Lynden Aged Care goes paperless and wireless
As a standalone, community-controlled aged care provider, Lynden Aged Care is as aware as any that investing in IT systems must have both a clinical and an organisational benefit. With a personally involved board and a CEO with a keen interest in IT, the organisation has made some targeted investments in IT that makes it better equipped than most in the sector.
Lynden Aged Care's facility in Melbourne's Camberwell has licences for 30 low care beds, 30 high care beds and 20 extra service places, and is currently undergoing a major capital development project that will add a new wing and accommodate 22 more people with high care needs. In addition, it has recently finished building six two-bedroom independent living units.
It has also gone fully wireless and has made significant investments in the iCareHealth clinical management system, iCareHealth's medications management system, and the Vocera communications and nurse call platform.
It also has an electronic time and attendance system for staff that allows them to simply scan their fingerprint when arriving at work, doing away with the need for paper timesheets, and staff can also log on remotely to apply for leave or make themselves available for shifts.
For CEO Ann Turnbull, the driving force behind the investments was the benefits she could see from the medications management system. “I saw that at a conference and it was clear to me how much time we would save and how it would almost eliminate medication errors,” Ms Turnbull says.
“Just to set that up was the expensive part because we had to go fully wireless. For that to work properly is where the investment came in, but once you are already wireless the add-on bits aren't anywhere near so much.”
It was a substantial investment – half a million dollars all up including the infrastructure, Vocera and medications management – but when taking into account the convenience for nurses of the Vocera devices and the time saved on medication rounds, the return on investment is clear, she says.
“Nursing staff just carry one device with them in which they can make and receive phone calls, they can receive nurse calls on it, they can talk to the residents, they can locate each other. There are no telephones and they don't have to carry a pager or any of that sort of thing, just the Vocera.
“With the medications management system, the main benefit is that the nurses have saved at least an hour every medication round. It has almost eliminated medication errors – that wasn't a major major issue for us but it's still something you don't want to have.
“And because we set that up and the staff really found the benefit from the medication management and the Vocera, they have embraced every other system introduction because they're not scared of it.”
Ms Turnbull says it helps to have a very involved board that supports investing in IT. “One of the real benefits of a place like ours is that most of the board members have got now or have had a family member living here, so they know what's good and they could see the benefits of the medication management system and the Vocera system,” she says.
“Their view was that this is why we make money – it is to spend it on residents, not to go into people's pockets – and they could see very clearly the benefits to the residents.”
With some figures showing that up to half of aged care facilities don't even have an electronic clinical or documentation management system, Lynden Aged Care is paperless. Asked why other aged care providers do not take the plunge, Ms Turnbull says it usually the cost.
“I would imagine that it is because if you tell them it's half a million dollars, they would flip out! But the cost benefit is just enormous. We have quite a few staff here who work at other aged care facilities as well and without exception they come back and say this is such a great place to work because it is so easy. They see the benefit so they embrace the other changes that you are bringing in.”
Participating in the PCEHR, however, is another matter. Lynden Aged Care has long seen the benefits of sharing information with other clinicians and providers, and participated in an early shared health record project established by the Inner East Melbourne Medicare Local and its predecessor, but the national system has proved difficult.
The main issue is that it is doctors who have to drive the system, she says, and she is not aware of any of visiting GP who are actively using the PCEHR. As someone who is acutely aware of cost-benefit ratios, the latter is not yet apparent with the PCEHR.
“By the time a person comes in to aged care, they've got their GP, they've got their relationship with the doctor and if he or she is into the PCEHR, then it will come along without any problems,” she says. “But it has to be done through the doctor. My own doctor doesn't even have the software to work with the PCEHR so there is no use in me hassling him because it won't happen. The doctors have got to be set up for it.”
Visiting GPs to Lynden Aged Care are all given access to the iCareHealth system when they are on the premises to make notes or changes to medications, and most are more than happy to do so. For the one who isn't, a nurse will type the details into the system and the doctor signs it.
“We don't have any paper so they have to come onto our system,” Ms Turnbull says. “There is no paper for them to write on.”
And while iCareHealth is PCEHR-enabled, it is not being used as yet. Ms Turnbull says the creation of a transfer document in the PCEHR would be very useful, but at the moment there was no benefit to the organisation to drive uptake.
“It would be terrific to be able to upload a transfer document and then when they get to hospital for it to be downloaded again, but to have that you've really got to have the residents signed up for it and the doctors participating.
“The GP who has most residents here is really into IT and she loves it. She's into telehealth, but I'm not sure whether she is signed up to the PCEHR. There just is not the benefit at the minute for us to drive it.”
Posted in Aged Care