A clinician’s MediRecords odyssey: unveiling efficient, mobile aged care medicine

A clinician's MediRecords odyssey: unveiling efficient, mobile aged care medicine

Here’s the latest in our series on how people use MediRecords. In this Q & A, Dr Gaveen Jayarajan explains why he made the switch to the cloud and MediRecords to power his Doctors in Aged Care mobile medical practice.

Tell us a bit about your practice.

I operate the Doctors in Aged Care mobile GP service that visits residents at several Residential Aged Care Facilities (RACFs) throughout metropolitan Melbourne. Our service exclusively does RACF work and is fully mobile and virtual; we see residents in their homes every week. We are committed to excellence in medical care of the elderly using innovative, non-traditional/hybrid approaches to healthcare service delivery.

Associated with our medical practice, I have built the Doctors in Aged Care (DiAC) Facebook group, which is a community of over 2300 doctors Australia-wide.

Please contrast MediRecords with the system you used prior to using MediRecords.

I had used all the common GP clinical and practice management systems working as a GP in medical centres for the previous eight years. Usually clinics would use two different programs, one for clinical use and one for practice management (i.e., appointments/billing/claiming/reporting). When I started working full-time in aged care, I used a popular GP clinical software system which was server-based. This worked okay in a medical centre but was not well suited to mobile work visiting RACFs.

As a doctor working in a challenging and inefficient setting, I urgently needed a reliable and stable solution. Hence my move to a cloud-based alternative, MediRecords.

My initial apprehension with using a cloud system was what happens if internet speed and connection were unreliable? To my surprise this was a non-issue. Using mobile broadband devices, which now give NBN-type speeds in some locations, internet speed was not an issue. I could also use my mobile phone as a Hotspot if needed.

MediRecords is an all-in-one, integrated clinical and practice management system. So, from a single browser window I could access the clinical functions I needed as well as seamlessly view my appointment book, create new appointments, perform billings, view current Medicare claims in progress, and generate reports for total invoices/billings over any time period.

The third change was no longer having to engage and deal with a third-party IT service provider. Now all of this was handled in the background automatically; updates are   installed remotely with no disruption or major technical issues.

How does MediRecords enhance your efficiency?

I use the MediRecords appointment book as a key tool to manage my workload, maximise efficiency and provide proactive rather than reactive care.

Every time a phone, email or fax request is received to review a patient, the patient’s name is entered into the appointment book for the next weekly visit day (or on the day of request if urgent) with an appointment type depending on the nature of the issue. It could be a “Regular” appointment or classified as for example, “Urgent’’, “Vaccine”, “Wound Review”, “Post-fall Review”, “Health Assessment”, “Phone Consultation”, etc. MediRecords allows multiple appointment types and durations to be created. Every time a patient is seen, a follow-up appointment is also made at an appropriate interval. When done for every patient, I can see with reasonable accuracy what my workload will be like. Unplanned extra patients, or “walk-ins”, can be added to the daily schedule depending on demand that day.

We further enhance our scheduled care by using the recalls or “Clinical Actions” function. For every new patient we have recalls for core things relating to Medicare item numbers and due dates, e.g., Health Assessments, Residential Medication Management Reviews and Care Plan Contributions.

Also useful for efficiency is the Tagging feature. I use Tags, along with another existing MediRecords feature of doing multiple patient invoices at once, to reduce the time taken to process daily billings to under five minutes.

Another recent improvement has come with my API integration of MediRecords with Snapforms. Using Snapforms I created a “New Patient Details Form”. Now when a RACF asks me to take on a new patient, I email them a cloud-based form with a URL link. They complete all new patient details, attach a recent patient health summary or hospital discharge summary and a current medication list. After they hit submit, something magical happens! A new patient file is created in MediRecords with the key demographic data already populated, and a PDF copy of the form and any uploaded health summary or discharge summary and medication lists stored in the Correspondence IN tab in the patient file.

