Digital Transformation Tech Talk – 25 October 2022

Janine Bennett:

Hello.

Hello all. Thank you for joining us for this our fifth webinar in our Tech Talk series run by the Digital Transformation and Delivery Division in the Department of Health and Aged Care. My name is Janine Bennett and I'm the Engagement Lead for the Transformation Program and I will also be today's event moderator.

Welcome to everyone joining us today from your offices and homes across Australia and overseas. I'm joining you from Canberra, Australia, the lands of the Ngunnawal people and would like to open our conversation today by acknowledging these and the many other Traditional Owners of the lands on which we meet today and to pay my respects to those cultural leaders past, present and emerging. I would especially like to acknowledge the presence of any Aboriginal and Torres Strait Islanders joining us. It's an honour to have you with us.

Shortly I'll hand over to Fay Flevaras, the First Assistant Secretary leading the digital transformation for aged care on behalf of the Department but first just to cover a couple of quick housekeeping items.

Firstly please note this webinar is being recorded. The recordings are made available on the Health website as soon as our captioning is completed. That usually takes us about a week or so after the event for that to go live.

If you have any technical difficulties during our presentation today we do recommend that you use a phone line to dial in. These details are all available in your invite, the phone number and the access code that will allow you to get back in. So if you have any troubles that's a sure-fire way to not miss any content.

As with our previous Tech Talks we have secured a block of time at the end for questions and answers. You can raise questions in the Slido app. Typically that shows in the bottom right-hand of your Webex screen. Just go ahead and type your question in Slido and click submit so your question can workflow its way through to becoming a public question. If you see questions raised by others that you like the look of definitely vote them up in Slido. We'll try and get to those most popular questions first.

As always I would encourage anyone raising questions to join us on the virtual stage so they can ask the questions themselves. To do that submit your question using your name rather than submitting it anonymously. We promise that we'll give you a fair warning before we invite you to stage so you can prepare and get your video turned on.

Now I know that asking questions can sometimes feel a bit nerve wracking on the stage but it really does make for a better conversation for everyone if we get you up and have a real discussion. And I promise the panellists are a really friendly bunch. They'll probably be just as nervous as you are so we might as well share those nerves together. If you are feeling shy though don't not raise a question because you don't want to come to stage. Just simply write 'no stage' in the question and I'll be happy to ask the panellists on your behalf.

As always we've got a really large group. We'll get through as many questions as we can.

So that's it for housekeeping. I'll see you again during Q&A but without any further ado I'll hand over to your event host, Fay Flevaras. Thanks.

Fay Flevaras:

Thanks Janine. And hello everyone and great to have you with us again for our ongoing Tech Talk webinar series. We have another packed agenda for you today. And we have Ian Frew, the Chief Information Officer from the National Disability Insurance Agency joining us today to talk a little bit about their agency's transformation journey. Then Ian and I will then have a bit of a chat around the potential future of provider management and some of the overlaps and synergies that we see as opportunities for the two organisations and then we'll get an update from our business colleagues on Star Ratings. So as always our panel of presenters will be available for Q&A before the wrap-up. So without further ado let's move into our digital transformation update.

Tonight there's the new Budget for 2022-23 will be released. And while we have a lot of work underway from the previous Budget we're expecting new investments for aged care. So looking forward to giving more of that in our next Tech Talk. But we don't have those details today because the official announcements will happen tonight but we invite you, our policy colleagues, to come along to our next meeting in December.

We're aiming for around the 6th at the moment which will be our final meeting for the year. We can talk about the work ahead and the timelines for the aged care transformation program for next year but also a bit of a year in reflection to see just how much good work we've done this year. But for now I'd like to show you our current status in terms of the digital transformation.

Next slide. Excellent. Thank you.

So for those of you who have not attended previous Tech Talks you may not have seen this. But for those that have you'll remember seeing a high-level release timeline that we put out there from a technical, digital perspective. As a reminder and for any of the newcomers we're using the high-level plan as a guide to outline some of our immediate priorities and linkages and to track some of our progress along the way with you guys.

As always and note this is draft timelines and subject to change based on policy and program decisions. So official announceables will always come from the Minister's office. And also any policy areas and business areas will be for the official dates.

The policy work is often evolving. And so that's why we want to make sure that we let you know that shifts are always probable and that priorities move depending on how we're going with the implementation.

But from an ICT perspective we want to keep sharing the current plan and ensure any shifts are clear and visible. And so as always we're just trying to keep the conversation going but the commitment around exact dates and details is always something that we confirm as we need to.

Some deliverables to talk and call out since we last met. We did a back-end identity access management system to uplift some of the permissions capabilities that we're going to need more and more and to support the upcoming extended representative work that the business are looking at. We also did an integration update around our systems to enable a consistent experience with Services Australia's new released myGov blue portal that people may be aware of.

But the big-ticket news is that the latest AN-ACC release has now gone live. And so for newcomers AN-ACC is the Australian National Aged Care Classification Funding Model. At our last webinar we had Mark Richardson and Amanda Inglis from the Health and Aged Care Department and also Jackie Horton from Services Australia who came along to talk to us about their planned AN-ACC releases and the readiness of the engagement with the sector that they've been working with.

We introduced new functionality and improvements to the AMO assessment portal and our app, the comprehensive assessors portal and their app and the service provider portal that Services Australia has.

I'm pleased to say that earlier this month the AN-ACC release went live. This represents a massive deliverable for our transformation program and it was two years in the making.

So congratulations to everyone involved. This includes both business and IT in the Department of Health and Aged Care, our partners and Services Australia and Quality Safety Commission from government. But importantly also a big thank you to you, the sector, who have adopted the new change and to your software providers who supported the changes in their software to make it all happen. So we did this together. Getting things done, across the line for quality on time and it only happens with you so thank you very much.

But the aged care reform is a big agenda and so we continue to focus on the next set of priorities. And so what is on our agenda next?

We quickly approach the end of this year and the answer is we've still got quite a lot to do. So it's going to be a busy couple of months before Christmas. And at the end of the month our warranty release, the large major release will go live. This includes any small fixes or enhancements we needed to some of the new capabilities that we introduced earlier.

They span across a number of different enhancements around AN-ACC, expanded representatives, some of our serious incident response reporting, enhanced carers gateway, special verifications and more. So as you can see we're constantly iterating, making sure we're testing and learning and deploying as we go.

But coming up before the end of the year we also have quarterly financial reporting, technical deployments. We have technical foundations release scheduled for the end of November for a provider trial that we'll use to run the sector to assess the usability of the new provider management system. We also have Star Ratings and quality indicators. So there's a lot more happening on the new platforms that we're introducing for Salesforce. We've also got the business-to-government gateway beta releases planned for early December. So as you can see the list is long. We also have some of our decommissioning of older systems as we continue in the background for our Aged Care Data Warehouse.

So moving on to the next slide. I wanted to also take a minute to cross-promote some of the engagement activities being undertaken by our policy colleagues in the Department over the coming months. And these are really, really important. This gives you guys the opportunities to provide your feedback in some of the policy that they're thinking about and it's their consultation with you.

So first in the Support at Home policy area a new discussion paper has been released for the public comment. The focus of the paper is the new program for in-home aged care. So looking at the four government-funded programs that help people stay in their homes for as long as possible today these include the Commonwealth Home Support Program, the Home Care Packages, the Short-Term Restorative Care and the Residential Respite one.

The intent is to design a new program of service that make access to care faster, easier to understand and navigate and to make sure that older Australians get the highest quality care and help they need. So to design this new program our policy colleagues are starting out by listening and talking to the grassroots people who use and deliver these services. So to that end a range of public consultation sessions are available from now until late November.

