Can Technology Help? Terms of Reference RELEASED IN 2017 The - - PowerPoint PPT Presentation

Aged Care Can Technology Help?

Terms of Reference

RELEASED IN 2017

The Roadmap recognises the need for technology to underpin the delivery of aged care services and ensure independence, choice and control for consumers.

Technology Roadmap for Aged Care in Australia

About the Aged Care IT Council

Formed in 2007 under the banner of ACSA and the then ACAA (LASA), Specific intent to raise technology issues with policy and decision makers and to improve technology uptake and innovation in sector, Emphasis on harnessing Technology to create sustainable aged care services.

ACKNOWLEDGES THREE ISSUES

Population ageing that has never been experienced at the same level; The rapid development of new technologies; and Reform of the aged care sector that fundamentally changes the way in which older Australians will be supported.

Intent of the Technology Roadmap

Recognised the need to outline a vision of an innovative, technology-enabled sector for the next five to ten years Help policy makers evaluate the benefits of embracing technology as well as provide guidance and information

DESTINATION 1

Technology-enabled operational, business & communication systems

DESTINATION 2

Technology-enhanced care & support for older people

DESTINATION 3

Technology-enhanced information & access to care

Roadmap Structure Overview

DESTINATION 4

Technology-enhanced assessment of eligibility & changing need

DESTINATION 5

Technology-literate and enabled workforce

Roadmap Structure Overview

Recommendations

• Aged Care Open Standards and Protocols that facilitate

interoperability and sharing of information.

• Technology Maturity Assessment and review use of technology

across the spectrum

• Collaboration with Australian Digital Health Agency and

Department of Health

DESTINATION 1 – TECHNOLOGY-ENABLED SYSTEMS

Recommendations

• Establish a national network linking end users with developers of

technology to support co-design;

• Explore with the disability sector scope to provide a specific

component focused on older people;

• Develop a series of Demonstration Pilots to demonstrate how to

extend existing telehealth and telemedicine programs.

DESTINATION 2 – TECHNOLOGY-ENABLED SERVICES

Recommendations

• Develop a national Digital Literacy Strategy for consumers,

supporters and providers to ensure they have the skills,

• Develop a national Technology Awareness Raising Strategy and

Equity Strategy,

• Develop a tool for aged care providers to profile their consumers’

technological readiness/digital literacy.

DESTINATION 3 – TECHNOLOGY-ENABLED INFORMATION AND ACCESS

Recommendations

• Develop a Pilot to trial the embedding of technology

expertise in assessment and care planning, and analyse

• utcomes achieved for providers and consumers.
• Review existing validated assessment tools, identifying those

that have been automated.

DESTINATION 4 – TECHNOLOGY-ENABLED ASSESSMENT

• National Workforce Technology Development Strategy

DESTINATION 5 – TECHNOLOGY-LITERATE AND ENABLED WORKFORCE

SUBMITTED AUGUST 2019

• Outlines the opportunities innovation and greater

use of technology can have on enhancing quality & safety in aged care;

• Underpin the policy direction of greater consumer

choice;

• Develop an agreed Agenda for funding and

investment in Information Communication Technology and care-specific technologies; and

• Engagement and collaboration with industry

Submission to the Royal Commission into Aged Care Quality & Safety

ITAC 2020

BRISBANE CONVENTION CENTER 3 & 4 MARCH 2020

PHONE

0499 006 729

EMAIL

secretariat@aciitc.com.au chair@aciitc.com.au

Contact Us

CRICOS code 00025B

Consumer-centric quality and safe care

Len Gray

Centre for Health Services Research The University of Queensland

CRICOS code 00025B

▪ An information strategy to support quality monitoring improvement and continuity of care

and…

▪ Reform medical care provision arrangements …for Aged Care in Australia

Two propositions

Centre for Health Services Research

CRICOS code 00025B

The Aged Care Data Ecosystem

Centre for Health Services Research

Phone assessment & triaging Eligibility assessment Clinical assessment & care planning Quality monitoring & improvement Hospital care Primary care

SETTINGS FUNCTIONS

Community care Packaged care Residential care Transition care

CRICOS code 00025B

▪ Clinicians ▪ Clinical administrators ▪ Service administrators ▪ Regulators and payers ▪ Consumers

Information stakeholders

Centre for Health Services Research

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▪ Standardisation of information recording and acquisition ▪ Standardisation across care settings and processes ▪ Where data acquisition is dependent on clinical recording, ensure that there are immediate benefits to clinicians (not only burden) ▪ Use of a common data repository for a variety of functions:

