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Aged Care Royal Commission missing the digital health opportunity

Baby boomers heading into aged care in Australia may be shocked to find themselves living in the past when it comes to digital access, according to Dr Tim Smyth, a health management consultant, Adjunct Professor in the Faculty of Health at the University of Technology Sydney and a former Deputy Secretary at the NSW Ministry of Health.

In the article below, Smyth says the 124 recommendations made to the Royal Commission into Aged Care Quality and Safety by its Counsel Assisting last month, as hearings closed, were both wide-ranging and welcome.

But he writes, they did not recognise the synergy and potential that is possible with the right balance of mandated requirements, incentives and accountabilities under an integrated digital health agenda for Australian aged care – both in the home and in residential aged care facilities.


Tim Smyth writes:

Counsel Assisting’s 475 page submission to the Royal Commission into Aged Care Quality and Safety on 22 October, containing 124 recommendations, is an interesting read.

The recommendations range across key aspects of aged care and seek to address many of the long-standing problems in the sector.

Adoption by the two Commissioners of the recommendations, followed by prompt acceptance and determined implementation by governments, regulators and aged care service providers will be welcomed by clients, their families and carers.

Only 4 of the 124 recommendations actually reference digital health:

  • Rec 62 — new models for GP and primary care
  • Rec 64 —- multidisciplinary outreach services provided by Local Health Networks
  • Rec 69 – greater access to medical specialists via telehealth
  • Rec 74 – use of “digital care management systems” and My Health Record.

Elsewhere, the submission touches on parts of the digital landscape – the My Aged Care website, the need for better data and enhancing the role of the Australian Institute of Health and Welfare, reporting on quality indicators and greater transparency.

Notably, there is little attention given in the submission to the use of digital technology to provide greater social connection with families and carers, provision of digital portals for relatives to check what is happening to their loved one, use of online booking systems for appointments or utilising online feedback and consumer ratings to drive improvements.

Sadly, Counsel Assisting have not recognised the synergy and potential possible by combining their recommendations and observations into an integrated digital agenda for Australian aged care.

Going back in time

Australian baby boomers, and the generations that will follow them, now take digitally enabled services, access to information and social interactions as a “given”.

They will be shocked to find that on entry into Australian aged care services they are back in a world of paper, waiting for a GP to drop in after they have finished their work in their practices for the day, hoping that someone can organise transport for a 20 minute visit to a specialist, giving the same information repeatedly to different providers and praying that when they arrive at a hospital emergency department in an ambulance, the hospital will know enough about them.

Digital technology and tools can radically transform this picture and support, strengthen and shape a person centred, high quality, safe and effective aged care system – both in the home and in residential aged care facilities.

Projects in Australia, and developments in other parts of the world, have shown that the intelligent use of telehealth video consultations, remote telehealth monitoring and other forms of virtual healthcare does deliver quality care, high consumer satisfaction and better cost effectiveness for government (and we taxpayers).

It also utilises the skills of all the health care team, especially nurses and allied health professionals.

Digital technology and tools do not replace the importance of face to face interactions, the power of human touch and the need for personalised care addressing physical, emotional, social and spiritual needs.

Digital health supports and supplements this personal care, provides an essential safety net, provides greater accountability and oversight of care and facilitates training and supervision of care staff.

We do not need to wait for technology and software. It is already in use in many community and aged care services. What is needed is the right balance of mandated requirements, incentives and accountabilities under an integrated digital health agenda for Australian aged care.

Don’t waste the opportunity

Others will want to add to the list of requirements, but as a start we should be requiring that all aged care support packages and residential aged care providers provide and support:

  • video consultations with GPs, other medical specialists, aged care nurses and allied health professionals
  • electronic medication systems
  • ability to provide remote monitoring of key vital signs for clients needing closer review
  • access to a 24/7 call centre for both staff and relatives, with the call centre staffed by experienced aged care nurses, geriatricians and allied health professionals
  • digital care plans and health summaries regularly updated and available to treating health professionals, the ambulance service and hospitals
  • routine collection of key data on resident conditions, meals, activities of daily living using tablets and mobile technologies to enable earlier identification of deterioration, better monitoring of quality of services and facilitating scheduling of tasks for care workers
  • access for relatives and nominated others to a digital portal to check on their loved one’s condition, make enquiries and lodge concerns
  • ready access for clients and relatives to video chats with their loved ones
  • regular reporting on service websites of quality indicators and client and carer feedback.

Let’s not waste this opportunity to use the Royal Commission as the catalyst for a digitally enabled and integrated Australian aged care system.

Who knows, in a few years when the health care worker drops in to see their client at home, they might be saying “let’s check your blood pressure and your NBN bandwith”!

Dr Tim Smyth is a health management consultant, Adjunct Professor in the Faculty of Health, University of Technology Sydney and a former Deputy Secretary, NSW Ministry of Health.

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With a health system that is facing unprecedented challenges we need all the courage and all the insight we can get our hands on. Croakey is a space that invites us to to challenge and interrogate our practice and our policy. Croakey’s journalism and activism inspires me to remain optimistic.

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Change Day Australia

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