IT capability a concern as aged care comes to grips with CDC

The relative lack of IT capability in the community aged care sector is causing concern as the first moves are made towards a full consumer-directed care (CDC) model, with some providers still looking for solutions to how they will manage the new reporting requirements.

From July 1 next year, all Home Care Packages – which provide personal, support and clinical care to older Australians in their homes – will be delivered on a CDC basis, giving recipients and their families choice and control over the types of care and services they receive and from whom.

These packages include services such as those provided under the former Community Aged Care Packages, which are designed to keep people at home for longer and out of residential aged care, as well as higher level support that was formerly provided under the Extended Aged Care at Home and Extended Aged Care at Home Dementia packages.

They can include basic support with household chores or personal hygiene, as well as more intensive support from district nurses and other health needs such as physiotherapy, nutrition assessments and hearing and vision services.

Under the new model, all recipients of a Home Support Package will receive a personalised budget showing how much government funding is available and how it is being spent. A Department of Social Services (DSS) spokesperson said the consumer must be provided with a monthly statement of income and expenditure, including the balance of funds.

That all sounds good in theory and most in the industry support CDC, but in practice it is causing a few concerns, not the least for the IT back-up that community aged care providers will need.

As industry consultant and former CEO of Aged Care Association Australia (ACAA) Rod Young puts it, a monthly statement for a handful of package recipients is doable in Excel, but when those numbers rise, so do the headaches.

“In the consumer-directed care environment, all package care recipients are to receive a monthly report on their services and their dollar balance,” Mr Young said.

“If you've got 30 clients you can probably manage that on a spreadsheet. If you've got 130 clients it becomes really difficult and if you've got 1300 clients it becomes impossible. The need for IT enablement in the industry becomes quite crucial.”

Community aged care is supported by a number of well-regarded software packages, some designed specifically for particular populations such as The Care Manager, some provided by residential aged care vendors such as iCareHealth and others developed in-house by larger providers such as Silver Chain subsidiary EOS Technologies.

However, for smaller providers, the looming CDC requirements are proving a bit of a nightmare, not the least because many still function on paper.

“When you get to applying it across the whole package in the community from July next year, and then you've got providers with hundreds and in a lot of cases thousands of clients, and when you get to hundreds of thousands of clients, you can do it by paper but it would take a small army to do that,” Mr Young said.

Patrick Reid, CEO of Leading Age Services Australia (LASA), said the provision of services and the budgeting requirements under CDC were about to become a lot more complex. “CDC in terms of the menu of services people provide and how people avail themselves of the opportunity to select their services, I think it’s going to be interesting,” Mr Reid said.

“The other issue is what happens in the true CDC model where people may pick more than one provider. In the past it has been sort of a job lot – you have services provided by somebody, but in this new world you could potentially have two, three, four, five different providers providing different things.

“Will consumers be aware that they are getting five or six or seven different reconciliations if they're choosing more than one provider for different service? Some of these things will come out over time – there is an assumption that the majority of these services will be provided by one provider – and what we are concerned about is that you will have the reconciliation process, but you will also then potentially have an arbitrage between different providers to have one provider as the point man for reconciliation.”

Mr Reid said the larger providers like RDNS, Silver Chain and Kincare are working hard on their IT capability and developing the infrastructure required, but others are finding it a bit more difficult.

“They are still struggling a little bit with what they need to do and how they are going to do it, because there is very little guidance and it is early days,” he said. “There is still a lot of grey out in the market place around this.”

The DSS spokesperson said that in addition to monthly reports, all information must be provided in a format that is simple for older Australians and their families to understand.

“Where required, the provider must arrange for the individualised budget and/or regular statements to be made available in a language other than English,” the spokesperson said.

DSS is not prescribing a template for these reports, and the reports will not be transmitted to the client online through the Aged Care Gateway.

“How a report is transmitted, and in what reporting format, is determined by consultation between the provider and the client as part of the Home Care Agreement and care planning process,” the spokesperson said.

Mr Young said the industry had known they have to do this for some time, but there are a lot scratching their heads over how they are going to manage it. It is also probable that CDC will be introduced to recipients of the Home and Community Care (HACC) packages, which are joint state and federally funded packages that provide low-level services in the home or through community care centres.

“There are a couple of IT vendors who can provide some of the solutions, but I think some people are going to get caught short or find it is going to be more difficult than they anticipated,” he said.

“It's an issue that most providers are now aware of in at least the package environment, and if the government does decide to extend it to HACC in the future, then they will have to take some time as they simply couldn't do it in the matter of a year. It would be impossible for the whole industry to become enabled.”

Mr Reid agreed. “There is still a way to go,” he said. “What we do have is the vendors who are manfully trying to deal with these things, but again, it seems a niche part of the IT world.

“From my point of view, for the good of older Australians, the government and the industry itself needs to have a good hard look about what they require and how they going to fund the infrastructure required to make it work as best as possible.”

Posted in Aged Care

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