Webinar – National Aged Care data strategy consultation – 12 October 2022

Gregory Pugh:

Good afternoon everybody and welcome to today’s webinar on the National Aged Care Data Strategy. For anyone with us today who also joined last week’s webinar welcome back, and I applaud you on returning for round two.

I would like to introduce myself and my fellow panel members. My name is Greg Pugh. I am the Assistant Secretary of the System Policy and Evidence Branch in the Reform Implementation Division of the Department of Health and Aged Care. With us today we have Jason Fraser who is the Assistant Secretary of the ICT Strategy Business Assurance Branch also in the Reform Implementation Division of the Department of Health and Aged Care.

Louise York joins us. Louise is the head of the Community Services Group at the Australian Institute of Health and Welfare. And to round out the panel we also have Mark Booth who is a Principal at Nous Group.

Before I go any further I would like to acknowledge the traditional custodians of the lands on which we meet today. In Canberra that is the Ngunnawal people and I pay my respects to their Elders past, present and emerging. I would also like to acknowledge any Aboriginal and Torres Strait Islander people here with us today.

I just wanted to give you a brief overview of what the next hour or so looks like. So shortly I’ll provide you with an overview of the aged care reform context. Jason will then provide an overview of our whole of Government and health and aged care strategic ecosystems. Jason will also provide an overview of the work he is leading in relation to the Aged Care Digital Strategy, its alignment with the broader Aged Care Data Strategy and how that also fits in within those ecosystems.

Louise will then take us through the Aged Care Data Strategy and the National Minimum Dataset.

And finally Mark will take us through the Aged Care Data Strategy consultation approach. We’ll leave plenty of time at the end for questions and answers from the audience.

So in terms of housekeeping as I mentioned there will be a Q&A session at the end of this webinar. For any questions throughout the webinar please write them in the Q&A section available at the bottom right hand side of the screen. We will also publish written replies to any questions we receive throughout the session.

As I mentioned I wanted to do a little bit of scene setting around the aged care reform context. So the Royal Commission into Aged Care Quality and Safety provided the platform for us to enact change within aged care. In particular the final report requires us to create better aged care services and a better standard of care for older Australians. The current Government made aged care a key area of focus in its recent election campaign and has committed to implementing practical measures to ensure our aged care system meets the needs of older Australians.

The Government’s plan to improve aged care includes commitments to having a registered nurse in every aged care home on site 24 hours a day seven days a week, mandating that every Australian aged care receive 215 care minutes per resident per day, a pay rise for aged care workers, better food for residents and improved transparency and accountability for how Government funding is spent to deliver care and services to older Australians.

So underpinning all of that, data, digital transformation and capability are essential enablers to the aged care reform agenda. As I mentioned a little later on in the session Louise will be talking to you about the work underway to develop the Aged Care Data Strategy and National Minimum Dataset. But first I’ll hand over to my colleague Jason who will talk in more detail about the strategic context in which we are operating and the Aged Care Digital Strategy.

Jason Fraser:

Thanks Greg. Hi everyone. Thanks for joining us today. I’m Jason Fraser, the Assistant Secretary of the ICT Strategy and Business Assurance Branch. One of the questions we receive frequently is how does the Aged Care Digital Strategy fit with other strategies and objectives across Government? Such a great question. And in developing the strategy it’s been very important for us to take the time to consider carefully how the strategy sits within and complements the broader strategic ecosystem.

As you can see from the diagram on the screen it’s critical that this strategy follows the lead of the Digital Economy and Digital Government Strategies. The last thing we want is for one strategy or a set of particular measures that we’re implementing to work against the broader digital objectives of Government.

When we look specifically at the health and aged care strategic ecosystem as you can see is on the screen, it’s equally important to ensure that we are clearly delineating between the various pieces of work underway and that each strategy has a clear focus or particular outcome it’s striving to achieve.

So I just wanted to provide a short overview about the work we’re doing on developing an Aged Care Digital Strategy which we’ve called Digital Age.

The strategy primarily stems from recommendation 109 from the Royal Commission into Aged Care Quality and Safety which outlined the need for a strategy to guide developments in information and communication technologies. As a result the Aged Care Digital Strategy we’re developing will provide the aged care sector with a clear and purposeful vision of how digital will shape the aged care system from now until 2030. The primary objective of the strategy is to ensure that the needs of older Australians are paramount and more specifically that they’re well supported and that older Australians are provided with consistent and equitable access to information and services they need when they need them.

