Aged Care ICT trends. Findings from a Logicalis survey of Australian Aged Care IT and business decision-makers

Transcription

1 Aged Care ICT trends Findings from a Logicalis survey of Australian Aged Care IT and business decision-makers

2 Unlike the commercial business sector, the majority of Aged Care providers are in the late majority when it comes to adopting new technologies and are cautious investors. For example, the most prevalent planned investment over the next 12 months is creating a mobile workforce. Some of the other lagging areas of ICT investment are: Public cloud offerings, with most providers only just starting to get serious about adoption. Depreciation cycles on existing infrastructure and concerns about hosting locations have slowed efforts in this area. The Logicalis Survey The Logicalis Trends in Aged Care IT survey was conducted at ITAC in July 2014, with a number of organisations followed-up with a phone interview. The data is based on 43 respondents from 28 aged care providers, representing a small but significant of the Australian aged care market place. Criteria Survey Australia Total Subsidies $1,080b $10,114b Total Beds 19, ,761 Total Packages 8,547 60,187 Based on DoHA web site data as at 30/6/12 Video-conferencing is finally attracting attention where providers have significant geographic spread. Capital cost and bandwidth limitations have been impediments; new capability with respect to webcams and smart phones are changing perceptions. However, the need to invest in new technologies is now a recognised need and most providers surveyed are expecting to have large IT budgets next fiscal year. In part, this is being driven by the need to remain competitive in the marketplace and to be able to provide a level of differentiation against like competitors. Better systems and client focussed technologies also play key parts in this approach. Aged Care ICT Trends Logicalis Business Survey page 2

3 Insights from the 2014 Survey Overview Medium and smaller aged care providers generally spend more than large providers as a % of estimated revenue. This reflects their need to increase their budgets to remain competitive in the market place. The number of IT staff decreases based on size of the provider (as to be expected) but: Small providers outsourced all services almost exclusively as there is rarely any more than one person charged with looking after IT Medium providers were divided on maintaining their own infrastructure and generally relied on vendors for application support. Large providers tended to be self-sufficient in all areas but had some limited managed services arrangements. Mobility is clearly the target for most organisations, and was the most frequently cited focus in term of ICT investment. Other items of interest were: Client Services encompasses resident telephony and wireless internet. It also includes access to corporate web portals for information. Interviewees were divided on whether or not they would absorb the additional costs for resident telephony and internet or make a small charge to cover costs. Telehealth was seen as important, despite the current difficulties in engaging GPs in the absence of Medicare Rebates. A common view is to provide video consultation with trained personnel such as a Registered Nurse. Many organisations have plans for introducing a medication management system. Org Size Average IT Staff Est IT Budget ( as % Annual Rev) Est IT Budget ($ pa) ICT Budget Increasing Large % 4,444,623 50% Medium % 1,801,591 80% Small % 171,135 86% Aged Care ICT Trends Logicalis Business Survey page 3

4 The Board is driven by what provides value to the residents and as such, they look for technology investments that will create efficiency and cost reduction to invest back into resident care Policy Manager ICT Strategy, Budget and Organisation Formal IT strategy plans were conspicuous by their general absence from most providers. However, technology as a marketing differentiator was considered as a current corporate philosophy or as desirable by over 65% of respondents. This was especially the case for smaller organisations, who came across as being more progressive when considering new technology. Technology decisions are mostly based on reduced costs and/or increase productivity. Most organisations interviewed then assess these improvements with a view to increasing resident care. There was a marked absence of robust Disaster Recovery arrangements across most providers. Only two organisations rated Risk Mitigation as being a key criterion for new technology deployment. Org Size Technology as a Differentiator Current Desired No Response Total Large Medium Small Aged Care ICT Trends Logicalis Business Survey page 4

5 Nurse Call systems Over half (62.5%) of Nurse Call systems were non-ip these results are not surprising in that most providers have a variety of Nurse Call systems within their property portfolio. Most organisations interviewed described their systems variously as archaic or unsupported but in each case, still working. Regarding future investments in Nurse Call, most interviewees would consider wireless systems given: Plans to invest in WiFi Difficulties in wholesale cabling of brownfield sites. Nurse Call Type IP Non-IP Hybrid 3 7 No Response 0 2 Wired 5 6 Wireless Aged Care ICT Trends Logicalis Business Survey page 5