• Clinical care, quality assessment, casemix

▪ Strategies to hear the voice of consumers

Requirements of an information strategy

Centre for Health Services Research

CRICOS code 00025B

The interRAI Suite of Assessment Systems

Centre for Health Services Research

Phone assessment & triaging Eligibility assessment Clinical assessment & care planning Quality monitoring & improvement interRAI Checkup interRAI Home Care interRAI Long Term Care Facility interRAI Acute Care interRAI Checkup

SETTINGS FUNCTIONS

CRICOS code 00025B

Primary Care ▪ GP continuity model ▪ GP panel model ▪ GPs with a special interest ▪ RACF employed GP Specialist Care ▪ Specialist visitation ▪ Transfer to hospital ▪ Telehealth

The current models of care*

Adapted from Richard Reed, Models of General Practitioner Services in RACFs Australian Family Physician 44, 4, April 2015

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▪ 100 residents, 23 doctors, 1-10 residents allocated, no specialist access ▪ Medication audit

• 83% >9 drugs
• 45% major tranquillizers
• 36% anti-depressants
• 67% hypnotics & anxiolytics
• 43% regular narcotics

Is this a problem for RACF management or individual doctors?

A problem scenario: Twilight village RACF

Centre for Health Services Research

CRICOS code 00025B

▪ Medical care provided by GPs

• No consistent contribution beyond individual consultation

▪ Access to specialists

• Visitation is rare
• Medicare telehealth option is available
• Health records are disparate, and fragmented

Health Care in Residential Care Facilities

Centre for Health Services Research

CRICOS code 00025B

▪ Articulated role for medical personnel within RACFs

• Structural arrangements for involvement of medical staff
• Contribution to program design, quality monitoring and improvement

▪ Strategies to ensure access to specialists

• Appropriate technical facilities for RACFs
• Integrated medical records
• Training and resource allocation for host nurses / hosting fee

Some suggestions

Centre for Health Services Research

CRICOS code 00025B

Thank you

Professor Len Gray

T +61 7 31765530 E len.gray@uq.edu.au.gray@uq.edu.au W www.uq.edu.au/chsr www.uq.edu.au/chsr W https://researchers.uq.edu.au/researcher/1121/1121 Tw @LenCG

Overcoming the blockers to the uptake of technology in aged care

Chris Gray Agnes

Do good. Grow better.

Innovation and the Royal Commission

“How best to deliver aged care services in a sustainable way, including through

innovative models of care, increased use of technology, and investment in the aged care workforce and capital infrastructure”

Terms of Reference for the Aged Care Royal Commission

Learnings from a technology provider

Aged care is a naturally collaborative and caring culture Innovation starts with people & culture, not technology 90% of the answers are already with your team An innovative culture begins with the leaders There is no size restriction to an innovative culture Government incentives have proven to work

System map of home care

Purpose driven innovators for aged care

Lively – an innovation mindset

Lively was founded in 2015 with a mission to address social isolation and loneliness among older community members To start, Lively connected older people looking for help with technology, to young job seekers who can give them a hand

• 50 young people employed (from 2,000 expressions of interest) to support 500 older

community members

Lively is now an accredited home care provider

• They have co-designed a model, based on connection & care, with young people, older

people and their families

• Lively are currently testing their care model in Darebin / Yarra council areas

Recommendations

• 1. Innovation is an organisation wide mind set
• 2. Reframe the question of innovation in aged care vs innovation in a corner
• 3. Technology is a tool, innovation is people & culture
• 4. Invest in the 10% help needed to get the 90% of innovation answers already

with your teams

• 5. Government incentives to help facilitate innovation in aged care will work

Chris Gray Director - Agnes

Do good. Grow better. chris@49agnes.com.au www.49agnes.com.au

Thank you.

