Age-old problem of lack of interoperability

In a week in which many of we colonials took a day off to celebrate the birthday of an elderly but still very chipper lady in England – excluding New Zealand, which took it last week; WA, which has to wait until September; and Queensland, of course, which holds it in October, while the lady in question was born in April – it was good to see a new report being launched with much fanfare at Parliament House offering up a roadmap for how technology should be deployed to help support older people to remain independent for as long as possible.

The report was a very worthy one but to be honest, we have seen these things before. There was the 2012 Pathfinder project, which investigated what would be required to connect the aged care industry to the PCEHR, and which sank without a trace, and after that there was the 2014 Digital Care Services IT blueprint, co-written by Accenture, which also fell into a hole and never came out again.

Meanwhile, quite a lot of money was expended on Wave 2 projects such as the one in Tasmania's Cradle Coast, which did a huge amount of very interesting work but has not been heard from since. And individual software vendors like iCareHealth, now part of Telstra Health, spent quite a bit of their own money on trying to document how residential aged care would interact with the system, work that will hopefully be revisited when the Australian Digital Health Agency turns its attention to the sector.

The new blueprint is an interesting one in that it very much concentrates on consumer-facing technologies such as smartphones and other mobile devices and how to use them, not just for care provision but by consumers themselves. It wasn't long ago that aged care technology was all about how to get service providers to use it; now, it's how consumers themselves will.

It's a bit of a shame then that the most recent figures on My Health Record uptake show that only 14 per cent of people aged 65 and over have registered for a record, the lowest percentage out of any of the age groups. (Thirty-six per cent of people under 20 have a record, meaning it's their parents who are signing them up, but apart from access to immunisation data one wonders why.)

This will all change of course when the system moves to opt-out, but it seems odd that the age group that could benefit the most from information sharing is the one that is, as usual, forgotten. Elderly people, particularly those living in residential care, should have been the focus from the start. They are the hardest and most complex group to be sure, but they are the ones who would receive the most benefit.

Imagine the burden that would be lifted from not just aged care nurses and the pharmacists serving resi care but the residents' GPs and even ED clinicians through easy access to digital health information. The My Health Record is certainly not essential for this but it could help, at least in advance of interoperability between care provider systems, which is still sorely lacking.

Telstra Health at one stage had great plans to be able to link up residential aged care software with dispensing systems and the GP medical record, and we hope it still does. Similarly, community care providers increasingly need to be part of the conversation as fewer people move into institutional care. It is the sharing of information and access to it at the point of care that will make a real difference, whether through interoperability or a bridge such as the My Health Record.

Our poll last week asked: Do you give ADHA a pass or a fail for its work over the last year? You're a harsh lot: 41 per cent gave a pass, but 59 per cent said fail.


0 # Dianne McKay 2017-06-20 10:47
As a practice manager of a large,regional general practice, I have a wry smile when reading each new edition of Pluse+IT advising of the latest wonderful digital "roadmap" or a new "wave" project.
Here, in the real world, where faxing is still the most commonly used way of communicating due to the due to the sad lack of interoperabilit y of systems, none of these wonderful initiatives seem to filter down to the front line user.
In GP land even the main clinical software systems are incompatible, not to mention only approximately 20% of our specialist letters are sent electronically- the remainder are sent snail mail.
All the nursing homes in our area are computerised but their systems are all totally independent so there is a patient file at the nursing home and one at the practice.
When I speak to other General Practice Managers we have all the same problem with interoperabilit y.
Access and sharing of patient information, at a primary health level, in my opinion, is the logical starting point.
Dianne McKay

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