NHHRC final recommendations – continued

53. The safety, efficiency and effectiveness of care for older people in residential and community settings can be assisted by better and innovative use of technology and communication. We recommend:

• supporting older people, and their carers, with the person’s consent, to activate and access their own person-controlled electronic health record;
• improved access to e-health, online and telephonic health advice for older people and their carers and home and personal security technology;
• increased use of electronic clinical records and e-health enablers in aged care homes, including capacity for electronic prescribing by attending medical and other credentialled practitioners, and providing a financial incentive for electronic transfer of clinical data between services and settings (general practitioners, hospital and aged care), subject to patient consent; and
• the hospital discharge referral incentive scheme must include timely provision of pertinent information on a person’s hospital care to the clinical staff of their aged care provider, subject to patient consent.

Caring for people at the end of life

54. We recommend building the capacity and competence of primary health care services, including Comprehensive Primary Health Care Centres and Services, to provide generalist palliative care support for their dying patients. This will require greater educational support and improved collaboration and networking with specialist palliative care service providers.

55. We recommend strengthening access to specialist palliative care services for all relevant patients across a range of settings, with a special emphasis on people living in residential aged care facilities.

56. We recommend that additional investment in specialist palliative care services be directed to support more availability of these services to people at home in the community.

57. We recommend that advance care planning be funded and implemented nationally, commencing with all residential aged care services, and then being extended to other relevant groups in the population.

This will require a national approach to education and training of health professionals including greater awareness and education among health professionals of the common law right of people to make decisions on their medical treatment, and their right to decline treatment. We note that, in some states and territories, this is complemented by supporting legislation that relates more specifically to end of life and advance care planning decisions.

The final report can be downloaded at http://www.nhhrc.org.au