6 Clinical and Medication Management There is a clear direction towards electronic collection of clinical data, and electronic management of medication (even though the latter was more of a future than a priority for the next 12 months). The absence of WiFi is seen as an impediment to timely implementation of both systems. Based on interviews, it would be wrong to include that collection of this data would necessarily occur bedside even though this was implied by the question. One interviewee planned to provide workstations in close location to rooms, while another organisation interviewed needed to deal with reluctance of staff to use tablets at the bedside for a variety of reasons, including unfamiliarity and infection control. Clinical Management Current Clinical Type Total Future Clinical Type Total Both 3 Both 2 Electronic Only 16 Electronic Only 22 Paper Medication Management Current Medication Type Total Future Clinical Type Total Both 2 Both 1 Electronic Only 5 Electronic Only 20 No Response 1 No Response 1 Paper 16 Paper Aged Care ICT Trends Logicalis Business Survey page 6

7 Mobility and availability of information According to those interviewed, when it came to the question of Do carers have access to the information that they need to do their job anywhere within a facility, there was a very mixed response, which was generally based on timeliness of access to data. For example, Rarely meant that few, if any, care staff had a mobile device with access to resident data. Conversely, Always meant that there was always a Nurse Station workstation that was used for information purposes. Typically, resident patient paper files were co-located at the Nurses Station. Sometimes and Often appeared to depend on how many Nurse Stations were (not) close by. When it came to access to information On the road (mobile access), again there was a mixed response from those interviewed. Generally, information available was limited to and occasionally files downloaded to the mobile device. Most interviewees provided mobile access to management only and not carers. On the other hand, all saw the need to have tablets and smartphones in the hands of carers as a priority. Based on interview feedback, most mobility policies were drawn up inhouse and rarely addressed more than use of a corporate device. Only one interviewee spoke of a BYOD program which was seen as a failure, and there was a clear preference to corporate supplied devices that allowed for reasonable levels of personal use. A number of providers stated that they are considering large scale tablet / smartphone deployments to assist facility staff have access to all relevant resident data while on the floor. The plan is to have one tablet per staff member on shift, although one provider is considering a tablet per room approach. This would act as an electronic clipboard to be used by staff or freely used by the residents at other times. Form factor was considered critical as most providers only wanted to provide one multi-purposed device. There were some providers who felt that many of their care staff were not comfortable using mobile devices, and all saw adequate levels of technology support as being critical prior to general deployment. As far as operating systems for mobile devices was concerned, there were a marked number of interviewees who thought that they would deploy Windows tablets Microsoft Surface 3 was most commonly mentioned - and Windows Phone 8 on Nokia phones was well regarded. Aged Care ICT Trends Logicalis Business Survey page 7

8 Video-Conferencing (including Telehealth) Most video-conferencing use was for internal communications only. The principal justification was to cut down on travel and accommodation between geographically dispersed offices. Many providers see expanded use of video-conferencing as a means to reduce travel and accommodation costs. Most are looking to blend formal video-conferencing facilities in one or more locations with remote workers logging in through either Microsoft Lync or Skype. Only two organisations interviewed indicated that they were actively using or had used video-conferencing in the context of Telehealth. In the first case, it was being used between Registered Nurse and Hospital. In the second, it was trialled within one Medicare district between provider and selected GP s. It is no longer being used since the pilot funding did not carry forward into this fiscal year. The lack of Medicare rebates is seen as a serious impediment to a wider scale use of the technology in aged care. Organisations who were willing to pursue Telehealth in the area of inhome were contemplating its use between care recipient and either a centrally located RN or, in one case, with the carer on a smartphone utilising Skype. Whether or not telehealth has been trialled by a provider, no-one spoken to seemed convinced that video consultation was an effective technique for diagnosis and treatment. Concerns raised were: Quality of video equipment Cost and quality of end diagnostic devices Communications bandwidth. Video conferencing Total Already 8 Expanding 1 No Response 1 Planning Aged Care ICT Trends Logicalis Business Survey page 8

