Notes SDF IT and E communications

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					                              Sector Development Forum

                         IT and Electronic Communication

                 Wednesday, July 21st 2010, 2.00 – 4.00 p.m.
Computers, software, emails and internet are an integral part of the working environment for most
workers in the community mental health sector and will be even more so in the future. This forum
aimed to begin a conversation across the sector about the ways in which the sector can best adapt to
and exploit the opportunities of the future.
Speakers gave insights into some of the opportunities for using the internet for services and networking
in the future, how IT and electronic records can be used within organisations to improve collaboration
and productivity, and what key questions to consider when looking to implement an electronic records
system and with regard to your IT and information management.

Julia Reynolds, ANU e-Hub
Julia reminded those present that we are at a time of change in mental health. There is more of an
acknowledgement in the broad Australian population of the prevalence of mental health problems, the
high costs of untreated mental health problems, the need for prevention measures, and the lack of
access to services. There is also an acknowledgement that the health system has limited resources and
could not possibly treat everyone with a mental health issue.
Health care provision can be conceived as a continuum between clinical medicine and public health
interventions. Online services can reach across from prevention to disease management on this
Online services fall into a number of groups:
       Information – often provided in an interactive fashion
       Therapy
       Peer networks – forums, blogs, and chat rooms
       Virtual clinics – best known are CRUFAD and Anxiety Online
       Online counselling – often to complement an organisation’s other services
What’s coming in the future? Mental health mobile applications are starting to appear – some credible
and some less so. Another new development is online therapy within online games/worlds such as
Secondlife and Habbo.
Further potential of the internet for the mental health sector includes the use of the web as a portal for
access to care and to support wrap-around care. The British Psychological Society discussion paper
Connecting Communities proposes to use the internet to virtually link individual mental health providers
in networks to facilitate access to multiple referrals.
Before jumping into setting up your own online service there are a number of issues to give serious
consideration to, however:
Safety – of users, including consideration of affect on each other, of disclosure, etc.
Privacy – consider who’s “listening”, ability to identify people from multiple bits of information over
time, etc.
Security – how safe is your electronic information from unauthorised use?

Keith Mahar,
Keith presented on his web project in development: The underlying ideas
behind the project are to assist people to connect to the local and global mental health communities via
technology, and to raise awareness of Recovery in the community.
Keith was very inspired by Professor Albert Bandura's work on the importance of a strong sense of self-
efficacy in enhancing human accomplishment through difficult tasks, and strengthening of a person's
belief in their own abilities by providing them with the opportunity to view other people who they can
identify with accomplishing comparable activities. This thinking strongly influences
as a vehicle for disseminating stories of Recovery and inspiring hope.
A starting point for is trying to overcome the pervasive fragmentation of services by
connecting people online and providing a type as one-stop portal to make content and activities
available to people, allow them to get involved, and provide a space for online peer support.
While is still at a very early developmental stage, but when fully developed will contain local, regional, national and global pages with a rich variety of local
information and national and global pages containing the best of local and regional pages.

Rupert Gerritsen, MH Foundation
Rupert pointed out that in the last 15 years we have become completely dependent on information
technology. However, the digital divide is very real and some are missing out on the opportunities
information technology provides. In particular some organisations in the community sector don’t have
websites or email and mental health consumers and carers are disadvantaged in this area as well.
Incredible amounts of information are circulated by email. Much of this information reaches Rupert at
the MHF information and referral service, but does not necessarily reach the relevant audience among
consumers, carers and other disadvantaged groups. A variety of different email lists and networks are
used in the attempt to target of information, but whether the information reaches the relevant
audience is still hit-and-miss and the variety of lists results in much cross-posting of information.
Managing information is therefore a question for the future. MHF compiles a Training Digest as one way
of managing the amount of available information. A question raised about this sort of digest was about
the validity and legitimacy of the information. Has someone checked the information and does digested
information appear more valid than information not collated?

Lisa Kelly, headspace
Lisa began by stating that headspace ACT actively uses technology for its benefits for clients. Headspace
is determined to drive the use of technology rather than be driven by it.
The background for using technology from the beginning in headspace ACT is the extreme complexity of
the service. Key to headspace’s beliefs and values is a commitment to collaborative and shared care.
There are a total of 27 individuals providing services through headspace ACT – many of them working
for external services. The aim is – from this web of individuals – to provide young people with integrated
care. The great challenge was to create a client file that would encompass this.
Headspace has a complex approach to confidentiality. This allows headspace to put in place an
identified care team around each client, who can share information between them on an ongoing basis,
because the client is asked to sign off on this from the beginning. The next challenge was to create a
client file and reporting system, which could be collaboratively maintained, would be understood by all
professionals involved as well as the client, and which could accommodate the need to report on 50
data points for each client.
To achieve this headspace uses MHAGIC. This mental health client record system was originally
developed by Mental Health ACT, but was sold and is now available from Global Health. Using MHAGIC
allows headspace workers to keep track of clients, other members of the care team and what requests
and information comes in. Developing the Management Plan within MHAGIC means MHAGIC will
automatically remind workers when a client is up for review, sends a warning if the client hasn’t
attended an appointment for a certain period and in other ways supports workers to keep track of their
various clients and stops clients falling through the cracks.
Workers can take a “briefcase mode” copy of MHAGIC with them and enter client notes straight into the
MHAGIC format with the client and automatically update the central file afterwards. The “briefcase
mode” copy also allows the worker to access contact info, referral information, other contacts and other
useful information on the go.
Headspace also uses Referralnet, which allows for connected GPs to refer clients directly to headspace
ACT via an online form, which in turn automatically populates a MHAGIC file with the relevant
information, as soon as the client has been accepted by headspace. MHAGIC can also record and analyse
a range of outcome measures as well as other data and provide reports automatically.
In conclusion MHAGIC does much of the work for the workers and allows them to maintain large case

