Aged Care Data Compare: Technical notes
Data standardisation
The project will deploy a ‘proxy’ data standard, based on the interRAI Long Term Care Facility assessment system (LTCF, see www.interrai.org and www.interrai-au.org), as a yardstick against which to map clinical concepts embedded in existing software systems. The interRAI LTCF comprises 250 observations of the characteristics and needs of the residents across an extensive range of clinical domains. It is the most widely used clinical assessment care planning system worldwide.
In the first instance, the team will map existing data elements to the interRAI items, and assess the integrity of the translation. In consultation with industry participants, a standardised proxy data set will be defined.
SNOMED CT AU compatibility
A gap analysis of the interRAI LTCF data elements and SNOMED CT AU will be conducted. This will involve mapping the interRAI LTCF data element values to SNOMED CT AU and identifying interRAI LTCF elements with no matching SNOMED CT AU content. Requests for new content to represent unmatched elements will be made to SNOMED CT using the organisation’s standard process.
Securing inter-operability
The project will define resources to represent assessment and clinical data for aged care in the FHIR® (Fast Health Interoperability Resources) paradigm and deliver a FHIR implementation guide (FHIR IG) initially using the data definitions and data elements within the interRAI LTCF dataset. The team will align this work with that being conducted using the interRAI LTCF in other jurisdictions (notably Belgium, Canada, Finland, New Zealand, Switzerland).
It is hoped that these (FHIR) resources will represent an industry interoperability standard for Australia, and potentially internationally. Integration of these resources into software solutions will pave the way for data exchange among software platforms within and beyond the aged care industry.
Compatibility with quality indicators & measures
The Australian Department of Health is currently trialling 7 quality indicators and is likely to resolve a final set later in 2020. The Aged Care Data Compare project will ensure that the raw data elements that enable calculation of these indicators are incorporated into the proposed standardised data set.
In addition, the team will create an inventory of quality indicators that have been created for institution-based long term care settings. These indicators will reflect both the processes and outcomes of care. The team will identify which of these indicators can be calculated from the Australian data set.
In collaboration with industry advisors, a test set of indicators will be created for trialling in the proposed data hub and benchmarking model. The indicator set will include those indicators developed and confirmed by the Department of Health.
The Aged Care Data Compare data hub
In collaboration with other University of Queensland entities, the team will design and construct a prototype data hub that will take into account the recommendations from the privacy impact assessment (PIA) process, and relevant state and Commonwealth laws and regulations governing the handling of de-identified health data and quality registries.
An analytics application will be constructed to enable ingestion and interpretation of provider supplied data, to create report formats that will enable benchmarking of selected quality indicators.
Upon completing the development and initial tests, the entire system will be tested using production data (simulated data) from at least three different vendors. The purpose of this testing will be to ensure that all the individually tested units of the system work as required as a unit. This will include the ability of the FHIR IG to effectively facilitate data exchange and the prototype data hub’s benchmarking capability.
Outputs and timeline
The project is scheduled over a 2 year period, and commenced in June 2020. The major project outputs include the data and quality indicator inventories, a FHIR implementation guide, a prototype data hub, and a benchmarking toolset, along with protocols for mapping, data retrieval and analysis. The inventories and FHIR guide are expected to be compiled in year 1, with the prototype data hub and benchmarking toolset constructed and tested in year 2.