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Analysis of the final recommendations of the Royal Commission into Aged Care Quality and Safety.

Analysis of the final recommendations of the Royal Commission into Aged Care Quality and Safety.

Lookout is being launched at a time when transformative change is urgently required. Many recommendations contained in the Commission’s final report will only be achieved through the adoption of technology and digital care management systems.

Five Good Friends is Australia’s first technology enabled and data driven approved provider of home care packages. In 2019 we made the decision to re-architect our proprietary digital care management software to a white label SaaS solution called Lookout.

Following the Royal Commission into Aged Care Quality and Safety handing down its final report we have released Lookout to the market.

We are supportive of the recommendations. The commentary below focuses on key recommendations that endorse the principles and insights we have drawn on to build Five Good Friends and Lookout.

Three broad observations:

  1. Technology: The recommendations support technology enabled, data driven home care organisations such as Five Good Friends and the adoption of technologies such as Lookout digital care management software to improve the quality, transparency and experience of care.

  2. Value Base Care: Many recommendations support the measuring, monitoring and reporting of outcomes which aligns to a Value Based Care model. The principles of Value Based Care are driving both the vision for the Lookout software and the service delivery model that underpins Five Good Friends.

  3. The informal carer: Five Good Friends and Lookout have been designed with the inherent customer understanding that growing older generally involves the love and support of family or trusted loved ones. The recommendations for the new act specifically call for the need to support informal carers. Informal carers are the heroes of our system and community. They provide care and support when others can't. Five Good Friends and Lookout recognises this important and critical relationship. The service delivery and software are designed to make care transparent and keep informal carers informed. ultimately the combination of the service delivery and software are designed to the give the care recipient and their loved one’s control and make them a partner in care.

Recommendation 1

A new Aged Care Act.

The recommendation of a new Aged Care Act with objects that provide a system of aged care based on a universal right to high quality safe and timely support and care is compelling and significant for the community, individuals and all providers.

Recommendation 22-24

Quality indicators; Using quality indicators for continuous improvement; Star ratings - performance information for people seeking care.

The design philosophy behind Lookout and the Five Good Friends service delivery model are driven by the principles of value-based care. Inherent in this is measuring, monitoring, reporting and responding to care outcomes. With Lookout, Five Good Friends, and care providers who use the software, can surface and publish real time quality indicators, respond to changes and set performance benchmarks. Lookout's survey library includes the Commonwealth Governments Consumer Experience Survey which enables recipients of care and their trusted loved ones to measurably provide feedback on their experience.

Recommendation 25

A new aged care program.

Because Lookout is SaaS solution, developed in Australia by a care organisation for care organisations, the updates required to reflect the new service types that will result from the new unified home care program will be implemented rapidly. This will place all organisations who use the software, including Five Good Friends, in the best possible position to operate under the new programme quickly and efficiently.

Recommendation 28

A single comprehensive assessment process.

Lookout's Comprehensive Online Assessment Tool, used to guide care assessments, and the corresponding Digital Care Plan can easily be configured to map directly to the assessment tool that will support the new single comprehensive assessment process including the needs of informal carers.

Recommendation 36

Care at home to include allied health.

Through collaboration tools such as shared notebook and tickets Lookout enables Five Good Friends and care organisations using the software to share information and co-ordinate multidisciplinary teams.

The Statements and Transactions feature publishes expenditure from direct, allied health and other services to the customer App. This keeps care recipients informed, updated and in control of their budget.

Recommendation 39

Meeting preferences to age in place.

This recommendation calls for the clearing of the current waitlist and keeping the wait list clear. Should this recommendation be adopted this will significantly increase demand for home care. Lookouts matching and verifications features will assist organisations to safely scale workforces and meet this demand.

Recommendation 41

Planning based on need not rationed.

This means people receive the funding they need not the funding that is available. If adopted many Five Good Friends customers may receive an increase in funding to the level, they have been assessed as needing. Five Good Friends are investing in growing and training the work force in anticipation of this and other demand generating recommendations.

Point (d) of this recommendation specifically calls out that the 'System Governor' and the new system collects data to monitor outputs and outcomes. Lookout's remote care intelligence platform captures and analyses data from observational notes, connected smart home devices, visit ratings and PROM and PREM surveys to detect changes in health and wellbeing and track the outcomes and experience from a care recipient’s perspective.

