RC calls to mandate digital care systems

The aged care royal commission’s recommendations on technology are a good starting point that need to be implemented via a well-structured and evidence-based approach, a technology expert tells Australian Ageing Agenda.

In the Royal Commission into Aged Care Quality and Safety’s final report released last week, Commissioners Tony Pagone and Lynelle Briggs said the future aged care sector “will need to operate in a technology-enabled environment for efficient clinical, business and operational systems,” the commissioners said in their report.

“These [systems] need to be designed to identify older people’s needs and preferences and to provide care tailored most effectively to their needs.”

They recommend that by July 2022 aged care organisations use a digital care management system that includes electronic medication management and is interoperable with My Health Record.

The commissioners  also recommend that providers place the care records of consenting aged care recipients on their My Health Record and keep them updated.

Aged Care Industry Information Technology Council chair Dr George Margelis said while it was positive to see technology-specific recommendations, there needs to be a strategic evidence-based approach to its implementation.

“Implementing technology isn’t just a matter of implementing a bunch of shiny technologies that have very specific outcomes; understanding the underlying infrastructure and data is important,” Dr Margelis said.

If you don’t implement it in an evidence and outcomes based way you might successfully implement the software but you don’t get the value or desired results, he said.

A collaborative approach between aged care providers, vendors and researchers is required to ensure a successful approach, Dr Margelis said.

Technology recommendations welcome  

The royal commissioners the government fund an Aged Care Research and Innovation Fund with 1.8 per cent of total Australian Government expenditure on aged care  and establish an Aged Care Research and Innovation Council.

The council should make recommendations on how to spend the money for research and innovation of aged care delivery, preventing and treating ageing-related health conditions and facilitating networks between researchers, organisations, industry and government to pilot projects and assist translating research into practice.

Dr Margelis said the establishment of a research and innovation fund and council are “well needed”.

“We know we need to do a lot of research into aged care, but the key thing here is we need to make sure we don’t turn it into an ivory tower academic research institution,” he said.

He said the research council needs to involve aged care providers and consumers from an early stage.

“[It shouldn’t work] on a theoretical model and then try to translate it, but instead work on what needs to be done at a ground level for continuous improvement in a rapid timeframe,” he said.

Technology infrastructure

In the final report, Commissioner Briggs highlighted major problems and limitations with current technology infrastructure and architecture in aged care, including variable use of digital record keeping for clinical and administrative information management.

“This is inefficient and often means there is duplicative record keeping,” Commissioner Briggs wrote.

“The current systems that are supposed to support the aged care sector are either designed to support specific administrative and financial reporting requirements or are program-centric. They are not focused on the person,” she said.

Commissioner Briggs recommends the Australian Government invest in technology, information, and communications systems that:

• enable better services for older people
• use pre-certified assistive technologies and smart technology
• allow for seamless systems for reporting.

Dr Margelis welcomed the recommendations and said there needed to be this investment in technology that enabled providers to easily scale up or down as required.

He said he also is a “very strong supporter” of the recommendation for universal adoption of My Health Record.

The commissioners also recommended funding assistive technology and home modifications, smart home solutions and artificial intelligence, which have been well-received various stakeholders (read more here).

The sector needs to take responsibility for digitising aged care, Dr Margelis said.

“Whilst the recommendations from the royal commission are important and highlight some of the major issues we have in aged care that we need to rectify, the industry now needs to think about how they develop answers to those problems and how technology plays a role,” he said.

“We need to get the basics in play now and see providers develop systems internally and not have systems forced upon us… so that we can use it and scale up going forward.” 

Tech stakeholders support recommendations

Epicor Software regional vice president for ANZ Greg O’Loan said he welcomed seeing major problems and limitations highlighted in the report such as the variable use of digital records for clinical and administrative information management, including the My Health Record.

Mr O’Loan said the recommendations are encouraging but there is room for improvement, such as having more deadlines for other recommendations.

Intelicare CEO Jason Waller said he “welcomes the opportunity to help shape the remit of the council so that technologists are involved shoulder-to-shoulder with researchers.”

PricewaterhouseCoopers healthcare partner Richard Ainley said the digital transformation can improve consistency and frequency of great care experiences across the sector.

“Digital 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,” Mr Ainley said.

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