9 Cloud (Private and Public) Most interviewees considered running a thin client computing environment with centrally located servers as being Private Cloud. Two organisations had already moved production systems to the public Cloud with one other in progress. In each case, they were paying extra for additional DR services. Three organisations were actively considering DR in the cloud and most organisations were actively evaluating Cloud options for new application requirements or applications replacement. Smaller providers seem more willing to deploy new administrative systems in the cloud. However, no-one was considering utilising the Cloud for confidential data due to their obligations under Australian Privacy legislation. There is a general opinion that : IaaS is only just reaching maturity to level where it becomes a viable alternative to buying new hardware, and SaaS is not yet sufficiently mature for business critical applications. Cloud adoption Total Already 10 Expanding 3 No Response 4 Planning 7 24 IaaS has only really reached maturity in the last 12 months and is now a viable alternative to data centre investment. On the other hand, SaaS is not mature and there are significant concerns over the privacy and sensitivity of client data. General Manager, Information Aged Care ICT Trends Logicalis Business Survey page 9

10 No, we do not have a properly converged environment. If it was converged, we would see integration between information system silos. We are planning to use SharePoint as the integration mechanism for sharing data across systems. CIO Technology integration At a hardware or platform level, most systems are already IP based Nurse Call, security, CCTV and building management systems are gradually being replaced by IP-based systems as they reach end-of-life. Progressive aged care providers are utilising systems like Mobicall as an enabler to effect system to system interconnection (eg nurse call and BMS components). Clearly, IP enabled systems simplify integration because share a common language (IP). This approach also enables an automation layer, allowing rules to be defined to facilitate the business process, and are slowly becoming the standard for new builds. However, application to application integration in aged care is rare. While disparate line of business systems from different vendors generally have a an interface to financial system, most data is still siloed finance, payroll, HR, Property, Residential, Community. Application with data on multiple systems. This also impacts mobility deployment, as there are no applications which can selectively pull data from different systems to provide a single view of a care recipient. Similarly, data captured on mobile devices is not integrated back into corporate database due to limitations in the backend systems: A number of respondents spoke about a desire to access data from multiple systems into the same user interface: Our biggest drawback from an IT perspective is that all our information is siloed across lines of business with no integration. Integration is essential for more efficient administration (Administration Coordinator). Aged Care ICT Trends Logicalis Business Survey page 10

11 Conclusions the bigger picture The majority of respondents especially from large agred care providers expressed a desire to use technology as a differentiator, but did not feel that this was being achieved today. In marketing to the next generation of residents, technology will become increasingly important, and wireless is a key driver in enabling new IT services: Residents see us using mobile devices so are clamouring for wireless Internet access using their own BYO devices. We are quite supportive of this and wireless is made freely available now that we have put appropriate security measures in place (Manager, IT Services). The end game for many providers is breaking down siloes between systems. Having the right information means the capability to transform business operations, and none of the survey respondents had fully implemented an effective data warehousing or even consolidation of information into a single repository, although some projects were underway. Technology is equally attractive in reducing carer workload and increasing productivity, enabling carers to spend more spend with residents. Consolidating resident information from multiple systems onto a single device, and then getting the data back into a single system, is still proving a barrier to effective deployment of mobility. Getting the right device is also a challenge that many providers are currently addressing, with Windowsbased tablets proving a popular choice, as well as ensuring that the mobile technology is easy to use. Aged Care ICT Trends Logicalis Business Survey page 11

12 Logicalis is focussed on understanding the challenges of Aged Care providers and developing a set of technology solutions that addresses the unique requirements of this sector, including technology integration, a single point of accountability for new builds and service desk capabilities. This research was undertaken in conjunction with Eldertech, whose mission is to bring technology out of the back office where it can be used for the immediate benefit of care workers and subsequently by care recipients and their families. marketing@au.logicalis.com Aged Care ICT Trends Logicalis Business Survey page 12