AIDS application enhances case managers' productivity and proactivity.

SOURCE: Paul Milakovich Deputy Director of Administration and General Counsel AIDS Resource Center of Wisconsin 820 N. Plankinton Avenue Milwaukee, Wis. 532024)487 Fax: [phone]

PROBLEM: Federal programs like the Ryan White CARE Act and the Housing Opportunities for People with AIDS Act are causing case managers to take on growing case loads and spend greater amounts of time responding to crisis situations and filling out reports. Since prescription costs for a person on a combination therapy can exceed $20,000 per year, funding is being squeezed from service programs like case management. Challenges imposed by these circumstances include delivering quality care without increasing agency staff size and reducing the administrative burden of compliance with government and other funding agencies' reporting requirements.

SOLUTION: In October 1995, the AIDS Resource Center of Wisconsin (ARCW), received a grant to purchase computer equipment to be used to automate the agency's case management services.

ARCW reviewed four vendor products and two products produced by the federal government. Agencies from across the USA that use or had used the products were contacted for comments and recommendations. None of the products were recommended by any agency. This process took about two months.

An ARCW board member approached Bret Ballinger, president of Groupware Technologies, Inc. (GTI), a local information systems consulting firm and Lotus Premium Partner. GTI recommended that a custom solution be built and then volunteered to do so. The company developed and installed what has now become a commercially available application called Provide HIV/AIDS Case Management Support. The system recently won the national annual Lotus Beacon Award for Best Philanthropic Solution.

COMPONENTS:

* Server Hardware and Software: HP NetServer Single Processor Pentium 100 with 128 MB RAM and a 28.8 kbps modem, Windows NT Server 4.0, APC UPS with Powerchute 4.0, GB DAT Tape Drive and Lotus Domino Single Processor Server software.

* Client Workstation Hardware and Software: HP Pentium 90 with 16 MB RAM, Windows 95, Lotus SmartSuite, Lotus Notes Desktop (version 4.x).

COST OF COMPONENTS: Server hardware and software: $17,000. Client workstation hardware and software: $2,500 per workstation.

IMPLEMENTATION: Since this was a custom application developed by GTI, ARCW worked with the early beta copies of the application. Once the system was fully developed, installation was completed in a week and training and conversion from a paper based to computerized client files was completed within two weeks.

STAFF, PATIENTS SERVED: Over 1,000 client files are being tracked on the system with expected growth to over 2,000 as other satellite agencies from across the state are added in 1997.

BENEFITS:

* Productivity: Over four hours saved each month for each case manager in generating report input information. Over two days saved each month for case management supervisors generating reports for funding sources. Referrals to other programs can be completed at the click of a mouse which used to require the completion of a referral form.

* Patient care, service: Case managers are now able to provide proactive case management services through the help of the daily newsletter delivered electronically to each case manager every morning alerting them of which client needs to be contacted and why. Referrals to the agency and to other programs are no longer lost.

ANECDOTE: A client who was receiving prescription drugs under the state AIDS Drug Assistance Program(ADAP) was hospitalized. Transferring prescriptions from the ADAP-selected pharmacy to the hospital pharmacy would require a tremendous amount of paperwork. The time the system saves allows us to focus our efforts on issues like making sure the patient's rent gets paid while they are hospitalized.