I use MediRecords on multiple devices including my Surface Laptop, Samsung Galaxy tablet and Samsung Z-Fold 5 mobile phone.

How does MediRecords enhance patient care?

MediRecords allows me to operate with the lowest and leanest cost base and make it financially viable and sustainable for the long-term. It enables me to maintain safe and high standards of care that are consistent, repeatable and maximise quality of life for patients.

What are your tips for people considering changing to MediRecords?

Have a clear idea and rationale for why you want to move to the cloud.

It can’t just be about saving money on software subscription costs or on upgrading or buying a new server. Independent GPs working at your practice will not be interested in this. Show them a way forward with a big picture view of how moving to the cloud can change the way they deliver healthcare, creating benefits they are not currently experiencing. Avoid trying to replicate like-for-like every feature of server-based software.

What are you looking forward to with MediRecords in the future?

The efficiencies we have been able to achieve by using cloud-based software have been done with an intense focus on optimising processes and managing costs – and without Artificial Intelligence (AI). We look forward to incorporating AI to further drive efficiency and improve patient care standards by automating more administrative processes and providing advanced clinical decision support and insights.

If you’d like to showcase innovative ways you use MediRecords in healthcare, please reach out to us via sales@medirecords.com.

Dr Gaveen Jayarajan is an investor and member of the MediRecords Medical Advisory Board.  

Read more about Doctors in Aged Care on their website.  

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    Critical care: 84% of healthcare workers facing burnout, putting mental health at risk

    84% of healthcare workers
    facing burnout, putting mental health at risk

    On World Mental Health Day, it is timely to remember the importance of supporting the mental health of healthcare workers.

    The latest data from Mental Health Australia’s (MHA) annual survey of the mental well-being of healthcare workers paints a concerning picture.

    The survey found 84% of respondents reported that the pandemic’s demands lead to burnout in 2022.

    The WHO describes burnout as a syndrome caused by unmanaged workplace stress. It includes feeling exhausted, negative about work, and ineffective.

    Burnout is linked to a conceptualised “COVID-19 fourth wave”, alongside psychological trauma, mental illness, and economic strain, according to the US physician, Associate Prof. Victor Tseng.

    Burnout significantly raises the risk of unsafe care by doctors and nurses, studies show.

    In a review of 13 studies involving 20,643 doctors, “physicians with overall burnout had almost three times greater odds of making self-perceived errors,” found a study in the Journal of Patient Safety in 2022. The odds were almost identical for nurses, with burnout likely to providing poor-quality care, a separate study found this year.

    One leading organisation supporting the wellbeing of healthcare professionals is the Black Dog Institute. It established The Essential Network (TEN), which aims to prevent burnout.

    TEN offers practical resources , confidential personalised support and up to five free telehealth sessions.

    “Every Australian has been impacted by COVID-19, but few have felt the brunt of the pandemic more keenly than health professionals,” said Black Dog Institute’s Deputy Director and Chief Psychiatrist, Professor Sam Harvey.

    Mental Health Australia CEO Carolyn Nikoloski said that, for the first time in 20 years, Australia does not have a national mental health and suicide prevention plan. She said: “A national roadmap needs to be developed to address these concerning trends and ensure equitable access to mental health care supports for all people in Australia.”

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      What are the keys to embedding telehealth into your practice?

      What are the keys to embedding telehealth into your practice?

      A new US study has identified reasons that some primary-care practices were better able than others to adapt to the surge in the demand for telemedicine during the pandemic.

      We wanted to know if the Australian experience was the same, so we asked our telehealth partner, Coviu.

      The study of 87 US practices, in the Annals of Family Medicine, found key factors were:

      • Prior experience with virtual health, such as knowing the importance of grouping telehealth visits together; and
      • Triaging rules, that is, clearly or not clearly knowing which patients could be treated virtually and which required an in-person visit 

      Coviu observed during the pandemic that primary-care practices, boosted by the rapid introduction of universal Medicare reimbursements for phone and video telehealth, were quick to adopt phone for telehealth, but were more reluctant to adopt video telehealth, according to CEO Silvia Pfeiffer.

