Post on 25-Apr-2020
Presented by Katrina Otto
Train IT Medical Pty Ltd
www.trainitmedical.com.au
Getting the most from your
practice software
SEMPHN - 6 March, 2018
1. Develop skills in essential clinical data collection:- to meet standards- facilitate quality improvement - maximise revenue.
2. Design a planned approach to quality improvements.
3. Improve clinical documentation and minimise risk.
4. Learn advanced tips and shortcuts for MedicalDirector.
Agenda & Learning Objectives:
Improve data
Improve revenue
Improve health outcomes
Data is a hot topic for general practices
Accreditation Changes:
- linked to data
Practice Incentive Payment
(PIP) changes:
- linked to dataPIP Redesign FAQsWebinar recording
RACGP Standards – New - 5th edition
Learn more
Health Care Homes
Use data to track care and improvements
Health Care Homes P. 7 Handbook for General Practices and Aboriginal Community Controlled Health Services, 2017
Managing recalls and reminders
Health Care Homes P. 7 Handbook for General Practices and Aboriginal Community Controlled Health Services, 2017
Health Care Homes P. 7 Handbook for General Practices and Aboriginal Community Controlled Health Services, 2017
Download the ‘Data Quality’ Checklist Learn more from the ‘Standards for Digital Health’ Webinar
Past History List [coding]
Criterion C7.1 – Content of patient health record, RACGP Standards for general practices 5th edition.
Only for chronic conditions & significant events
Significant active or inactive conditions
Different from Reason for Visit (Past Visits)
Only tick ‘Add to Past History’ if you are adding a new significant diagnosis
Can choose ‘Another’ for more than one reason for visit.
Set your Options
Main Screen: Tools > Options:
Untick ‘Save in Past Medical History
? Untick Save in Past Medical History
“Practice staff must ask the patient for the information, rather than provide the identifying information and then ask the patient to
confirm the information.” RACGP Standards for general practice – 5th edition, p64
https://www.racgp.org.au/download/Documents/Standards/5th%20Edition/racgp-standards-for-general-practices-5th-edition.pdf
https://www.racgp.org.au/download/Documents/Standards/5th%20Edition/racgp-standards-for-general-practices-5th-edition.pdf
Advanced Tips
• One click Medical Certificate• Two click letters• Shortcuts for progress notes• HealthLink SmartForms• Options, options & options!
Search tools to assess your data quality
Clean up before you analyse your database:
1. Mark deceased patients as ‘deceased’.
2. Inactivate patients by searching for patients not seen for two years.
3. Delete Sample patients.
4. Delete records with no clinical data.
5. Merge duplicate patient records.
Why Improve Data Quality?
1. Improved Patient Safety
2. To enable sharing of data (Care Plans, My Health Record etc)
3. Proactive population vs episodic care
4. For analysis and to identify exceptions
5. To improve process quality & financial opportunities
Kidney Disease
Proactive Population Based Approach
Build a Register of patients with a particular condition e.g. Asthma or Diabetes etc
Why Improve Data Quality?
1. Meet standards
2. Improve patient safety
3. Streamline sharing of important patient clinical data eg
Health Record, eReferrals etc
4. Proactive population vs episodic care
5. For analysis and to identify risks and exceptions
6. To improve process quality, reduce waste and improve
financial opportunities.
What data will you focus on?
Chronic Conditions
Payments
Allergies
MBS Item #’s
EthnicityObservations
Results
Screening data
Waiting Times
& more
Income Estimator
MedicalDirector Clinical Inbuilt Searches
Data Extraction / Aggregation Tools
Polar Canning Tool
Pen CAT4Doctors Control Panel (DCP)
ElicioPractice Health Atlas
www.nevdgp.org.au
Business Process Improvements
Identify all patients with a chronic condition without a GP Management Plan
Need to manually enter screening results
Can enter from Holding File or Patient File >
Access Cervical Screening learning resources.
Download summary sheets for entering screening data in
MedicalDirector.
