Virtual support from the cloud

Residential aged care facilities in the Hunter region of NSW are being “empowered” by cloud-based virtual clinical decision support software, provided by their Medicare Local.

By Stephen Easton

Hunter Urban Medicare Local (HUML), north of Sydney, is “empowering” aged care staff to support primary healthcare delivery for residents using clinical decision support software delivered via a cloud computing platform.

Nursing and care staff in many aged care facilities have been able to contact after hours doctors and nurses for decision support for some time, through the national service called Healthdirect Australia.

As part of the establishment of the first Medicare Locals, it was suggested that the new primary care hubs could help residential aged care workers bypass this national service and speak directly to local GPs and nurses over the phone.

According to Simon Gould, operations manager of the GP Access After Hours project, a similar system had already been underway in the Hunter region for some time and while it had served its purpose, was not without its own disadvantages.

“The problem is the GP [who is contacted] has no knowledge of the patient, they are unable to prescribe, there is no handover to an acute facility if the patient needs to go somewhere else and it completely leaves the treating GP – the patient’s own GP – out of the loop,” Mr Gould said.

“The increased mortality and morbidity of aged care patients, once they enter the acute sector, is well documented, so we’re trying to manage them in the facility rather than sending them off to the emergency department.

“…Also, from an ideological point of view, it takes away the decision making power from the people who should make the decisions, and we didn’t think that was good long term strategy for managing healthcare.  

“What we wanted to do was empower the staff at the residential aged care facility level – regardless of whether they are a nurse or a care assistant – to make good decisions.” 

Working together with cloud computing services provider Australian Cloud, cloud infrastructure provider Ninefold and UK-based software vendor Avia Health Informatics, HUML has deployed a version of Avia’s Odyssey CareAssess application specially adapted for the terminology, medications and protocols used in Australian general practice.

Being a cloud-based application, residential aged care staff use the Odyssey CareAssess ‘virtual decision support’ application on tablet computers, which are supplied by the Medicare Local in the current pilot.

Mr Gould said trials of the clinical decision support software had shown promising results in the UK, where Avia trades under the name Plain Healthcare, including a significant reduction in unnecessary emergency department admissions and the empowerment of aged care workers to be more involved in clinical decision-making.

“But the real breakthrough for us, because you have [residential care] homes with various levels of IT capability, is that we’ve made a marriage between Australian Cloud and Plain Healthcare,” he explained, “so we don’t have to rely on the technology that is there in the ACF.”

“My vision for this is, I can see a day when an aged care worker is at the bedside of a patient – and remember, you might have a single aged care worker looking after 70 patients after hours, and that bedside might be half a kilometre away from the main office.

“And then that person has got a tablet and on that tablet they can pull up the patient record, view the eHealth record, pull up some cloud-based software and that will guide them through making really good decisions – to make contact with a GP or hospital [immediately], or perhaps give some treatment before they make contact.”

Tags: cloud-computing, e-health, ehealth, gp, medicare-local, primary-care, software,

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