The Department has also released a short-term restorative care survey for providers and care recipients to hear about their thoughts and experience with the program. So the team will provide an update on the progress in our third webinar around Support at Home scheduled for early December. You can see the dates on the slide. That's a webinar led by our policy colleagues. Not to be confused with the Tech Talks. But we always like to make sure that we're cross-promoting within government so you guys can see we're one government and that you're getting the information from multiple sources. Finally we targeted discussions with the industry stakeholders of their plan to commence in February next year.

More broadly in the interest of cross-promoting the important engagement work being undertaken by our policy areas, a reminder that the online Aged Care Engagement Hub is the best place to go and get up-to-date news on the programs of policy work and consultations. And there's quite a few out there at the moment so we just wanted to bring these to your attention. These are all publicly available information regarding aged care policy reform and it's available on the site, including their upcoming consultation calendars and the ability to subscribe to the fortnightly aged care newsletter.

So we want to ensure a strong link between the policy work and our digital transformation, the what and then the how. So the enabling IT pieces of policy puzzle as you could say that comes in underneath. We also want to make sure our Tech Talks are promoted on the Engagement Hub webinars page and in the aged care newsletter. So keep an eye out for all of those things to come.

So that's enough about where we're up to in our transformation, the lot of work that we're looking at together with you.

I would now like to make you a little bit more aware that there is a lot of work proceeding in Health but we know that other agencies across the Commonwealth are just as busy delivering on their Ministerial commitments and plans. And so part of our Tech Talks is to have other agencies come and speak to you about what they're doing. And I don't want to pretend that it's easy but as part of our public engagement plan we make connecting across government a big priority.

We've had visiting speakers from Services Australia. We've had regular invite representatives from Australian Digital Health Agency to these events. And in fact we have Laura here today from ADHA on our Q&A panel. Thank you Laura.

And in that spirit of cross-collaboration I'm really pleased to have Ian Frew joining us from the National Disability Insurance Agency. So Ian is the Chief Information Officer at the NDIA. Having worked across Asia, Europe and the USA and of course in Australia Ian has proven a track record of delivering transformations and digital strategies.

I'm keen to share with you the conversation Ian and I had around potential for cross-government solutions for the providers working in our sectors of interest, both in aged care and disability. But before we do that I'd like to welcome Ian to the stage so he can share with us his IT transformation journey being undertaken at the NDIA. So welcome Ian.

Ian Frew:

Thanks Fay.

And yes it's been quite a journey. So over the past four years the NDIA has been executing a massive transformation program. And I will attempt in about 10 minutes to cover off what, the how, the why and possibly some lessons that if anyone listening plans to go down a similar path.

So for a start what's been delivered to date? Well first of all two years ago the NDIA launched a fully accessible mobile app for our participants to view their budget and to make claims. Then 18 months ago we launched the Specialist Disability Accommodation on our new Salesforce platform and this year we've piloted a new accessible participant portal. So now following a 70-week build we'll shortly be commencing a pilot with the new CRM underpinning the day-to-day operations of the agency with a national rollout in the new year. If that wasn't enough, in parallel to all of this we've also been rolling out a new network and physical and desktop environment.

So the past four years have been a bit of a rollercoaster. To understand how we got to today we need to go back about six years. The NDIA went into what's known as full scheme in July of 2016. It coincided with the launch of a new CRM built by DHS, now Services Australia, to the NDIA's requirements.

The NDIA back in 2016 was very new. Most corporations and large government departments have been around for 30 to 50 years or more. This means that they have an inherent maturity, they know what has to be done and they've developed national processes. The NDIA in 2016 was still very much getting on its feet. Their new CRM was primarily built to provide the initial plan to participants and not much more.

By 2018 the NDIA learnt enough to be able to articulate a business strategy and operating model but they also realised that over 50% of their work was done off-system and we started to address this. By 2019 however it became clear the existing CRM could not be modified fast enough or cost effectively to meet the business demand.

So the board approved our first strategy and the approach to market for a new CRM, not as a replacement but as a case management layer over the existing one. We could therefore bring more work on-system while still enhancing the core CRM which was to remain our system of record.

We also commenced looking at a BYOD strategy to allow our partners in the community - these are third-party organisations which make up approximately 50% of our workforce - to use their own device while still accessing the NDIA systems.

So why did this turn into a transformation? The tipping point was the need to make the participant plans more flexible with more fungibility. The existing CRM was essentially hard coded in this respect so this change would be both exorbitant as well as very high risk.

By mid-2020 the business had also matured significantly and was able to articulate a new streamlined planning and delivery methodology. But before we could start any development we had to onboard all of our build teams right in the middle of COVID. The first drop was the delivery of the Specialist Disability Accommodation, SDA, in February of 2021 which up until then had been handled manually.

The major build took 70 weeks and by the time we went into code freeze a couple of weeks ago we had developed almost 1,900 stories. Throughout the build however we continued to provide business benefit. For example we provided email-to-case for the contact centre. Plus our new environment allowed us to move much quicker and support urgent priorities such as the hospital discharge work.

Meanwhile the BYOD initiative had also been influenced by the move to the new CRM. The NDIA needed to stand up additional systems - logging, monitoring, document storage - and therefore needed to control its own network and hence its own desktop. The timing for the NDIA was just right. For once Sod's law actually worked in our favour. These days the cloud and cloud vendors are now able to deliver promises made over 20 years ago. You get Zero Trust out of the box, infrastructure as code, can use a standard no-frills NBN digital network, sovereignty issues are mainly solved. And companies such as Salesforce have committed that anything not WCAG 2.1 AA which is the international accessibility standard then they consider it as a bug and have been honouring this which is great. Large cloud providers also connect you to their worldwide seams with invaluable insights and protection.

I'm not pushing or promoting any particular vendor but for those interested our environment consists of the Salesforce Health Cloud, Microsoft manage our desktop both physical and virtual, we use both Azure and AWS, we expose older systems still hosted by Services Australia by Zscaler and we have Cloudflare over the top.

So if you're going down this path what are some of the key decisions you need to make? The first one would be do you use a system integrator. The NDIA chose not to engage in SI. I've got nothing against SIs but I do believe you need to own your own environment. Whether you use an SI or not you must take it over in the end.

No one knows your company's business like the people who are working in it all the time. And IT needs to own the business relationship and understand what they want and why and provide them with options. An SI can in some situations come between you and the business. You also need to be if you're in IT part of that discussion for the SME selection.

So what processes are you going to use such as Agile, Waterfall or what? Well pick the process to suit your organisation. I personally always go down the Agile over Waterfall thing but simply because it involves the business far earlier and you can get continuous feedback. The issue is Agile can come with many zealots. I have no time for zealots. Agile is a process, not a religion and zealots can cause massive disruption.

Whichever process you elect, modify what the book says to suit your business. The three key things are everyone - business and IT - need to know what that process is. Secondly everyone needs to use the same nomenclature. And then thirdly you need to have a common central repository of all artefacts preferably online. These three things are absolutely vital in large organisations with departments in different locations.

So what are the other things you need to consider before going onto a true transformation? Well the key thing for me is that transformation is not a light switch. You don't rush into a transformation. Is your business and your IT ready for such a significant step?

If you think about the NDIA's journey we knew we had to do something but it took us over two years to say no this is what we really need to do. And so there was many debates both at ELT and board before we decided to go down this path. Most organisations, however nimble, will take between 12 to 18 months to get into a rhythm.

