My Aged Care and a shocking tale of neglect
The one-word title of the interim report of the Royal Commission into Aged Care Quality and Safety is stark: Neglect. The report is a sobering read for those working in and around the aged care system and details much higher levels of poorly managed continence, malnutrition, overprescribing of psychotropic drugs and actual physical abuse than previously thought. Dental health is bad, wound care is worse, nutrition is abominable.
The report details a litany of problems with the sector, especially workforce problems, but unfortunately a lot of them start when older people and their families first begin to investigate their options for care. Their entry point is My Aged Care, a system that was recommendation of the Productivity Commission's Caring for older Australians inquiry in 2011. The My Aged Care website went live six years ago and the contact centre and client record about four years ago, but according to the commissioners, it is not delivering the vision the Productivity Commission outlined of seamlessly allowing people to navigate the system, and does not seem to be delivering much at all.
In fact, the interim report dedicates a whole chapter to eviscerating My Aged Care. “People are met with a telephone and internet-based national aged care entry system called My Aged Care that many people in their eighties and nineties find frightening, confronting and confusing,” they report.
“They are then referred for a face-to-face discussion to assess how much care they can receive and whether that will be in their own home or a residential care provider. This is the first of many assessments. Too often they must tell their story over and over again.”
The My Aged Care contact centre and central client record were supposed to solve a lot of these problems. It certainly doesn't seem to have managed the job. The commissioners have also eviscerated the federal government's claims about waiting lists for home care packages, which are getting worse and worse. People are dying while on a waiting list for home care and in some circumstances detailed in the report, people who have been approved for a package are not even told about it.
This comes as the Department of Health finally ponies up to improve the referral process to My Aged Care from GPs, who previously had to phone, fax or use a clunky webform to refer patients. Now, they will be able to use HealthLink's SmartForms to write and send a referral from within their practice management software, technology that was available when the contact centre was being set up and should have been considered for implementation at the time.
You'd have to wonder if it's worth it, though. One witness to the Royal Commission summed it up: “I ended up absolutely at the end of my tether. I am a very persistent person. I am trained as a librarian and I always thought that if it’s out there, I will find it, but My Aged Care defeated me.”
The commissioners said they will give further detailed consideration to the future of My Aged Care, including the need for appropriate local infrastructure and comprehensive information, in the next phase of their work. During its hearings, the commission itself heard from a number of people about the role of technology in improving the provision of aged care, but it is clear from the report that the problems in the industry are so profound that technology is its least concern.
You can read the Aged Care Industry IT Council's submission here. We also like a recent report from the Aged Care Innovation Roundtable Series, co-hosted by Accenture, Elsevier and Healthily. Nothing really prepares you for the commission's interim report though. It's heartbreaking.
Meanwhile, our top story this week concerned SA Health's plans for an interoperable secure messaging system to send out discharge summaries and receive inbound referrals, which is a step in the right direction. We also heard from the Australian Digital Health Agency about its plans for modernising the national infrastructure over the next few years.
ADHA CEO Tim Kelsey reported that the number of active records in the My Health Record system had grown substantially, from the 6.24 million before the opt-out process to 12 million now. There are 22.61 million records in total.
There was also some movement in the pathology sector, with WA public pathology provider PathWest uploading reports from community ordered test requests in addition to hospital-generated pathology reports, and we hear that quite a number of Sonic Healthcare subsidiaries are now or will soon join Sullivan Nicolaides Pathology in uploading reports. ADHA tells us that more than two million reports are being uploaded per month. More importantly, ADHA plans to begin publishing data on clinical interactions with the system.
Finally, our blog last week on the fuzzy numbers being put forward by MedicalDirector about its market share and take-up of Helix got a very strong reaction from readers. We've had numerous sources tell us that MedicalDirector has undergone several rounds of redundancies this year and last, including 15 more people let go just this week. Our sources say it looks like MedicalDirector's owner, private equity firm Affinity Equity Partners, is preparing the company for sale by “trimming the fat”, a most unappetising term. We'll have more on that next week.
Last week we asked: Do you think MedicalDirector can be sold for more than $155m? The vast majority – 82 per cent – said no.
Our poll question this week is: Can My Aged Care be salvaged?