However it’s important that we also recognise the needs and objectives of all our partners in the aged care system specifically aged care workers, carers and family members, aged care providers, ICT vendors, Government agencies and departments. And relevantly the Royal Commission made an important connection between data and the systems that collect and transmit data.

The Royal Commission noted ‘Information and communication systems used by approved providers of aged care should operate so that information that is routinely collected for their own purposes can assist them to meet responsibilities to provide data, including for the national aged care data asset’.

So the Aged Care Digital Strategy that we’re developing includes five key principles to help guide our decisions, initiatives and investments.

Number one. The first principle is that the use of digital technologies should improve service reliability and trust. Number two, the focus on older Australians being at the centre of this work, they are well supported with consistent, equitable access to information and the services they need. Number three, that new technology improves operations with more time to deliver quality services. Number four for our workforce, that digital transformation supports quality care and an individual’s wellbeing. And number five, that there should be an open, competitive marketplace designed in partnership to support digital solutions that meet the needs of all partners in the aged care sector.

Another key component of the Aged Care Digital Strategy will be the development of an agreed enablement framework. This framework will set out very practical initiatives and activities required to realise the longer term vision for digital in aged care. The framework is intended to provide a platform for providers, workers and ICT vendors to participate in a collaborative way to genuinely meet the needs of older Australians. You can see here that each partner in the aged care system has specific needs from an enablement framework and that’s the key challenge, to ensure that all needs are reflected.

There will be many opportunities to engage on the development of the Aged Care Digital Strategy. So look out for further opportunities on the aged care engagement hub. Thanks again for your time and I’ll hand over to Louise York to take you through the Aged Care Data Strategy. Thanks Louise.

Louise York:

Thanks Jason and good afternoon everyone. So I’m Louise York. I’m Assistant Secretary for the Community Services Group here at the Australian Institute of Health and Welfare. And I thought I’d start with a slide that brings us back to what we consider the Aged Care Data System to be. And as you can hopefully see on the slide it comprises the comprehensive range of data related to aged care in Australia and the arrangements that support capture, use and sharing of these data.

It includes aged care data such as information collected by services and reported to the Department of Health and Aged Care and other data that’s highly relevant to aged care such as hospital data collected by state and territory Governments or Medicare data collected and supplied to the Commonwealth as a biproduct of Medicare services.

And importantly the system includes the data governance, ICT and infrastructure arrangements associated with the capture, use and sharing of these data such as the digital enablers just referred to by Jason. And so I’ve included this because it provides a bit of context for what we consider the Aged Care Strategy needs to drive improvements in.

So if we move to the next slide. The AIHW has been funded by the Department to work on several data improvement activities and key to all of these is the need to ensure that the strategy benefits all users of the aged care system and aged care data. So this includes older Australians and their carers and family members, service providers, Government agencies and secondary users of data such as research organisations.

The Royal Commission told us as did many reviews beforehand that aged care data is not fit for purpose. It’s fragmented and incomplete, of variable quality and hampered by inconsistent terminology, use and data definitions yet so much of it is collected and provided. Various recommendations went to the need for data improvements. In fact data improvements ended up being a component of a really large number of the recommendations from the Royal Commission. And as part of this the Department of Health and Aged Care and the Government has provided a four year funding commitment to develop an Aged Care Data Strategy and several associated data improvements that I’m going to talk about today.

The Data Strategy will drive the approach for developing and continually improving a comprehensive aged care data system that’s responsive to the needs of different stakeholders I just mentioned. It will do this by presenting and developing an agreed vision for the future national aged care data system, describing why data improvements are needed, what they are and how they’ll be implemented. The goal is that it will provide a unifying and coordinating strategy for a range of aged care data activities working towards the vision set out in the strategy via an implementation plan. And through this the plan is that it will drive the adoption of ICT, infrastructure and governance arrangements that support the legal, ethical and safe data supply, storage, linking and release so that this information is actually used to inform decisions at the point where those decisions need to be made.

The final version of the strategy will be delivered in June 2024 and developed obviously through the sorts of consultation we’re conducting today and it has seven core elements that will be developed between now and then. And some of those elements are on the screen now, the key elements that we’re consulting on during this period and we’ll come to the process for consulting later in the presentation.