Technology lens on assessment & care planning

Dr Isobel Frean PhD Information Services, Bupa A&NZ 14082019 Public

Agenda

1. Funding reform requires reform to assessment and care planning in Australia 2. Lessons from overseas 3. Recommendations

14 08 2019 Public 40

Reforms to aged care funding will see ACFI replaced by a new casemix assessment tool

The reform of residential aged care funding will see:

• Replacement of the current Aged Care

Funding Instrument (ACFI) with a new Australian National – Aged Care Classification (AN-ACC) casemix

• External assessors responsible for

assessing and assigning residents to 13 new casemix classes

• These assessments will inform the

funding provided to care for the resident

• Provide the DoH with a consistent

casemix profile of residents entering RACF

• AN-ACC assessment data will not

available to residents or providers

14 08 2019 Public 41

AN-ACC

Funding reform will need to be accompanied by reform to assessment of need and care planning

• RUCS Report* recommended to the Department of Health that a best practice needs

identification and care planning assessment tool be developed for use by residential aged care facilities

• The reform options for progressing this include:
• Australia develops a new tool
• Australia adopts an existing evidence based tool
• Whether adoption should be mandated or voluntary
• How it would support care providers to understand and improve care outcomes
• How it supports effective and timely monitoring of quality and safety outcomes and

assists service providers to transparently demonstrate compliance with new and emerging regulatory standards

• How it would help prospective residents to select a provider that meets their needs
• This debate and the outcomes will be influenced by the deliberations of the Royal

Commission

14 08 2019 Public 42 *University of Wollongong, Resource Utilisation and Classification Study (RUCS) 2019

Assessment for care planning: capabilities

Australia requires standardised needs assessment instruments for routine care that can serve other purposes Assessment and care planning tools must be capable of reflecting the rapidly increasing prevalence of chronic diseases Take into account:

• Differences in the prevalence of conditions related to ageing and chronic disease
• Cultural and institutional differences in care service provision
• Self reported needs and experiences of the older person / individual

Support comparing differences at population and individual level to address the complexities of maintaining quality in long-term care Enable the use of data driven algorithms that generate outcome scales, care planning support protocols, quality indicators, and support appropriate resource utilisation Must support the recording/capture of data at the point of care to optimise time to deliver care and support not documenting

14 08 2019 Public 43

Current reform advocates a separation of assessment for funding and assessment for planning

14 08 2019 Public 44

Best practice needs identification and care planning assessment tool - tbc Australian National – Aged Care Classification

‘Best practice’ needs identification and care planning assessment tools support re-use of point of care data

14 08 2019 Public 45

Lessons learnt from New Zealand

2013 Ministry of Health NZ recommended use of an best practices needs assessment for care planning tool in care homes across New Zealand July 2015 mandated it’s use as a condition of funding Also mandated:

• Online assessment using nation platform
• Only RNs to complete the assessments
• RNs to be trained and must refresh their training annually
• No interoperability of data

This has meant:

• Negatively impacts RNs to want to work in aged care
• Redundancy (data reuse, time, vendors, residents, MDT)
• Costly for everyone

14 08 2019 Public 46

Lead time Consistency Data quality Competency MoH = data owner Inefficient Vendors excluded Reduces innovation Unsustainable

Roadmap for funding & care assessment reform: sample only

14 08 2019 Public 47

AN-ACC Trial

1 2 3 4 5

AN-ACC bedding-in period

Costing studies ?

Review of AN-ACC? Transition period Revise / Replace AC-ACC

Oct 2019- Mar 2020 Oct 2020 – Oct 2022 2021 AN-ACC replaces ACFI 2030?

Assessment for funding (hypothetical only)

International review & consultations

1 2 3 4 5

National benchmarking entity established (e.g. AIHW)

Australia joins international benchmarking network Selection of standardised tools Oct 2022 – Oct 2023

Care outcome benchmarking possible Tender for international assessment & care planning system

Introduction of standard assessment for care planning tool (Vendor agnostic)

RACF use existing assessment tools

• Dept. conducts review

Trials funded Oct 2021 2025-26

Assessment for care planning & quality improvement (aspirational)

Recommendations for standardised assessment for care planning in Australia

Transparent lead time so all stakeholders able to plan for and resource adoption of a new approach

• A voluntary adoption period should be introduced

Must be digitally enabled and supported from the start

• Digital care data / record standards defined to support continuity of care
• Full interoperability of assessment data between care provider vendor systems and any national quality

benchmarking entity Aged care providers should be allowed to use the vendor of their choice The assessment and care plan should belong to the individual

• Accessible to all members of the individual’s care team, including family, GP, specialists

14 08 2019 Public 48

Thank you

Isobel Frean PhD Head of Clinical Systems Capability Bupa Australia & New Zealand Isobel.Frean@bupa.com.au @isobel_frean

14 08 2019 Public 49

Discussion

What recommendations would we like to make to the Royal Commission on how technology can play a role to improve quality and safety for residents in aged care.

14 08 2019 Public 50