Tony Campbell, Supportlink
Tony opened by acknowledging that our community is moving forward into IT and suggested that we as
a sector need to move forward at least as quickly as the general community.
Tony also noted that Supportlink back in the day was looking for a tool to link and refer between
agencies, in particular for police to refer cases to Supportlink for intervention or further referral. While
cases could be referred by fax before the experience was that police hardly used this option to refer at
all. No solution was available at the time and Supportlink ended up developing its own system, which is
now being utilised across Australia and is possibly being exported to USA as well. The success of this
system has been great and 100% of referrals are now made electronically. Importantly police now refers
lots of cases to Supportlink.
Tony then proceeded with his presentation covering the following questions:
1.   Should we keep electronic records?
2.   Do you purchase a software package?
3.   Do you develop your own package?
4.   What solution would be most cost effective?
5.   How do we store the information?
6.   How do we manage the information?
In relation to 1 Tony argued that if you have to keep only a small amount of records then the answer is
probably NO, but start considering the change. However, if you keep moderate to high levels then the
answer would be YES.
In relation to 2, organisations should look to what other organisations are using and whether the
funding body is considering introducing a sector wide software package. Good software is often
available and compatibility across the sector should be a main consideration.
3: There are several things to consider: There is no such thing as a one off cost when you develop your
own package, it will require ongoing work and maintenance. On the positive you can modify it as it suits
you. Cost is potentially prohibitive, though - A small package may cost $20,000 to develop + $10,000pa
to support, a large package may costs hundreds of thousands to create.
4: A shared solution across a number of organisations, which is web based and stored in a secure data
centre is likely to be the most cost effective solution for medium to large organisations. Several
telecommunications companies will put your server or information in a high secure environment for you
at a reasonable price.
5: Very carefully is the first consideration! Physical security, access, storage, retrieval and disposal are all
key considerations.
6: This is an important question across your organisation and your IT environment. Make sure you
establish a working group to take responsibility for managing this area and plan for the future.
Important don’ts: Don’t cut corners! Don’t share data (that identifies a client) over the email. Don’t rely
on just one person to control your data management. Don’t forget to budget correctly for your data
management (about 5% of your gross budget is probably right on average).
Disclaimers, consent and disclosure: It is vital to inform clients what information will be collected, how,
and what it may and will not be used for. Getting client consent to collect and use information is of
central importance. Good disclosure information will ensure clients know who their information may be
disclosed to and for what purpose and helps them be comfortable about giving consent. Clients should
also be informed about the security arrangement for their data and what the procedure is for requesting
corrections to the data held by your organisation.

Darell Burkey, CASE
Darrell was asked to speak about managing technical support and gave a short and pertinent overview
of key issues.
He outlined a set of key challenges for the sector:
       Limited resources to allocate to IT and technical support resulting in lack of professional advice
        and management of systems and setup
       Viruses and malware
       Outdated equipment due to lack of resources set aside for IT
       Unpatched software causing security issues and malfunction
       Staff issues, including diverse ages and skill sets and high staff turnover
       False authority and a lack of capacity among staff to recognise spam/phishing
There are three key responses to these challenges:
1. Become pro-active! Organisations tend to seek out professional technical support only after a
   negative and sometimes disastrous event.
   1.1. Critical business systems require professional configuration and monitoring. Responsibility for
         management of your systems needs to be assigned to specific staff
   1.2. Budget correctly for upgrades and maintenance and ensure you have a ‘Service Level
         Agreement’, which meets your needs and means you get good and timely service.
   1.3. Consider an IT audit. Get professional help to ensure your systems are adequate.
   1.4. Create a ‘Disaster Recovery’ plan, so your business doesn’t stop because of an IT failure.

2. Avoid False Authority!
   2.1. Most spam and phishing emails are ludicrous, but we still re-send them! Be better informed and
   2.2. When in doubt - ask a professional. Make sure you check the qualifications of your IT technician
        and whether he is a member of a professional body.

3. Support your staff!
   3.1. Do you have an Acceptable Use Policy? This helps staff to know what they are allowed to do and
   3.2. What training do you provide for your staff?
   3.3. How well are your IT systems documented? Is it documented who your ISP is? Where to renew
         your domain name? Are your passwords recorded somewhere safe?
   3.4. Ensure you have appropriate support. Your IT and technical support services should match your
   3.5. Knowledge empowers!

More information can be found on the MHCC website:

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