A roadmap for technology: Need of the hour

Written by Anne Livingstone, Executive Lead at the Aged Care Industry Information Technology Council, for the Hello Leaders Summer-Autumn Edition.

Are we there yet? Has the aged care industry reached a level of digital maturity that meets the needs of a contemporary high-quality and sustainable sector?

In 2016, Aged Care Industry Information Technology Council (ACIITC) recognised the need for further research to enhance understanding of the role of technological disruption and innovation in the aged care industry. I was part of the industry’s voluntary effort to create an evidence-based sector-specific Technology Roadmap for Aged Care in Australia published in 2017.

This was the starting point in the development of a range of evidence and benchmarking which ACIITC has undertaken, and this has contributed to the understanding of the level of digital maturity in the aged and community care industry, but also the gaps in the utilisation of technology, and the uptake of innovation, along with the level of investment required.

The ACIITC Technology Roadmap was designed to complement the Government of the day’s Aged Care Roadmap which was developed by the then Aged Care Sector Committee to provide a strategic roadmap for the next five to ten years of developments in the sector.

However, this initial roadmap did not address the critical role that technology, and the uptake of innovation, would have in the future of provision of higher quality, more reliable, and innovative services, and support for older people.

Developing the ACIITC Technology Roadmap was a timely and important undertaking raising the possibilities along with the challenges that could be realised from a more digitally mature aged and community care sector. The Technology Roadmap was structured around five key destinations:

• Technology-enabled operational, business and communication systems
• Technology-enhanced care and support for older people
• Technology-enhanced information and access to care
• Technology-enhanced assessment of eligibility and changing needs
• A technology-literate and enabled workforce

A plan of action was framed against the Short Term (1-2 years), Medium Term (3-5 years), and Long Term (5-7 years) which mirrored the timeframe applied in the Government’s Aged Care Roadmap.

Six years after the Technology Roadmap was released another aged care roadmap has been released, this time by the Department of Health and Aged Care – the Aged Care Reform Roadmap, which summarises the key reforms being pursued by the Government and the sector between 2023 and mid-2025.

While it focuses on the key recommendations that the Royal Commission in Aged Care Quality and Safety (Royal Commission) tabled, again some would argue that this Roadmap lacks a robust filter that acknowledges today’s complex digital environment.

One of the key issues identified by the ACIITC 2017 Technology Roadmap was the failure of the sector to integrate technology as a core feature of aged and community care, rather than an after-thought, or as an ad hoc add-on.

A growing number of aged and community care organisations are cognisant of the importance that technology has in enhancing care, and as a necessity for underpinning data collection and analysis, along with improving the effectiveness and efficiency of operational systems, however, need guidance and investment to achieve essential digital maturity. 

In recent ACIITC projects, it has been identified that the sector critically needs leadership, and massive investment, to adequately embed the potential that quality digital systems can have in providing higher quality care and support.

We have identified key areas where funding models and workforce design need to change radically, and where guiding standards, policies and new funding models are critically needed.

The Royal Commission responded to the ACIITC Technology Roadmap for Aged Care in Australia with a number of specific recommendations in its final report (2021) as well as a separate report focused on ICT infrastructure for aged care (2020).

The Commission’s response identified five major deficiencies within the aged care sector and Australian Government, arising from: 

• Disconnected business processes
• Lack of data collection and sharing
• Poor interoperability
• Obsolete technology
• A fundamental lack of standardisation (Royal Commission 2020: 4).

The current state of the services and technologies used across the aged care sector has significant deficiencies and gaps in comparison to other sectors like banking, retail, and transport. These deficiencies are severely impacting the way aged care is provided. In summary, the current state can be described as a fragmented ecosystem containing legacy technologies that provide little or no integration which are cumbersome and provide poor user experience. The impact of technology deficiencies is further exacerbated by workforce skill gaps, specifically a lack of digital literacy (Royal Commission 2020: 13).

The five major recommendations have a strong focus on improving the interface between the aged care and health care sectors, including by providing for interoperability between both to support efficient data collection and data sharing. They also acknowledged the need for the aged care sector to build its investment in technology and ICT systems infrastructure, and in assistive and smart technologies that will enhance care provision.

The Commission’s recommendations do reflect some of the vision and directions set by the earlier Technology Roadmap for Aged Care in Australia (ACIITC: 2017). In particular, the identification of the following issues under Destination 1, Technology-enabled systems:

• The need for interoperability, open standards, and common platforms.
• Underdeveloped sector technology readiness.
• Fragmented capacity building and a failure to embed technology in aged care.
• The need for national data exchange and readiness for electronic data usage.
• The need for Aged Care B2B and B2G Interfaces in order to create an open ecosystem of secure data exchange.

However, many industry commentators, along with contemporary research evidence, recognise that there is a range of other critical areas requiring focus and attention to achieve a minimal level of digital maturity industry wide.

So how far have we got since the handing down of the Royal Commission’s 2021 report, and are we there yet in achieving a digitally mature and capable sector? My observation is that, whilst we need to build basic sector capability and capacity, we have a long way to go.

Not only to fully achieve improvements in the essential areas that both the Royal Commission and the ACIITC Roadmap have identified but also to address the real danger of missing out on the potential that new and emerging technologies could have in the provision of higher quality and user-centred care.

Along with detailing the potential on the horizon that a variety of disruptive technologies will bring, there is a serious and urgent need to revise the industry-led Technology Roadmap and provide the sector with a new pathway. My hope is that the current Government will answer the call to properly invest in this.

Anne Livingstone has over 40 years in aged and community care service delivery and systems reform as well as extensive experience in service design for special needs groups in community settings.