Building integrated systems in aged care

SoOne study¹ found 72.6 errors in care team records per 100 medications, with 48% able to cause moderate harm and 9.8% severe harm. Another study² showed facilities were spending an hour completing forms or transferring data between systems. It is clear that more practical steps are needed for integration without requiring aged care executives to become software developers.

What do we mean by integration?

A well-integrated system passes several tests. Firstly, it should enable data to be entered once and then passed securely to other systems. Secondly, when an event occurs in one system, the data is automatically placed in all other systems where it is relevant to save time. Finally, the integration should connect externally with pharmacists and doctors to have one up-to-date source of truth with no re-transcribing.

Why’s it been so hard?

Historically, there have been three barriers to integration: technical, cost and mindset. Trying to get aged care systems to speak together is like communicating with someone in a different language. You first need a way to translate the language and technically link the systems. The second barrier is cost, as building bespoke integrations can outweigh the benefits for the developer and, thirdly, software companies’ mindset. Some software developers have a closed integration policy that restricts the customer from integrating with external systems in favour of retaining revenue.

What’s changed

Over the last five years, the technical barrier has been reduced as the consensus has formed around a new integration standard called Fast Healthcare Interoperability Resources, known as FHIR. This reduces the first and second barriers enabling different software to integrate efficiently. That leaves the third, more nebulous barrier. Unlike the USA, Australia does not yet regulate that health systems be open, so executives need to ask the right questions to avoid being trapped.

How can you build integration?

As the customer, you have a voice. Look for open systems that connect to partners across the aged care network. Ask if they integrate with other systems to enable two-way data sharing and if they are using FHIR standards. Will they integrate with systems that compete with their own modules, such as medication management or patient family apps? If not, take time to view alternatives and understand options before renewing. BESTMED is seeing increasing numbers of facilities enquiring about their systems integration status and are willing to migrate to a system with an open integration policy. For the record, BESTMED uses the FHIR standard and integrates with all the major resident management systems that are willing to do so. With a $2.5m development budget focused wholly on medication management, we’re always looking for new ways to improve integrations and are happy to offer advice for facilities.

First published in The Source, 12 November 2022

1 The General Practice and Residential Aged Care Facility Concordance of Medication (GRACEMED) study

2 Examining the role of information exchange in residential aged care work practices – a survey of residential aged care facilities.