The tide is high and it’s moving on
To coin a phrase, time does move quite slowly in the aged care sector, but in the last decade in Australia at least, recognition that aged care has been severely ignored to the point of criminal neglect has finally filtered through. The Royal Commission into Aged Care Quality and Safety, driven by some seriously good journalism from the ABC along with the long-term efforts of whistleblowers, has revealed what can only be described as an abject state of affairs in the residential aged care sector in Australia. And who knows what goes on it community aged and disability care.
Thankfully, the Royal Commission has been proved to have been a massive wake-up call and all sides of politics have committed to trying to fix the problem. It will be increasingly difficult as workers desert the industry due to low pay and over work, and that is something everyone really needs to come to grips with. Even with a newly elected government promising 24/7 registered nurses, an increase in weekly minutes spent on direct care per resident and more money spent on better food, the problems aren’t going to go away soon.
The new government promises a lot, but remember that the new Minister for Health Mark Butler oversaw the introduction of consumer directed care back in 2012, and that hasn’t gone too well. It’s not that the alternative has been any better – former aged care minister Richard Colbeck is probably the worst we’ve seen beyond the infamous Bronwyn Bishop – but hopefully it won’t be any worse. We suspect that the money for real aged care reform is beyond the new government in its first year, and will remain a festering sore.
So, health IT comes to the rescue! We all know this is unlikely but there is absolutely no doubt that IT can help solve a lot of the efficiency and safety problems for aged care. The documentation and reporting requirements for each facility are more than any medical practice has ever experienced, and the pay is much, much lower. There are numerous IT solutions out there to help solve the problems, but those solutions require systematic change that most of these organisations are not equipped to deal with.
So while we welcome initiatives like the money being spent on researching aged care data capture standards, subsidising resident management and medication management systems, integrating existing digital systems with GP and pharmacy software and patient software like the My Health Record, and the increased emphasis on patient portals to allow families to monitor their loved ones in care, it really doesn’t stack up to a hill of beans if there are not enough staff to handle it all.
That’s what it does come down to, in the end. You can mandate that a registered nurse be on duty 24 hours a day, that there are enough care staff per resident, that GPs are paid properly to visit in person or by telehealth – the doctors’ lobbies have thankfully stopped demanding that an examination room be set aside for their eminences in each nursing home – but it will come to naught without adequate funding. The only way to achieve that is through minimum wages, upskilling workers, and in our opinion, ploughing the subsidies lavished on private aged care homes into the public sector.
IT can still make a huge difference, and we have been seriously impressed with the progress that the Aged Care IT Industry Council (ACIITC) has made over the years. The council has long been associated just with managing the annual ITAC conference, but change came a couple of years ago with the appointment of George Margelis and Anne Livingstone to head the council. They’ll both agree that change has been long, slow and hard, but it is finally coming to fruition. Standardisation of IT systems and data, projects to validate systems in the real world, and most importantly workforce digital enablement have all flourished in the last year or so.
The ITAC conference in Sydney in a fortnight will highlight all of this progress, as well as the work that remains to be done.
In our poll question last week, we asked: Is five years and $300m enough to finish the ieMR roll-out in Queensland? I’m afraid it’s yet another thumbs down from Pulse+IT readers – just 20 per cent said yes.
We also readers that if they said yes, why are they confident? If no, what could go wrong? Here’s what you said.