It is common for people not to plan for the later stages of life and when the need arises to self advocate, their voice can be lost due to frailty, illness, lack of confidence or acceptance of prescriptive care provision.
Currently less than 30 per cent of ageing Australians have valid aged care planning documentation. It is important to have an end-of-life plan in place to honour people’s wishes, and to take the pressure out of decision-making for families when their loved one is unable to make decisions for themselves.
Nurses April Creed and Rebecca Glover founded ExSitu in 2019 to address the need for everyone to have an end-of-life plan. They built an advance care planning web-based app as a facilitated delivery model with a view towards ongoing process improvement.
This solution provides a clearer, calmer and easier way for people to create holistic advance care directives. It helps people drive the direction of their future ageing experience and empowers them, while also giving valuable information to aged care providers.
The nuts and bolts
An online interactive process, ExSitu helps people navigate difficult conversations about the later stages of life, recording their core values within advance care directives and other holistic protective documentation that can be reviewed, signed and shared.
The intuitive web-based app applies a combination of traditional practice and sophisticated predictive algorithms to guide people through a reflective card sorting process, to help them identify their values and desires. The answers are documented and automatically presented in a downloadable document, in a legally and clinically recognised format.
ExSitu’s unique advance care plan and hierarchy of values document integrates into existing aged care platforms so that aged care providers can have insight into their clients, their wishes and values, which helps support person-centred care.
Collaboration with IRT
Collaborating with aged care providers is an important component of any product or service designed to improve the lives of older Australians. In the case of ExSitu, it was a dynamic collaboration with aged care provider IRT and its staff that helped drive the ExSitu business model.
This experience is now used in April and Rebecca’s mentoring of NSW Western Local Health District staff and used as an example to pitch for seed feeding for health-based research projects, in order to continue to deliver viable improvements to aged care.
Delivery of the platform
Until now, April and Rebecca delivered ExSitu only via trained facilitators in aged care settings. They have now built upon this work using intuitive algorithms and app supported video explainer content within the ExSitu platform.
This has addressed increased consumer appetite for telehealth solutions, particularly with the onset of COVID-19, and has enabled any individual in Australia to record their values and create documents, without the need for assistance or facilitation. The direct-to-consumer web-based app went live in September 2020.
The ExSitu app was well received and is supplied to people via four large care providers nationally, while version two of the platform, which can be accessed by anyone, has improved the uptake of advance care planning among ageing Australians.
ExSitu now gives ageing Australians the benefit of highly personalised, clinically relevant and holistic advance care planning documents, without the need for assistance from a care provider or medical professional, facilitating a smoother delivery of care.
ExSitu with IRT was a Finalist in the innovAGEING Improving Consumer Choice Award 2020 and the innovAGEING Increasing Access to Care and Services Award 2020.