AutumnCare readies for PCEHR pilot and consumer-directed care

Aged care software vendor AutumnCare will begin beta testing its eHealth-enabled solution at a pilot site in Sydney next month.

AutumnCare, a member of NEHTA's aged care software vendors panel, has already achieved a number of its milestones under the NEHTA contract, including passing its notice of connection (NOC) with the Healthcare Identifier Service last year, along with the capability to render CDA documents in its software.

AutumnCare's managing director, Stuart Hope, said the Sir Moses Montefiore group in Sydney had agreed to be the pilot site.

“They are very keen and are a bit more advanced than some others in terms of IT,” he said. “We appreciate their input as a pilot site as it enables us to execute our development methodology and maintain the high quality of our software.

“While some aged care providers are very interested in participating in the PCEHR, most of them are adopting a wait and see approach. There has been some resistance from the health industry in general to the PCEHR, which is understandable as it is unproven in many areas and they, quite rightly, need to be conservative in their approach.”

The next tranche of work the company is undertaking is being able to write to the PCEHR and the ability to do HPI-O and HPI-I searching, he said. “We are currently have a team working on this and expect to deliver ahead of schedule.”

AutumnCare's suite of products has long had standards and integration capability, including the AutumnCare Interact product, which provides full B2B integration with Medicare for all aged care events including ACFI claiming.

AutumnCare's prime products are its Enterprise solution, a full management and clinical system aimed at single or multi-site enterprises, and Harmony, which is cloud-based and hosted by AutumnCare on its servers. Harmony is aimed at single-site operations that don't want to install and manage servers, systems software or back-up systems, although Mr Hope said some multisite organisations are also using this solution.

The AutumnCare suite includes Connect, which gives access to forms, care plans, case notes and assessments for nurses as well as alerts, messaging tasking, visual indicators and decision-making advice; ReportIQ, which is a reporting and data-mining tool; Toolset for system customisation; and Activate, to enable single sign-on via MS Active Directory. AutumnCare also offers a full community care solution.

Last year, AutumnCare added a medications management module called Medicate, which Mr Hope said had been designed from an aged care clinical perspective, rather than from a pharmacy perspective.

“Medicate is integrated into the clinical process and we have a closed loop approach to clinical practice,” he said. “For instance, if a PRN is given – medications given as required – we automatically create a note properly categorised, flag it for hand-over, and can notify clinicians if an organisation's processes require it. We also graph the time of administration.

The closed loop approach with multiple indicators and advice helps ensure proper documentation and follow up of the administration, he said. Medicate is completely integrated into Enterprise and Harmony, which both include an automated hand-over function.

“The nurses have to sign off on all medications they administer, or give a reason why they haven't,” he said. “In the next release, due in April, we are going to get even more sophisticated around these clinical processes.”

Medicate has been fully integrated with a number of pharmacy systems, including the market leaders FredPak and Webstercare, and the company has agreements with the other pharmacy software vendors. The pharmacy data is treated as a source of truth for the medications.

Mr Hope said this had been a complex piece of work. “With Fred, for example, we run our own software to analyse the Fred data and built change sets. These change sets then go to our own messaging broker, and staging system, before being applied to Medicate.

“It is reasonably complex but the reason we are doing it this way is to ensure that no matter what pharmacy is being used, the data will be normalised and the clinician will see the same interface. We have some customers with 20 or 30 sites scattered across Australia, so we need to cater for all the pharmacies they use and ensure consistent reporting across the organisation.”

In addition to the eHealth work, more complex changes have been made to the software to cater for the federal government's Living Longer Living Better policy. This includes the new thrust towards consumer-directed care (CDC).

“Handling CDC involves a completely different software model, as each dollar has to be accounted for each individual community care consumer,” he said.

“These changes are also coming in rapidly. The new CDC reporting requirements come in on July 1, and all new packages allocated under the December Aged Care Approvals Round now need to be offered as CDC. It is understood the old packages will be under the old regime until 2015.”

Despite all of the complexities the changes are bringing to healthcare, Mr Hope said he supports the eHealth initiatives such as the PCEHR.

“What we are going to deliver in this year is a really great start as it covers the fundamentals such as identifiers and the ability to be able to view health documentation,” he said.

“I have flagged that the government should also consider adding another function to the eHealth system – an electronic transfer summary as well as the electronic discharge summary.

“About 50 per cent of the presentations to the acute sector are from aged care. They need a transfer summary as knowing current medications, demographics and special care needs assists the acute sector in their assessments and management of the patient. A subset of this information is also required by the ambulance services.

“Having seen firsthand some of the issues caused by a lack of or inaccurate transfer information, I think it is essential we get this right.”

Posted in Aged Care

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