STARTTS is the biggest and most comprehensive mental health service provider for refugees and communities affected by scars of torture in the State of NSW.

Operating out of multiple sites across NSW, and working closely with ancillary service providers to meet the needs of refugees, STARTTS required a platform that could transparently store, manage and interpret electronic health records to ensure accurate and timely client information.

The Situation

The story is familiar. STARTTS displayed some of the classic struggles in working with outdated database systems and processes. The existing database showed a polarised view of client data, functioning really just as a data entry platform. Lengthy and disparate client record forms and double handling of data through manual processes was resulting in report error; extracted data showed discrepancies between client record vs. data entry form vs. what the person had actually entered. The data had lost its value – it could no longer be trusted.

Carlena Tu, STARTTS Health Information Services Manager, knew things could be improved. STARTTS was packed with talented and motivated people, but their efforts to capture the data they needed was obstructed by their processes, and technology infrastructure. Inaccurate data in resourcing decisions was affecting client outcomes and funding opportunities were being missed.

“It was the system and the people operating together. With the old system, everything that needed to be changed to improve the process needs to go through a consultant - time was being wasted, and lots of money was being spent”.

Carlena Tu, STARTTS Health Information Services Manager

With accuracy and collaboration critical between partner agencies, the STARTTS national body, The Forum of Australian Services for Survivors of Torture and Trauma (FASSTT), considered building something internally, but once evaluating the time and resources, STARTTS tendered for the solution. Initially looking at single function platforms for e-records and case management, STARTTS reviewed other systems that sister agencies were using that would meet the functional, data, reporting and confidentiality requirements.

“During the tender process, a competitor actually told us about Arcitecta – they said to us very honestly that, “I think there is a system that is more appropriate than us”. They shared what Arcitecta had done with Melbourne Health in VIC. We got in touch right away.”

Working Together

Internally, STARTTS had struggled with a problematic database that had made people skeptical in a new solution. Understanding that transformation is a demanding process, Arcitecta worked hands-on with STARTTS on a change management strategy that included working closely with key stakeholders to involve them in the localisation of the platform.

“The process of getting the project rolling was centred around having lots of conversations with Arcitecta. They were very helpful and the communication on where things were and how they worked, this really helped in securing buy-in from the clinicians,” Tu.

The Way

Based on an examination of the STARTTS systems and practices, Arcitecta were able to localise its healthcare data solution, CAReHR, to solve identified problems. STARTTS established a pilot user group to test usability, and changes were made accordingly; positive changes were evangelized by the team to the clinic at large.

“Lewis [from Arcitecta] was so open and made the platform so simple to understand. This made it really easy to work together to enhance the system, which has been a really cost-effective method as well. What a complete 360 of the old database system!"

Instead of the daunting task of completely transforming existing practice, with blanket changes across multiple sites, a more practical approach was taken to implement the platform incrementally across sites.

“This approach required some additional problem solving with two systems in play, but in the end, it worked out well to generate rippling transformation from within the organization itself, and made the best use of limited resources.”

The Solution

“CareHR is overall a very clean and simple user interface. One of the most important reasons CareHR is working is that we received a platform that exceeded expectations.”

At STARTTS, the development of the database is an ongoing process. Using CareHR, platform administrators are able to move and adapt the system themselves as they find ways to improve their internal processes, without the need for an IT consultant.

“Before CareHR, any changes had to go back to the consultant. We had to explain what was needed, have it costed up and approved – then finally build it. With CareHR, we are more simply and cost-effectively able to adapt the system as our business needs evolve. We can set up a new process on a test platform, try it, and then implement it locally – we no longer need an IT savvy person.”

The Outcome

For the clinic, improvements have been dramatic.

• Increased Funding - Because STARTTS had the information so readily available through CareHR, STARTTS were able to build an accurate case to secure additional funding based on actual, rather than predicted, numbers of clients being serviced.
• Client Outcome Improved - With access to the data that is needed to manage wait times across holistic services, STARTTS are able to better schedule clients to see more clients with shorter waiting times.
• Clinician and Partner Confidence - With simple collaboration and accurate data through a single system, CareHR has improved trust between STARTTS and external referrers.
• Greater Return - CareHR has significantly reduced STARTTS dependance on additional IT resources, not only reducing the out of pocket but also delivering better control to spot opportunities to enhance the system or potential problems and act locally to better harness the value of their data.