This appeared a few days ago:
Australia embarks on 'first phase' of its digital transformation of aged care following royal commission
The Aged Care Royal Commission in 2021 found "the aged care system is well behind other sectors in the use and application of technology" and recommended government investment.
By Lynne Minion
May 12, 2022 04:56 AM
Australia's Department of Health has embarked on the "first phase of the journey" in its ambitious digital transformation agenda for aged care by calling on industry volunteers to codesign APIs needed for data sharing with the federal government.
Speaking at the Department's first "Tech Talk" webinar into the substantial digitisation program, Fay Flevras, First Assistant Secretary for the Digital Transformation and Delivery Division, said, "Today is the first step, certainly, in engaging specifically around the technology" that will help in delivering "a once in a generation aged care reform".
WHY IT MATTERS
In 2021, the Aged Care Royal Commission's final report led the Australian Government to agree, or agree in principle, to 126 of 148 recommendations to improve the sector and announce an $18.8 billion reform package. Of those recommendations, over 30 are significantly dependent on ICT and digital enablers to implement.
"Importantly, all of this relies on a connected, streamlined, interoperable, digital ecosystem, a better connected aged care network that is consolidated, standardised, automated and modern," Flevras said.
Consumer access to their data, eradicating duplication, more time for staff to provide care, improved crisis response, better evaluation of service provision, and improved data quality and data sharing are just some of the expectations of a new, digital aged care sector.
"The current infrastructure and design of aged care systems don’t support the increased maturity and responsiveness that we demand in our daily lives and across government and in your aged care facilities," she said.
This is not an exercise in "tech for tech's sake", according to Flevras, but was a significant program of work that would harness digital capabilities to solve ongoing aged care challenges.
"First, moving to a consolidated, modern and automated aged care system isn’t an insignificant undertaking. It won’t happen overnight and despite our best efforts it’s unlikely we’re going to get it right the first time or be perfect. Secondly, to be successful we need to work in partnership across government and within the sector. And thirdly, improving our customer experience remains at the core of all of our efforts to bring innovation to the digital ecosystem.
"This is not about tech for tech's sake but it’s about enabling digital change through people, process and the tools needed to enable the benefits for our customers."
Flevras asked for "some volunteers who, in the sector, would like to codesign some of those APIs" needed to communicate between industry software and the Department's My Aged Care platform.
"This is the first phase of the journey where we’re just laying some of the foundations and we need to get our business-to-government gateway and those public APIs started."
Lots more here:
I thought it was re-visiting this after the blog last Friday given the interest and what I see as some real issues.
To me all this to date seems to have two objectives.
The first it to have the industry develop systems and APIs to make it easier for the Government to accumulate the information it wants from the sector participants. It also seems the DOH is not keen to actually invest in supporting development of such data collection APIs.
Just what these systems are meant to do to assist those who work in the sector and their workload is not entirely clear – remembering that most Aged Care facilities are very pushed for time to deliver care etc. before worrying about feeding data to the DOH!
The second is the nonsense of suggesting this same busy staff would use a clunky and slow #myHealthRecord rather than solutions specifically designed to assist busy staff to deliver and document the care they deliver to individual patients.
Having APIs designed to specifically support care delivery, not data collection, is the key here I believe.
Also, while I know there has been a quite recent Aged Care Royal Commission which has a few Digital Health recommendations I am not aware of a fully developed clear Digital Health Strategy for the sector. That might just clarify what should actually be proceed in a sensible fashion. Could be a good idea?
Does what is going on at present in all this make any sense to you?
David.
7 comments:
Wonder if they have bothered to look at the cost of ownership for Aged care centres.
Initial costs for comms room facilities, electrical mechanical, new cabling, expensive switching equipment, UPS, racks, storage and compute and then the ongoing maintenance and a set replacement every 3,4,5 and 7 years.
I look a bit of technology but I really see the issue is more fundamental than a few gadgets networked together.
"... Consumer access to their data ..." !
Is this reference to 'consumer' referring to Aged Care Residents?
Surely they don't mean the 70, 80, 90 years olds in nursing homes and retirement villages approaching the end of their lives and incapacitated with a stroke or inflicted with some other debilitating condition!
In search of the fabled magic bullet.
