Smart BI System for Non-profit Compliance

Medical case management is a complicated field, as people-served can be enrolled in different programs funded by different sources, each having its own compliance requirements. In this project, we helped a client automate compliance tracking and deployed a business communication system to remind case managers to complete compliance items for each people-served.

Situation

Client is an agency providing medical case management that uses a COC-default data platform to keep track of services. While exceling at providing stellar services for people-served and excellent training for case managers, management at this agency was not technically equipped to harness the data captured in the default data platform, which is in itself a notoriously inflexible and convoluted platform, to keep track of compliance requirements for each person served. Compliance requirements include: at least 2 progress notes per month, 1 acuity assessment, 1 individual service plan, and 1 HRSA form (if HIV-positive) within 30 days of intake and every 6 months thereafter. As a result, the agency came under scrutiny by funders for not being able to show that compliance requirements have been met.

Solution

Upon inspection, Anfluss team assessed that the problem is not purely technical. On one hand, the agency needed a way to comprehensively monitor compliance items for each and every people served. On the other hand, case managers, who directly serve people, need to understand the importance of entering data to reflect their works correctly (from a data-centric and reportable viewpoint). Therefore, we implemented a dual solution to:

• Develop a business intelligence system that allows both case managers and supervisors to know exactly which person served, belonging to which case manager, are missing what compliance item, in one dashboard view, as opposed to clicking through each person’s files;
• Train case managers on the importance of correct data entry to give credits to their actual works

An add-on feature of the BI system that turns out to be extremely helpful was a reminder email operation, wherein every month, the system sends an email to each case manager, cc-ing their supervisors, with an Excel attachment highlighting which people served still miss what compliance items that should be fulfilled by specific deadlines.

Results

Within 6 months of implementing this system, compliance fulfillment rate (people meeting compliance over all people served) increased from 40% to 80%. Not only did the agency maintain compliance and thus good standing with funders, their case managers and supervisors can now spend less time keeping track of compliance items in a disparate, siloed manner, and more quality time serving people and building deeper human connection.