So moving to the next slide. The Institute’s working on two key areas of data improvement that are central to the strategy, a National Minimum Dataset and an aged care data asset. And both of these activities will be informed by consultation.

The National Minimum Dataset will be a core set of standardised data elements for mandatory collection and reporting at a national level about aged care. The purpose of a National Minimum Dataset in this context and in any context is really to improve data quality, comparability and usefulness in aged care. So it should meet the needs of aged care data users by providing meaningful, accurate and consistent information to really increase the value of information that is collected and it does this by establishing data standards and supporting metadata for those who are collecting the data and then using it for subsequent purposes.

The plan is to develop the aged care National Minimum Dataset progressively with content added over time. The first step has been to use clear criteria to identify and prioritise items for the first version of the National Minimum Dataset, version one, and this version will then be refined through consultation and published by mid-2023. So that will be the first version of the NMDS with then a program of regular updates to enhance and expand the NMDS beyond then.

The data asset on the other hand will be a multi-source enduring linked dataset that integrates the core information about aged care with information from a range of other areas all relating back to a person. And the purpose of that is to bring together information that’s really highly relevant to aged care such as information about hospital services or income support payments and so on to look at pathways and outcomes for people who are using aged care services.

It’s just important to point out that the information in both the National Minimum Dataset collection and the national aged care data asset will be de-identified but have many benefits.

So if we move to the next slide. The key point of this slide is to highlight the point made earlier by Jason about the importance of reusing data that’s routinely collected for one purpose such as clinical care or administration of a service so that it can be used for other purposes such as monitoring the quality and safety of care in an aged care setting. And what it does is it just steps through our understanding that there’s a broad range of data that are collected for those multiple purposes in delivering care of which a subset are provided on to the Department of Health and Aged Care or the Aged Care Quality and Safety Commission or other bodies for various purposes, of which some of those data are then collated and brought together to help understand and monitor the aged care system through management and reporting for example at the Department of Health and Aged Care level. A subset of the data again are then provided on to the Australian Institute of Health and Welfare for inclusion in the National Aged Care Data Clearing House and across that spectrum we see the National Minimum Dataset as providing a common language about some of the core elements of that information that need to be repeatedly collected and that would really benefit from the availability of common data standards.

I’ll just close by saying that complementary to the activity on the National Minimum Dataset is a range of other work on the digital front that Jason referred to before. There’s work to create clinical information standards to guide better data capture at the point of care and a lot of work to improve the exchange of information between healthcare settings. And we’ll be keeping a close eye on that as we go about developing the asset, the minimum dataset and the strategy.

It's really, really important and we understand that all of these activities are pulling towards the same vision.

So with all of this in mind our key lines of enquiry during this consultation are really to hear from you about what success would look like from a data strategy. So we have some questions on the screen now about what future improvements to the aged care data system are important to you, what do you see as the most significant barriers and enablers to achieving those goals, and really what outcomes would you like to see and how do you see these as delivering real improvements for people.

So I will now hand over to Mark who will talk us through the next part of the webinar. Thanks.

Mark Booth:

That’s great. Thank you very much for that Louise. So hello everybody. My name’s Mark Booth. I’m a Principal with the Nous Group based in Canberra. Nous Group is going to be engaging and consulting with the sector alongside the Institute to really drill into those key lines of enquiry that Louise has highlighted in the previous slide. I’m going to briefly go through some of the issues around the consultation process that we’re going to be running and going through.

Prior to doing that I should note that we are very aware of the fact that the Institute has been consulting in various forms with the sector over the last 12 months and this consultation has already shaped some of the thinking and the materials that are going to be discussed during the consultation. It’s particularly relevant I guess because several of the organisations that are represented today and are attending this webinar are likely to have already provided written submissions about the Aged Care Data Strategy via the Department’s aged care engagement hub. So I’d just like to reassure people that we are very appreciative of all the input that you’ve already provided if you have and we’re going to make sure that it does feed into the consultation. So it’s not been lost and it will be used. So thank you very much for that.