"Surely they don't mean the 70, 80, 90 years olds in nursing homes and retirement villages approaching the end of their lives and incapacitated with a stroke or inflicted with some other debilitating condition"
Haven't you heard of assumed consent? The whole system is built upon the concept. Even if you've got dementia or are unconscious.
The system is built on dreams, not reality.
"consumer access to their data, eradicating duplication, more time for staff to provide care"
Sounds like a mixture of unrealistic expectations and a set of mutually exclusive objective.
According to an article in today's media Dr Neela Janakiramanan:
Prognosis for health system is grim
Healthcare workers are leaving the sector in droves. If the exodus continues, the system will collapse.
EHR contain data errors = nightmare.
Tweets from “Nicole Lee Schroeder, PhD” @Nicole_Lee_Sch
“Looking through my medical records and God what a nightmare. So many incorrect allergies, medications, and diagnoses. Having drop down or fill in menus is not efficient or accurate. Just let patients fill these sections out themselves and get verbal confirmation in office.
If I have to explain how to spell Ehlers Danlos syndrome, or Arnold Chiari, or any of the other "rare" diseases I have to some nurse who's never heard of them I am going to just fully disassociate and go through the rest of my appts as a disembodied ghost. I'm out.
I have had the wrong meds sent to me all yr bc they click eye drops instead of pills every single time. I have had to petition for months to get a dx of terminal brain cancer removed from my files bc it was totally inaccurate and it made Drs question all my other real dx.
There is so much inaccurate medical information in my files. Inaccurate information that could kill me. And I have never in a decade of trying to fix multiple records, actually had all of the information properly corrected.
Let patients write and submit virtual appt notes. Let them fill out their own dx. You're asking them verbally anyway, so it's clearly not an integrity issue. And you could idk actually read their files to find out but insurance makes that prep impossible.”
https://twitter.com/Nicole_Lee_Sch/status/1525333571308769280?s=20&t=pmZSWoRQlRFGIge8qSgy0Q
Talking about Data Quality, this is from the Concept of Operations, September 2011 Release 47
"Quality of data within source systems
The PCEHR System relies on data extracted from a range of source systems, which means the quality of the data in the PCEHR System is dependent on the quality of the data in the source system.
To help ensure that source systems are capable of providing data to a minimum standard, any systems that connect to the PCEHR System will be required to undergo conformance assessment prior to obtaining a PCEHR System Notice of Connection
To help healthcare organisations meet a set of minimum standards around data quality within their source systems, the Change and Adoption Program will include an element devoted to enhancing the quality of data within source systems (see Section 8.4.2).
Monitoring data quality
Achieving a high standard of data quality will be challenging, as it will require continuous measurement and targeted improvements in culture, policies, processes and technology. To help support this change over time, the PCEHR System will implement a quality management framework and system that addresses the fundamentals of data quality, including:
• Stakeholder-driven identification of key metrics and their associated collection protocols on quality dimensions such as accuracy, completeness, consistency, currency, timeliness, fitness for use, provenance and compliance.
• The identification of minimum levels to be achieved within a specified timeframe.
• Preventative and corrective actions to be taken to improve data quality (including technical solutions such as enhancing data entry screens or fixing back-end system issues and non-technical solutions such as training).
• The creation of a series of data quality reports (e.g. via a ‘data quality dashboard’) to help profile and track different metrics in relation to their targets.
• The introduction of an issue tracking system to track known issues and progress of corrective actions.
The quality management system will be embedded within a broader governance model (see Section 7.2) and will also be embedded within a Service Level Agreement and subject to performance management.
Achieving high standards of data quality is a not a single step process. It will be a process that runs over the entire life of the PCEHR System and will require continuous improvement."
So that's OK isn't it?
Well, the PCEHR was never implemented as designed (there are no source systems - i.e. data repositories) and what has been implemented are feeder systems that include things like Shared Health Summaries and Discharge Summaries.
I'm happy to be corrected but there appears to be nothing resembling any of the actions designed to achieve data accuracy etc. i.e a "quality management framework and system that addresses the fundamentals of data quality"
Neither is there any evidence of "a process that runs over the entire life of the PCEHR System and will require continuous improvement".
But the ADHA and myhealthrecord.gov.au do have flashy websites and MyHR has a second rate dashboard.
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