You need commitment from all areas and I'm pleased to say within the NDIA we had this. So for example your main business sponsor needs to be able to commit that they're going to spend 25 to 50% of every one of their days on the transformation. If they're not then don't start. Your CEO or department secretary needs to commit that they are going to spend some part of each and every one of their days on the transformation. If they're not then do not start. If your ELT sees this as an IT program, run.

Transformation by its very definition is doing something the organisation has not done before. So it's not a system replacement. Again two things to be careful about. First of all you need the right SMEs. SMEs are the people who know how everything works but be careful they don't decide to rebuild the present. This can happen if they feel their importance might be diminished if they're no longer the expert.

The second and most important one is that transformation means massive ambiguity. Many people are great when they can follow the road but as soon as that road disappears then they can struggle. People who cannot handle ambiguity should not be in transformation leadership roles.

Be aware of the extent of changes due to your transformation. Certainly within the IT space you will be touching identity, monitoring, alerts, storage. You also have many third-party relationships. But from the business side, apart from needing to provide requirements quickly in a consumable way for the IT squads, it is a massive change management exercise. For many staff their daily job will change. Your IT staff's job will also change. And it's a funny thing about change, everyone's for it as long as it doesn't affect them.

Don't customise. It's very hard to do but there's massive and obvious benefits if you pull it off and we've all heard the horror stories. If you employ a lot of developers the funny thing is they'll want to cut code. So balance your squads. We actually lost some very good people because they deemed our work was too boring. We were very much configuration only. But the payoff's been massive because we've already gone through a number of significant upgrades and they've all flowed through overnight, nothing for us to do. So we use the old adage 'reuse before buy before build'.

Nothing succeeds like success. Deliver something early to whet the appetite like we did with SDA. Deliver incremental benefits. So we did email-to-case and hospital discharge. This might be considered a distraction to the main game but it's absolutely vital that the business both sees something and actually starts getting excited as to what's coming over the hill.

Finally build for all Australians. I know we all say we put the customer into the centre of everything we do but do we? How many times do you feel that you've got to understand how a business is structured internally before you're able to interact with them? This is why we're very supportive of the provider work phase leading from the Department of Health which we'll be talking about shortly.

An example from our side would be when we were considering the participant mobile app we actually before we did anything else we sent the UX and UI team around Australia where they interviewed, videoed and recorded literally hundreds of participants so that we understood what they wanted and how they could access it.

So this is a really important point. Because if you look at standard usability, you plot of all your customers and you end up with a bit of a bell curve and you say chop off 10% on one side and 10% on the other, you focus on that centre 80% and if you get that right then you're looking good. The trouble for the NDIA and the NDIS is that the 10% you chop off on each side are generally our participants.

And this was really brought home to me when I was looking at one of the findings we had. And they'd interviewed one of our participants who had mobility issues and this person was in a wheelchair and couldn't move their hand. So what they would do to use the mouse and computer is they'd actually rest their hand on the mouse and then manipulate it by moving their wheelchair. So if you're designing something where you need the participants say to login to quickly enter a six-digit code then that's going to be something very hard for this person to do.

So what have been the outcomes? Well the participant community has actually reacted very positively to our mobile app. I checked again last night and it's still sitting at a 4.2 rating in the Apple store.

Simple things like email-to-case has made the contact centre staff more efficient and effective. And with respect to our 70-week build the feedback from the business has been extremely positive. Obviously we've done multiple drops and we've done multiple mini-UATs and so we've collected feedback all along the way. And I actually met the finance UAT team last week and I said 'How's it going?' and I was very pleased when they just looked at me and said 'This is awesome.' So hopefully we've done it all right but the proof of the pudding will be when we launch the pilot.

As a bit of an epilogue the good thing of working in government is you can share things across departments which is a great bonus. We've always worked very closely with Services Australia but it's true to say that they were somewhat sceptical when we started our cloud journey. However after seeing what they were doing they actually asked if we could give them our operating environment's configuration. Which we did and now they are actually rolling out the equivalent of our future operating environment and planning on rolling that out throughout Services Australia. So I really feel that in some ways David has influenced Goliath.

So I'll finish there and happy to take any questions. Thank you.

Fay Flevaras:

Well thank you Ian. And there were just so many invaluable insights there that I think that we can all take away, all from being human centred and actually concentrating on that 10%. If you can get it right for them you can get it right for everyone to be honest.

And at Aged Care we did take a copy of your WCAG work that you've done to make sure that we've learnt from that and that we start out with that as the bare minimum. We don't necessarily need to reinvent that wheel. And so there's a lot of what you've been doing that we're learning from and making sure that we apply here. So thank you so much.

I might just move into the next bit and save the Q&A for later if that's okay.

Ian Frew:

Sure. Yeah.

Fay Flevaras:

And you touched on it in your presentation. You're very focused on the participant side of things so far. And you and I have been talking about the work we've been doing in aged care around the provider piece.

The problem we're trying to solve I think is that we know that the demand on care and support services is expected to grow significantly over the next 10 years. And a number of departments are working with providers to deliver government support services. And often in our different departments we're working with the same providers but we ask them to do things slightly differently. And we know that through the current provider solution the use of multiple different processes and software across aged care, NDIA and even DVA, veterans' affairs.

So the feedback from the sector is that it kind of makes it a little bit more confusing as an environment to operate and it's also a little bit more of an administrative overhead. So some of the current provider frustrations that have been voiced to us was potentially some outdated or difficult to use registration processes or some larger administration burdens when they're reporting three different ways to three different agencies.

So we're kind of on a bit of a mission to go while we as a government are very conscious of what we need but if you're going to put the customer - in this case it happens to be providers - at the centre, we're conscious around that increased cost and duplicated effort.

So that's kind of I think what we've thought the problem space is that we're trying to solve. So we were keen to explore a whole-of-government provider management system that could do that and where we could provide a simple one-touch capability for providers. They tell us once and it's streamlined and interoperable experience for them and their users. Improve their data quality so they know that they're - and the collection of reporting.

So they're some of the focus areas that I think we've kind of talked about. And we also started by kind of working out well what's the commonality? And on the next slide it kind of shows a bit of an architecture of the value chain. And just at a really high level going where are we the same and where are we different. And we often think that we're different, like no we're special, we need to do it a different way. But at its core about 65% of those business capabilities are the same.

So that's the analysis that we've done together with you and NDIA and the DVA folk. What are your thoughts at a first view of where we've landed?

Ian Frew:

Look Fay as we've discussed many times I totally agree. And this is where we're forcing in this case providers to actually understand how all of our DVA, Health, NDIA work, get them registered multiple times all for the Federal Government and it's crazy.

So the various systems were set up at each individual time for probably the very best of reasons. But I think that given the increased costs such as providers are facing to do business with the Federal Government, this sort of work is long overdue. And so that's one of the reasons we're really supportive.

Fay Flevaras:

Now I need to qualify all these things. You know we're in Tech Talk here and so there's always the disclaimer when I do these Tech Talks. It's about this is a technical focus at this point in time. Policy reform is a separate discussion.

So irrespective of what might happen there, there is still an element and a platform at a foundation level where there's still 65% of technology that can be reused and we can configure the other 35% of the policy. So to your point a bit of a low-code approach to that. And so we're starting the conversation I guess is where we're up to and that we're starting to set up some inter-departmental committees to meet monthly and see how we can progress this as a working group.

Ian Frew:

Yeah.

Fay Flevaras:

For the - go.

Ian Frew:

I was just going to say from the technical thing the biggest issue to me is how we behind the scenes handle the identity.

Fay Flevaras:

Yes. There is that.

Ian Frew:

But everything else, the portal, how it works providing a single pane of glass, technically is not that difficult.