In terms of the consultation that we’re doing we are really concentrating on three main groups of non-Government stakeholders who are highlighted on the slide in front of you. We’re going to be talking to providers, and that includes aged care service providers, workforce associations, the peak bodies and those organisations that provide services to the sector such as service delivery partners who work in terms of the IT systems, who provide HR services and provide finance services. We’re also concentrating on the research and academic side of things by hoping to link in and talk with universities as well as independent research organisations in the sector. And we’re also talking to research and associations that represent older Australians, importantly those organisations that represent carers, represent families and represent users of the system. So those are the three groups that we’re concentrating on.

In doing this work we recognise that each group has different contexts, they have different ways of approaching things and they have different levels of interest in the data strategy. So we’ve come up with a number of different consultation methods.

So we’re going to be doing multiple methods as we consult with people. We’re going to be doing webinars. Of course this is one of the webinars. This is the second webinar. We held one last Wednesday. But we’re also going to be looking at focus groups, specific interviews, one on one interviews with interested people, and we’re also launching a survey which will be widely distributed and we’re encouraging as many people as possible to complete and link in with.

So to just briefly go through each of those in session now. So the webinar that we’re all in at the moment, the idea of this is this is a high level information mechanism really to allow representatives of the Department of Health and Aged Care, the Institute and Nous to really go through the key aspects of what’s going to be covered during the consultation session. And as I mentioned this is the second one of the two that we are doing.

The next level down will be focus groups. These are small group sessions with specific groups, small groups of stakeholders. The idea of the focus groups really is to give people who are in the same areas the opportunity to provide insights and comment on the opportunities and barriers and any other areas that they wish to in terms of the Aged Care Data Strategy and we are going to be running those focus groups from now through to mid to late October.

We’re also going to be doing interviews with key stakeholders that are most likely to be impacted by changes. So these will probably be slightly more in-depth conversations with those that are most impacted by the data reforms that we are looking at. We are going to be doing these again throughout October 2022 and we will potentially go into early November but hopefully trying to get through them by the end of October.

The final way that we are collecting information is a general survey that’s available for all stakeholders to ensure that everybody has a chance to participate. Now importantly if you do want to participate in either a focus group or an individual stakeholder interview session there will be opportunity to register for this through an expression of interest. Following this webinar participants are going to automatically be given the opportunity if you choose to and click on the button to, to go through to the Institute web page that has both a survey link on it so you can complete the survey now and it will also have an opportunity to register your interest for a particular focus group through an expression of interest process. So that will happen automatically when the webinar finishes this afternoon.

And the outcomes? Well what we’re really trying to do is to talk to as many people as possible. As with any strategy it’s important to get that input into it. And after the consultations with the non‑Government stakeholders we’ll be working with the Institute to analyse the results and to feed those results back into the Institute to make sure that the insights that we find are reflected in the data strategy that’s produced.

So thank you very much and I think it’s time for Q&A now so I will hand over to Greg.

Gregory Pugh:

Thanks for that and thanks for all the people who presented before me just now. So we’ll go to a bit of a Q&A session. Just a reminder if you do have any questions you would like answered by anyone on the panel please pop them in to the Q&A chat in the bottom right hand corner of your Webex screen. I’ll start from the top. And with a couple of these I might start off with the answer and then throw to either Louise or Jason or Mark to answer in further detail.

So the first question that I can see there is:

Q:         Currently we have PHNs, LHDs, ACPRs, LGAs and then a number of ABS classifications which makes any health system planning including aged care infinitely harder because nothing quite overlaps. Are there any plans to align these?

So I’ll start. Yes. The Data Strategy would absolutely need to contemplate alignment of these geographies. We also need to consider how that would be reflected in the new Aged Care Act. Part of this will need to consider some of those specific geographical design elements that might apply specifically for some sectors. So for example PHNs and LHDs might better suit hospitals. But it might not just suit to make ACPRs into PHNs for example. But Louise did you have anything you wanted to supplement for that?

Louise York:

Just to say that this has been a problem or something we’re aware of for a long time. And in reporting we can map between all of those different geographies and on the GEN website we already report according to various – we let users choose their selected geography. So that’s a post-hoc way of addressing the problem through reporting but it doesn’t solve the underlying issue of the different planning regions.

Gregory Pugh:

Thanks Louise. And while you’ve got the floor there’s another one in here around – it says:

Q:         Like any good strategies outcomes should be measurable. So how will outcomes be evaluated and what process will the strategy undertake to develop an evaluation framework?