      “This has remained the major approach to telehealth in primary care,“ Dr Pfeiffer said.

      “This trend persists despite the government’s push for the adoption of video and compelling evidence suggesting that, for many visits, video results in better outcomes than phone calls.

      “But for many primary-care services, phone telehealth is completely adequate, and for many patients without connectivity, phone is the only telehealth option.”

      Coviu confirmed that practitioners throughout the Australian healthcare system demonstrated greater adaptability to telehealth when it was already integrated into their practice model, such as in rural settings, or when it was part of their pre-pandemic strategy.

      “The absence of clear and consistent triage guidelines, especially early in the pandemic, contributed to the challenges faced by healthcare providers,” Dr Pfeiffer said.

      “Triage guidelines help determine which patients should receive in-person care, telehealth consultations, or home care, and their absence can lead to uncertainty and increased workload for clinicians.”

      She said when initially adopting telehealth during the pandemic, primary-care practitioners faced significant challenges including “unmet basic requirements, such as the absence of webcams or sufficiently powerful computers for telehealth”.

      “In addition, many GPs lacked adequate training on what could be accomplished through video telehealth.”

      Today, obstacles to wider adoption of telehealth include, “the stigma associated with video consultations, particularly among practitioners accustomed to in-person care”, Dr Pfeiffer said.

      “Slow change management within healthcare organisations hinders progress, with a perception that video visits are inferior to in-person appointments, which does not apply in all instances. For example, mental health advice often leads to better outcomes when delivered via video in the comfort of a person’s own home.

      “Reimbursements are still a challenge as the rules continue to change, causing confusion.

      “Misinformation about privacy and security concerns as well as regulatory requirements also loom, impacting patient trust.

      “Furthermore, inadequate training, both in technical software use and determining the clinical appropriateness of remote consultations, remains a hurdle.”

      Factors Coviu says lead to successful telehealth adoption include:

      1. Digital knowledge within practices that already had digital communication mechanisms set up with their clients.
      2. Practices that strategically integrated telehealth into their workflows and adopted technology to make this seamless
      3. Practices that prepared their staff with training on their virtual-care workflow
      4.  Adoption of triaging rules by clinicians, as proposed by industry experts such as the RACGP, and other industry bodies and federations.

      MediRecords has partnered with Coviu to streamline booking of video consultations with practice clients. Once your Coviu account is connected to MediRecords, any consultation nominated as a telehealth appointment auto-generates a link to the Coviu virtual consultation and your client is sent an invitation via SMS or email.

      MediRecords and Coviu are both Australian developed cloud-hosted health technology companies.

      Read more about Coviu on their website

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        Innovation that takes the stigma out of STI testing
         

        Innovation that takes the stigma out of STI testing

        Approximately 30,000 Australians are using a revolutionary service that saves them from awkward face-to-face conversations with doctors about sexually transmitted infections

        The service, Stigma Health, is part of Australia’s largest sexual health network specialising in online STI testing. And it uses MediRecords for patient records, appointment management, Medicare claiming and more.

        Stigma Health eliminates embarrassment by removing the need for in-person clinical consultations and allowing consumers to get a non-confrontational STI-test pathology referral online then take it to any of the 10,000 pathology collection centres Australia-wide.

        Australian data shows that one in 25 people aged 15-29 had chlamydia in 2021, but fewer than one third received a diagnosis. Additionally, 2,630 Australians are unknowingly living with HIV. Reluctance to be tested is likely to contribute to these statistics.

        Stigma recommends STI testing whenever people have a new sexual partner — or every three months.

        Founders James Sneddon and Dr. Mitchell Tanner believe strongly in the power of new technology for the greater good.

        “We use MediRecords as it is a cloud solution, which is fantastic for our remote workforce,” the CEO, Mr Sneddon, said.

