Information management in aged care needs to be transformed if the sector is to fully realise the benefits of big data in the future delivery of services, writes Jenny Davis.
The Australian aged care sector is an information rich and information intensive environment; yet technology and related information systems remain under-developed, poorly integrated, and under-utilised.
To be effective, ICT systems must be fully integrated and developed to support accurate, efficient and timely communication of client information for the multiplicity of users across the broader health and aged care sectors. The value of such ICT systems as tools for data collection, storage and manipulation that enable reliable information retrieval, sharing and exchange is dependent on both system infrastructure and primary data structure.
Whilst such systems are shown to have positive impacts on service delivery and client outcomes, poorly developed information systems and processes, including the lack of electronic systems in the aged care sector, contribute to risks of suboptimal care coordination and handover of client information.
Effective collection and use of information supports a variety of organisational processes and purposes including: administrative; financial; regulatory and compliance; care delivery; and quality improvement. Providers of aged care services require timely, accurate, reliable and comprehensive information on which to base decisions, actions and communication related to the business of client care. While information management systems in aged care have historically focused on business functions, such as funding, regulation and reporting, there is an increasing focus on measures and transparency of aged care quality, safety and continuity of care.
In the context of an ageing population with increasingly complex care needs and expanding community-based services, timely access and efficient communication of comprehensive client information is essential to support continuity of care, minimise associated risks for adverse outcomes for older people and ultimately support business efficiency.
In this context, it is imperative that key data needs related to aged care service provision are well understood and optimised, based on a philosophy of ‘creating once and using often’.
However, there are significant administrative barriers to aged care data quality, access and reporting, particularly the current poor capture and visibility of community aged care data. Key data needed to support secondary information purposes, such as reporting, policy, governance, decision support, should be derived from primary data, for example, aged care entry, point of care service delivery. This secondary data – big data – can then be used to provide feedback to improve and enhance primary service delivery and program reporting.
However, the quality of big data is only as good as the quality of our primary data – or what I refer to as little data.
The phrase ‘garbage in and garbage out’ typifies the risk to big data if we fail to recognise the key importance of primary data quality for building a strong foundation of aged care information, knowledge and wisdom into the future.
Whilst access to national aged care program data for research purposes has improved following the establishment of the Aged Care Data Clearinghouse, the continued reliance on secondary data from existing program reporting means it remains susceptible to impacts of poor primary data quality.
Nationally, there are currently 11 different aged care related programs. The number and complexity of these aged care programs, each with multiple and often very different data collection and reporting requirements, represents a significant administrative burden for the sector, particularly in the context of poorly integrated information systems. Across these aged care programs there are five related data dictionaries, three minimum data sets and five program standards or quality frameworks, in addition to multiple client assessment and eligibility data requirements, highlighting the need for robust and strategic information management systems.
To fully realise the potential benefits of big data in the future delivery of aged care services, we must firstly determine key information needs across the diversity of aged care providers, settings and jurisdictions. With this in mind, both upstream and downstream data needs related to aged care provision more broadly must be considered, whether for primary and secondary use or internal and external purposes, including consideration of the providers and end users of that data. This does not mean we collect all the data simply because we can; it must be purposeful, meaningful and strategic.
Like a jigsaw puzzle, we need to establish the key information or data pieces that inform the aged care client, provider and sector bigger picture. In this way, we are better placed to have collected the right information, which is consistently and reliably available in the right format and at the right time to support care delivery and related processes.
It is hoped that ongoing discussions between industry and government will capitalise on the opportunities that efficient ICT and related information management systems offer in support of service efficiency, safety and quality for improved client outcomes, and to meet anticipated consumer demand into the future.
The importance of little data to big data is undeniable; being the essential building blocks for systems to efficiently, transparently and reliably translate diverse data into knowledge and wisdom to better inform the future sustainability of aged care in Australia.
For an extended version of this article, see the current edition of Technology Review magazine (January).
At the time of writing, Jenny Davis was project manager at Benetas for the DSS funded SALLY Project – Sub Acute Linkage in Later Years; examining ways to improve older person service access and health outcomes; including the management of information in aged care in Australia.
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