Fay Flevaras:

And so that's when we need to bring in some other colleagues from across government to agree on all of that and I think we'll definitely have a way forward. So look thank you so much and we'll look forward to the Q&A a little bit later on.

So we'll just move on to our next agenda item which is a bit of an update on Star Ratings.

And for that I'd like to introduce - we've got Emma Cook, she's from the Quality and Safety Commission and the Quality Assurance Division and she's going to go and provide us with a bit of an overview of the policy goals for Star Ratings and a bit of a view of when it's happened, how we've got here, why are we doing it and where we're up to on the work.

So thank you Emma.

Emma Cook:

Thanks so much Fay and I'm really glad to be joining you.

So as Fay said my name's Emma. I'm the Director of the Star Ratings Section and pretty excited to be sharing our progress on Star Ratings today largely from a policy perspective. And of course very capably supported by Fay and all of her IT and tech knowledge that I'm sorry I won't be able to speak to as proficiently but excited to talk about the policy front nonetheless.

So the Royal Commission - jumping to the next slide - around why we got here, to reorientate ourselves to the problem. The Royal Commission into Aged Care Quality and Safety highlighted that aged care quality should be defined, understood and capable of being measured and that current data is fragmented and incomplete within the system. Which makes it difficult to determine the extent of substandard care and also provides a lack of information about service quality to inform consumer choice, to support provider quality improvement or assist government's risk-based regulation and policy development.

So government responded to the recommendations of the Royal Commission which included a commitment to publish Star Ratings for all residential aged care services by the end of 2022.

So to jump to the next slide. The development of Star Ratings has comprised a rigorous process. This has included research on internationally well-established health and aged care rating systems and performance systems which identified around 20 of these in around 18 different countries. And we considered these really in-depth, reached out to many of our international colleagues and sought to really draw learnings and stand on the shoulders of those who have trodden this path before us.

We moved on to consultation where we presented the evidence review findings and really sought to understand stakeholder views and in particular older Australians and their representatives views on the fundamentals of the system design. So this process included 24 workshops, 154 written submissions and as I said countless expert consultations.

We then transformed those findings into I guess the fundamentals, so the consensus points. These were things like assessing the - we sought to establish the maturity versus the importance for each different dataset included and from that derive how much weighting they would be given in the overall ratings. We applied that sort of methodology to come up with the fundamentals of the system and translated that into a prototype using Salesforce. We refined that prototype with older Australians and their representatives, as well as a range of stakeholders over seven weeks.

And then in addition or parallel to this we undertook extensive data analysis and benchmarking in particular with the support of the AHW. We sought to establish risk adjustment models that allow fair comparison across different cohorts or levels of acuity in different service populations. We started to progress our internal IT builds and put primary legislation in place to support the publication of Star Ratings.

So jumping to the next slide. We have four components to the Star Ratings. So they'll be published as an overall and four subcategories. We've got quality measures which relate to five crucial areas of care that are currently reported under the National Aged Care Mandatory Quality Indicator Program. These are things like pressure injuries, restrictive practices, unplanned weight loss, falls and major injury and medication management.

We have service compliance ratings. So this is the information that we obtain from our Aged Care Quality and Safety Commission and their regulatory activities. We have residents' experience. So this is based on at least 10% of care recipients at each residential aged care service in Australia and interviews with them through a new third-party workforce. And staffing which is reported through the quarterly financial reporting and considered in the context of the AN-ACC which was spoken about earlier and the case mix that that provides.

So if we jump into where we have landed. So these four elements as I said combine into an overall and into subcategory ratings. Which on the next slide I will talk you through briefly the high-level design and what this is intended to look like.

Now what I do have to emphasise in doing this is that obviously we're seeking to provide an overview and share as much information as possible but as you can see on the screen the final design certainly remains subject to Ministerial decision. So this is by no means the final design that is committed to.

So we have a one-to-five star scale with no half stars. We're expecting this to range from significant improvement needed through to excellent.

The overall rating as you can see in the top-right corner is comprised of 33% consumer experience, 30% compliance, 22% staffing and 15% quality indicators or quality measures.

In terms of how each of these are calculated and bear with me for the first one. The quality measures. So this is calculated quarterly through existing reporting on our quality indicators as I've mentioned. Basically we invert those to a slightly different construct as they are currently reported and it's more appropriate for publication. So that's just the removal of some less significant data points to ensure that they can be published through Star Ratings.

We apply a risk-adjustment model which as I mentioned is derived from the AN-ACC classifications and seeks to allow fair comparison across different services. We then allocate the performance of each quality measure into quintiles, so into 20% buckets, and then we apply ratings based on the severity of an event. So a stage 4 deep tissue pressure injury for example is a higher weighting than a stage 2. And following that application of weightings we assign points and we're able to allocate a rating for that quality measures component.

Now that is the most complex which is why I said bear with me for that one. It took a fair bit of working through with some of the best academics in the country to get there and internationally. So believe me the next are much simpler to follow.

The residents' experience is calculated annually. So it's a Likert scale, 1 to 4 points for corresponding answers and there's 12 questions. So you'll get a total score out of 48 and a rating assigned.

The compliance again fairly straightforward. A severe non-compliance or regulatory action such as a sanction will constitute a 1. A less severe but still obviously very significant compliance action constitutes a Star Rating of 2 for that component. A 3 would be compliant at this point in time. And then 4 would be compliant for a longer period of time such as a year. And 5 for a full accreditation cycle of three years.

And then finally staffing. So calculated quarterly as I said through that QFR reporting process and then case-mix adjusted based on AN-ACC targets for care minutes which relate to registered nurses and personal care workers. And basically these ratings are based on - it's a matrix of the two, of the overall and the RN minutes, and it's allocated based on the extent to which you have met or exceeded a target for your service.

So that is the overview of the design. And you can certainly I'm sure appreciate from that the number of algorithms, the number of data sources, the number of business rules that all need to combine to result in this build and to make this system work. So it's been tremendously complex and well supported by our IT colleagues.

In addition to this and in addition to just the Star Ratings themselves we'll have supporting information. Things like historical performance over time to show improvement over time, specific service information and offerings of course noting that people are often interested in that supporting content too.

And I should note that providers are expected to receive a preview of their ratings before go-live which would allow them to raise or have rectification of any perceived IT or data issues before publication.

So as you can see on this next slide it provides a brief example of what you can expect to see on My Aged Care when the Star Ratings are published for each service. They'll be identified through an enhanced Find a Provider tool available on the My Aged Care website. And you'll see an overall rating as well as the four subcategory ratings. Each can be clicked upon and looked into for further granularity of data and supporting information relevant to each of those fields. There'll also be separate pages available providing details of calculations and Star Ratings.

And on the next slide you'll see the significant volume of work that I've outlined and tried to speed through in this overview presentation that's taken place over the past 18 months to develop and deliver Star Ratings. And this has included as I've spoken through policy development, data analysis, primary legislation, IT delivery, as well as communications and change support that will continue as we move towards the publication of Star Ratings on My Aged Care along with the whole suite of business-readiness activities that are required.

So this will be a tremendously important digital reform and first step that will enhance transparency, quality and choice for older Australians receiving aged care. However we hope that there are opportunities in future to enhance these Star Ratings over time through data and technology. And these may include as you can see on the screen the inclusion of additional information sources as these become available, automated reporting of data which would be great to see and would allow greater granularity and frequency while reducing the burden for providers and those reporting this information, further refinement through continued user-experience testing to ensure that we're really realising the maximum benefits of this landmark reform in particular for older Australians. And of course quality improvement through future reviews and uplift of performance benchmarks over time that will drive improvement and including through the use of that provider-preview functionality that will be critical in providing performance information and report cards that allow providers to compare to peers and compare to themselves over time and of course engage in that critical improvement that we want to see and that would ultimately drive improved quality for older Australians.

