DSS gears up for data exchange amid criticism of My Aged Care

The Department of Social Services (DSS) held webinars this week for aged care service providers and their IT vendors as it nears the roll-out of its DSS Data Exchange web portal for service activity reporting for the Commonwealth Home Support Program (CHSP).

The DSS Data Exchange (DEX) will replace all existing service activity reports including Home and Community Care (HACC) minimum data sets for the CHSP from November 1 and promises to be a streamlined way for aged care service providers to upload mandatory data.

DEX will allow for six-monthly automatic uploads or manual bulk uploads in XML format, but also offers small aged care service providers a free online client management system.

The roll-out comes amid complaints by the aged care industry over slow response times and a backlog in processing referrals to home care providers and Aged Care Assessment Teams (ACATs) since the go-live of the My Aged Care referral system in July.

DSS acknowledged there were problems with the expanded My Aged Care in a communique to the aged care sector following a workshop on August 13.

Problems with call centre software and the screening process were found to be contributing to the backlog in referrals, causing data entry errors and referrals to be issued inappropriately. DSS has also had to add extra staff, bringing to 250 the number employed at the call centre.

Doctors have also complained about the web-based system, with the Royal Australian College of General Practitioners (RACGP) writing to DSS last month to complain that it is not integrated into GP software or workflows and does not allow for the use of secure messaging services for eReferrals.

There is also concern in the aged care industry that while most providers have gone through the process of applying for access to the system, many have not yet set up the ability to receive referrals electronically.

DSS figures show that there are more than 2000 aged care organisations identified in My Aged Care. According to the figures, detailed in Aged and Community Services Australia's (ACSA) national report this week, of those organisation, over 90 per cent have registered their organisational administrator, who is authorised to make changes to the organisation's details in the system.

But while 72 per cent have “activated” at least one outlet, only 37 per cent have assigned a team leader to at least one outlet. A team leader must be assigned in order to receive and process referrals sent from My Aged Care.

Statistics provided to the My Aged Care Transition Working Group, which was set up by the federal government to prioritise and resolve issues relating to the new system, show that the My Aged Care call centre was receiving on average 16,000 calls per week, thousands more than expected.

The figures, detailed in aged care peak organisation Leading Age Services Australia's (LASA) most recent national bulletin, also show that between July 1 and August 30, more than 29,000 clients have been registered in the new system, with over 23,000 referrals for home support assessment and 6500 referrals for the more comprehensive assessments conducted by ACATs. The system is currently processing over 10,000 service referrals per week.

The My Aged Care referral system has been built to allow carers, assessors and home and residential care service providers to receive, view, accept and track referrals electronically. When a referral for a person new to the federally funded aged care system is made or for a change in needs that requires a new assessment, a central client record is being created to capture essential information about the person, which can then be shared.

An initial screening process is conducted by the My Aged Care call centre, after which a referral notice is sent to an independent Regional Assessment Service (RAS) or ACAT by email. The email does not contain personal details, but instead alerts assessors that there is a new referral, which can be accessed through a web portal.

However, while this process has been designed to allow transparency for the aged and community care sector, carers and the client, it has raised the ire of some GPs, who say it has not been designed with their workflows in mind.

RACGP president Frank Jones wrote a letter (PDF) to DSS last month to detail several problems with the system from a GP perspective. The college wants DSS to allow referrals to be sent using SMD-compliant secure messaging services such as HealthLink and Argus.

The RACGP also complained that the My Aged Care referral template requires doctors to duplicate information already entered into their clinical systems and does not even allow a cut and paste option. Nor is the web portal integrated into each practice management software solution, as most GPs prefer.

DSS representatives told an aged care sector briefing in March that while it planned to build a business-to-government (B2G) gateway to the referral system in future, for the time being it would allow referrals from healthcare providers to be made by existing methods such as fax or phone. GPs can continue to directly refer elderly patients to ACATs in emergencies.

DSS also plans to build an interface with hospitals so discharge nurses can more easily ensure older people have adequate care before being discharged from hospital.

In the meantime, DSS told Medical Observer that it was planning to introduce a webform specifically for GPs next year.

The new DSS Data Exchange portal has been live since last year but from November 1 will start to apply to the CHSP, which brings together the former HACC program, the Assistance with Care and Housing for the Aged program, the National Respite for Carers program and the Day Therapy Centres program. From 2017, it will also include the home care packages program, which involves seniors living at home but with more complex needs such as home nursing care.

DSS says DEX will enable fewer, more targeted data items to be reported but provide greater access to client outcome data. Aged care service providers receiving grants from DSS will need to upload a set of mandatory priority requirements twice a year, but the system also allows for a voluntary extended data set that providers can choose to participate in, which DSS calls the partnership approach.

By providing more data to the system, providers will receive in exchange access to a number of self-service reports to help inform service delivery. Lead trainer for DEX Marita Baier-Gorman told a webinar last month that this data would be de-identified using a statistical linkage key (SLK).

Ms Baier-Gorman said DEX will replace all existing service reports for CHSP, including the HACC minimum data set.

The DSS data exchange will allow providers to submit data in three different ways, she said. One is a system-to-system transfer using existing client management systems, which will require modifications to be made by vendors.

There is also a bulk-upload capability to allow providers to manually upload the data in XML format. Technical specifications for both of these options are being prepared for vendors.

The third option is aimed at smaller providers who don't have their own client management systems. DSS is providing a free CMS through its web portal to allow providers to manage their clients' information.

As with the My Aged Care provider portal, users need to apply for an AUSkey from the Australian Business Register to access the DEX. An AUSkey is a secure login that identifies and authorises businesses in their transactions with the government.

Posted in Aged Care

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