Aged care record to go live with no link to the PCEHR

The central client record that is due to become available from next July as part of the roll-out of the Aged Care Gateway system will not be linked to the PCEHR, but there are plans to do so in future.

The aged care sector has become increasingly concerned that the Department of Social Services (DSS) is in effect creating two eHealth records by allowing the inclusion of healthcare information on the central client record alongside the separate roll-out of the PCEHR.

Industry representatives have told Pulse+IT that the sector was still in favour of the original plan to either link the record to the PCEHR to provide a comprehensive view of the older person's needs or to use the PCEHR as the central client record with added functionality to include specific aged care social and living requirements.

What they don't want, they say, is two separate records that do not interact with each other.

A DSS spokesperson confirmed that the central client record will not be linked to the PCEHR in 2015 but rejected claims there would be in effect two eHealth records.

“The central client record will be available from 1 July 2015 as part of the national rollout of the Gateway system,” the spokesperson said.

“The central client record will ensure that clients only need to tell their story once. It will hold information about clients’ care needs and any current services being received, as well as a history of screening and assessment events and past service delivery.”

While the client's healthcare priorities and concerns may be included as part of the screening and assessment process, this does not mean that it was an eHealth record, the spokesperson said.

“Gateway assessment and service provision information in the central client record is specific to assessing the aged care needs of a client to help develop their support plan and access to aged care services.

“The central client record will record aged care client needs, as determined during the client screening and assessment process, but will not contain specific information relating to a client’s medical history.

“The central client record will not be linked to the PCEHR in 2015. This functionality is planned to be pursued as part of future enhancements to the Gateway system.”

The Aged Care Gateway was one of the centrepieces of the Labor government's Living Longer Living Better aged care reform package – the majority of which has been supported and will be implemented by the Coalition government – and was originally recommended by the landmark Caring for Older Australians report by the Productivity Commission in 2011.

The Gateway aims to create an entry point for the aged care system and enable timely and reliable information to be accessed by older people, their families and carers.

A key element of the gateway is the My Aged Care website, which aims to provide consolidated information on ageing and aged care services. It currently provides a searchable database of residential aged care providers, their accommodation prices and services, as well as other community-based services such as Home and Community Care (HACC) and the Home Care Package Program.

It will eventually include quality indicators and a rating system for aged care services, and recently went live with home care and residential care fee calculators.

From next July, all new entrants into the aged care system will be assessed for their needs and a central client record initiated. The record, designed by DSS after what it calls “extensive collaboration” with the National Aged Care Alliance and the state and territory governments, will be accessible by the client and their authorised representatives, such as family and carers, as well as relevant assessors and service providers.

The DSS spokesperson said authorised representatives could also include GPs and other healthcare practitioners if so desired.

“The registration process will collect information relating to a client’s personal details,” the spokesperson said. “The screening and assessment process will involve collection of information in response to structured decision support questions to assist assessors to determine the type and level of aged care services required.

“Information collected during screening and assessment will include the client’s current level of support (formal and informal) and engagement, carer availability and sustainability, health concerns and priorities, functional status, psychosocial and psychological concerns, home and personal safety considerations, and decision-making capabilities.

“Screening and assessment will also identify any complexities a client may have that indicate a level of vulnerability.”

In the original plan, the idea was to link the central client record to the PCEHR to provide a comprehensive view of the client's social and living needs as well as their healthcare information.

This is something the aged care sector would still like to see. Concerns were raised at a forum at the ITAC conference in Hobart earlier this year about the potential creation of two health-related records for each person.

At the forum, industry consultant Rod Young and health informatician George Margelis voiced strong disapproval of the perceived plan and urged the industry to step up lobbying efforts with the government to change direction.

“They are proceeding with an aged care health record, that is what they are proposing, and if we are to change this we need to run a campaign,” Mr Young said. “This is policy silliness.”

Dr Margelis agreed, saying “it is not a time to be polite: it is time to shout on the street and say this is ridiculous”.

Mr Young told Pulse+IT that he understood the central client record would stand quite separately from the PCEHR, or My Health Record as it is expected to become known.

“What we were arguing in that panel session was, does this make a great deal of sense?” Mr Young said. “Particularly if the government, which I believe they will, adopts one of the primary recommendations from the Royle review and that is that we move from opt-in to opt-out model in the future.

“Our view was, wouldn't it not make more sense to actually start from the point of integrating the My Aged Care record and My Health Record into a common platform.

“That's what we want them to do. My understanding at the moment is that there will be two quite separate standalone records and the two will not, for the foreseeable future, have any interoperability at all. That was our point in Hobart.

“As far as we are aware, and we are happy to be told we are wrong, but our understanding is at this stage there will be no interface between the two systems.”

The DSS spokesperson said the department currently plans to run a demonstration project of the central client record at a site in Victoria from the end of March 2015, until commencement of national rollout on July 1.

“The project will entail early rollout of Gateway functionality,” the spokesperson said.

Posted in Aged Care

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