Louise York:

I think that it will be essential that there’s an evaluation framework for the strategy. So as part of developing it we’ll be considering what that evaluation should look like and what success looks like.

Gregory Pugh:

Thanks. There’s a question/comment.

Q:         Early focus should be made on better use of currently published data.

So yes absolutely agree with that. We are looking into streamlining and improving our analytic and reporting capabilities in aged care and that will be both for the public to use and also for researchers and secondary data users. That will help to generate insights and also for the Department to inform policy and future programs. So yes that’s a very good comment to be making.

I’ll move on to the next question. This one’s probably back to you again Lou.

Q:         What’s the plan for integration of state and federal health datasets within aged care data or with aged care data?

Louise York:

Well I think that that’s the key goal of the national aged care data asset, that it needs to bring together Commonwealth and state data as it relates to older people and particularly people who are using aged care but also beyond that to look at people who might be about to need aged care. There are quite a lot of developments in the country at the moment trying to improve integration infrastructure to make that easier and we’re hoping that with aged care we’ll be able to piggyback on some of those initiatives. But at this stage we’re really scoping what would be the most important data collections to bring together and looking at how we could do that.

Gregory Pugh:

Thanks Louise. All right. There’s one here on generation of reports. Jason I might start then ask you to supplement if that’s all right. So the comment again is:

Q:         We need to be able to generate reports at facility level.

And so yes agree that should be within contemplation of both the data and digital strategies. I think from my view we would need to make sure that appropriate privacy considerations are taken into account and adhered to. The National Minimum Dataset would specify a provider facility and person level data items and they ought to be reportable and useable amongst some of the other data domains. But did you want to add anything from a digital perspective Jason?

Jason Fraser:

Thanks Greg. I think the only thing I would mention is that we are aware that there’s variability in terms of digital system usage by providers. So not all providers are going to be the same. For example very large providers may invest a lot of money into their digital systems and have very sophisticated systems but on the other hand smaller providers or those located in remote regional areas may not have the same level of investment. So certainly in terms of our strategy the starting point is that we are aware that there’s a great level of variability in that provider cohort and we’re starting from that as our baseline.

Gregory Pugh:

Excellent. Thanks Jason. Mark this one might be for you. So the question is:

Q:         Are we planning to consult with the state and territory government aged care providers?

Mark Booth:

The answer there is yes. As we said before the aim is to consult widely across the non‑Government sector and that includes all providers. So certainly those state and territory aged care providers would be included within there so we are keen to hear there. We’re also aware that there are a wide variety of different providers and different provider models that come across the country. So once again we will try and reach out or we would be keen on people highlighting and contacting us to make sure that they highlight that they’d like to be contacted about this. So the answer there is yes.

Gregory Pugh:

Thanks Mark. Louise I might come back with one for you. This is quite a comprehensive question so bear with me. But it goes to diversity data. And so the question is:

Q:         There is limited or for many issues no data on LGBTI older people to guide in service planning and delivery. In 2020 the ABS endorsed the standard for sex, gender, variation of sex characteristics and sexual orientation variables. So will the ABS standard to collect data on sexual orientation, gender identity and variations in sex characteristics be fully adopted across the aged care sector including this project and especially for the National Minimum Dataset?

Louise York:

Thanks. That’s an excellent question. We are very supportive as a statistical agency of course of that standard and very familiar with it and working as an organisation to try and see that implemented wherever we can in surveys or minimum datasets. I think at this point it’s an implementation issue mostly. This seems to be the main barrier to collecting information there and what we need to be looking for is a pathway similar to how Indigenous status is now routinely collected. We need to look at how you could sensitively collect information about this in the course of service delivery. There are similar issues with questions on disability. So a long answer. There’s an issue around mandating collection of data and there are some issues to work through. But if it was included it would certainly need to use the established classification that was worked up in excellent consultation with the LGBTI community.

Gregory Pugh:

And this is obviously quite a topical question. This one came up at last week’s webinar as well. Probably to supplement your answer as well we have been engaging through our diversity consultative committee on this. So it’s well known and we’ll make sure that it is captured to the extent that it can be as part of this work.

All right. We might go into the next one which is a question around whether MPS sites will be included as part of the strategy as they provide residential care. Yes. The answer to that one is they will be. Or data collected through the MPS sites will be captured by the strategy and the NMDS.