        “Further, the MediRecords app is the most secure way to communicate and share results with our patients.

        “The SMS-on-demand feature is also a fantastic communication/notification tool.”

        Stigma Health has recently introduced telephone and video appointments.

        “We are managing these with MediRecords appointments and the COVIU video platform, Mr Sneddon said.

        “These appointments also carry Medicare claiming, which is simple with the MediRecords platform.”

        “In my role as CEO of our group of clinics, MediRecords allows me operational transparency to understand our capacity, our efficiency and, best of all, our outcomes.

         “MediRecords’ facilitation of APIs and working towards keeping their system open and able to integrate is of huge value to our organisation,” Mr Sneddon said. 

        Legal drug testing

        In a world first, Mr Sneddon and Dr Tanner have also started harm-minimisation telehealth testing service for users of anabolic androgenic steroids (AAS) & performance and image-enhancing drugs (PIEDs).

        Also supported by MediRecords software, the service, Roidsafe, is a legal, judgment-free platform.

        “Many steroid users rely on ad-hoc information from other users within their community,” the site noted.

        “Regular Roidsafe testing gives you insight into how your body functions pre, during and post-cycle, so you can make informed decisions.”

        It tests liver and kidney function, cholesterol levels and a range of hormone levels.

        “Our platform is 100% confidential and more affordable than making multiple visits to your GP to gain a referral, plus follow–up appointments to get your results,” Roidsafe stated.

        “Getting tested with us is easy. We deliver your online referral, you get tested at a local pathology clinic, and your results will be sent securely to your mobile phone.”

        Read more about Stigma Health on their website

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          Untapped potential: Hybrid care benefits remain overlooked post-pandemic

          Untapped potential: Hybrid care benefits remain overlooked post-pandemic

          Hybrid care — that is the mixed delivery of in-person and telehealth consultations by a clinic — is decreasing in Australia, according to leading telehealth platform Coviu.

          “This compares to a continued increase in the use of self-paid telehealth consultations with online-only GP services,” Coviu CEO Silvia Pfeiffer said.

          “The recent introduction of GP telehealth services by Woolworths for a fixed $45 rate is a clear example demonstrating what consumers want, but what their own GPs may not be delivering.”

          “While hybrid care is deemed the future of healthcare, we seem to be going in a direction where we are facing a segmentation of the industry into technology-only service providers and technology-averse service providers.”

          For hybrid care to function successfully, new reimbursement models and new models of care are necessary, Dr Pfeiffer said.
          Currently, most practitioners favoured the in-person attendance of patients, and patients did not feel empowered to ask for telehealth consultations, she said.

          “In a situation of clinician shortage where brick-and-mortar clinics have sufficient in-person patient traffic, there is very little incentive for the adoption of telehealth.

          “This will unfortunately lead to a continued reluctance of the adoption of hybrid care [and] lead to patients turning their backs on their own local GPs, instead seeking telehealth services from online-only providers.

          “This cannot be a desirable future.”

          Coviu’s position is that today’s Medicare reimbursements for telehealth consultations, “certainly are not designed to encourage the use of telehealth”, requiring an in-person visit at least once a year before patients become eligible for telehealth consultations.

          “This creates extra administrative burden on the practice, even discouraging practice administrators from offering telehealth consultations to patients,” Dr Pfeiffer said.

          “Better training and better triage rules for healthcare professionals, practice managers, administration staff, and nurses would certainly help to empower the industry with better telehealth capabilities.

          “It would address the technical capabilities gap in healthcare, the reluctance to video telehealth adoption, and facilitate necessary changes in patient pathways.”

          MediRecords has partnered with Coviu to streamline booking of video consultations with practice clients. Once your Coviu account is connected to MediRecords, any consultation nominated as a telehealth appointment auto-generates a link to the Coviu virtual consultation and your client is sent an invitation via SMS or email.

          MediRecords and Coviu are both Australian developed cloud-hosted health technology companies.

