CAReS

CAReS = Clinical Appointment and Referral electronic Service 

CAReS is an integrated web-based electronic system to be used for all referrals between all levels of care from our Community Health Workers to our quaternary sub-specialist clinicians. CAReS can be used on a cellphone, a tablet, a laptop, or a desktop computer. CAReS can be used via a downloaded app or via a website. Importantly CAReS connects to all other electronic services used in the Health and Wellness Department.

There are two components: Referrals and Appointments.

The first component is an electronic system which allows a seamless process for referrals from any and all categories of staff to any other category of staff, across all levels of care, to assist with the treatment of a patient. 

The appointments system component assigns a specific date and specific time slot for an appointment to each individual patient, in order to decrease waiting time at a health facility before being attended to, and to decrease congestion at health facilities. This is the second component, which is being developed after the first component is stable. 

The aim of CAReS is to give Health Care Workers a tool to get patients referred for specialised care and then back-referred when stable. Referrals could be within a facility (between departments or specialities) or between facilities. If a Referral is between facilities, then it should follow a logical geographic area, with lower-level facilities referring to higher level facilities that are geographically closest to them in terms of travel time, and vice versa.

The existing system for referrals is mainly via a mix of electronic services and via telephone. None of the electronic services being used connects with the other electronic referral services or with the existing electronic services in the Health and Wellness Department. This is a critical limitation of existing electronic referral services and in particular it prevents automating appointments after a referral is accepted. Although electronic referrals have become an essential component of the provision of seamless integrated continuing care for patients, none of the existing electronic services are owned by the Health and Wellness Department. This is considered an important risk as access and/or affordability of these other electronic services remains a constant threat.  

Hence, it became necessary to develop a Clinical Appointment and Referral electronic Service (CAReS), that drives the explicit intent to shift to an integrated electronic referral process, with automated capture and storage of the referral information, which is then easily accessible to all staff caring for the patient. CAReS will additionally provide summary reports with operational information, which can be used to improve the referral process and overall healthcare services to the population of the Western Cape.

CAReS will facilitate:

• Transversal support for electronic Appointments and Referrals
• Improve patient and staff experiences with Referrals and Appointments
• Automation of the appointment process once a referral is accepted
• Reduce the burden on health care facilities using intelligent data driven appointment and referral management

The Referral system component is an electronic system which allows a seamless process for referrals from all and any category of staff, to any other category of staff, to assist with the care of a patient.

The Appointments system component automatically assigns a specific date and specific time slot for an appointment to a patient, once a referral is accepted. This is done to decrease the waiting times at a health facility for patients and to decrease congestion at health facilities.

CAReS makes use of different Referral types:

• Emergency referrals
• Outpatient referrals 
• Inpatient referrals

A referral can be either accepted, redirected, or advise can be given on the referral only. The fact that CAReS allows for all kinds of attachments makes it so much easier to evaluate the patient without having to spend time doing repeated tests, which helps reducing costs.

A referral can be either accepted, redirected, or advice can be given if the referral is not accepted.

CAReS allows for all kinds of documents, pictures, videos, x-rays and test results to be attached to the referral. This makes it so much easier to evaluate the patient without having to spend time doing repeated tests, which helps reduce costs and assessment time.

CAReS allows Chat functionality via various communication channels.

• CAReS is quick and easy to use. 
• CAReS streamlines referrals.
• CAReS synchronises referrals and appointments.
• CAReS can be used on any device.
• CAReS links to all other health information systems.
• CAReS enables the ability to improve the planning, scheduling and management of patient clinical appointment services. 

CAReS is an in-house developed system which interacts with all other information systems in the Health and Wellness Department and allows the Department to customise it to our particular needs.
Bringing the development in-house means that CAReS can continuously be adapted to our evolving environment and will always be available for use, eliminating the risk of non-availability and unaffordability that external systems would have.

• A web-based Referral system that can be used anywhere with any device (cellphone, desktop, laptop, tablet), either via a website or as a downloaded app.
• Automatically links an accepted Referral to an Appointment date/time.
• Allows for easy capture of required clinical information.
• Allows for attachment of pictures, videos, documents.
• Provides iterative Chat function between clinicians.
• Provides a feedback loop for a summary of findings after the patient is seen by the accepting clinician.
• Will be linked to all other information systems in the province:
  • OPD referral will be linked to SPV, Clinicom, PHCIS, eCCR, and to CAD (for HealthNet transport).
  • Emergency referral will be linked to SPV, HECTIS, eCCR and CAD (for ambulance transport).
• Provides Reports and a customised Dashboard.

Piloting of CAReS has been taking place since September 2024.

To log into CAReS you need to be given permission to access CAReS via your Head of Department.

Once given access to CAReS, the url to the CAReS test environment is available at:   
https://cares-training.westerncape.gov.za

No, CAReS can be accessed via the public internet without a VPN.

It can be accessed with any device (cellphone, tablet, laptop, desktop) that can access the internet.

To log in to CAReS, you need to be given permission to access CAReS via your Head of Department.

Once given access, you will be provided with the url for CAReS: https://cares.westerncape.gov.za/welcome

Copy and paste the url to your browser and you will be taken to the login screen.

CAReS can be used on a cellphone, a tablet, a laptop, or a desktop computer as a downloaded app or via a website.

Watch the CAReS Training Videos to learn the various functionalities of CAReS.

You can consult the CAReS Training Infographics and watch the CAReS Training Videos.

CAReS allows for interaction via SMS and email with both, patients and staff.

CAReS caters for different directions of referrals: 

• Referrals can be 'Up' (Referrals are made to a higher level of care.),
• 'Down' (Referrals are made to a lower level of care.),
• 'Lateral' (Referrals are made to a different discipline of care.) and
• 'Back' (A patient, who was initially referred to a higher level of care, is referred back to the staff member, who initially referred the patient.)

A feedback note on the outcome of the Referral will be sent automatically to the referring clinician to ensure the continuity of care.

CAReS will provide the Department of Health with monthly Reports for analysis and progress towards integration with existing departmental systems including a Dashboard that can be customised for different user groups.

All information captured on CAReS is made available to the Provincial Data Centre for integration into SPV (Single Patient Viewer) and hence the advice provided for a Referral is stored as part of the patient’s records.

Several teams collaborated to make CAReS happen:

• Specialised Services Support
• Information Technology 
• Systems Development
• Health Services Representatives
• Communications
• Change Management
• And of course: You!

Please use this easy form to submit your feedback or suggestions: CAReS Feedback Form

For any queries regarding general IT problems, please contact the Centre for e-Innovation Service Desk:

Tel: (021) 483 4800

Fax: (021) 483 6280

Email: CeI.ServiceDesk@westerncape.gov.za

No: The OPEXCO mandate states not to intrude on the clerical functions. Updating patient details needs to happen through the correct channels.

In the short term we are sorting and filtering the Referrals. Later the Referrals will be archived after a period of time (probably 6 to 9 months).

Patient interaction will be added when we add appointments capabilities. In the short term the clinician will engage the patient manually.