This one might be back for you Louise.

Q:         Are there any plans for introducing the national aged care data assets into MADIP?

Or maybe the question there is what’s the relationship between what we’re doing and what already exists within MADIP?

Louise York:

Thanks. And for those who don’t know what MADIP is it’s the Australian Bureau of Statistics system. It’s called the Multi-Agency Data Integration Project and it brings together a whole range of Commonwealth datasets and integrates them. What we would hope is that we will be able to draw on those datasets rather than MADIP itself to bring together the relevant state data and aged care data into an aged care data asset. So in other words we use what has been done for MADIP but not add it actually into MADIP which is already a large Commonwealth only asset effectively. And we’re working closely with ABS on this, on the pathway forward.

Gregory Pugh:

Thanks. Again this might be another one for you actually. But the question here is:

Q:         Is there an opportunity to review the ANNSIC classifications to provide more disaggregation?

Louise York:

I think that’s a question about more disaggregation in workforce and it’s just tapered off at the end of the question. Yes we will use this process to ask for more disaggregation in the workforce classification that’s used to collect information about Australia’s care workforce. And for anyone on the line who doesn’t know it is an ongoing issue around trying to distinguish different players in the care workforce, aged care, nurses working in aged care versus disability care, that sort of thing.

Gregory Pugh:

Thanks. There’s a question here from OPAN around whether or not we plan to use the national aged care data asset to report on consumer pathways in aged care like the 2014 PIAC link map. I might give that one to you to answer. I mean I would think that reporting on consumer pathways would be exactly what we’re planning to do through the data asset but potentially up to you to speak to the future of PIAC itself.

Louise York:

Thanks. Yeah. So the pathways in aged care link map was the early version of an aged care data asset and we’re really hoping – and what it does is bring together information at a person level about people using aged care across different programs from assessment through to residential aged care and it also includes information about cause of death. And we’ll be able to re-use and enhance that information. Importantly at the moment it doesn’t include information about hospital care which is really important to look at that interface between aged care and hospital use both from a quality point of view for people for example in residential aged care but also in the community, to look at hospital care and hopefully Medicare and pharmaceutical use.

Gregory Pugh:

Thanks. Jason there’s probably two here for you, one that I think fits nicely with your overview at the start around the ecosystems and then also one that’s specifically requesting an answer from you so we’ll definitely let you take that one. But the first one is:

Q:         There’s a bit of a lead time before the Data Strategy is planned to be officially released. How are we making sure that all the initiatives across the Department of Health and Aged Care, the AIHW and Services Australia and probably more between now and mid-2024 are strategically aligned to make sure that investments are being focused in the right areas?

Jason Fraser:

I mean certainly as I outlined with the Health portfolio ecosystem we work closely with Services Australia. Not only Services Australia but the Australian Digital Health Agency also and our colleagues within the Department who are working in the digital health space to make sure that the systems that we’re developing on behalf of Government are interoperable, work well together. I think there’s a way to go in that space but we certainly work together quite often to make sure there’s cooperation in our investments and developing platforms. Was there another question Greg?

Gregory Pugh:

Yeah. And so the second one was:

Q:         Jason will you be building strong systems and data for more able providers that have more complex systems or greater capability to enable implementation quickly and first and then giving others time to catch up?

So usually things are done the other way around which really slows down the entire digital transformation. So I guess it’s are you going to help those providers who have shown a greater digital capability at the start, for them to lead the way and then let them sort of set the benchmark and for other providers to then catch up from there?

Jason Fraser:

That’s such a great question because I think when we say that we acknowledge there’s a great level of variability in terms of digital use in the aged care sector there is some really good work being done and there’s some really innovative approaches to the use of digital in aged care. I think what we need to do in terms of establishing the enablement framework is we need to actually help those businesses who are kind of leading the way to showcase what they’re doing and to share their experience with the broader aged care sector provider cohort in particular. So I agree we certainly don’t want to hold back that innovation and those providers who are really leading the way. We want to showcase it and we want to actually use that to build the sector capability over time.

So I think that’s such a great question and it really speaks to what our fundamental goals and objectives are of the Aged Care Digital Strategy. It’s a great question. Thanks Greg.

Gregory Pugh:

Thanks Jason.

