Aged care IT gears up for eHealth

Leading aged care software specialist iCare has recently completed testing several components of the national eHealth system in the field, working with three lead sites to deploy software that will allow the aged care sector to link to the PCEHR.

iCare managing director Chris Gray said the company had gone through testing with NEHTA to enable access to the PCEHR under the B2B Gateway standard and had integrated the standards required to enable users to view CDA documents.

iCare is part of NEHTA's aged care software vendors panel, along with Autumncare, DCA, Leecare Solutions and EOS Technologies, which is working to implement the standards necessary to allow the aged care sector to implement and use the PCEHR system.

The panel was established mid last year, and since then progress had gone well, Mr Gray said. “All of our PCEHR functionality and testing we are doing with NEHTA has been happening over the last two months – November and December and into January as well,” he said.

“We now have our standards in place to start being able to look at CDA documents, and three of our customers will be our lead sites where we will deploy the software into their organisations in late February and early March.”

Mr Gray said the three sites, all in Victoria, were chosen because of their location and resident demographic and wanted to be involved in eHealth. “They will do a lot of the learnings. The technology we can do because of our background, but the bigger challenge is the learnings that we have to share with our customer base and the wider industry. That is around change management and that is the bigger challenge now rather than the technology.”

Mr Gray said implementation of the technology would not be overly difficult as it was standards-based, but the main challenges will be working out how to gain the residents' consent, ensuring privacy laws were followed and engaging with Medicare Locals.

“All of those learnings that our lead customers – the work they will do, what worked for them and what didn't work for them – we'll collate that over the coming months and be able to deliver that back out to our customers because once the software is written we can start deploying it.

“More broadly, it is about sharing that knowledge, and actually the customers sharing that knowledge. We've recently set up some really good collaborative electronic tools so they'll be able to share documentation and share what the learnings are with each other.”

The benefits of eHealth for the aged care industry were enormous, he said, as residential aged care was a big consumer of information. More widespread use of secure messaging was just one benefit, and with a national standard in place he expects to see the flow of information electronically to improve.

“With the standards in place, this is what is going to be used for the hospital discharge summaries, which is a critical part of aged care,” he said. “You will also be able to see the information from the GP through the shared health summary in the PCEHR.

“Aged care is in a lot of ways the recipient of that information: aged care nursing staff are really big consumers of information, and that is why it is key for us to deliver this to aged care.

“As a resident comes into aged care, having that history from the GP and being able to get that information electronically, the most complete record possible when they first enter an aged care facility, is essential.

“Building on that while they are in the facility, and then if they transfer to hospital if they have a fall for example, once they are in hospital and there is a change in care, or a change in medication – at the moment most of that if not all of that is paper-based.

“Information is going into envelopes and it may or may not come back with them so the ability to have a hospital discharge summary showing what were the changes in care from the nurse and the medication changes, being able to use that and look at it with the GP when the GP is in – that is why they are such big consumers of the information on a day to day basis.”

iCare was involved in the first phase of the establishment of the MedView project, which aims to set up a national medications history repository that is linked to community pharmacy, GPs, the hospital sector and aged care. Mr Gray said the ability to have a traceable history of all medications prescribed to and dispensed for a resident would be invaluable to aged care facilities.

“MedView also helped us test the HI Service and information coming into the aged care facility electronically and having a complete record – that was a great thing to get learnings out of and rolling that into what is happening now.

“There were a lot of challenges that we are still facing like getting the resident's consent, what privacy settings will be needed, what are the challenges of a power of attorney, who are the right staff on the floor who have access to the information.

“We will have three of our customers going through that so we will follow the steps of the regulations and then come back and say this is where the challenges were, this is how they can be overcome or this is a difficult process that we could think through and come up with another way to remove that roadblock.”

The national eHealth system is certainly a big topic for discussion, but Mr Gray said it was more the momentum around eHealth that was important.

“There has been a big investment from the government that has gone into eHealth and the hospitals around the country are putting in the eHealth standards, the GPs putting it into their software, and then you've got the aged care vendor panel…

“That is one of the key drivers but it's not the only one. The others are things like telehealth and research and devices in the home. With the ageing population, we don't have enough workers in the current model to be able to deliver care in residential aged care. Technology is going to play a big part in having that network of carers and choice of carers in the future.

“It's not our area of expertise but when you hear people talk about sensors in chairs, so when a person stands up each time it starts to monitor them and starts to realise there is a bit of a change or a risk of a fall – it is very, very intelligent. It's an exciting area and is another example that it's not all just about the PCEHR.”

Last year, iCare formalised a long-standing relationship with UK-based h.e.t Software by acquiring the community care specialist, and iCare is now developing a product suite for its aged care customers, many of which are working in community care as well.

“Most of the aged care providers in Australia, if they are in the not-for-profit sector, will have community care packages, so we are working with our customers at the moment to understand what their needs are really going to be.

“The idea is to find out how do you create that one record where an older person is in her home but now she needs to go into an aged care facility, how do you transfer all of those records electronically.

“It is just the same as the eHealth record: how do you set that up for an aged care provider so they collect the same sort of information at home. That will be a great part of our business and over the next couple of years we really look forward to the focus on having people staying longer in their home. People want to stay in their home and with new technology, they will be able to do so.”

Posted in Aged Care

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