          Read more about Coviu on their website

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            Head in the cloud: embracing cloud technology for virtual care

            Head in the cloud: embracing cloud technology for virtual care

            A case study on how MediRecords helped Doctors on Demand embrace cloud technology for virtual care. 

            At the international MedInfo conference in Sydney, MediRecords had the pleasure of leading a panel with key client Doctors on Demand. The focus of the session was managing the transition from legacy server-based software to MediRecords’ cloud-based technology.

            MediRecords Group Manager of Customer Success, Michael Alldrick, and Doctors on Demand Director of Governance and Programs Amanda Yeates, discussed the challenges of server-based software for virtual care businesses, the process of changing to the cloud, and benefits that have flowed from making the move. For those who could not attend, here are some highlights from their conversation.

            Doctors on Demand Overview

            Michael: Before we delve into the details, let’s start with an overview of Doctors on Demand and the services the company provides.

            Amanda: Doctors on Demand is a virtual healthcare service provider that connects patients to doctors through video conferencing. We prioritise technology, and our 100% remote workforce allows patients to access healthcare from anywhere. Initially, we faced challenges with our on-premise practice management software, which was retrofitted to meet our needs. However, as we grew, it became clear that a more seamless and scalable solution was required, leading us to explore cloud-based options like MediRecords.

            Michael: The limited options for cloud-based technology in 2015 necessitated careful consideration. Can you explain the challenges faced during the transition and the decisions that led to embracing a cloud-based solution?

            Amanda: Certainly. We established virtual servers to provide remote desktop access for our doctors, enabling them to access clinical information about patients. However, this setup created a complex workflow, where doctors had to toggle between their own desktops and the virtual server, leading to inefficiencies and scalability issues. We needed a seamless solution where doctors could access patient data anytime with an internet connection. After surveying the market, we chose MediRecords as the cloud-based system that aligned with our requirements.

            Data migration and maintaining continuity of care

            Michael: Moving from an existing system to a new one while maintaining patient continuity of care is critical. MediRecords placed a lot of emphasis on this and worked hard to ensure complete patient record and appointment history was migrated. How did you feel about this process and was it enough to ensure a smooth transition into a new system?

            Amanda: The data migration process was complex due to the extensive amount of data accumulated over the years. We worked closely with MediRecords’ data migration team, implementing a phased approach to ensure minimal disruption to our 24/7 service. We started with a few doctors, gradually migrating data in tranches. Our collaboration with MediRecords ensured that the data was accurately represented in the new system. Despite the size of our clinical workforce, we managed to complete the transition within a few weeks, thanks to MediRecords’ support and training resources.

            Cost savings and streamlined operations through cloud technology

            Michael: During your transition to MediRecords’ Doctors on Demand achieved substantial cost savings by eliminating the need for a dedicated IT team to manage your previous complex on-premise system. Can you elaborate on how this switch streamlined your operations and led to significant improvements in efficiency?

            Amanda: Certainly, Michael. The move to a cloud-based solution with MediRecords was a game-changer for us. As mentioned, we had previously set up virtual servers to provide remote desktop access for our doctors, which introduced complex workflows leading to inefficiencies and scalability issues. With MediRecords’ cloud technology, and the ability to access patient data anytime and anywhere, we eliminated the need for a dedicated IT team to manage our previous on-premise infrastructure. The cloud-based solution is more user-friendly and requires minimal maintenance. The API integration also played a crucial role in automating tasks, reducing administrative overhead, and saving on operational costs. Thanks to these cost savings, we could reallocate resources to enhance our virtual care services, expand our offerings, and pursue future growth opportunities, creating a more sustainable and efficient healthcare model for Doctors on Demand.

            Harnessing the power of cloud and APIs

            Michael: Embracing cloud technology can significantly impact workflows and patient care. How has the integration of MediRecords Connect API service supported your doctors and users, and how does it enhance your current workflow?