So thank you for the opportunity to provide an overview on this linchpin aged care reform that will I hope deliver measurable information about service quality and help older Australians to make choices about their aged care.

Thanks Fay.

Fay Flevaras:

Thanks Emma. And apologies. I said you were from Quality Safety Commission but that was just a slip of the brain. You're actually from the Department of Health and Aged Care, just to qualify, and the Quality and Reform Division. So thank you.

That was a great summary of a quite complex area and a testament to you and the teams that have been working together to get all this pulled together. You're correct, there's many, many different sources involved. And so looking forward to putting the first bit out there and seeking feedback from the sector and the providers as we continue to improve together.

So without further ado I think we're moving on to our Q&A. And it's at this point that I'll hand over to Janine to help moderate some of the questions for us. We're going to invite our panellists who have presented here today.

Janine over to you to bring them up.

Janine Bennett:

Thanks Fay. Okay everyone time to put your questions to our panel but first some introductions. You will have already met our speakers. So Fay, Ian, Emma thank you for joining the panel. I'd also like to welcome Dale Naughton from the Department of Health and Aged Care and Laura Toyne from the Australian Digital Health Agency to the stage. Welcome Laura. Welcome Dale.

Laura can I just ask you to introduce yourself first of all?

We might start with Dale actually. No there you are. I was going to say your video's not on yet.

Laura Toyne:

So Laura Toyne, Digital Health Agency, managing program and project delivery. Thank you.

Janine Bennett:

Welcome. And Dale.

Dale Naughton:

Good afternoon all. Dale Naughton, Health and Aged Care. Really working on I suppose the technical platform and some of the interactions we're having of business-to-government type work. So thanks for having us.

Janine Bennett:

Great. Okay so in the interests of fair warning I'm going to let Wendy Rocks know that we will be inviting her to stage to ask her question in just a moment and then after Wendy we'll invite Linton to the stage to ask his question. But we might get started with an anonymous question. And this one I think is for Ian.

Q:          Are you able to advise what email-to-case is?

Ian Frew:

Yeah. Look apologies there. Email-to-case is simply when you send an email to say a mailbox, then in this case Salesforce will pick up that email, do a little bit of artificial intelligence on it and create a case and potentially route it to the appropriate team to action. And it can also keep track of when there's been multiple emails going in and out. So that what this means is that the person say in the contact centre when they receive a phone call can quickly call up that case and they see the whole flow of what the information was rather than having to search in mailboxes and other areas. So it comes out of the box, it was very easy to set up and configure and it made a significant improvement to the contact centre staff.

Janine Bennett:

Great. Thanks Ian. Appreciate that. It just shows the potential of some of those back-end configurations to make our jobs easier.

Just on that do we have actually Wendy available yet?

Wendy if you don't mind just turning on your video.

I might just go with another question in the meantime and this one is for Emma.

So the question is:

Q:          Those are some complex algorithms. Is there somewhere we can go to look at that information in more detail?

Emma Cook:

Yeah. They are some complex algorithms indeed. And certainly as I said once we have that final Ministerial agreement we will be sharing more details and a range of communications and change supports that will be made publicly available on the Department's website, as well as some more simple information on My Aged Care. So in particular I think the document you'll be looking for will be the technical or provider manual and that is expected to be made available over the coming weeks following that Ministerial agreement.

Janine Bennett:

Great. Thanks so much.

Wendy I think we've got your sound but not your picture but feel free to jump in.

No.

I might have to raise it for you. I think we're having some technical difficulties there. We can sort of hear you in the background but we don't have any voice.

So for the panel there was a couple of comments from Wendy. One was just a reminder about the use of acronyms. That acronyms can mean different things depending on who you're working for and the sector that you're working in. So if we can just make sure that we explain what we mean by the acronyms it will help everybody understand. So that was one of the points that Wendy made.

But she also had a question.

Q:          And this is about the NDIA app that allows clients to view budget and make claims. She notes that it has synergy for home care consumers in aged care. Are there any plans to use it in aged care?

Ian Frew:

Well we'd be delighted to share all our learnings. Clearly the app itself is closely tied to the budget constructs and the claiming capability within our system. But there's a lot of very simple things and the basic framework absolutely it's totally reusable and it wouldn’t take long to implement.

Fay Flevaras:

Yeah. We'd be always open to review these things. I think for us starting with the Support at Home policy consultation that's happening and then we can hopefully look at where the synergies are.

Ian Frew:

Yeah. The big learning is in the accessibility side as well. So an enormous amount of work went into that and so that would be easily leveraged.

Fay Flevaras:

Thanks Wendy.

Janine Bennett:

Thanks Wendy. I hope that answers your question.

Thanks very much.

Okay. So we'll invite Linton to the stage next and then if we can invite Htet Loor.

We've got Linton now. Great.

Audience Member:

Good afternoon everyone. Thank you very much. Ian my question's really directed at you with your experiences. And I was really interested to hear the pushbacks and the progress you made etcetera.

Q:          Is there any possibility we can get a lessons-learnt summary or list or something to help us along our journey?

Ian Frew:

Yeah. Look absolutely. Because we haven't actually launched the pilot, that's a couple of weeks away, we haven't gone and done a formal lessons learnt. So there's nothing shall we say in any format at the moment but when we do I've got no problem with sharing it. But if you've got direct questions at any time then I'm certainly quite happy to participate in phone calls or hook-ups of any sort if there's something urgent that you'd like to get through.

Audience Member:

Thank you Ian. That's great. Thank you very much.

Fay Flevaras:

Thanks Linton.

Janine Bennett:

Thanks so much for joining us Linton.

Okay. So if we can get Htet Loor queued up and then we'll have Christine after Htet. And in the meantime I'll ask one of our anonymous questions.

So this one I think is to Laura.

Q:          What is the ADHA plan re connections of My Health Record to the provider system?

Laura Toyne:

Yeah. Thanks Janine. It would be helpful to know who that question's come from or what perspective you are because providers even in this context could be different.

But if I take the question to mean residential aged care providers, so service providers, then we have talked before at the Digital Tech Talk about the work the agency's doing in supporting the connections of residential aged care facilities to My Health Record. And we've talked about the fact and I'm happy to reshare that we're working with clinical information systems in this space, a number of vendors, up to 14, to make sure that there is clinical information systems and software available that exists now in residential aged care facilities, to ensure that there's that direct integration into My Health Record for those providers that are using those particular vendors.

But equally as well the agency at the moment is conducting a pilot for how we can better support the residential aged care providers to connect into My Health Record using the national provider portal. And we should have more information about the outcomes of that pilot I would think early in the new year. We're certainly keen to learn and understand the difficulties around that for providers and to make sure that we can support you through that process in the next calendar year.

So I'm going to take the question at the moment to mean that given I don't necessarily have the context behind the provider.

So thanks Janine.

Janine Bennett:

Thanks very much Laura. I appreciate it.

I think we have Htet online but we're just in the process of queuing him up.

With Christine we've got a few Christines on the line. So we're just struggling to know which Christine it is. So I might just go ahead and ask Christine's question for her.

So Christine asked and it was a popular question:

Q:          When will we know more about standardised software requirements?

Is this a good one for you Fay?

Fay Flevaras:

Yeah. Absolutely. So there is a large body of work that's currently happening as part of the business-to-government gateway work, which we have Dale on the screen here leading in the team, and Laura's ADHA where we're trying to figure out what is the best interoperability and conformance process. And so that's part 1 of it.