Analyse & set your improvement goals
Total Patients seen 1652 1749 1771 1798 1720 1735 1339 1490 1811 1866
705Long Health Assessment (45-60 mins) Non-ATSI 0 0 42 52 42 37 26 14 40 50
715ATSI Health Assessment 13 49 0 0 0 5 19 22 25 23
721Prepare GPMP 12 23 70 80 105
723Prepare TCA 12 23 9 12 40
732Review of GPGMP/TCA 0 4 5 8 2
739Organise CC 20-40 mins 0 0 3
743Organise CC > 40 mins 1 0 1
3short consult 9 21 15 21 28
23< 20 mins consult 522 1174 900 816 667
36>20 mins consult 304 497 350 339 279
44>40 mins consult 52 112 74 76 56
52Brief consult (non VR GP's)
53Standard consult (5-25 mins) (Non-VR)
54Long Consult (25-45 mins) ( Non-VR)
57Prolonged consult (>45 mins) ( Non-VR)
10962 (Podiatry)
10988Immunisation 1 7 41 42
10989Wound care 0 2 43 26
10990Under 16 YO OR Concession Card Holder Add on Fee 619 1316 1088 1036
2700GP Mental Health Care Plan (not trained) > 20 mins 4
2701GP MH Plan > 40 mins
2712GP MH Plan review 7
2713MH Surgery Consult > 20 mins 10
2715Prep GP MH Plan > 20 mins 5 9
2717Prep GP MH Plan > 40 mins 8 8
2504 (PAP > 4 years) PAP > 4 years since last, Level C 0 1
2521Annual C of C Level C
2525Annual C of C Level D
30026(sutures)
30061 (removal foreign body)
11506 (Spirometry) 6
11700 (ECG)
Your KPIs – track performance
Tips: Encourage a team effort to achieve the goals by setting a target on the graph & place graph in the staff room/noticeboard to encourage a proactive approach.
My Health Record Expansion Program
www.myhealthrecord.gov.au
2018
www.digitalhealth.gov.au www.myhealthrecord.gov.au
My Health Record Statistics – 25/2/18
Learn More
Approx 98% of your patients will be ‘green’
(indicating they have a My Health Record)
following My Health Record Expansion Program.
Approx 98% of your patients will have a My Health Record
Navigation panel
Provides access to each section within the view and also to the most recent Shared Health Summary and Discharge Summary (if available).
The blue underlined hyperlinks can be used to navigate between the sections
My Health Record – Medicines Preview
Pathology & Diagnostic Imaging in My Health Record
Prepare for patients seeing their own results
RACGP - http://www.racgp.org.au/standards/153
Now might be a good time to start to explain to your patients:
- doctors will still receive results first. Detail your practice process for follow-up.
- just because a result is marked red/‘abnormal’/outside the value range doesn’tmean the result is not normal for them.
- just because a result is marked ‘normal’ doesn’t mean further discussion orinvestigations are not necessary.
- patients can let the doctor know if they do not want a specific result uploadedto their My Health Record.
Factsheet: Pathology Reports for Clinicians
Manage well for positive change
Create a sample dialogue to fit your own practice system.
Example of GP dialogue (relevant to one specific practice system):
“I receive your results directly. You may also see those results. If I am worried I will contact you. If you are worried please
make an appointment and I will be happy to discuss them in detail with you”.
http://www.labtestsonline.org.au
Quality patient information
http://www.imagingpathways.health.wa.gov.au/index.php/consumer-info
1. Complete the (free) eLearning modules on the My Health Record system
2. Download the step-by-step ‘guides’ for your software.
3. Watch the software demonstration for your software
4. Practise in the ‘On-Demand’ Training Environment
5. Register your patients
6. Improve data quality
7. View and upload health summaries.
My Health Record – what you can do right now!
Read more about Practice Incentives Program (PIP) eHealth Incentive
Change Champions - GPs
Dr Steve Hambleton writes on his patient letters:“This patient has an active ‘My Health Record’. You may be able to access this through your clinical information system or the provider portal”.
When doctors ring asking for his patients’ health summaries he tells them to look on the patient’s My Health Record.
“I no longer fax our patient’s health summaries, when the hospital calls I just tell
them it will be on the patient’s My Health Record and to have a look”.
Cara Young (RN) Practice Manager, Surf Beach Surgery, Batemans Bay
Success stories
How effective is your ‘Recalls & Reminder’ system?
P. 7 Health Care Homes: Handbook for General Practices and Aboriginal Community Controlled Health Services, 2017
This is what can happen without a ‘system’:
General Practice Standards
“Some information may also be transferred to national
state-based registers (eg. cervical screening etc)
Read RACGP 5th standards
RACGP 5th Standards Criterion
C4.1 - Health promotion and preventive care
Remind patients when they need to have another screening
(do not rely on patients receiving reminders from these registers).“
Actions, Recalls and Reminders
REMINDERS eg. immunisation, skin check,
routine Cervical Screening Test (CST)
RECALLS (ie clinically significant/medico-legal)eg previous melanoma, inconclusive CST
✓ Define your reminder list
✓ Label your reminders so patients don’t stress if they receive a sms or letter with the reason
✓ Keep your list tidy
Save time, money & minimize risk
With a list like this how do you identify true recalls ie. Clinically significant/probability of harm/must follow-up/medico-legal/keep the doctor informed & document every single contact attempt?
Tools > Options
Label so patients don’t stress if they receive a sms or letter with the reason.
Set up
New Recall/Reminder labels required
Time for a Clean Up?
