Abstract
This chapter examines how information and communication technology (ICT) and working anywhere was adopted in a not-for-profit aged care organization in Australia. The aged-care and services sector is expanding, leading to shortages of skilled and experienced workers. At the same time, the sector is dealing with significant changes relating to how services are funded, an increase in competition from both not-for-profit and for profit providers, a rise in demand for services, changes in technology, as well as variations in government regulations. Using ICT to streamline operations, communicate and collaborate has become critical for delivering efficient and effective services the aged care and services sector. The not-for-profit case study in this chapter shows how a first mover in ICT adoption and utilizing working anywhere (telework) can support cost savings, provide the ability to respond to the changing regulatory environment, as well as attract, recruit, and retain skilled and experienced workers.
TopIntroduction
The number of people in care across the world is expected to be 2.3 billion by 2030, driven in part by older persons living beyond their predicted life expectancy. Although many older people can contribute to economic and social prosperity, more people are surviving after suffering from chronic illness and experience multi-morbidity and frailty (ILO & OECD, 2019). The aging stage of life should be one where the focus should be on the quality of life, not just quality of care. Across the globe, there is a recognition that keeping people in their homes and communities (keeping them 'in place') assists in reducing social isolation and leads to a better quality of life for an aging population (Freek et al., 2019).
Reliance on care systems to support older people will require more workers in the aged care sector in the future (ILO & OECD, 2019). Worldwide, there are and will continue to be challenges in recruiting and retaining suitably qualified workers to care for our aging population. The shortfall of workers and the increasing costs of caring for older people requires the innovative application of various information and communication technology (ICT) solutions to support the skills of the workforce (Freek et al., 2019). The overall goal of applying technological solutions in this sector is to improve both the life expectancy and healthy life expectancy gap for the aging population (Kang, 2016).
In the Australian context, the population is getting older, with around 25 per cent likely to be 65 or older by the middle of the 21st century. Residential care homes are becoming larger with the home care and home support sector expanding (Kostas et al., 2017). The Australian government has moved to a consumer-centered, community-based, independence-focused model for aged care because it is more cost-effective and provides more choice for consumers. Projections of growth in the aging population suggest that demand for aged services will increase. However, it is unclear how many people will live longer than 85+ and to what extent older people will be healthy or potentially living with disabilities and/or chronic health conditions (Baldwin & Chenoweth, 2015; Chomik & MacLennan, 2014).
Not everyone will need care as they age, and a substantial proportion of people may never need any care in their lifetime depending on their level of health (Chomik & MacLennan, 2014). Between 2008 and 2016, the utilization of aged care in Australia remained consistent, that is, although the number of people receiving aged care services increased, the proportion of older people needing and receiving aged care did not change (Khadka et al., 2019).
In 2012, the Australian government adopted a ten-year Living Longer, Living Better policy to reform the sector to be consumer-driven and reduce costs (Chomik & MacLennan, 2014; Department of Health and Ageing. Canberra, 2012). The reforms included a web portal 'My Aged Care' that replaced three community-based programs ((Community Aged Care Programme, Extended Aged Care at Home, Extended Aged Care at Home-Dementia) (Khadka et al., 2019).
On the 1 July 2015, it became mandatory for all home care packages to be delivered on a customer directed care (CDC) basis. From 27 February 2017, all home care packages were provided to individual consumers instead of the home care packages being awarded to approved providers under an allocation process (Department of Health, 2019). This reform of choice-focused care models with individualized budgets is consistent with the US, the UK and some parts of Europe (Phillipson, Low, & Dreyfus, 2019).
There are two primary services in the Australian aged care and services sector. The first is residential care (in institutions), and the other is community care (support to stay at home and in the community) (Aged Community Services Australia, 2015; Chomik & MacLennan, 2014). Until recently, Australia relied on the not-for-profit sector to supply both residential and community aged care services. An exception is in rural and remote areas where some services are state-owned (government) hospitals or through multi-purpose services (MPS) co-funded by the state and Commonwealth governments. In more recent times, there has been an increase in private-for-profit ownership of residential aged care facilities (RACF), primarily in the metropolitan regions and a reduction of government beds in rural and remote regions (Henderson, Willis, Xiao, Toffoli, & Verrall, 2016).
Key Terms in this Chapter
Telehealth: The use of telecommunication techniques to provide telemedicine, medical education, and health education over a distance.
Community Care: Supports people to continue living at home for as long as possible, and provides more choice and flexibility for people receiving care at home.
Healthy Life Expectancy: Average number of years that a person can expect to live in “full health” by taking into account years lived in less than full health due to disease and/or injury.
Information and Communication Technology (ICT): All the technology and resources used to communicate, and to create, disseminate, store, and manage information.
Residential Care: A special-purpose facility which provides accommodation and other types of support, including assistance with day-to-day living, intensive forms of care, and assistance towards independent living, to frail and aged residents