There's also another part where in aged care they're looking at national minimum data standards. So we're looking at that from that lens and how the information will connect. And there's also already existing connections with the ATO and Services Australia and even I'm thinking with NDIA as I look at Ian as well.

So trying to come up with a view of all the ways that people can connect to government today and figure out how can we re-use some of that and create a reciprocal conformances approach but also start to build to that national standard.

I know definitely from the ADHA perspective and I won't put words in Laura's mouth but definitely for My Health Record it's the FHIR standard. So I think it's balancing all the different perspectives and really coming up with that data dictionary and catalogue of services out there.

I'm going to throw to anyone else on the panel who wants to add a bit, like Dale, Laura, Ian. No. We're all going no.

Laura Toyne:

Come on Dale, you can do it.

Dale Naughton:

Yeah. Look probably just - thanks Fay and thanks Laura.

I think it's probably in those we do have a number of forums running. But yeah just to sort of reiterate it's really looking at from our perspective how would you streamline those interactions, the importance of the data. Speed to market for us is important as well ... And it's really just trying to take that burden and as much as we can proceduralise to a standard and make sure that we can interoperate a lot better, I suppose get just better outcomes for providers.

Fay Flevaras:

And I always say the words 'in a safe, secure environment'. And I think given the last month's worth of data breaches across the industry, like private sector, I think more and more we're trying to make sure that we do that in a frictionless way but we've got to be safe and secure with people's data.

Laura Toyne:

I might even take that one step further Fay to think about the clinical safety aspects as well. When you're talking about a person's health information in particular we have to make sure that systems themselves are both connected for that information transfer, they're interoperable and that we actually have clinically-safe outcomes as a result of the use and the connectedness of these systems. So I also think we have sort of a slightly different take on it in the agency around that as well, an extension as it were.

Fay Flevaras:

A good point Laura.

Janine Bennett:

Great. Well I'd like to welcome Htet to the stage. I hope I'm pronouncing that correctly. Go ahead and ask your question.

Audience Member:

Hi. I do not have any questions. I like all the information that was given. So this is my first time attending to this meeting so I really appreciate for the invite.

I also appreciate it for all the information that has been given. So I'm still trying to understand the committee. Thanks.

Fay Flevaras:

Thanks Htet. We like the feedback and we're glad you're finding the information useful. If there's any particular information topics that you guys would like to know about please make sure you put them in the questions. We always like to line up speakers ahead of time. But yeah thank you so much for the feedback.

Audience Member:

Thanks.

Janine Bennett:

Nice to have participation.

And a quick question that I'll direct at Dale if I could.

Q:          How can we participate in tomorrow's 26th of October two-hour information session and all the other sessions here?

So I think that was relating to the Support at Home sessions Dale.

Dale Naughton:

Yeah. Thanks Janine. Look I think the simple answer to that is that we've got everything and all this information will be available on our Aged Care Engagement Hub. And what we'll do post this is just make sure in that email that we send out some links and whatnot so people can easily find information.

Janine Bennett:

Great. We'll be sure and add that to the post-event email so people will know exactly where to go on the Engagement Hub to get it.

We'll invite George to the stage next.

We'll see how quickly George can come up. Look there he is already.

Okay. You've got a couple of popular questions there George. I'll let you run with it.

Fay Flevaras:

We can't hear him.

George we can't hear you.

There's a speaker setting that maybe is not quite right.

Janine Bennett:

Perhaps I'll run with an anonymous question and George can have a minute to have a look at his settings, take the pressure off.

So one of the anonymous questions we had was:

Q:          There was a lot of talk about interoperability. How would the NDIA, Health and Aged Care and the DVA link between each other to enable interoperability?

And I'm happy for anyone on the panel to jump in for this one.

Ian Frew:

Well we already do quite a bit. For example we're already using - and the answer is you do it through APIs. But we're already connecting some of our systems with Services Australia systems in this way. And sometimes we use our - you know we use either MuleSoft on our side because they've got API Connect.

It's really just coming up - and I think this was part of the earlier discussion - of having a common standard as to how we're going to do it and everyone understanding and following that. But these days the systems that we have such as Salesforce and I'm sure that the other vendors do it as well, they're all built around APIs and so it's very easy to expose various processes in that way.

Laura Toyne:

So that's a tech perspective on it absolutely. I think it's also important to know that you need a common set of identifiers as well being captured, whatever that set of identifiers is. And so we can't necessarily lose sight of that in all of the digital transformation and interoperability that we're trying to lean into towards and do across government more broadly because that is also a part of that solid foundation for the information transfer.

Janine Bennett:

Great.

All right. Just another example of how digital technologies are helping us transform the environment and make things easier. So great to see interoperability is front of everybody's agendas.

I'm not sure how we're going with George. I might just give a warning for Tony Jones if you want to get ready to come up next.

And in the meantime I do have another anonymous question.

Q:          Will this session be recorded and shared?

The answer is yes. All of our sessions are recorded. We put them up on the Health website under the Digital Transformation for Aged Care Sector site area. And they're usually available about a week after our Tech Talks, as soon as we've got our closed captions done. They are almost as good as live and unedited. So they'll be available for you there when you want to check them out.

Fay Flevaras:

And I think Janine if you subscribe. I know that on my phone I get like a YouTube prompt. So if you get a subscribe out there you'll get them prompting and notifying you directly.

Janine Bennett:

Perfect.

Good to know.

Okay. How are we going George?

Fay Flevaras:

No.

Janine Bennett:

No.

I might jump in and ask one of George's questions in the meantime.

Q:          So the digital transformation is a hard one and the challenge that providers are facing is that it is just one of the many transformations they are undergoing.

It's a good comment and how might the panel respond to that?

Fay Flevaras:

It's a difficult question. And it's a different answer for each person because everyone's starting from a different starting position.

I think from my perspective if we all acknowledge that we wanted to just focus on bettering the aged care community and for ageing Australians and that is our why and our purpose then it is about then focusing on those priorities that we've all decided. That we want to make sure that reporting and measuring of what we expect and going digital to help alleviate some of the administrative burden or administrative tasks to enable more time for other things. I think it's actually just a symptom not just in aged care but more generally in society where we're just trying to do more with digital happening all the time. So I think it's about prioritising what's important to your area and focusing on those priorities.

And I'm going to throw to Ian because he had some of those gems in there about thinking big but starting small and providing value along the way and really focusing on some of those pain points so that you can make things easier and more frictionless.

Ian did you want to add anything there?

Ian Frew:

Look I think you've said it very well there Fay. I think that the other part of it - and this is shall we say the sad part - is that as we mentioned earlier about Optus and Medicare, sadly we also see a lot of providers who are suffering breaches. CTARS was in the news, that was a significant one.

So the tough thing for the providers are how do they balance getting that automation efficiency shall we say at the same time protecting the information that they have and have collected on whether they're NDIS participants or aged care or DVA or what. It's a very, very challenging space and the cost of it is getting higher simply because the protection you need is just increasing. So that balancing act is a tough one.

Fay Flevaras:

Thanks Ian.

Janine Bennett:

Thank you. We've got Tony Jones joining us on the stage. Thank you so much for your patience Tony and for hanging out on stage while we answered that last question. Jump in.

Audience Member:

Yeah. Hi everyone. Look I was more than happy for someone to read my question out but now that I'm up I may as well just give you a slight background. I'm actually an NDIS participant but I also work for Spinal Cord Injuries Australia and we've been doing some advocacy particularly with the rollout of the new Support at Home program. Because from our perspective it's important that the settings are right for newly injured over the age of 65 and avoiding some of the current problems of the home care program that exists. So yeah anyway that's my ramble.

