Feros Care will go gung-ho for an opt-out PCEHR

Despite facing huge challenges in implementing the PCEHR for its aged and community care clients, aged care provider Feros Care will be “gung-ho” in supporting clients to use it to monitor and self-manage their health if it becomes an opt-out system, the organisation says.

Feros Care's manager for health and wellness, Kate Swanton, told the Information Technology in Aged Care (ITAC) conference in Hobart last week that the company, which has residential facilities in Byron Bay, Bangalow and Wommin Bay as well as a large number of in-home and community care packages, had put its hand up as an early adopter of the system for the aged care sector and remained committed to rolling it out to all clients, despite numerous challenges it has faced.

Associate Professor Swanton said Feros Care had registered about 600 clients for the PCEHR, and had found that most were keen to take part, with only two who were not. Some clients were actively engaged in their records, including several with diabetes who are uploading their measurements to the personal section of their PCEHR.

Other clients were not interested in viewing their records but felt much safer knowing that healthcare providers will have access to their information, she said.

PCEHR registration is offered to all clients participating in Feros Care's My Health Clinic at Home NBN trial – made all the easier in that this has been funded – and the organisation is pushing for a link to be added to the tablet PCs used in the trial to make it easier for them to access their record and avoid the myGov website, which is still a very challenging interface, she said.

In addition to unanimous support for a name change from the PCEHR – affectionately known as the pecker – to something like the My Health Record suggested in the Royle review, A/Prof Swanton said the organisation was very supportive of a change to an opt-out system.

“Our lives would be so much easier if the recommendation about the opt-out system is accepted,” she said. “For us registration is a real challenge. We’re really committed to it but it is very challenging. If everyone automatically had a record it would be so much easier.

“We do a lot of vital signs monitoring with our community clients at home via tablets so this is a great opportunity to upload those vital signs. They’ll be useful for GPs and health providers but also useful for our clients to see their progress over time.

“If we get that opt-out recommendation accepted we will be gung-ho in supporting our clients to make use of the record to enable them to much more effectively monitor and manage their own health.”

Feros Care plans to have 100 event summaries uploaded by June next year, and is on the way to its target of registering 70 per cent of its clients by that time.

Never-ending pecker journey

For Feros Care, the PCEHR fits in well with the organisation's service philosophy, in which technology is used as an enabler to help maintain independence for clients, there is a focus on positive ageing, clients remain connected with family and friends and there are better connections with providers.

Five years ago the organisation was a basically a small aged care provider in Byron Bay with two residential facilities and a few community care packages. A/Prof Swanton said Feros Care had grown very rapidly since then – “but we are still very Byron, still a little bit odd,” she said – and that expansion has been enabled by a concentration on technology.

“We now have clients down the east coast of Australia, our staff are connected virtually, we have an electronic record, we communicate electronically,” she said. “We’ve adopted the use of telehealth and tele-care to provide services for our staff, and an eHealth record was really attractive to us in terms of supporting our clients and better managing their health.”

Feros Care was interested in being an early adopter of the PCEHR as it saw it as a critical alignment with its service philosophy, and it wanted to showcase the functionality of the record for the aged care sector, she said.

“We wanted to allow our providers to access the system and to encourage staff and other providers to contribute to it. We also thought this was such an opportunity to access critical information that would enable us to communicate more effectively with our clients and collectively define our care packages.”

The process, however, was long and arduous, she said. “It won our service desk record. All IT requests go through our service desk, are monitored and usually closed off very effectively and efficiently and we have benchmarks that we need to meet.

“This one was the never-ending pecker journey. It was very complicated, this project. We needed to register as an organisation and can I say I have never seen so many forms before … so many secret numbers, so many mystery secret numbers that we had to enter into systems.

“And there were new roles: we’ve all got new glamorous titles. I’m an OMO – I used to think OMO was a washing detergent but I am now an OMO in our organisation.”

There were problems registering clients from the start, including finding each healthcare provider's Healthcare Provider Identifier – Individual (HPI-I) and sorting out what a seed and a network organisation were. Some care managers, while having tertiary qualifications, are not registered healthcare providers and therefore are not given an HPI-I by AHPRA. And yet, these are the people who would benefit most from having access to health information on their clients, she said.

The early registration process was near-impossible to navigate, with Feros Care's CEO Jennene Buckley and CIO Glenn Payne – both very IT-savvy – unable to register online for their own PCEHR. Medicare offices were not helpful and the telephone helpdesk was the same, with instructions given too quickly for older people to understand and none of the helpdesk staff questioned by A/Prof Swanton admitting to having signed up for a PCEHR for themselves.

The eventual release of an assisted registration tool (ART) was a step forward, but even so, she said, community care staff have to remember and enter a 16-digit code every time they try to register a client in the field through the organisation's care software package, TCM.

“We weren’t funded to register clients and it takes a lot of time for our staff to explain the benefits of the record and go through the essential information that we needed to provide for clients, including verifying ID,” she said.

“For our community clients we had to provide 100-point ID and aged care clients … [mostly] don’t have an available passport or driver’s license or have the documentation that would equal 100 points.

“What we did do to help facilitate the registration process was to establish a number of strategic partnerships. We had an MOU with the North Coast Medicare Local and they agreed to go out with us and engage our clients and they registered on the spot using the ART tool.”

Aged care profile

A/Prof Swanton praised NEHTA for the assistance it gave the organisation, saying NEHTA was able to rewrite certain processes based on feedback on what would and wouldn't work in the aged care sector.

Now, shared health summaries are even starting to appear. “We don’t always see the shared health summary because that is reliant on the GPs to provide that information,” she said.

“Having worked closely with GPs and knowing how busy they are, if they have to duplicate the process [of writing progress notes] that is going to take part of the consultation time and it won’t happen, but we are starting to see more GPs entering information.

“We are starting to enter information as well so we are starting to get a profile for aged care. Event summaries of significant events, medication prescription and dispense records and hospital discharge summaries are invaluable for a residential establishment.”

With the NBN trial also involving registering clients for and using the PCEHR, Feros Care is now embedding the system in its initial assessment process. A link to the PCEHR is also embedded with the TCM software, although the organisation would like to see an eHealth link added to the client's tablet as well, allowing them to bypass the notorious myGov access route.

Now, the organisation is awaiting the outcomes of the consultation process on the PCEHR review, which A/Prof Swanton said she was completely supportive of.

“They are very sensible recommendations and hopefully they will be endorsed,” she said. “We’ve had the name change to a much easier name, because trying to sell a personally controlled eHealth record to aged care clients is a bit of a mouthful, and our lives would be so much easier if the recommendation about the opt-out system is accepted.

“We really see this as an invaluable tool to effectively improve our communication with GPs, hospitals and allied healthcare providers. It is about raising the profile of aged care, to show what services we are providing our clients. We want to register and train all our providers to actively access and use the record.”

Posted in Aged Care

Tags: Feros Care

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