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Blog: The cost of conformance for aged care software

10 March 2023
By Kate McDonald
Image: iStock

The Department of Health and Aged Care has been running a series of online tech talks for the aged care industry in the last year as the sector grapples with the monumental changes it is confronting from the recommendations of the Royal Commission. We’ve always found the webinars pretty good in terms of explaining what the department is up to in its digital transformation agenda, so if you’re interested in the sector, have a listen here.

Last week, some of the discussion was around the roll out of a hospital portal for the My Aged Care system, which will give nurses access to information on the patient that goes beyond just their stay in hospital and helps them plan for the transfer of care back to the patient’s home, to their GP, to rehab care or to residential aged care. They’ll also be able to add clinical notes such as discharge summaries to the client record. It’s a good step in digitising the transfer of care process, and will be helped later in the year when the Australian Digital Health Agency hopes to release its transfer of care summary for the My Health Record. This may finally see the MAC and the MyHR working together, as was envisaged all of those years ago.

There was also some really good discussion on what the digital transformation agenda means for aged care providers and their software vendors, particularly those struggling with constant changes to reporting requirements. The burden of these new requirements is a huge problem in a cash- and staff-strapped sector like aged care. But it’s also falling on the heads of aged care software vendors who are increasingly being asked to make big changes to their software but are not being recompensed for it.

These issues are becoming more obvious, even though they were skirted around in last week’s webinar. During one Q&A, an aged care provider representative said her vendor was passing on the cost of the new requirements to customers and it was simply becoming unaffordable. Another questioned the vast number of products on the market (420 that they counted) and what the hell to make of it all. Another wanted the government to provide a list of products that were conformant that the industry could then choose from.

That latter suggestion was pretty quickly ruled out although ADHA does have conformance registers for the My Health Record and the transitional electronic national residential medication chart (eNRMC). ADHA is also working with the Aged Care Industry IT Council on agreed standards for aged care software, which should be ready mid-2024.

In the meantime, while aged care providers are under the hammer through the new reporting requirements – six new quality indicators will be required from next month – as they face new staffing arrangements, you get the feeling that paying for new software is the least of their concerns.

Discussion is rife in the industry, both aged care providers and their software vendors – that if the government wants it to use conformant software to meet these requirements, it is going to have to come to the party in terms of paying for it. That is already happening with the eNRMC, in which very generous grants are available to RACF owners to use a conformant product. The primary health networks (PHNs) have also been given quite substantial amounts of money to run grant programs for digital maturity assessments and telehealth capability assessments, and these seem to be very popular.

However, you get the feeling that one off grants – generous though they may be – are not the way to go for a sustainable, digitally enabled aged care sector. General practices will soon be able to apply for money for software and equipment under the government’s Strengthening Medicare fund, but is this just a slush fund and is there a better lesson from general practice for aged care?

Practices have been eligible for the eHealth Practice Incentive Program (ePIP) for over a decade, and this has managed not just to subsidise the use of clinical software but also to help software vendors with their development costs by providing a ready market. The ePIP was in the past just used to help with the cost of practice management software, but has for some years been used to encourage investment in prescription exchange services and secure messaging, along with adopting the My Health Record and healthcare identifiers.

While some have called it a stick rather than a carrot when changes have been made, there’s no doubt it is a popular and important program for digital health in primary care (so much so that the specialists have always wanted a bite of the cherry too.)

Could a similar system to be introduced to residential aged care, whereby incentives are paid on a quarterly basis to providers that adopt and more importantly use resident care software? (We ask this in view of this excellent comment on our story on eNRMC grant funding from last year.) Grant funding has a habit of encouraging organisations to rush out and buy equipment but does little of nothing to encourage its continued use. It’s a good thing that training is now included in the grants, but the concept of meaningful – or at least reportable – use still appears to be a problem in aged care.

Let us know what you think. Our poll question for this week is:

Do aged care providers need an incentive program to invest in resident care IT?

Vote here and comment below.

Meanwhile, the other big news this week was the passage of Victorian government’s somewhat contentious (we think the controversy is overblown) legislation to allow better sharing of medical records through its proposed electronic patient health information sharing system. The other big news was our story on NSW Health’s Lumos data linkage program, which has not seen the same scrutiny but is firing away leaps and bounds.

Lumos will be discussed at the Australian Healthcare Week session on patient experience in Sydney next week. Last week, we asked whether the my health app had saved the My Health Record? Readers were split down the middle 50:50.

Here’s what you said.

2 comments on “Blog: The cost of conformance for aged care software”

  1. The important first step is that we are having an open conversation between the stakeholders: government, providers, vendors and consumers. The Tech Talks led by Fay Flevaras are a great example of this open communication which the ACIITC strongly support.
    There is much work to be done to bring the entire industry into the digital age. The reality is that the aged care industry is facing multiple challenges, and while technology will play a major role in its response, many of the other challenges are potentially fatal to many providers.
    We are on a journey, and whilst many of us are impatient we need to ensure what we do is first safe, second effective, and also efficient and delivers value.
    There is no manual on how to do this, however we can learn from other industries, and from each other as we move forward.

    • Name - George Margelis
  2. So, do aged care providers need an incentive program to invest in resident care IT? The vast majority agreed: 91 per cent said yes.

    We also asked if you voted yes, how you thought such a program could work? If no, how else could aged care providers be incentivised?

    Here’s what you said:

    – There are too many pieces of software to choose from, they are not fit for purpose, too expensive, most aged facility don’t have IT trained staff, consider funding technology to support robotics.

    – Provide funding to support investment

    – Subsidised purchase of systems. Paid professional development

    – Post successful implementation funding proportional to number of clients. Implementation being defined as meeting reform requirements.

    – There needs to be excellent products in the market and stability. That doesn’t exist at present.

    – Many aged care providers do not have excessive additional funds they are simply trying to provide the best care for the elderly residents. From my extensive personal experience in aged care, the daily staff are overloaded and computerisation will not improve anything.

    – Mandated universal software

    – Stepped program with a certain level for records only, next level for e-medication management systems and next level for remote access for GPs, pharmacists, allied health professionals and geriatricians.

    – Either a tax deduction or cash payment by site

    • Name - Pulse+IT

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