So we’ve got a couple here. Probably one back for you Lou and it might be a lead on from an answer you provided earlier. So this is around whether aged care consumers’ health conditions and disabilities be reflected in the aged care data collection and reporting, and this will provide better insights on whether services are appropriately supporting consumers.

Louise York:

Yeah. So I think this has been the most common theme of all discussions, has been how to get better information about the health conditions, disability, functional needs, support needs of people seeking to or actually using aged care. So it’s one of the highest priorities for us and it’s why I mentioned earlier that it does involve lots of careful thought about which are the best terminologies or classifications to use that make the best use of how people are currently capturing information. So we think that’s of the highest priority, is that information. It will be really important not only for managing care but for also looking at risk adjusting things like the quality indicators that are being collected so that you have fairer comparisons.

Gregory Pugh:

Thanks. We’ve got one here on oral health.

Q:         Will there be an oral health component in any of the reporting frameworks? At the Australian Dental Association oral health in residential aged care is a major area of concern and datasets in this area are scant.

So I might start. So we know that oral health particularly for people living in residential aged care was quite a focal point of the Royal Commission. There were some specific recommendations that were made around establishing a seniors’ dental scheme. So I would just say that we do collect some data where it’s relevant in the aged care assessment process and the strategy would and should contemplate opportunities for how we better expand and collect those particularly in the residential aged care context. But did you want to supplement anything on that one Louise?

Louise York:

Only to say that oral health data is one of the more problematic areas in Australian health information. Similarly a lot of information on allied health. And this potentially goes to another question that I can see has been raised there about making best use of existing data, so data that’s already collected and bringing that together with data that’s collected as a biproduct of what’s happening in aged care. Unfortunately in the case of oral health data there’s no readymade dental data that can be brought in but that’s something that we can and should be looking at. And I think that we should capture that as part of all of the allied health data that’s required to provide good care and to monitor good outcomes.

Gregory Pugh:

I think that probably segues nicely into some of the other questions we’re getting around workforce. So in particular:

Q:         Are there any plans to include information about aged care workforce in the data strategy?

Yes. That’s a priority for us, to include both in the strategy and in the NMDS.

Okay. So there’s a question here around:

Q:         Will aged care data be able to look at aged care healthcare as a continuum of care from primary to secondary care?

That one takes the record for the most mentions of care in one question. But Louise did you want to have a go at answering that one?

Louise York:

Yes. And again I think in our mind that’s really the aim of an aged care data asset is that it follows a person in a deidentified way – I’ll just reinforce that – to be able to look at different pathways and use of different forms of care. So being able to look at journeys of different access to general practitioners, use of emergency departments, admissions to hospital. Anywhere where data already exists in the health system should theoretically be able to be brought together to look at how people are accessing those services. Obviously you also need information about outcomes and that’s where new data is required and in some cases is being developed.

Thanks. There’s an interesting question here from earlier that I missed.

Q:         Is the NMDS in any way modelled on the NMDS that the US Department of Human Services requires of subsidised aged care providers over there?

Louise York:

Yes. I think that question might be referring to the interRAI collection that’s used in several countries and has really useful and interesting information about clinical care needs and health conditions and all sorts of things. And we’re definitely having a close look at that as part of the NMDS development.

Gregory Pugh:

Thanks. There were a couple of earlier ones that I actually inadvertently missed so apologies to those who posed those questions. I mean we’ve talked about standards and classifications review. There’s one in here around whether there will be an opportunity to review the ANNSIC classifications to provide more disaggregation across the care sector. And the example given here is that home aged care is not identified separately and is considered part of social assistance. So that one for you as well Lou?

Louise York:

Yeah. And that’s the one I think I was answering before but it was a shorter question. But it’s definitely part of the – there are many things we’re looking at to try and improve workforce data. And going back to an earlier person’s question we really want to look at making best use of data that’s already collected to get a better handle on workforce issues rather than having to ask providers to supply extra information or at least to only ask for the marginal information that’s needed to supplement existing information. So there’s some possible opportunities there but it only goes as far as the classification allows at the moment and it has had some problems that we’ll certainly be advocating for those to be fixed.