            Amanda: As a patient-driven service, it was crucial for us to have real-time access to clinical data during consultations. MediRecords facilitated this through API integration, enabling data to seamlessly flow into our practice management software. Doctors now have immediate access to essential patient information during consultations. Additionally, our administrative team can enter doctor schedules in MediRecords, which are promptly reflected on our website. The two-way communication facilitated by APIs streamlines our operations and enhances patient care. 

            Future growth and advancements

            Michael: Doctors on Demand has shown progress in corporate health, private insurance, and other areas. What are Doctors on Demands future plans, and how does the company envision growing its services?

            Amanda: Like many health tech companies, we have an ambitious pipeline of work for the coming months and years. In the next financial year, we plan to focus on mental health services, providing virtual primary care and mental health care plans. Additionally, we aim to strengthen our partnerships with corporate entities, leveraging the advantages offered by MediRecords’ 2.0 interface. This new interface will enhance patient communication capabilities, including email and demand management.

            Michael: Exciting times ahead! Lastly, based on Doctors on Demand’s experience and decision-making process, what advice would you give to organisations considering new technologies to future-proof their businesses?

            Amanda: Making the transition to new technologies can be challenging, but it’s crucial for scalability and growth. As an organisation, we were determined to embrace change. Education, support, and collaboration were key in successfully navigating this journey. MediRecords’ training resources, webinars, and live chat support played a significant role. Despite the initial resistance to change, we managed to onboard our large clinical workforce within weeks. So, I would encourage organisations to thoroughly assess their needs, seek support, and embrace new technologies for long-term success.

            Conclusion

            The collaboration between Doctors on Demand and MediRecords highlights the positive impact of cloud technology on virtual healthcare services. By migrating from a legacy server-based solution to MediRecords’ cloud-based system, Doctors on Demand overcame challenges, improved workflows, reduced costs, streamlined operations and enhanced patient care. The seamless data migration, ongoing support, and future growth plans demonstrate the successful transformation enabled by embracing cloud technology for virtual care. 

            Read more about Doctors on Demand on their website.  

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              Global healthcare facing a diabetes tsunami
               

              Global healthcare facing a diabetes tsunami

              Diabetes rates are set to soar worldwide, a new study in The Lancet reveals.

              By 2050, an “alarming” 1.3 billion people are expected to be living with diabetes, up from 529 million in 2021, if no action is taken, the Institute of Health Metrics and Evaluation at the University of Washington has found.

              Lead author Liane Ong warns that the rapid growth of diabetes poses immense challenges to health systems worldwide, as the disease is associated with other severe health conditions like heart disease and stroke.

              “The rapid rate at which diabetes is growing is not only alarming but also challenging for every health system in the world,” Dr Ong said.

              The surge in diabetes cases can be attributed to rising obesity rates and demographic shifts, with older adults particularly vulnerable.

              Funded by the Bill and Melinda Gates Foundation, this study emphasises the necessity for more effective mitigation strategies and an equitable approach to diabetes treatment.

              The looming crisis, underscored by a series of Lancet articles, has prompted an editorial in an edition of the journal last month, which argues that “the world has … underestimated the true scale and threat the disease poses”. It calls for a “course correct”.

              MediRecords can support patient-centric diabetes care with features including templated assessment forms and care plans, and ePrescribing. New ‘Premium’ features supporting Case Management and Group Appointments are coming soon.

              Remote monitoring effective

              Previous studies have shown that remote monitoring of diabetic foot ulcer (DFU) reduces the number of visits to the outpatient clinic, but a new study, published this month in The Lancet Regional Health – Europe, has found further benefits.

              A randomised controlled trial with 180 participants by a group of French researchers led by Dured Daldari found that remote monitoring of DFU by an expert nurse significantly reduced cumulative hospital days — from 13.4 days (95% CI 9.0–17.8) in the control group to 7.1 days in the intervention group (2.8–11.5).

