Aged-care reform puts technology on the table

After a two-year investigation, the Royal Commission into Aged Care Quality and Safety has made 148 recommendations to overhaul Australia’s aged-care system.

Summarising the extensive Final Report, The Conversation outlined four takeaways:

1. Australia needs a rights-based aged-care system.
2. The system needs stronger governance.
3. Workforce conditions and capabilities need to improve.
4. A better system will cost more.

Technology reform has been identified as an important part of delivering a new and improved aged-care system. Epicor Software Regional Vice President for ANZ Greg O’Loan said that the technology recommendations put forward from the Commission’s final report were encouraging.

“It’s important to acknowledge these recommendations aim to bring a universal standard to aged care, he said. “We are satisfied with the number of technology-focused recommendations that were put forward — specifically, a whole section of the report looks at improving aged care through data, research and technology — but we do wonder if the additional investment of $452 million to meet these improvements falls short of what is required.”

Recommendation 34 states that, “The Australian Government should implement an assistive technology and home modifications category within the aged-care program that provides goods, aids, equipment, technologies and services that promote a level of independence in daily-living tasks and reduces risks to living safely at home.”

O’Loan commented that some home-care providers are already implementing smart technology in the homes of clients to help in the provision of care.

“By providing user-friendly technology, as well as training and support, this kind of technology will become increasingly important as the number of home-care recipients continues to grow in the next 10–20 years. We must be at the head of this curve, and residential aged-care facilities have some catching up to do.”

O’Loan accepted the report’s mention of major problems and limitations with current technology infrastructure and architecture in aged care, commenting that he looked forward to these being worked through. These include the variable use of digital record keeping for clinical and administrative information management, including of My Health Record.

“While these recommendations are encouraging there is still room for improvement, and we would like to have seen more deadlines put forward. For instance, by 2024 we would like to have seen a new common aged-care program that combines all existing resident, respite and home-care programs — providers would then benefit from a solution that provides a single client record while being able to support operations and funding for all categories of aged care,” he said.

“Additionally, we would have liked to have seen a fully working data governance and minimum data set in place by July 2023 — providing easier data sharing, integration and interoperability. This allows software solutions to integrate through open-source APIs, providing reporting for quality indicators, prudential requirements and other care-giving reporting requirements.”

Workforce and digital capacity

Commenting on the final report, PwC Australia Healthcare Partner Richard Ainley said there is a significant opportunity to improve the consistency and frequency of great care experiences across the sector, in particular, two key areas:

1. A skilled aged-care workforce will be essential to service transformation, with a focus on a holistic, person-centred approach.
2. Digital transformation: includes digital tools, from those that support day-to-day operations, to digital technologies to facilitate virtual communications.

Ainley state that while Commonwealth reform will be the key to enabling change, ultimately, it will be up to providers to transform the way aged care is experienced by older Australians and their families.

“While many of our leading aged-care providers and their staff provide outstanding care, reform must enable this experience to be available for every older Australian.

Ainley stated that a focus should be placed on building organisational capabilities that can withstand a range of reform scenarios.

“Meeting consumer and community expectations requires the industry to move beyond compliance towards a strategic, systems approach to quality that drives continuous improvement rather than minimum standards.

“A high-performing, engaged and skilled aged-care workforce will be essential to success in the new aged-care system. Yet workforce supply remains one of the most pressing concerns for providers and policy makers, further exacerbated by the pandemic.

“Establishing and sustaining compliance with the new regime will be one of the most pressing issues now facing providers. Special attention should be paid to financial, quality and risk management, as well as reporting.”

Ainley stressed that digital capability will be key to future success in aged care. “Alongside new innovations, we need to get the basics right. For many providers, major investments are first needed in core infrastructure and systems to ensure safe care, compliance and sustainable businesses,” he said.

Telehealth

Coviu founder and CEO Dr Silvia Pfeiffer believes telehealth can play an integral role in ensuring our older Australians have timely access to GPs when and where needed.

Recommendation 63 suggests expansion of access to specialist telehealth services to also include older people receiving personal care at home. The recommendation requires that aged-care providers delivering home care must have the necessary equipment and clinically and culturally capable staff to support telehealth services.

“Requiring aged-care providers to make available the necessary equipment and staff to receive telehealth is a step in the right direction towards a futureproofed, digitally transformed healthcare sector,” Dr Pfeiffer said. “What is surprising, however, is that the request for telehealth services is limited to medical specialists. Amid the pandemic, we’ve witnessed numerous GPs and allied health practitioners successfully deliver their services via video telehealth. Many millions of telehealth sessions have helped keep our elders safe from potential infection where the likelihood of coming into contact with an infected patient was high if done in person. Why then does the report only mention specialist telehealth services as a recommendation for expanded reimbursements?

“Surely, the delivery of GP and allied health services via telehealth is just as important in reducing exposure to harm. In fact, video telehealth for these primary care services may even lead to more timely access to care as is necessary with older people who can find it difficult to find a carer to take them to the GP, the physiotherapist, the dietitian, the dentist or the psychologist.”

Dr Pfeiffer commented on Commissioner Pagone’s suggestion based on Recommendation 56, which refers to trialling a new primary care model, of which telehealth would be a part, for six to 10 years.

“Why do we need to trial this? The pandemic has given us enough data to confirm that it [telehealth] works for providing timely, clinically adequate and outcome-oriented care. We can’t wait another 10 years to make video telehealth part of the standard way of delivering health care to our elders,” she said.

“Video telehealth addresses existing issues around a lack of timely access to GPs and allied health practitioners when/where needed, reduced mobility, and [can] address language barriers, geographic limitations and plays a key role in supporting the mental health of patients.

“In a bid to expand access to subsidised telehealth services and ensure providers have the necessary equipment and capable staff to support it, telehealth needs to be holistically integrated into the aged-care system. If it’s integrated holistically, we’ll have the ability to enhance healthcare delivery for older Australians, upskill and reduce time/work pressures on residential aged-care workers, enable more clinicians to service more aging citizens, as well as implement funding arrangements to offset costs for patients.”

Image credit: ©stock.adobe.com/au/fizkes