At the request of the Administration on Aging (AoA), the National Long Term Care Ombudsman Resource Center (ORC) examined computer utilization in the Long Term Care Ombudsman Program, including identifying the software being used in different states for complaint and other program data. A questionnaire was distributed in the fall of 1999 to determine what computer systems are currently in use, their strengths and limitations. A draft summary was distributed in March 2000 with revisions made through June. Information about each state’s ability to communicate by e-mail was also obtained. Forty-four states (85%) responded, and Center staff continue to solicit additional information. This study is relevant as ombudsman programs seek to improve their software systems and pursue measurable outcomes. In addition, the study points out that ombudsman communication via e-mail is a significant method of relaying information between and within state programs. The state-by-state responses are detailed in the Appendix.

For more information about this study or to update information contact Jeni Coyne, Ombudsman Specialist, at the Ombudsman Resource Center, 202-332-2275 or jcoyne@nccnhr.org

Even though some state ombudsman programs have used computers to track program operations for ten years or more and the Administration on Aging’s (AoA) National Ombudsman Reporting System (NORS) has been in place since 1995-96, there is little uniformity in the computer software used by the states to collect case, complaint and program operations data. In fact, the thirty-nine states that reported using computer programs to capture data use twenty different software programs. Sixteen of these were developed in-house by individual states and four are standardized programs – OmTrak, Ombud 2.0/3.0, RASCAL and Microsoft Access based programs. Interestingly, five of the reporting states do not use a computer system at all to collect and analyze data – Arkansas, Colorado, Pennsylvania, Puerto Rico and Virginia.Most of the software programs utilized are relational data systems that allow state and local ombudsman programs to examine a wide number of variables and their relationship to one another, including the number and type of complaints by facility. Relational databases provide local and state ombudsmen with information that can identify trends, relationships and patterns that can aid in program management (i.e., deciding which facilities need increased visits) and systemic advocacy (i.e., determining emerging and on-going issues that need to be addressed).

The data which states submit in their annual reports to AoA under NORS is simply aggregated, not relational. Therefore, variables cannot be analyzed in relationship to one another at the national level. This limits the depth of analyses that can be undertaken at the national level about the ombudsman program itself and about the long term care system. For example, it cannot be determined what types of complaints are resolved to the satisfaction of the resident or what types of complainants generate what categories of complaints.

In 2001, the Administration on Aging (AoA) will recommend changes in the national data reporting system to the Office of Budget and Management. AoA and Center staff met with the state ombudsmen at the April 2000 Spring Training and solicited ombudsman input through an e-mail inquiry in June 2000. The recommendations will be based on further input from ombudsmen, state directors on aging and others about future data needs at the local, state and national levels. Elements in NORS may be added or changed as AoA seeks to expand the information about the ombudsman program and increase data reliability. However, significant changes to NORS may be limited due to the inability of states to obtain new software and hardware to accommodate reporting changes.

On a state level, ombudsman programs seek program software that will generate useable, accurate and relevant reports. Sue Wheaton, AoA’s Ombudsman Program Specialist, reminds ombudsmen that, as we look to the future, state data collection software systems need to be flexible so they can be adapted as needed changes are identified and implemented.

As stated above, state ombudsman programs are using a variety of computer software programs including:

· OmTrak - There was no initial cost to states; the software was provided through an AoA grant in 1993. Some states have added additional software packages such as OmView (~$25,000) which acts as an overlay program to assist with analyzing and reporting the NORS data.

· Ombud 2.0/3.0 - States reported costs varied from $320 to $995 per license depending on which version was purchased.

· Microsoft Access - Only one of the 6 states using a Microsoft Access-based software program indicated a cost. Maine noted a cost of $15,000 for the development of a customized software program. The Microsoft Access-based programs vary state-to-state. Some states have purchased customized software programs from a contractor while others have developed their own reports.

· Developed in-house - None of the 16 states with computer programs developed in-house indicated specific costs.

· RASCAL - Minnesota reported cost of $30,000 for the rights to the RASCAL software, $5,000 for training costs and $9,000 for 3 years of technical support.

State ombudsman opinions about the systems they use vary as much as the systems themselves. There was no clear-cut preference for any of the software programs. There was, however, agreement that the RASCAL program was not meeting program needs. Interestingly, 80% of the respondents (31 states) indicated that they have a relational database capable of more in-depth analysis than NORS.

The questions below detail the advantages and disadvantages of the software systems being used.

Do you (the state ombudsman) like the software you are currently using?

Would you recommend this program to other states?

Is the computer software available for sale to other states?

Is the data entered at the local level?

· Relational data system 31

· Straight aggregated data system 7

· Unsure 1

List computer software’s strengths: (sampling of responses)

· OmTrak - Easy for new people to use; does what it is supposed to do. (Note: most OmTrak users had no comment for this section.)

· Ombud 2.0/3.0 - Compiles all information for annual report; data is easy to enter and open complaints are easy to track; comprehensive and easy to learn. It works out of Windows.

· Microsoft Access - Easily modified to accommodate changes; interfaces with Word and Excel; flexible programming. 

· Developed in-house – (Comments reflect uniqueness of individual state’s program): Able to meet AoA requirements; allows for case notes entry; good tracking; custom-designed to meet the needs of the Ombudsman Program; comprehensive. None!

· RASCAL - Allows for case notes entry; meets federal requirements. None!