But my question is:

Q:          Will the Star Ratings system be rolled out to home care services as well?

Thank you.

Emma Cook:

Thanks Tony. Thanks for the question and for the context.

The government's commitment at this stage is for the residential aged care service and I think residential aged care services to have Star Ratings published by the end of 2022.

With respect to home care I think you quite rightly point out the volume of reform that's currently in play and the rapid work that's being done to develop the Support at Home system. So I think that's really kind of important context when considering the role of the Star Ratings and potential introduction of Star Ratings.

But the short answer to your question is at this stage the government's committed to residential aged care, a commitment hasn't been made to home care. But that's not to say the government doesn't like the idea or won't consider it in future. I think you're just very right in pointing out the current focus is certainly on landing that system design before establishing a rating system for it.

Thank you.

Fay Flevaras:

Thank you very much Tony.

Janine Bennett:

Thanks so much.

So we'll invite Michelle Jenkins to stage next but I will just ask George's other question while we're waiting for Michelle.

Q:          So can you suggest how providers can prepare for digital transformation by assigning new staff roles or training?

And this is for the panel.

Laura Toyne:

That's a good question right. Good one George.

I'll probably have to throw to the Department there but from my perspective talk to your vendors as well. For small providers, for small resi aged care providers or smaller service providers out there, if you are using a software system at the moment talk to your vendor as well about how they might be able to support you with their product. I know it's probably not the right answer but I do think there's value in doing that too. But Fay, you know the Department, you've probably got a different perspective.

Fay Flevaras:

No. It's a good start. Ian over to you first.

Ian Frew:

Laura I think you're absolutely correct. So what the NDIA has done and it started end of 2018 is to start publishing a number of APIs that allowed providers to use to access our systems and submit claims etcetera.

Now what's happened out of that, which is how the market works, is that there's a number of software vendors who have also gone through our accreditation process. And what they do is now can go to a provider and say 'If you use our system it comes with built-in connections automatically back into the NDIA which means you can actually do everything from your system and you don't need to do a second step for these sorts of things.'

And we're looking at all sorts of other open ways that we can have this. It was announced a couple of weeks ago where we've actually signed contracts to start putting together a point-of-sale - or 'payment at point of support' I think is what we're calling it. And part of that is how do we make that integrated so it's integrated into the provider's system and they don't have to do anything extra to make that claim through to the NDIS. So yeah there's multiple ways but talking to your various vendors is the right way to go.

Fay Flevaras:

And then I'll just add that a parallel track to our Digital Tech Talks is actually our sector partners. So we currently have over 65 companies who are in the sector-partner community with us who speak with us every fortnight. And when we don't have such a jam-packed agenda we usually do a bit of a playback to say what we've been working on here.

I think the key there, and it's touching on what Ian said, was they're actually helping us to not only build the platforms that we're going to make accessible from government but coming up with the design of potentially what that catalogue of API services could look like in advance and then looking for opportunities to prioritise.

I'm hoping that through the open discussion and design it will allow for the private sector for other innovation to happen and they can step in and build other business applications to make the sector's life easier that has nothing to do with government and regulation and so forth.

So I think it's a bit of a watch this space as the community continues to connect, as we continue to work out how to make it interoperable and safe and secure and make sure we get the right outcomes. But I think there'll be potentially hopefully a momentum there as it starts to perpetuate.

Laura Toyne:

Yeah. And I think it's a good point Fay. And there's a final thing which has come up in a few Tech Talks, at least the earlier Tech Talks, which is around the workforce in your facility, in your sector. And making sure that you're thinking about how you can skill them digitally and make sure that the workforce has the capability to use the technology that you might either be investing in, considering or using now and how they can use that to the greatest extent possible to help those workflows.

So I think don't lose sight of that as well. As a CIO that's incredibly important. Look for those opportunities to skill your workforce in the digital. And it's certainly something I know that the agency is quite focused on is the digital capabilities out there and how we need to work to assist that.

Janine Bennett:

Thanks very much.

Dale Naughton:

- Laura. I'm just thinking too just to finish on that one probably two other areas. One is just to stay informed in these sort of sessions as best you can and stay connected. And probably the other part for me there's so many lessons learnt. And Ian you were running through a couple of gems just before. Like make it your business if you can just to really understand and have a look at some of those lessons and see what can be learnt from that.

Janine Bennett:

Thank you all. That was a really great response.

We have Michelle joining us on stage. Hi Michelle. Go ahead and ask your question.

Fay Flevaras:

We're definitely not having luck today with the volumes.

Janine Bennett:

No.

Fay Flevaras:

No. We can't hear you Michelle.

I think it's your speaker setting. We're going to probably have to do a user instruction maybe on the speaker settings. Under where your mute button is there's an option to select some of your audio settings. You must have a different setting there.

Janine Bennett:

We'll give Michelle a second. No pressure Michelle. I'm happy to ask your question for you if you're not able to find the right setting.

But I will just note that we've had a good morning from Avat in WA. Hello, good morning, good afternoon for the rest of us over here on the east coast.

Your question I think we've already answered but yes the video will be shared. We also do share the slide deck on the Health and Aged Care website under Digital Transformation for the Aged Care Sector. So thanks for that and welcome from WA.

How did we go Michelle?

No luck. All right. Feel free to smile and I'll ask your question for you.

Q:          How do providers address significant cost implications of digital transformation with capped funding constraints?

A good question.

Fay Flevaras:

I'll take this one. And it's actually some feedback that we've received beforehand. It is a priority of discussion internally. I can't say where it's going at the moment. But I think in some ways there is a recognition that there is a cost to change.

And so I'll probably leave it at that. There's not a lot more I can say here. I think there is an element of each provider whether it's your not-for-profit or a profit and like they've all got different dynamics of accessibility to funds to be able to change.

I'm not sure if that's answered - I know it hasn't answered your question in totality Michelle but I guess what I'm saying is it's recognised.

Janine Bennett:

Thanks very much Michelle. I appreciate you coming to stage. So we'll invite Stuart P next.

And in the meantime just a comment from Fiona:

Q:          Great to hear a commitment to streamlining across government departments.

Fay Flevaras:

Thank you. We often talk about it being the coalition of the willing. So yeah thank you so much for the feedback.

Janine Bennett:

Okay. Stuart. I can see you've got yourself a big room there.

Audience Member:

I certainly do. I'm actually going hand over to Louise who's going to ask the question.

Audience Member:

Yeah. It was a question from me I suppose. We do a lot of training, as do all aged care providers, with our staff. But we also have the added responsibility of providing NDIS training for all of our staff who may come into contact with or do come into contact and provide care for residents or clients who are NDIS participants as well. So my question was:

Q:          Is there any plans at any stage to recognise one or the other training as being relevant across both sectors? I mean how can we join those I suppose if you like?

Fay Flevaras:

Yes. Ian I'm going to go flicking to the tech folk and I'm going to go -

Ian Frew:

It's an excellent question and I can only - because we get similar sort of requests that providers feel that they're duplicating things many times. So all I can say, similar to what Fay said to the previous answer, it has been a subject of discussion.

Sadly I think that whether it's Health or NDIA we get so fixated in the issues within our own space it probably doesn't get enough play. But it's definitely being discussed.

Fay Flevaras:

And so thank you for raising it again. Because we do take the messages and questions that we have here and we do actually then table them across to all the other First Assistant Secretaries within the Department. And so they do see that there's a repetition on certain topic areas that are coming up. And so we'll make an effort to highlight this again.

Audience Member:

Thank you very much. And thanks Ian and the panel.

Fay Flevaras:

Thank you.

Janine Bennett:

Thanks guys for the question.

