the sphere of community health. From patient-facing technology such as patient portals, online bookings, SMS, and e-commerce, to evolving government reporting programs that prioritise patient outcomes.
What the industry needs are technology partners that immerse themselves in the business of Community Health and take on the challenge of keeping up with all these moving parts. Most importantly however, we need technology providers that put the clinician and client experience at the centre of all their design decisions. A true patient-centred and team-based EMR that is built with strong clinical foundations and modules that then incorporates the billing, reporting and business management requirements around it is the key to unlocking the potential for technology-supported outcomes between clinician and client.
At MasterCare, we take pride in collaborating with our clients to improve our technology to adapt to and improve the business of Community Health. It’s a vital pillar of our Healthcare community and we’re thrilled to be a part of it.
This article was written by Kye Cherian, Chief Product Officer at Global Health.
Learn more about our solution for community health.