IT opens the door to a new era in the delivery – and cost – of aged care

Published 02 April 2013 09:56, Updated 12 April 2013 16:34

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IT opens the door to a new era in the delivery – and cost – of aged care

A technology trailblazer, Cranbrook Care’s Campbell Meldrum says expectations of aged care services will rise as more baby boomers move into care. Photo: Louise Kennerley

More than a million Australians currently receive some form of aged-care services. By 2050 the ageing demographic of the nation means that number will have blown out to 3.5 million.

Over the same period, government spending on aged care will rise from about 0.8 per cent of gross domestic product to 1.8 per cent. The combined public and private spending on aged care is more than $13 billion each year, with about 2700 organisations providing residential care and 1500-plus providing community care.

Comprised of a mix of private operators, religious affiliates, not-for-profits and government-owned organisations, these aged-care providers will need to somehow triple their headcount from about 250,000 staff today to 800,000 by mid-century to cope with surging demand.

Technology could prove a game-changer and not only lift productivity in the sector but to enable older Australians to stay in their homes longer while still having access to the health and care services they require. These can be achieved by combining advanced care solutions with in-room sensors, e-health solutions and high-speed broadband networks; leveraging the personally controlled electronic health record (PCEHR); and embracing innovative mobile rostering and care systems.

Despite technology’s promise, until the mid 2000s about half the aged-care sector was still largely paper based. Increasingly rigorous accreditation and certification of the sector has led to a flurry of technology adoption – but the computerisation of the sector is still beset with problems.

In its landmark 2011 report into aged care, the Productivity Commission noted the lack of technology infrastructure in the sector and the need for “systemic incentives to improve technology use in aged care”.

Two years on, these incentives have not materialised and the issue was again on the agenda at a meeting in March between the peak industry body, Leading Age Services Australia, and the Minister for Mental Health and Ageing, Mark Butler. Patrick Reid, chief executive of LASA, says that while GPs have received funding to support technology rollouts (as part of the Medicare Practice Incentive Program) there has been no equivalent funding to support aged-care providers.

Yet just like doctors, aged-care providers need to prepare for the advent of e-health services and PCEHR, which will host important health-related information for people who opt in. (Available since last July, there are about 80,000 Australians currently registered for a PCEHR.)

While there are a handful of major technology companies with an aged-care focus – GE and Intel have a joint venture in the area – other initiatives have floundered. A cloud-based aged-care solution launched with great fanfare by NEC in 2010 and endorsed by leading bodies in the sector was intended to deliver cost-effective access to clinical, residential and community care applications such as iCare, Comcare and AutumnCare.

That has quietly been discontinued and NEC has sold the platform to AAPT, however the company still sells some point solutions to the aged-care sector.

Like a hotel, only smarter

Never flush with funds to invest in technology at the best of times, the aged-care sector is now feeling the pinch more than ever. LASA argues that changes introduced last July to the government’s Aged Care Funding Instrument will cost the residential aged-care sector $751 million by the end of 2014. For some in the private sector it has proved a bridge too far and many providers such as Lend Lease, AMP and BUPA are reviewing or attempting to offload their aged-care portfolios.

Some private providers, however, have recognised technology as delivering an opportunity to do more with less. Campbell Meldrum, part-owner and executive director of Cranbrook Care, a Sydney-based, private provider is a technology trailblazer for the sector. Operating at the premium end of the market, Cranbrook runs three facilities with 212 aged-care beds. Its services span low to high care along with respite, dementia and palliative services.

Each of Cranbrook’s rooms features a built-in touchscreen that links to the facility’s specialised care software and the highly automated and comprehensive back-office administration systems – which even monitor fridge temperatures in the kitchens – which are important for the accreditation process.

Each resident’s room features an array of sensors to enable full dementia monitoring. There are also bed sensors and passive infra-red remote monitors, which can be switched on when the resident requires that level of care.

Cranbrook also uses the in-room touchscreens to access a home-grown application allowing residents to select their meal choices, with that data fed directly into a food ordering system. In the two new Cranbrook facilities being planned, the touchscreens will be replaced by tablet computers.

Unashamedly targeted at the premium end of the aged-care market, Meldrum says Cranbrook is “somewhere between an aged-care platform and a hotel system”.

However, he predicts that with only about seven years until the first of the baby boomers make their way into aged care, expectations will continue to rise. As will numbers.

Even if you are in a not-for-profit, there is no excuse not to adopt technology to increase your productivity and the benefits for residents.

“If you look at where we are going, there will be an extra 1.8 million people over 85 by 2050,” he says. “Even if you are in a not-for-profit, there is no excuse not to adopt technology to increase your productivity and the benefits for residents.

“Technology has the ability to transform the sector – there need to be more people focused on it. In the future I think that the NBN and e-health will be a game-changer – the problem, however, is it could be many years before everyone is running at 100 Mbps.”

The head of the CSIRO’s health services team, Dr Sarah Dods, agrees technology is an important element in future aged care thanks to its ability to underpin virtual residential care.

In such a scenario older Australians might live in their own homes and connect via the internet for regular consultations with health and care professionals, have their vital signs remotely monitored, and their activities tracked by sensors, while also making use of fast broadband networks and innovative communications solutions to tackle what might otherwise prove to be crippling social isolation.

The CSIRO is currently involved in a pilot with not-for-profit provider Autumn Lodge, in Armidale, northern NSW, one of the early NBN sites. The CSIRO’s Smarter, Safer Homes trial is being run in association with the Armidale-based University of New England. Colin Griffith, director of the Australian Centre for Broadband Innovation, says non-invasive technologies have been installed in the homes of 20 Autumn Lodge clients to track variables such as activity, heat, water and electricity use. The trial also uses accelerometers to monitor what people are doing – and register changes that might require intervention.

The system, which runs on iPads, provides feedback to users, and also has the capacity to capture medical data such as blood pressure readings.

Griffith says that a white paper planned for mid-year will deliver analysis of the service model and the business model for wider deployment of these sorts of technologies.

Could the application be bundled by an ISP? Would it make sense for private health insurers to offer such systems to their so-called “frequent flyer” customers?

“Aged-care providers are very interested in this because they can’t provide enough beds, so how could they provide virtual aged care?” says Griffiths. “There are a variety of models still emerging.”

Developer turns vendor

Western Australia’s Silver Chain – a $200 million not-for-profit business delivering community aged-care services – is morphing a small part of itself into a technology vendor. Having developed and refined software to support community aged care, it established EOS Technologies, which is now charged with selling the system into the sector.

Allan Turner, EOS Technologies CEO and formerly chief information officer of Silver Chain, says EOS’s ComCare system handles electronic referrals, assessments, service and supplier contracts, clinical information, wound management, care plans, consumer-directed care packages, billing and rostering. A medication management system is planned for 2014.

The ground-breaking ComCare rostering system works on Android smartphones, integrates with Google Maps to calculate routes and completes the loop by using GPS tracking to check that visits have been made to clients.

Turner acknowledges that although innovative technology is available for the sector, as a whole, aged care is renowned for not having much money for IT.

“Many organisations see it as a cost rather than a strategic asset,” he says. “But you can’t guarantee compliance [without technology] unless you are very, very small. You need sophisticated systems to ensure compliance – the penalties are significant.” And they include being forced entirely out of the business.

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