Plan to roll out advance care repository for aged care
Funding to extend the deployment of electronic advance care directives being piloted in four aged care facilities in Tasmania will begin to flow from July, with development of an implementation plan to upload the documents to the PCEHR currently underway.
Advance care planning functionality has been developed by the Cradle Coast eHealth site, one of the Wave 2 projects for the implementation of the PCEHR. Cradle Coast has developed a repository to store the advance care directives that is accessible to aged care facilities and healthcare providers, and NEHTA is currently working on developing specifications to enable copies to be posted to the PCEHR.
At a Senate Estimates hearing in Canberra recently, Department of Health and Ageing representatives said funding to deploy the advance care directives to other aged care facilities throughout the state would be available in July, although an implementation plan is still being negotiated with the Tasmanian government.
The funding is part of the $325 million Tasmanian Health Assistance Package, announced by federal Health Minister Tanya Plibersek last June.
Of the $36.8 million allocated in the bail-out to eHealth initiatives over four years, $11m has been provided to expand the Cradle Coast eHealth site to support improved palliative care service delivery.
According to the preliminary report into the assistance package from the independent Commission on Delivery of Health Services in Tasmania, which was appointed last September to monitor the implementation of the package, the money will be used to expand deployment of electronic advance care planning across residential aged care facilities in Tasmania, develop national advance care planning specifications, and provide implementation support to other eHealth sites involved in delivery of palliative care services.
The money will also be used to continue the operation of the Cradle Coast advance care plan repository and to provide training for up to 91 residential aged care facilities across Tasmania in the use of advance care planning tools.
NEHTA has been funded to develop a national specification for advance care planning to enable broader deployment, and for vendor support to encourage upgrades of aged care and GP desktop software to create and receive advance care plans and upload them to a PCEHR repository.
The assistance package also included $19 million to enable public hospitals to connect to the PCEHR and to upload electronic discharge summaries. Hospital clinical systems will also be upgraded to be able to create specialist letters and event summaries.
NEHTA CEO Peter Fleming told the Senate hearing that eDischarge summary functionality should be available in Tasmania before the end of the year.
“We would expect by around about the middle of this year – between June to September – certainly one of the first things you will see flowing through is that all of Tasmanian public hospitals will be capable of posting discharge information through to the person who controls the electronic health record,” Mr Fleming said.
“Certainly from a Tasmanian perspective, we would expect that through the course of this year and certainly by the end, any Tasmanian citizen who is registered for the PCEHR, if they do go through the public hospital system, would also be able to get their discharge information flowing through into their record, as indeed it would flow through into the primary health system there as well.”
Tasmanian Senator Carol Brown said there was a lot of interest in the palliative care project in the state, and asked how aged care facilities could sign up to use advance care directives.
Linda Powell, first assistant secretary for eHealth change and adoption with DoHA's eHealth division, said the government was spending a small amount of money this financial year to continue the operation of the advance care plan clinical repository.
“That funding will go to the Tasmanian government and that is for this financial year,” Ms Powell said. “Following that, as part of the Tasmanian package, there are a number of elements that we will be working on, which will include making advance care plans available through the shared electronic health record.
“It will look at putting together a repository to store these and develop an advance care planning tool that is going to be useful to everybody. That package is something that we are working through with the Tasmanian government at the moment.
“We do not have the details of that finalised, but we are talking to them about exactly what form that will take and look like over the next couple of months.”
The Commission on Delivery of Health Services in Tasmania, which published its preliminary report last month, has targeted accelerated uptake of the PCEHR as one of three areas where additional funding is likely to have a significant impact, along with clinical redesign capacity building and improving the management of elective surgery.
“Accelerated implementation of the PCEHR presents an outstanding opportunity for the Tasmanian health system, and is critical to reform,” the commissioners reported. “This appears to be a strong candidate for clinical redesign funding in 2012-13.
“A consistent message we heard during our consultations was the need for wider uptake of eHealth across Tasmania to support more efficient and consultative practice, enable streamlined and coordinated referral pathways, and reduce repetition of diagnostic testing.”
Posted in Aged Care