Preparing aged-care facilities for assessor-led funding under AN-ACC

Telstra Health’s Clinical Manager is a core operational system used daily by residential aged-care providers to manage clinical documentation, administration, and compliance. It sits at the centre of how care is recorded, evidence is assembled, and regulatory obligations are met.

Following the Royal Commission into Aged Care Quality and Safety, funding reform replaced ACFI with AN-ACC and changed how resident classifications are determined. Providers no longer determine funding outcomes but remain responsible for the quality and completeness of evidence reviewed by independent assessors. This work updated Clinical Manager to support assessor-aligned preparation workflows within that shift.

Clinical Manager operates across a national footprint of approximately 60,000 residential aged-care beds, situating this system update within a large-scale AN-ACC funding and compliance environment.

At a glance

System shift: System shift: From provider-led funding calculation to assessor-aligned preparation

Capability: Evidence traceability organised by national assessment structure

Scope: Assessment preparation embedded within a live, legacy care platform

Operating environment

Context

Organisation: Telstra Health (Aged & Disability)
Environment: Residential aged-care software platform (Clinical Manager)
Users: Clerical and clinical staff preparing residents for assessment
Role: Senior UX Designer
Timeframe: 6-month delivery window

Constraints

Government-defined funding and assessment model
Classification authority external to providers
Long-established platform with embedded legacy workflows
High audit and compliance exposure

Assessment authority shifted outside facilities

PART 1

Policy context

The Royal Commission identified systemic issues in aged-care funding, including inconsistent classification practices and incentives misaligned with resident need. In response, the Australian Government replaced ACFI with AN-ACC to standardise assessment nationally and remove funding determination from providers.

This was not a product change.
It was a structural shift in responsibility and accountability.

The ACFI operating model

Under ACFI:

Assessments were completed internally.
Evidence was collected, scored, and reviewed in-house.
Funding outcomes could be estimated using a calculator.
Scoring logic was visible to providers.

This transparency shaped behaviour. Because outcomes could be anticipated, preparation practices aligned to known scoring mechanics. During the Royal Commission, this dynamic was cited as a risk to equity and consistency, including optimisation around residents aligned to higher funding bands.

Clinical Manager reflected this model through calculator-led workflows and score-driven interpretation.

What AN-ACC changed

AN-ACC shifted assessment responsibility away from providers.

Under the new model:

Independent assessors apply a national assessment tool.
Classifications are no longer determined internally.
Funding depends on assessor interpretation of submitted evidence.
Classification logic is not visible to providers.

Internal systems shifted from assessment to preparation.

Early interviews with service managers highlighted concern about funding risk, assessor interpretation, and whether existing documentation would be sufficient under external review.

Flowchart titled 'Classification responsibility shifted outside facilities' comparing 'ACFI (Before)' and 'AN-ACC (After)' processes, showing steps such as 'Provider completes assessment' and 'Provider prepares evidence' on the left, and 'Independent assessor determines classification' with a final 'Funding outcome' at the bottom on the right.

Visual 1 - Assessment moved from provider-led scoring to external classification.

Loss of calculation visibility

At rollout, the logic used by assessors to determine classifications was not available to providers. Preparation quality now depended on whether assessors could:

locate relevant evidence,
understand its context, and
interpret resident need accurately.

This increased the importance of structured, complete, and easily retrievable evidence.

Resulting system mismatch

Within Clinical Manager:

Existing workflows reinforced a scoring mindset that no longer applied.
Evidence existed across notes, charts, and forms but was not organised by assessment section.
Calculator patterns implied predictability and control that providers no longer had.

The primary risk was not usability.
It was preparing staff for a process that no longer existed.

Comparison chart showing the organization of a resident record before and after a system update. The 'Before' side displays generic icons for notes, forms, and charts around a central box labeled "Resident record." The 'After' side shows a more detailed hierarchy with icons representing different document types branching out to labeled sections: Section 1: Health, Section 2: Mobility, Section 3: Cognition, and Section 4: ADL.

Visual 2 - Documentation existed but was not organised by AN-ACC sections.

Insight

Staff were not seeking to influence outcomes. They wanted clarity on how to prepare evidence that would withstand external review.

Shaping a preparation system aligned to assessor interpretation

PART 2

System intent

Before interface decisions, the system boundary was made explicit.

The system would:

support preparation for assessment,
reflect the AN-ACC assessment structure,
surface evidence in assessment context.

The system would not:

determine classifications,
predict funding outcomes,
reproduce ACFI optimisation patterns.

Diagram showing the system boundary for assessment, divided into Clinical Manager and Government. The Clinical Manager side includes Prep system with structure, evidence, and supporting context. The Government side includes Determination system with assessment, classification, and funding.

Visual 3 - Clinical Manager supports preparation; assessment and funding sit externally.

Structural decisions

Decision

Avoid optimisation patterns that imply control over classification.

Screenshot of a medical scoring system for a patient's health assessment, showing details such as resident information, funding, and various health categories with scores and color indicators.

Visual 4 - Calculator-led workflows reinforced internal scoring.

Decision

Do not reproduce funding calculators or prediction logic inside Clinical Manager.

Decision

Use AN-ACC instruments as the primary information architecture.

Assessment navigation mirrored the national instrument structure, creating a shared definition of completeness and reducing missed sections.

Diagram of the AN-ACC instrument structure, showing six categories: Health, Mobility, Cognition, Activities of Daily Living, Frailty, and Palliative Care, each represented by an icon and accompanied by multiple evidence sources.

Visual 5 - Navigation mirrors the AN-ACC structure.

Decision

Link evidence at the assessment-section level.

Evidence remained part of the resident record while becoming explicitly linkable to assessment sections, enabling traceability without duplication.

Screenshots of a healthcare assessment management software dashboard showing resident's AN-ACC assessment, evidence, and linked documentation.

Visual 6 - Evidence is linked to assessment sections without duplication.

User experience prioritisation

Predictability governed the UX:

stable navigation by assessment section,
consistent layouts across instruments,
visible evidence status in context,
linear progression over branching.

This reduced decision load while staff continued routine care.

What was rejected

Facility-side scoring or funding prediction tools
Free-form evidence repositories detached from assessment structure
Parallel funding packs outside the resident record
Global evidence visibility without role-based controls

Each weakened traceability or implied outcome control, conflicting with AN-ACC’s separation of preparation and determination.

Capability created and supporting evidence

PART 3

Capability created

Assessor-aligned preparation structure inside Clinical Manager
Clear separation between preparation and external determination

Evidence

Structural impact:

One preparation flow replaced four to five disconnected screens
Assessment sections and linked evidence presented together
Increased staff confidence during readiness activities

Measured outcomes:

Evidence lookup time reduced by ~70% (6–10 min to under 2 min)
Reduced follow-up clarification after preparation

What was not proven

Classification accuracy
Funding outcomes
Long-term documentation behaviour change

Computer screen displaying a medical assessment tool named AN-ACC assessment tool, with patient details and mobility index assessment options.

Visual 7 - Implemented AN-ACC preparation interface showing how evidence is organised by assessment section within the live Clinical Manager environment.

Outcome

Facilities regained control over preparation quality without implying control over classification outcomes.

Reflection

AN-ACC reframed funding preparation as an evidence and interpretation problem.

By aligning system structure to the assessor lens and making evidence explicit within the resident record, Clinical Manager implemented a preparation model capable of supporting reform-driven change without reworking underlying care workflows.