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old CMA 1. Idea Brief 492634121

Trilogy Care Portal : CMA - 1. Idea - Brief

Section

Details

Problem Statement

  • Support at Home (SAH) requires ≥1 direct Care Management activity (CMA) per client per month (≥15 mins).

  • In Trilogy’s self-management model, clients operate independently, meaning natural monthly contact doesn’t occur with all clients.

  • This creates compliance risk and lost CM revenue while undermining proactive client engagement.

  • Current processes (manual notes, calls, emails) are fragmented and reactive.

Possible Solution

  • Build a data-triggered communications system that ensures compliance and proactive engagement.

  • Data Integration Layer (Databricks): analyse CRM, budget, incident, and utilisation data against trigger rules.

  • Portal Alert Dashboard: queue of client alerts by care partner; shows trigger reason + draft comms; one-click approve/edit/reject.

  • Communication Templates (MVP – 4 scenarios): service gap, fall incident, vulnerability (isolation/homelessness), budget overspend.

  • Multi-channel delivery: email + SMS, routed to client preference, with delivery tracking.

  • Activity logging: auto-create CM note with 15-min entry, linked to trigger, for audit/claims.

  • Human oversight: all communications require care partner approval/edit before send (no AI personalisation in MVP).

Benefits

  • Compliance: 100% monthly CM coverage.

  • Revenue: Capture full 10% CM pool + vulnerable cohort allowances.

  • Efficiency: Automated detection + drafting reduces manual gap checks.

  • Client experience: Proactive, relevant outreach via preferred channel.

  • Data quality: Triggered comms linked to evidence and audit trail.

Owner

To be assigned – Product Owner / Care Operations lead

Other Stakeholders

  • Primary: Care Partners / Coordinators

  • Other: Recipients & their representatives/supporters; Service Providers; Internal Finance, Compliance, and Operations teams

Assumptions & Dependencies

  • Databricks integration available for data processing.

  • Reliable SMS + email delivery services in place.

  • Portal infrastructure ready for alert dashboard + workflows.

  • Client contact data accurate (representatives, preferences).

  • Services Australia system stable; SAH requirements unchanged.

Risks

  • Data quality issues → false/irrelevant alerts.

  • Over-communication → client dissatisfaction.

  • Integration complexity with Databricks, CRM, SMS.

  • Staff adoption risk if alerts overwhelm or drafts need heavy editing.

  • Compliance gaps if audit trail isn’t watertight.

Estimated Effort

Effort: ~4–5 sprints (Databricks + Portal + comms + logging)
Cost: $90k–$150k (engineering squad, integrations, delivery infra)
Time: Phased delivery Aug–Oct, go-live 1 Nov 2025

Proceed to PRD?

Yes – directly tied to SAH requirements for monthly direct care management activity