Clean up
Clean up: merge lists if duplicated
For ‘reminders’ that are only for the clinician, consider:
‘ACTIONS’ eg. Discuss screening, discuss smoking
Actions, Reminders & Recalls
RECALLS (ie clinically significant/medico-legal) eg previous melanoma, inconclusive
REMINDERS eg. immunisation, skin check,
routine Cervical Screening Test (CST)
Outstanding action prompts appear on opening the patient record and can be tracked from the main screen (Clinical > Outstanding Actions).
Actions
What’s your Correspondence Management ‘system’?
CR
EATE
YO
UR
OW
N
Download a blank flowchart here:
Evaluate your practice ‘system’?
SAM
PLE
ON
LY
Display Actions Pane (Audit Trail)
Follow Up Recalls & Reminders
• Track Contact Attempts
• Review Audit Log
• Remove recall once complete
Consent for SMS
✓ Bulk select and bulk send SMS. ✓ Opt-in consent now in PracSoft✓ Add Preferred Contact in Patient Details in MedicalDirector Clinical✓ Tickbox ‘Do not send SMS’ if patient consent has not been given.
When patient returns: delete recall
Audit trail of contact
Change Management is a process
Share success stories:
eg.
Share inspiring success stories of what other practices are doing Link to what’s new that we need to know about:Cervical screening tests good data is vital Medicines view – in My Health RecordPathology & Radiology becoming available in My Health Record
These are all attention grabbers. New Practice Incentive payment linked to improvementsePIP payments all about uploading New era where patients see their info
Choose one thing at a time to focus on (can be one small aspect eg. allergies) and celebrate success.
Celebrate your success!
Learning Resources
• RACGP – Putting Prevention into Practice (Green Book)
http://www.racgp.org.au/your-practice/guidelines/greenbook/
• AMA- Recall systems and patient consent - https://ama.com.au/position-statement/patient-
follow-recall-and-reminder-systems-2013
• Avant – The Dos and Don’ts of patient sms http://www.avant.org.au/news/20160419-dos-and-
donts-of-patient-sms-communication/
• HealthLink SmartFormsRTA Fitness to Drive formAustralian Hearing Form
• Train IT Medical – Practice Management free resources –
http://trainitmedical.com.au/practice-management-free-resources
Learning Resources - Data Quality:
RACGP
Using Data for Better Health Outcomes
Australian Digital Health Agency:
Importance of Data Quality
Data Cleansing & Clinical Coding
Data Quality Checklist
Train IT Medical
Data Aggregation using Pen Clinical Audit Tools (blog)
Cancer Screening & Prevention – Free Resources (blog)
5 Steps to Data Quality Success (blog)
Pen CAT4 summary sheet
Pen Clinical Systems
CAT4 Recipes
Learning Resources – Health Care Homes
Australian Association of Practice Managers (AAPM): AAPM Guidance for Health Care Homes
Health Care Homes WIKI
Dept of Health Recorded Webinar: Becoming a Health Care Home (11/2016)
RACGP Standards for Patient-Centred Medical Homes
‘From good to great: the potential for the Health Care Home model to improve primary health
care quality in New Zealand.’ CSIRO Publishing
FAQs - http://www.health.gov.au/internet/main/publishing.nsf/content/health-care-homes-faq
Pulse IT article ‘Health Care Homes practices given a year to use compliant software’
Australian Digital Health Agency:www.digitalhealth.gov.au
Get Started
On Demand Training (practise in the sandpit)
Training Resources
www.myhealthrecord.gov.au
Pathology
‘NSW patients first to view their pathology results in My Health Record’
Train IT Medical:Digital Health Free Resources including Pen CAT4
Developing a ‘My Health Record’ Practice Workflow (blog)
My Health Record – your questions answered (blog)
Top 30 questions doctors ask about My Health Record with Katrina’s responses (blog)
Event Summaries (blog)
Katrina Otto’s ‘My Health Record’ detailed presentation
Learning Resources: My Health Record:
Learning Resources – Cancer Screening
Train IT Medical Free Resources – Cervical Screening Program
National Cervical Screening Program - Dept of Health - FAQs
Cervical Screening Changes FAQ - Video - Dr Sally Sweeney Hunter New England Central Coast
PHN (HNECCPHN)
NPS Information & FAQs
NPS free eLearning
Cancer Council Australia Cancer Guidelines Wiki
'Cancer Council study confirms starting cervical cancer screening at age 25 is safe'
Cancer Institute NSW 'Information for Health Professionals'
Untold Stories - Cervical Cancer Screening - Audio-visual stories
(Family Planning NSW). Spoken in Arabic, Assyrian, Dari, French, Hindi, Karen, Khmer, Mandarin, Nepalese & Vietnamese.
'Changes to cervical screening will benefit Australian women' RACGP media release
NCPHN Cervical Screening Workshop Presenter Slides
.
Keep in touch! With best wishes, Katrina Otto
katrina@trainitmedical.com.au
Twitter: trainitmedical
Facebook: trainitmedical
www.trainitmedical.com.auAccess more free practice resources
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