As part of our involvement in the National eHealth Transition Authority’s (NeHTA) aged care software vendor panel, we have collaborated with a group of aged care organisations to implement the software that will allow their facilities to access the national eHealth system.
The journey has inspired us to step back and take a closer look at some of the key challenges faced by these aged care organisations as they prepare to connect their facilities to the eHealth system. In this series of posts, Donwood Community Aged Care, Lynden Aged Care and mecwacare each share the challenges, as well as tips for other aged care providers embarking on the eHealth journey.
Understanding the terminology
We’ve previously written about the puzzling language behind Australia’s eHealth record system and trust me, you’re not alone in trying to understand the difference between HPI-Is, HPI-Os, PKIs and HPOS, ROs and OMO. We have discovered that most aged care providers are similarly challenged with understanding the language and terminology behind the national eHealth system.
Lyn Hornsby, Director of Care, Donwood Community Aged Care: The sheer amount of acronyms were probably the hardest thing to actually understand throughout the process.
Ann Turnbull, CEO, Lynden Aged Care: There are enormous challenges around understanding the exhaustive eHealth terminology including acronyms and numbers. The language is completely new, so you’re not completely sure what it is they’re asking for you to complete. The problem is, you don’t know what you don’t know and when you’re trying to ask for help, you don’t really know what to ask for.
Our tips: To help you better understand the puzzling language behind the eHealth system, refer to our handy glossary of the most common terminology, along with definitions and explanations. If you’re looking for more eHealth basics, you may also like to read some more essential eHealth information for aged care providers. Alternatively, you can call 1800 723 471 with your eHealth record enquiries.
Volume and complexity of documentation
Another issue that concerns the majority of aged care providers was the confusing process around the completion and submission of the required documentation.
Michele Lewis, Chief Executive, mecwacare: We believe the registration process for organisations is more difficult than it needs to be. We have allocated considerable resources in order to complete the necessary documentation and forms, and provide this information to senior management. It has definitely been a long process for us. For smaller, stand-alone facilities, there may be a reluctance to participate in the eHealth system, simply because they may not have access to the resources needed for the initial registration process.
Lyn Hornsby: I can certainly see why an aged care organisation would think it is all too hard. The registration process is far too cumbersome and there is just too much information. I was assisted throughout the entire registration process, and I still didn’t fill out quite the right amount of forms or correct forms that I needed to. A clear process on the requirements for document submission is also lacking. Each form must be sent at a different time throughout the registration process, and to different locations to further complicate things.
Our tips: Identify a key point person within your organisation who is interested in eHealth and can commit the time to familiarising themselves with the entire registration process, and oversee completion and submission of the documentation. This person can also act as the go-to resource for senior management and staff. Also, don’t expect to rush through application stages. Expect the completion and submission of necessary documentation to take time – a couple of months at minimum. Be sure to give your organisation sufficient time to properly complete the registration process. Medicare Locals are an additional resource that may also be able to support you in the completion of your eHealth registration forms.
Preparing care and nursing staff for changes
One of the greatest challenges associated with the implementation of any new technology is the fear of change from the employees’ point of view. As aged care providers make the transition to eHealth, change management will be vital in ensuring the success of the system.
Lyn Hornsby: Communicating the benefits of eHealth to care and nursing staff is critical. Firstly, if our staff aren’t interested in signing up for their own eHealth record, it won’t make the concept very enticing for residents. We also want staff to understand that the switch to an eHealth system will be the key enabler in providing them with greater visibility across residents’ health information. Once the staff realise that they will have rapid online access to things like discharge summaries, pathology results, and other important information uploaded by GPs and specialists, I think they will jump on board.
Michele Lewis: Many staff are keen and can see the benefits of eHealth however, others are concerned that it might cost them more time and be a duplication of their efforts. The focus should be on explaining how inefficient and inaccurate it can be to manually process information, compared with the potential of electronic handling of residents’ health information.
Ann Turnbull: Nobody really likes change so you have to give staff a strong reason for changing. If you can get them to explain the problems that they are experience currently, then demonstrate how an eHealth system will provide the solution, they will come on board. With that said, our staff actually have a very positive outlook when it comes to information technology. They have already experienced first-hand the efficiency gains of our electronic clinical, care and medication system so they are very accepting of the concept of eHealth, and can already see the tangible benefits.
Our tips: The successful implementation of eHealth will rely on a complete change management approach that considers preparation, communication, collaboration and support strategies for care and nursing staff, as well as residents. eHealth.gov.au recommends implementing the changes by breaking them down into small, manageable steps that provide immediate benefits and align with your organisation’s own circumstances and strategic objectives. Visit their website for more information on the suggested Model for Improvement (MFI) and other change management methodologies.
Selling the benefits of eHealth to residents
Another major challenge all aged care providers will face is getting residents registered. If residents’ fail to register for a Personally Controlled Electronic Health Record (PCEHR), the eHealth record system will offer few benefits to aged care providers so it is essential to educate not only staff, but residents and their families as well.
Michele Lewis: In terms of registering residents, the main challenge facing mecwacare now is providing the right information to residents and families about the benefits. There is a general lack of knowledge about eHealth across the community so our role at the moment is really to educate both residents and their families, and raise awareness around how eHealth will improve how we manage their health information. So far, we’ve held information sessions with residents and relatives, which were great forums and the messages were very warmly received by everyone. We have a very good relationship with our residents so they are generally very willing to get involved with new initiatives. Medicare Locals have also attended these meetings to assist in explaining the system and sign up processes and we’d recommend tapping into your own Medicare Locals as an additional resource.
On the downside, it is a very time-consuming process for our facility staff by the time we raise awareness of eHealth and promote the specific benefits to residents and their families. For this reason, I think there will be many facilities that will struggle with this process because it requires significant resources just in convincing residents and their families to register. In due course, it will be great to see residents already having a PCEHR before they enter the facility.
Lyn Hornsby: Once we do the initial work in terms of getting the existing residents registered, keeping the momentum going will be relatively easy because eHealth record registration will become a standard part of the resident admission process. In the meantime, I anticipate getting our current resident’s on board will be the biggest challenge. There are many residents (and facility staff) sceptical regarding the use of eHealth records, so it will be important to reassure them on the privacy and security of their information.
Our tips: Once again, it will be helpful to identify a key point person – or if the budget permits, a dedicated resource – within your organisation who can commit the time and effort to spreading the eHealth message to residents and their families. Use brochures, video, presentations and case studies to convey the benefits to them, which are all available from the eHealth.gov.au, NeHTA and Medicare Locals websites. This person can also assist in helping residents to physically register for an eHealth record, which brings us to the next challenge – assisted registration.
To learn more about the challenges associated with assisted registration in aged care and more, continue to part two of this post.
(Image credit: Danilo Rizzuti)