Okay so I'll give Paul Gavitt a bit of a heads-up. And Jennifer Crust we'll get you to stage next. And in the meantime I'm going to ask a question on behalf of Barbara.

Q:          Will Star Ratings be applied to home care services in the future? If so what is the approximate timeframe for such a rollout?

And I think this one might be for you Emma.

Emma Cook:

Yeah. I think this is probably quite a similar kind of question and answer to that that I discussed with Tony. And that's that the current government commitment is to publish residential aged care Star Ratings for services by the end of 2022. Obviously there's quite a lot of reform happening in Support at Home or in the development of Support at Home and the in-home care system and there's currently no commitment to publish Star Ratings. That doesn't mean that there won't be or that government isn't interested in it but the immediate commitment is to residential care. And I think we'll all be interested to see that development of in-home care system further, as well as how we might enhance or expand Star Ratings over time.

So that probably answers that question.

Janine Bennett:

Great. Thanks very much Emma.

And welcome Paul.

Audience Member:

Thank you very much.

Janine Bennett:

Feel free to jump in.

Audience Member:

This is probably more a policy question my guess is but it's around:

Q:          The quality systems and will system participants, whether that's aged care or say in residential or in-home care, have the option to not have their data collected in the process of quality auditing such as 'I don't want you to write down how deep my pressure wound is', or will participants have to accept that if you're receiving subsidised aged care services then you have to opt in to data gathering around a quality system?

Fay Flevaras:

I'm going to throw to you Emma on this one. You're probably the most qualified out of all of us to answer this one.

Emma Cook:

No absolutely. So with respect to something like you've put forward we don't - I guess how we deal with consent is that obviously consent is always required when some sort of physical intervention occurs if that makes sense. You can't touch people or conduct an assessment on them without that.

However in saying that the majority of data that's collected for things like quality in care as you've cited there is done through routine care processes. And so the expectation is that - and without kind of stipulating how people should run their business or prescribing it right here, that's not what I'm doing. But providing an example which is to say we're going to - are you prepared to bathe now or take part in a personal care process and to conduct that skin assessment as part of that bathing process or as part of that, in the instance of the newer quality indicators, incontinence pad changes, those processes if that makes sense.

So there's consent of course to always touch or provide that care and there's that open communication as there always is. However - yeah and so that's how it's dealt with. And so we haven't really experienced an issue whereby people simply couldn't deliver that routine care if that makes sense.

Audience Member:

Yeah. Okay. Thank you.

Janine Bennett:

Thanks Emma.

Emma Cook:

No worries.

Janine Bennett:

You're operating in the dark.

Emma Cook:

I know. I'm trying to wave my arms around and turn the light on. So apologies for that and if I was a bit disjointed.

The only other thing I was going to say with respect to the question about alignment, and this isn't directly relevant to Star Ratings specifically or my scope, but what I would say is that there is a lot of awareness around the opportunity for harmonisation and greater convergence between disability and aged care. And so reforms such as the current review of the Aged Care Quality Standards is taking that view and that lens to align with disability to a greater extent.

And that review and consultation process is now open. So if there is that interest and alignment in convergence across disability and aged care which we're all talking about and working towards, then those sorts of reforms and processes are underway and involving or inviting your input as well.

Fay Flevaras:

Thanks Emma.

Emma Cook:

No worries.

Janine Bennett:

Great. And lucky last question of the day. Jennifer welcome to the stage. We just don't have your video on so we'll see how we go with this one.

Audience Member:

Sorry. I was just trying to get my video up.

Janine Bennett:

Great.

Audience Member:

Hi. I'm the CEO of Gulgong Hostel which is located in central west New South Wales in a town of about 2,000 people. We're very small. We have 25 beds and about 35 home care packages. We have a very flat management structure. There's me and I do everything that's not clinical.

And we don't have any onsite IT. And I was just wondering if there's any help out there for tiny rural or remote organisations so that we can get our heads around everything. I mean sorry to say but I understood sort of one-in-three words of what you were talking about. So any help would be greatly appreciated.

Fay Flevaras:

So Jennifer I don't have an answer for you here and now but I would love to get your contact details and meet up with you and just get a little bit more of an insight into your problem space that you have.

Small, medium, large, like we need to understand all the different types of providers. And the services you provide are integral to that area and that community and so I would love to be able to speak to you to find out how we may be able to help you.

Audience Member:

That would be fantastic Fay.

Fay Flevaras:

Thank you.

Laura Toyne:

And Jennifer from my perspective just on the sort of health aspects and how you look after the kind of healthcare of your aging residents?

Audience Member:

No. We provide fantastic care. We're actually accredited for four and a half years. So it's just these rating reforms. I mean we've got new you know SIRS coming into home care, there's been no guidance, no training. We can't get down to Sydney for the training next month. And you know all this new QI stuff next year. My care manager spends probably at least three days every quarter just colleting that data.

We have electronic clinical documentation systems but they're not quite presenting it in the way that the government wants it. So we spend a lot of time - I'm doing my QFR at the moment and I've spent most of the day on it.

There's just so many different things and so many hats that we need to wear.

Fay Flevaras:

Thank you Jennifer. I really appreciate the insight. We'll take an action to meet with you and to get a better understanding. You would not be the only one. And so if we can learn from you and make it work for you then we can make it work for the masses.

Audience Member:

That'd be fantastic. I mean we've got a very strong peak body subcommittee out here and I know that so many highly-talented aged care managers are leaving because it's all getting too hard.

Fay Flevaras:

Yeah. Thank you.

Emma Cook:

And just to jump in quickly. There are business advisory services and business innovation funds available through the Department. So it sounds like we can gather a little bit of that information for your future meeting and provide you those avenues of support.

Audience Member:

I mean I've had fantastic support through the PwC programs and they've been great but nothing who has taken an overarching look on our interoperability of our systems.

Emma Cook:

Yeah. Perfect. It sounds like a good further discussion.

Audience Member:

Yeah.

Janine Bennett:

Thank you so much Jennifer. We'll take that as a piece of homework. So we'll make a point of talking to you before our next Tech Talk.

I'm so sorry everybody but that's time actually. We've run a couple of minutes over which we really try not to do.

Thank you all for a great discussion. Many thanks to our presenters and our panellists Ian, Emma, Laura, Dale and Fay. As always it's wonderful to have digital leaders in government who can handle ambiguity and are willing to talk to our attendees with such openness and candour. Thank you so much for being open to that discussion.

As we've mentioned recordings of this event will be published in the Digital Transformation area on the Health and Aged Care website in the next week or so. You will receive an email post-event which will have a link to a survey or the QR code is on screen and available for you there.

Our final Tech Talk for the year will be scheduled on the 6th of December. We hope to talk a little bit more about some of the items coming out of the Budget. In the meantime feel free to email us if you have any agenda items or any suggestions for how we can make these Tech Talks better.

That's it from me. I'll hand over to Fay for closing words. Thanks Fay.

Fay Flevaras:

Thank you. And a big thank you to everyone, all our panellists. It makes the content and topic areas really informative for our viewers.

I'd like to thank everyone for joining. This is not our day job. We are not you know content people in that sense. And so hopefully you can appreciate it for being the real-real that we are here, all the lights going off and things not going exactly to plan. But we feel it's really important just to keep connecting with you all, opening the dialogue, listening to you so that we can learn from it.

Today's a big day. It's Budget day. So looking forward to the next Tech Talk on the 6th where we can bring some of that feedback back to you. If there's any particular topic that you want to hear from us please let us know. It'll be the last one for the year and then we'll be taking a hiatus in January and we won't be back until February.

So with that thank you all and have a good week.

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