Recommendation 63

Access to specialist Telehealth services part b requiring home care providers to support Telehealth services.

Lookout supports Telehealth workflows and rostering of Telehealth appointments.

Telehealth features built into the Lookout App such as ‘Should Know’s and Shared Notebook enable care managers to remotely direct the care workforce to complete tasks and collect data as well as sharing information directly with the care recipient and family.

Recommendation 67

Improving data on the interaction between the health and aged care systems.

Because Lookout is developed by care, for care here in Australia, should this recommendation be adopted, the updates required to add the unique aged care identifier from the Medicare and PBS datasets to improve interaction between the health and aged care systems will be done as quickly as possible. The underlying principles of value based care guiding the ongoing development supports this recommendation to improve the sharing of data across systems enabling better outcomes for care recipients.

Recommendation 68

Universal adoption by the aged care sector of digital technology and My Health Record.

Part a The Australian Government should require that by July 1 2022

a. every approved provider of aged care delivering personal care or clinical care:

  1. uses a digital care management system - including electronic medication management system - meeting a standard set by the Australian Digital health agency and interoperable with My Health Record.

As the developer of Lookout, Five Good Friends started as a technology enabled data driven care provider. Unlike many other sectors, providers in this category have been starved of software solutions focused on solving their problems. This has made it difficult for organisations to evolve and modernise. This recommendation will drive that change. Lookout is a complete end to end digital care management SaaS solution. It supports care organisations of all sizes and in all geographies.

We have been waiting for the opportunity to integrate with the broader health system including being interoperable with My Health Record. Because Lookout is developed by care, for care here in Australia, should this recommendation be adopted, we will work as swiftly as possible with the Australian Digital Health Agency and other partners to ensure Lookout meets the necessary standards.

Recommendation 77-78

National registration scheme; Mandatory minimum qualification for personal care workers.

Ensuring the industry as a whole is able to meet the demand for aged care services with appropriately trained and qualified people is an issue facing all providers. Technology such as Lookout also has a significant role to play in enabling more efficient workforce planning and use of resource through telehealth and remote care monitoring services.

Recommendation 88-90

Legislative amendments to improve provider governance; Leadership responsibilities and accountabilities; New governance standard.

Five Good Friends and Lookout has expanded its Board in 2020 to include two new non-executive directors with skills in allied health and digital healthcare. As part of our quality care governance all directors have 24/7 access to Five Good Friends quality dashboards which are powered by the Lookout software. These dashboards provide real time information on key aspects of care quality and customer satisfaction including; emerging risk, incidents, client and family NPS, care worker NPS, incident trending, incident review and close out times, care manager performance and WHS. Board meetings have standing agenda items to review the trends and data surfaced in the quality dashboards. These processes already align to and support key aspects of recommendations 88-90.

Recommendation 94

Greater weight to be attached to the experience of people receiving aged care.

As part of its suite of remote care monitoring tools Lookout provides the Commonwealth Government’s Consumer Experience Survey in the survey library for users of the software. Five Good Friends were one of the first organisations in Australia to deploy this survey. Results from surveys are captured and stored in a care recipients health timeline. Declines in reported experiences or outcomes are flagged for investigation by care teams.

Recommendation 109

ICT architecture and investment in technology and infrastructure part b of this recommendation states: pre certified assistive technologies and smart technology to support both care and functional needs and manage safety and to support the quality of life of older people. These technologies are to:

  1. be universally available and enabled through internet and wifi access and funded by the Australian Government.

At the heart of Lookout is a Remote Care Intelligence Platform. This enables care providers to capture and analyse data from observational notes entered into the app as well as alerts raised by smart home technologies (for example pattern recognition systems) that are used to enhance oversight and ensure the safety of people living in their homes. The platform is agnostic. This will enable Five Good Friends and users of the software to design and deploy care plans that blend services and smart technologies to improve safety and quality of life for older people.

Recommendation 123

Payment on accruals basis.

We have anticipated this change based on the new payment arrangements already set in place by the Government. Lookout will enable providers to claim appropriately.

Recommendation 124

Standardised statements as services delivered and costs in home care.

Because Lookout is developed by care for care here in Australia should this recommendation be adopted the changes required to meet the Government standards will be rapidly deployed. Today Statements are published directly to the care recipient and their trusted loved ones through the app, providing complete transparency on expenditure, services and budgets.

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