The Federal government and opposition must make technology-supported care at home an election issue, the NSSN’s 3rd Ageing Forum heard last Friday at NSW Parliament House.
The forum explored how technology such as smart sensors, smart phones, wearables, artificial intelligence and telehealth can alleviate the aged care workforce crisis as it allows older Australians to live in their homes longer.
It also launched the preliminary results of an Australian-first survey of 1000 older Australians and their family and carers attitudes to using technology in their home, which was funded by Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE).
The survey found respondents were happy to accept government-funded technology in their home if it means they can continue to live at home.
Professor Paul Eggleston from the University of Newcastle’s FASTLab said technology-supported care at home should be an election issue if governments are serious about allowing older Australians to stay at home longer to take pressure off hospitals and aged care facilities.
“I think we need to advocate for where technology and humanity work hand in hand to keep our parents, grandparents, healthy at home, and I’d like to suggest we make this an election issue,” Professor Egglestone said.
The event was organised by the NSW Smart Sensing Network and its partners in the Healthy@Home consortium and the Sydney Partnership for Health, Education, Research and Enterprise.
It comes as federal parliament passed major changes to the aged care sector – such as expecting some aged care residents to pay more for care – to alleviate the demands of Australia’s rapidly ageing population.
Describing the survey findings, Professor Jason Prior from the UTS Institute for Sustainable Futures said half of the 1000 respondents found using technology supported care at home to be very or extremely appealing. The levels of appeal were similar across age groups (65+) and gender.
“Most were confident in their ability to use technology, and most were comfortable using technology,” Professor Prior said.
While most participants think smart-sensor technologies should be funded via home care packages or other types of government assistance, just over half of the 1000 respondents were also happy to contribute a small amount each month to the technology.
“Seven out of ten (respondents) were somewhat, definitely or likely to adopt smart sensor technology, or encourage an older person living independently to adopt smart sensor technology in the home…which is quite high,” Professor Prior said,
"Significant” ageing challenge
Twenty-six speakers from industry, university and government partners spoke at the ageing forum.
Senior Research Fellow in Cognitive Neuroscience at Western Sydney University, Associate Professor Celia Harris, said Australia’s ageing population was “the most significant demographic change that we are seeing in society, in Australia, and worldwide”.
She described a situation at a Sydney hospital last month where “thousands of beds are occupied by geriatric patients who have nowhere else to go because there’s no aged care spot for them, and this is one of the main reasons why hospitals are full”.
NSSN Human Health Lead Catherine Oates Smith said the forum was examining how data collected by smart sensor technology in an older person’s home can be used to improve care outcomes; how that information should be stored securely; and who pays for the technology.
But she said getting everyone to work together on the issue, particularly across the state and federal government divide, was a challenge.
“Payment of our GP’s and administration of our aged care package payments is handled by the Federal Government,” she said.
“Whilst our hospitals, and the transition of patients from hospital to home, are managed by our state government departments. We need both to work together to make this easier for our ageing citizens who want to receive care at home wherever possible.”
She said that setting the funding levels for the new home care package payments – “the largest government expenditure going forward for the next ten years” – was a significant political issue which needed consumer input.
“The kind of innovation that will define the future of aged care”
The forum was opened by NSW Health Minister Ryan Park, who commended the work of the ageing forum and said, “we cannot simply build our way out of this (health) challenge”.
“The number of Australians aged 65 and over is expected to double by 2057,” Minister Park said.
“Our traditional care models and workforce are not equipped to meet this demand. Both the Royal Commission into Aged Care Quality and Safety and the Aged Care Taskforce have made it clear that the aged care sector in its current form is not financially or operationally positioned to deliver the care Australians need.”
The Health Minister said initiatives which allowed older Australians to age in place, staying in their homes where they feel comfortable and connected to their communities were crucial.
“Together, we are proving that technology isn’t just a tool; it’s a lifeline for an ageing population and a foundation for a more resilient healthcare system,” he said.
A new ecosystem which relies on data
Independent Chair of the Aged Care Industry Information Technology Council, Dr George Margelis, described a new aged care ecosystem which uses smart sensors to not only provide a better patient experience and high-quality care for older Australians, but produce cost efficiencies for the aged care sector.
“We want to be able to do this in the home environment…where they are happy…but at the same time we know they will interact with the acute care sector, the aged care sector, the social care sector,” Dr Margelis said. “We can automate and make those processes a lot more efficient and effective by using technology.”
He said sensors, interfaces and apps – “an ecosystem of technology” – play a big part.
“Sensors are critical, and we can capture information that we never knew was viable before. In this brave new world of AI, we have an opportunity to now look at that data in a whole new way,” he said.
Dr Margelis suggested the federal government’s My Health Record Modernisation Act – which will allow people access to all their own radiology and pathology data – could be widened to include sensor data.
“If that data becomes available, we start thinking of new ways of delivering care, we change the paradigm of what a care model is to enable people to play a much more active role in that care model, but also to make that care model more effective,” he said.
Data storage and accessibility concerns
Associate Industry Professor at UTS and former NSW Chief Data Scientist, Dr Ian Oppermann, said if we could securely store information about ourselves and access it, “our long-term personalised journey through the health system and the ageing system would be greatly facilitated”.
He said while most Australians have a My Health Record ID, most don’t access this information.
“Digital identity is key to us being able to access important information about ourselves” Dr Oppermann said. “But we trust social media sites apparently far more than we trust authorised sources or store of data. There’s something we need to do about that.”
He said given our ageing population, the increased use of data, sensors and technology was inevitable to approach the need for care and productivity “that we must have to at least provide that level of care we have today”.
Consumer advocate Harry Iles Mann said the Australian Digital Health Agency is working on a vision for a national health information exchange which could have “better connected data about a patient’s health information”.
“From a patient point of view…if there was a way to see an active script list (this would be useful), ‘what am I on right now, what am I missing, what do I need repeats on, when am I about to run out of repeats of certain important medications’. So, it’s about really bringing all of that together.”
A Healthy@Home approach
Leading Geriatrician, Healthy@Home partner, and Director of Aged Care and Rehabilitation at South Eastern Sydney Local Health District, Associate Professor Peter Gonski, said the policy of the Southcare Aged and Extended Community Care service – which saw 1000 patients a year – was to treat older citizens at home or in aged care facilities.
“Nurses and doctors get in their car where they can do pathology, they can do scans and ultrasounds, they can do all sorts of things because everything is with them,” he said.
Those in need of specialised care are taken to an area of the Sutherland hospital where they can be treated by a team within four hours. He said the model is keeping 95 percent of older patients out of hospital.
“It’s much better for the person...it’s much better for the hospital as it frees up beds.
Older Australian, Janet McDonald AO said the aged care system was “muddled” with responsibilities shared between the state and federal government.
“Most people don’t think about being aged, or caring (for an older person), until it happens to them, and then it’s a very muddled system,” she said. “We need to think about how we find our way through that muddled system.”
“Most people want to stay at home, they don’t want to go into hospital.”