ITAC: aged care concerned over “policy silliness” of client record

The aged care industry needs to step up its lobbying efforts over the direction of the central client record being planned as part of the Aged Care Gateway, with industry representatives voicing concern that it will duplicate the PCEHR and providers will be saddled with two aged care health records for each client.

At an industry forum held at the ITAC conference in Hobart on Tuesday, panelists including former Aged Care Association Australia (ACAA) CEO Rod Young, the University of Western Sydney's George Margelis and aged care provider Feros Care's manager of allied health and wellbeing, Kate Swanton, voiced their opposition to what they see as a doubling up of effort.

However, all three were strongly in favour of a move to an opt-out model for the PCEHR, with a consensus view that the former Labor government should have chosen that model when it legislated for the system in 2011.

On the PCEHR, Associate Professor Swanton said she thought it was a good idea and was improving all the time. Feros Care has rolled the system out in association with its software vendor, TCM, first to the company's community care clients and then into residential care, but A/Prof Swanton said the organisation would be “gung ho” in its support for the system if it moved to opt-out.

Mr Young criticised the tediousness of the registration process required, but said he entirely supported the view that an eHealth record was necessary, particularly for older people. However, he said the system should always have been opt-out if the benefits were to be realised.

Dr Margelis said it was to Australia's credit that we were the first to try an eHealth record on a national scale, but criticised the rushed implementation and the lack of clinical input into its design and use. He said one of mistakes the previous government made was that “they were too nice about it”.

“They sort of said, 'you can have one if you want, you can use it if you want'. The reality is that to get the value out of it you really need critical mass.”

He said the system needed to go beyond a repository of data to become a tool used for clinical care, but there were some unreasonable expectations from many who thought it would be all things to all people. “Where we are up to now is we have a lot of people on board, but not a lot of data on board.”

While there seemed to be a consensus that opt-out was the preferred model – one audience member said it was a small minority of privacy advocates and civil libertarians who had spooked the government into changing to opt-in at the last moment – the most immediate concern was over the planned central client record for all older people accessing aged care services through the Aged Care Gateway.

Originally designed to be a record of personal and social data on older people as they began to use aged care services, the plan was to link it to the PCEHR as the recognised health record. However, it appears that the closer the central client record comes to final design, the more it is resembling an eHealth record.

Mr Young voiced strong disapproval of what he said was the potential creation of two health-related records for each older person 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”.

Panel moderator and conference organiser, Aged and Community Services Australia's (ACSA) national corporate relations manager Judy Martin, said the peak organisations had already begun lobbying the government about their concerns, with plans to ramp this up as the final design got closer.

“It is going to be a nightmare administratively and time-wise, but it is also the explanation to your clients [about another record],” Ms Martin said. “There will be a myriad of confusion and all of us as an industry are trying to alleviate a lot of that confusion.”

Dr Margelis said it was technically possible to link the central client record to the PCEHR, but that all health IT roll-outs had shown that “a single source of truth for all data is critical”.

Posted in Aged Care

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