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CAISI Project
OSCAR-CAISI
Collaborative Software Raises Hope for the Homeless
Challenge
Many people and agencies are involved in helping homeless people in Ontario, but without an administrative home of their own so they could not communicate with each other.
Based in a donated office at St. Michael's Hospital in downtown Toronto, the CAISI Project manages the development and distribution of OSCAR-CAISI, a software program that has begun to help improve the care of homeless people and cut the myriad costs of providing it.
Founded in 2005, the CAISI (Toronto Access to Integrated Services) Project has an annual budget of $400,000 provided by the federal government's Supporting Communities Partnership Initiative. It has eight full-time staff and a large corps of volunteers. The volunteers include social service agency staff, students, software programmers and homeless people. All have a role in OSCAR-CAISI's development.
The central problem that the CAISI project is addressing is that the homeless receive help from such providers as hospitals, clinics, shelters, drop-in centres, public health services, outreach teams, emergency medical services and housing programs - each acting separately.
Each keeps records of the service it provides, but there's no way for it to know what assessments, treatment and other services their clients have had from other providers. This precludes integrated care and can be dangerous, as when, say, a homeless man gets treatment at a clinic without telling the doctor about medication he received elsewhere.
Solution
OSCAR-CAISI is an electronic medical and case-management record that integrates information among multiple agencies for the care of homeless people and provides data for community programming, planning and advocacy.
Building upon an open-source product known as OSCAR McMaster, developed at McMaster University in Hamilton as a brand of EMR software (electronic medical record), the project is collaboratively developing and releasing the OSCAR-CAISI system, which is also open-source.
They include common intakes; streamlined admissions and discharges; bed management systems; rapid multi-agency and multi-disciplinary referrals and multi-disciplinary role-based access to records.
OSCAR-CAISI can also produce real-time statistical reports. For example, it is now possible to do precise counts of people with severe mental illness and disability in a certain homeless population. Program-, agency- and community-wide reports can be used for program planning, funding applications and advocacy.
OSCAR-CAISI's still-evolving scope and features are the product of the work and suggestions of a remarkable range of individuals and organizations. In 2005 and 2006, people from 34 agencies participated in a succession of roundtables, and 12 of the agencies formed the External Reference Committee to generate ideas about project governance.
In Toronto, Ottawa and Hamilton, more than 50 other agencies are involved in the project, which has received more than 3,600 hours of in-kind staff time. And in Toronto, about 85 people who are or have been homeless contribute individually or as members of the Client Advisory Board. The project has also received advice from three provincial government departments, University of Toronto researchers, local advocacy organizations and private-sector health care, IT and privacy and security consultants.
Full-time project staff evaluate all of the suggestions received for enhancing CAISI-OSCAR. The ones that best serve all are improved, programmed and tested and then released. The guiding principle is "release early, release often."
Results
The OSCAR-CAISI open-source software has been implemented in 12 agencies in Toronto, Ottawa and Hamilton. But, while they are now capable of integrating their services they have yet to do so, largely for administrative reasons. Nevertheless, all use OSCAR-CAISI for internal case management, coordination of provider tasks and intra-agency referrals.
The new software has enabled the agencies to do away with paper files. Creating records and locating information is now far more efficient. Other benefits include:
- Previously, many hours were spent doing statistical program reports by hand or with spreadsheets. Now they can be created in about five seconds.
- All facets of an agency's business can be managed with a single software program. Previously, staff had to flip back and forth between programs or use combinations of paper and electronic information.
- Privacy and security measures are improved.
- Service activity, such as client interviews and vaccinations, is automatically tracked, thus improving service planning.
- There have been dramatic time savings in triage systems, which encompass admissions, referrals and queuing. Previously, too much time was spent compiling wait lists on blackboards and finding and handling paper files.
Innovative Use of Technology
The homeless are among the most marginal people in society, yet the CAISI Project is giving them a say in the development of a technology that has a direct bearing on their lives.
The project's open-ended nature and "release early, release often" principle encourages continuous feedback from users, potential users and a remarkable range of outside experts and other interested citizens.
A 2007 CIPA Winner!
For its excellent and creative application of information technology to transform processes and bring benefits to its stakeholders, the CAISI Project has been awarded a 2007 CIPA Silver Award of Excellence in the Efficiency & Operational Improvements, Not For Profit category.
Technology partners
OSCAR Canada and OSCARservice inc
McMaster University
People Tech Services
Bugzilla
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