Aged Care Data Compare - Q&A

No. To our knowledge no other research teams are pursuing this work. There are other national and international teams conducting related work in data standardisation, and we are in communication with them to share knowledge and for technical efficiencies.

This project will not collect or use residents’ personal information or data. We will develop data standardisation models (based on FHIR resources, applicable SNOMED CT terms, the LTCF proxy care assessment) and a prototype data hub. We will do this with input from technical, clinical and aged care experts. We will use “dummy” data to test the use of these FHIR resources with the software vendors of RACFs. We will also test the prototype data hub with dummy data for its ability to collate, present and analyse such standardised data.

In the future, capabilities based on outcomes from this project may use de-identified data related to residents’ needs and outcomes. Such use would be the subject of relevant data privacy, consent and security laws and standards; and data privacy, consent and security agreements between project participants. With this in mind, a privacy impact assessment (PIA) process has been initiated as part of this project, and relevant state and Commonwealth laws and regulations governing the handling of de-identified health data and quality registries will be followed. This process will inform the design and development of outcomes from this project so that they are ready and compliant for future use with de-identified data.

LTCF stands for the Long-Term Care Facilities assessment, and interRAI is an international collaborative that develops comprehensive assessment systems. interRAI Australia is supported by a Coordinating Centre based at the University of Queensland. The LTCF assessment enables carers to make a comprehensive, standardized evaluation of the needs, strengths, and preferences of persons in residential aged care settings. This assessment covers much more than medical issues and includes items to assess a person’s wellbeing (physical and mental), their needs for daily living, and to plan for their care. The interRAI LTCF (or previous versions) is used extensively across Europe and North America. It is mandated by governments in many nations, including Canada, Finland, New Zealand and the USA.

We chose the LTCF dataset as the basis to standardise data elements and definitions in this project. Aged care providers will be collecting similar or overlapping information as part of their ongoing assessments of resident’s needs. The naming, definitions and recorded responses will, however, vary between organisations and IT software.  We selected the LTCF assessment as a proxy reference because it provides comprehensive coverage of relevant issues, has clearly articulated specifications, has good reliability and validity, and it is the most widely-used, long-term care assessment system. This approach also ensures that this project will have international relevance; it opens the door for Australian software vendors to position themselves in markets where the interRAI standard is mandated (e.g., New Zealand, Canada) or emerging (e.g., China, Hong Kong, Singapore).

AN-ACC stands for Australian National Aged Care Classification and was released in early 2019. The AN-ACC assessment captures clinical information that is directly related to the cost of care delivery.  As part of this project, we will assess the ability of the proposed AN-ACC data set to be mapped to the interRAI LTCF.

FHIR® stands for Fast Health Interoperability Resources. It is a standard for describing health data and exchange of this data. FHIR is published by Health Level Seven International (HL7), a not-for-profit standards developing organization. FHIR allows for the development of an implementation guide (IG) for healthcare data exchange in a specific setting. We will use FHIR-based data description for our standardisation agenda, and this will allow sharing of data from aged care organisations that use different aged care information technology (IT) systems.

FHIR IG stands for a FHIR Implementation Guide. An IG describes how standards and interoperability problems are dealt with for a particular care setting, via the FHIR standardisation method and model. The IG gathers all the parts into a logical whole and is published to assist care providers, software vendors and other interested parties. Development of an IG for the residential aged care is an aim of this project.

SNOMED CT stands for Systematized Nomenclature of Medicine - Clinical Terms. SNOMED CT is a standard for medical terminology and is employed to solve interoperability and exchange issues in the electronic recording of health care information. SNOMED CT aims to capture information accurately, promote data sharing, and facilitate analysis and research among other goals. This terminology standard is owned and maintained by SNOMED International, a not-for-profit association. As part of this project, we aim to make our proposed data standard SNOMED compliant.

Quality indicators (QIs) in aged care are measures developed and validated to help aged care providers understand and improve the care and services they provide.  QIs enable providers to identify and watch trends in care performance over time, plan their improvement initiatives, and compare themselves with other services. QIs can also be useful for people looking to judge the quality of care provided by an aged care service. All Australian residential aged care homes must provide QI data to Department of Health as a condition of Government subsidy of aged care. There are currently three mandated QIs for Australian residential aged-care facilities concerning pressure injury, restraint use and unplanned weight loss. Other quality indicator concepts exist; either in development, or in use internationally.

No, not directly. This project aims to produce a standard for aged care assessment data and build a prototype data hub that could collate such de-identified data. Our project team will, however, examine how current mandated QIs (and additional QIs; such as medication management, and falls and fractures) could be calculated from current assessment data collected by vendor software offerings, and from a proxy standardised assessment (the interRAI LTCF). We will also explore QIs in use in other nations (e.g. New Zealand, Canada, and USA) and assess their relevance to, and ability to be calculated from, the standardised data elements produced by this project.

This project is designed to create and test mechanisms that will enable sharing of information collected by aged care providers. In the future, it will enable provider organisations to indicate how they measure quality and show how they are currently performing. Such indicators will be of interest to current and future residents, and their families and carers.