Gregory Pugh:

Thanks. There’s one here that goes to reporting. This is around whether or not the data will be captured in a way that won’t further burden the frontline staff. So I mean there is a large recognition that with the aged care reform agenda there has been additional reporting obligations placed on providers and their staff. The question here is:

Q:         With the additional NQIs, with food reporting, SIRs, NDIS and now finance reporting, residential aged care facility staff are spending a significant portion of time reporting to different avenues already so it will be great if there is avoidance of duplication for reporting.

Yes. This is something that we at the Department and AIHW are all very, very cognisant of. I think Louise it might be beneficial to explain just what the NMDS will do in terms of setting the standards for collection of information and how that should actually make life easier in terms of what we report on and how.

Louise York:

Thanks. Yeah. So the plan is that – there is a lot of information that’s coming in, all the different programs that are mentioned in the question. The NMDS should aim to provide common information standards so that if information is collected repeatedly across those datasets it’s always requested in the same way. But the whole strategy and thinking of aged care data as a system view should also provide opportunity to then go back and hopefully reduce burden, collection burden by removing things that are duplicated potentially across programs. So they’re a couple of ways we see that burden as being reduced. The standards also – by really being clear on information standards they should be able to be built into software over time. And I think there was another question about lead time. That’s the importance of having a long lead time before mandating collection of new information. And that’s why the first phase of the NMDS really is focusing on things that are already collected. It’s just trying to put more rigour around how they’re collected and understood.

Gregory Pugh:

Jason is there anything you wanted to supplement from a reporting front? I mean you might have already covered elements of this in your previous answers.

Jason Fraser:

Thanks for throwing to me Greg because I really did want to say that in terms of the Digital Strategy we’re really conscious of the kind of administrative burden that is imposed on aged care workers. And as far as possible one of the principles of our Aged Care Digital Strategy is to make sure that aged care workers have more time to spend meaningful time with older Australians and caring for them. So the systems should be intuitive to use, easy, they should be interoperable and they should require the information is only entered once and used many times.

I should also say that we did receive some funding from Government in MYEFO last year to develop a business to Government capability which is in the pilot phase. Really that’s seeking to streamline the transmission of things like compliance and financial reporting from providers into Government, into the Department, and really to ease the administrative burden on aged care workforce so that they can actually spend that meaningful time with older Australians.

Gregory Pugh:

Thanks Jason. We’re drawing close to time. I think the opportunity to wrap up sort of three questions into one because they’re all sort of semi-related. So one goes to whether or not there is an intention to link in AN-ACC data. Yes. Absolutely. As the new residential funding model we would absolutely want to be making sure that we capture that data as part of the Data Strategy and the National Minimum Dataset.

But there are also two here around whether the strategy will engage with and share data – sorry.

Q:         Will the strategy engage and share data with the NDIS on younger people living with disability in aged care and will it also draw on the carer gateway data from DSS in relation to carers and use of services such as planned and emergency respite care?

So I mean the answer to those ones for my mind is that yes you would have to have those within your frame of reference for the strategy and NMDS. We know that younger people in residential aged care in particular, the former Government and also all levels of Government set specific targets to have as close to zero as possible for younger people under 65 living in residential aged care. But Louise did you want to supplement that from either the younger people or the respite care front?

Louise York:

Sure. Yeah. On the NDIS front the AIHW is already doing some work linking together the information about younger people in aged care with NDIS data. We’re still going through the ethics approval for that but that’s in train as all of the objectives of reducing entry and stays for young people in residential aged care. So that’s a good step forward and again illustrates that at the moment at least in a fairly piecemeal way you can bring together data about aged care and other services but what the aged care asset needs to do is make that a much more standard and streamlined approach so that people know what’s available and there’s a good plan for how to keep enhancing that over time to get the best possible picture of some of those interactions.

Gregory Pugh:

Thanks Louise. Okay. So we’re at time. I wanted to thank, a big thanks, to everyone who came along to this webinar and who asked questions. Please note that you will be directed to undertake the survey. If you have time please do. And if you would like to sign up for a focus group or to be part of any further consultations on the strategy or the NMDS from here please make sure you visit the aged care health engagement hub to do so and also the GEN aged care website.

Thanks everyone. Look forward to speaking again with you soon.

[Closing visual of slide with text saying ‘For more information, please visit: www.gen-agedcaredata.gov.au/Data-improvements’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Australian Institute of Health and Welfare’]

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