Senate Community Affairs Legislation Committee, , 3:03:45 to 3:09:40
Officials discuss the upcoming independent review of aged care classification and prioritization algorithms, which will incorporate clinical expertise and dementia care feedback.
Topics: Health, Artificial intelligence
Speakers: Senator Penny Allman-Payne, Mr Blair Comley, Ms Sonja Stewart, Mr Greg Pugh, Senator Ellie Whiteaker
Chair, if I could just have another question given the long answer that Mr. Comley has just given me in relation to this line of questioning. We've heard evidence during our support at home inquiries, and particularly in relation to the IAT, that the tool as it currently stands doesn't adequately take into account things like cognition, medication management, social issues, toileting, care profile, psychological issues, physical personal health and frailty. We've heard from functional assessment experts that these are critical debt domains, and yet in the way the algorithm is designed, to the extent that we have been able to understand it, noting that the Ombudsman says it's still a bit of a black box. They come in so late in the decision making tree that at best they move people up one or two levels, whereas what functional assessment experts are saying is they should be at the front of the algorithm. So that so that the questions people are being asked at the start of the algorithm throws them basically to the top or the bottom of the tree, and then all of these things that are really critical for understanding older people's needs come in so late that they can hardly shift people. So is it how is it appropriate for cognitive issues to exist in the test as a secondary consideration rather than a primary one when when functional experts are telling us that that that is not right?
So the government so Senator Ullman Payne, that can be addressed. Um the government will consider and finalise terms of reference for the review that it is um announced in terms of the classification algorithm and the priority algorithm and the points that you go to are particularly relevant to the classification algorithm and the involvement of experts in in that review.
Stewart's response? So uh as the government has announced there will be uh the independent review of the H care classification and prioritization uh algorithms, uh, and we're making sure that we, as we should ground that uh review in clinical expertise, so we will have an expert advisory group that will bring together experts in gerontology, uh First Nations culturally and linguistically uh diverse uh groups, allied health, and to your point, dementia care. So we have heard that feedback. We have worked with Dementia Australia and other um peak bodies uh around here in their concerns, and we will be making sure that this is incorporated in that review of which the terms of reference will be made publicly available in the not too distant future.
Okay, so with that answer in mind, I just want to come back to my original question. Given that you've just said to me how extensive the concerns are that have been raised by providers, assessors, families, peak bodies, gerontologists. How can you have confidence that the integrated assessment tool is accurately assessing older people right now, particularly those with cognitive issues?
So the reason that I have the confidence is because the integrated assessment tool is the is the clinical tool that is used, and then what we're talking about are the algorithms. So I have a lot of confidence in the tool that was uh you have confidence in the algorithm. Well, uh the confidence in the algorithm, the government's um the government's announced its review to do that.
Does that mean you don't have confidence right now, hence why we need a review?
So, Senator, I I have confidence the algorithm is at top of Ms.
Could I just get the answer to the question, please, Chair?
And then I'll Okay, every if everybody could just hold on for a minute.
Sure.
We will go to the department, the officials at the table for a question.
Yeah. So we have confidence in the algorithm being well tested, reflecting people's needs on the integrated assessment tool. That is not to say we can't go through approved process of continuous improvement. One of the things that's happened with the integrated assessment tool is the number of people appealing, the outcome of that is actually been very small. It is still 0.6% have actually appealed against the decision of the integrated assessment tool from expert input from assessors. Um we have a high degree of confidence in that, notwithstanding the fact that we think continuous improvement is possible. I think it's important to draw the distinction between the prioritization algorithm and the IAT and the algorithms associated with that. The prioritization algorithm with the government earlier on announced a rapid review of the prioritization algorithm. I think did reflect the fact that the prioritization algorithm was too had too few criteria that was not accurately reflecting some of the needs on prioritization. So that is the one that we've done the rapid review. We'll now be also reviewing the IAT, but we have a high degree of confidence the IAT on the classification side is doing a good job of determining need. We acknowledge that external parties have views and that we're really keen to engage with them further as we go through the review process to ensure we can continue to refine uh a mechanism that is being used to allocate a very large number of packages.
Thank you, Senator Allman Payne. Senator Ruston.