Building an eHealth bridge to connect the aged care sector.
Currently aged care in Australia is split between Residential Aged Care, Independent Living and Community Living. Technology is sporadic throughout however, there is currently a lot of movement in this sector taking into account that this is where the most chronic and complex patients are:
Residential care is for frail older people who can no longer live in their own homes.
Community care is for people still living in their own home or in independent living facilities, who receive in-home care and support from approved providers.
Flexible care addresses the needs of people, in either a residential, independent living or community care setting, in ways other than the care provided through mainstream channels.
Given that we have an ageing population with the first of the baby boomers having turned 65 in 2011, we can expect to see people in the 65-84 age bracket more than double in the next 30-40 years.
Over the next 30 years, the older population will also continue to change in its internal age structure. The number of older Australians aged 85 years and over, among whom the need for services and assistance is greatest, doubled over the past 20 years and is projected to increase more rapidly than other age groups: from 333,000 in 2006 to 1.1 million in 2036 (from 1.6% to 4.2% of the total population).
People aged 85 years and over are also projected to increase their share of the total older population from 12% of older Australians in 2006 to 18% in 2036. Over this period, the number of centenarians is projected to increase from less than 5,000 to more than 25,000
Australian Bureau of Statistics (ABS 2006t)
At 30 June 2006, 2.7 million Australians were aged 65 years and over, representing 13% of the population. In 30 years to 2036, the number of people aged 65 years and over is expected to more than double, from 2.7 million to 6.3 million, and will represent 24% of the total population at that time.
Currently the number of Australians accessing services in 2012-2013 were 900,000, by 2023 this number is estimated to be 1.6million and by 2050 it will be 3.5 million with an estimated 80% of these services being delivered in the community. Government spending does not match growth … now there’s a surprise! I think they are going to need an electronic helping hand to get this sector across the line. Time to provide that solution!
While there is a need to help the residential aged care sector transition to an electronic solution to improve healthcare and resident health outcomes, there is also a need to develop electronic solutions, to support the growing number of elderly that will be living in the community on packages of care provided by the government.
The general consensus for the future is that by the time a person is in residential aged care, they will be a high care patient on 10+ medications with multiple conditions and requiring 24 hour care, in other words our most chronic and complex. Imagine if we could share their health information between clinicians electronically, so that their patient journey through the health system is seamless and not fraught with complications, duplications and delays in locating their medical history, medications and end of life wishes. The current processes are not only demanding for the clinicians treating the patient but equally stressful for the patient involved and their family.
IT literacy in the aged care sector is less than 50% even though more than 90% of staff use a mobile device. The workforce is diverse where in cases English is not their first language and training is challenging. They need all the help they can get so having a solution where implementation is seamless and minimises the change and adoption process makes it a real possibility. Implementing a totally new system would be a major undertaking, training staff is a long term project and implementation is slow. However taking their current documents and making them electronic could definitely be the key to unlocking the aged care IT maze.
Understanding where the aged care sector is in the IT journey is paramount, so we can determine how we can assist them to move forward towards an electronic solution. Knowing and understanding your clients applies equally in this complex sector. A full assessment of each facility is valuable as each Aged Care Facility (ACF) has its unique needs. One thing that is a constant is that residents regularly go to the emergency department of local public hospitals and the information that goes with them is inconsistent. This is where we are looking for a solution.
I don’t see Australia as unique in this sector, I expect it is similar around the globe. Population ageing is common to most developed countries and, as in Australia, is caused by sustained low fertility and increasing life expectancy.
Some statistics to scare us into action:
Of the 36 ACFs locally to Sláinte’s Sydney office, 17 ACFs are totally paper based, the remaining 19 ACFs are using a cocktail of systems they are only partially functional. None are using the medications modules, choosing instead to reply on pharmacy to provide the Webster Pack of medications or sachets and paper medication charts.
- GPs play an important role for the elderly in the community. It is their shared health summary that will provide the information for hospitals, community care and other primary care providers. The question is…. How can we get that information around these cohorts more efficiently?
- About 80% of aged care and support is provided in the home by informal carers, including partners, family, friends and neighbours.
- More than one million Australians over the age of 70 access some form of government subsidised aged care services (about one in four people aged over 70 years).
- The total number of operational aged care places across the aged care system at 30 June 2011 was 247,379 – an increase of 4.3 per cent over the previous year. This included 185,559 residential care places, 58,471 community care places and 3,349 transition care places.
- By 2050, more than 3.5 million Australians are expected to use aged care services each year.
Food for thought and watch this space… more updates to come
- Aged Care Consultant, Australia