Accredited software, better interoperability and real-time data required to implement Counsel Assisting recommendations: Health Metrics’ Steven Strange

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The recommendations from the Counsel Assisting to the Royal Commission represent a “new true North” for the sector, according to the CEO and founder of Health Metrics, but will provide the most significant shake-up of the system in 15 years – and providers will need the right systems to survive.

In a webinar yesterday on interpreting the Counsel Assisting’s submissions, Steven (pictured above) emphasised that providers cannot plan early enough for the changes that will come from the recommendations, which he divided into five categories:

The new Aged Care Act

Avoiding the “tinkering at the edges” or previous reviews, Steven says the recommendations would deliver a new system where human rights will trump clinical models and cost into the tens of billions.

The role of boards will be pertinent to implementing the changes, with the recommendations “very prescriptive” about their role.

“It may be hard to find willing participants especially for volunteer boards,” he stated.

Information technology and innovation

While Steven commends the financial incentives for innovation, he said IT departments will need to work hard to respond to the need to collect minimum data sets and follow new protocols for health and social care.

He agreed that accreditation of software providers will be critical to make sure they are consistent with the Quality Standards. This will also require services with the interoperability to allow for data exchange, he said.

Steven used the example of a retirement village resident who moves into residential care for respite and then returns to their village.

“Providers will require much more flexible and agile systems,” he said.

This will take in greater use of My Health Record as well as activity-based systems that differentiate the activities by rules.

“Not being able to decipher and sift between specific activities by role is going to make it very difficult for you to participate,” he said. “I suspect a lot of systems are not ready to cope.”

Workforce and education

With no real mention of ratios, Steven pointed to the recommendation for minimum staffing time, but warned this would amount to a 30% hike in carer hours.

While the scheme does not begin to be implemented until 2022, Steven says their data shows the increased RN time will amount to 46.3 hours a week – a significant cost for smaller operators.


In terms of finance, Steven noted the recommendations removed the assessment for funding requirements from providers to external assessors which he said would provide the Government with more certainty (trust?) around where funding is being spent but also require finance departments to understand the bureaucracy around it.

He also stressed that based on their data, the recommendation to move all younger people out of residential care by 2025 will result in a 1% decline in the sector’s overall occupancy which could financially impact providers that have younger people as part of their cohort.

Their figures also showed there was a 36% gap between funding for the highest-level residential care and Level 4 Home Care packages, meaning that more funding will be found if the Royal Commission goes ahead with the recommendation for the two to be equivalent.

Transparency, disclosure and publication

With the recommendations requiring more stringent and regular financial reporting, Steven said providers need to know now if their systems are capable of dealing with regular high integrity reports.

Providers will also need the ability to produce real-time data, he added as the regulator would be given stronger powers to search and enter premises and compel documents and information.

“It’s not too early to plan,” he concluded. “Being agile and capable will mean survival. Those with ageing systems will really struggle.”

Viewers agreed – 95% of those who watched the webinar agreed that they liked what was coming in the recommendations.