              Further reading
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                MediRecords stepping into outpatient clinics at MQ Health

                MediRecords stepping
                into outpatient clinics
                at MQ Health

                Leading Australian cloud health software company MediRecords will be the new clinical record system for MQ Health outpatient clinics.

                 

                MediRecords has been selected following a competitive tender process to support 18 clinics providing a range of services including breast health, cardiology, endocrinology, haematology, neuropsychology, neurology, ophthalmology, plastic and reconstructive surgery, and urology.

                The project will also involve integration with MQ Health’s electronic medical record, an InterSystems TrakCare solution.

                MediRecords CEO Matthew Galetto welcomed the partnership with MQ Health’s leading clinicians, researchers, students, and Australia’s first university-owned teaching hospital.

                “This is an amazing opportunity to support the work of multidisciplinary outpatient clinics providing such vital services to Sydney residents,” Mr Galetto said. “We look forward to working with MQ Health teams and getting data migration and implementation under way.”

                MediRecords supports hospital and outpatient clinic clients including:

                • The Victorian Virtual Emergency Department and Northern Health mental health team, as an ePrescribing system
                • Queensland Health’s Metro North Virtual Emergency Department as an ePrescribing system
                • 13 Queensland Health Hospital and Health Services as a billing and claiming system for outpatient clinics
                • My Emergency Doctor virtual teams providing senior emergency physicians to Urgent Care Centres, hospitals and ambulance services across Australia
                • Private hospital Visiting Medical Officer consulting suites as an electronic health record (EHR) and patient management system.

                MediRecords is also the clinical EHR for another major university.

                For the full list of MQ Health clinics, see MQ Health Medical Services & Clinics.

                Media inquiries

                To arrange to speak with Mr Galetto, or for further information on the MQ Health project, please email Tim Pegler or call  0412485146.

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                  A Missed Opportunity
                   
                   

                  A Missed Opportunity


                  Matthew Galetto - Founder and CEO

                  How the Australian Government Failed to Maximise the Potential of the GP Grants Program for Digital Health Adoption

                  The Australian Government recently launched the Strengthening Medicare – General Practice (GP) Grants Program, allocating $220 million over two years to support general practices and eligible Aboriginal Community Controlled Health Organisations (ACCHOs). The program aims to provide funding for improvements in patient access, support safe and accessible quality primary care, and enhance digital health capabilities.

                  As an observer of the digital health landscape both as a consumer (patient) and participant as a software vendor, I was eagerly awaiting the unveiling of the GP Grants program. I was hopeful that the grants would finally start to address the pressing issues of our time – a need to modernise digital health infrastructure, both private and public, focusing on standards and real-time information exchange at point of care. These are not just my observations; just about everyone working in the industry understands these problems, including the government itself within health departments and at the Australian Digital Health Agency (ADHA). And, of course, patients get it too. We all experience gross inefficiencies when we visit a doctor.

                  Recently I learned from a colleague working at a primary health network (PHN), that no further details regarding the eligibility of the grant funding have been provided. The government has seemingly failed to establish eligibility criteria that effectively address the challenges faced by our healthcare system and specifically primary care and GP’s.  I don’t even think security of patient information is a requirement!

                  Could have, should have – if only I had lobbied harder!

                  Fast-tracking the benefits of a more connected healthcare system is crucial for improving patient care, reducing medical errors, and making healthcare more efficient. The adoption of Fast Healthcare Interoperability Resources (FHIR) and other interoperability standards can enable seamless communication between different electronic health record systems, thus facilitating information exchange and collaboration among healthcare providers.

                  Unfortunately, the current GP Grants Program does not set specific eligibility criteria that focus on the adoption of cloud, security, FHIR or other interoperability standards – not even clinical coding standards! As a result, the program risks missing a critical opportunity to substantially enhance digital health capabilities across GP practices.

                  The government’s lack of focus on cloud services, security, FHIR and interoperability adoption is concerning, considering the many issues GP practices face due to siloed databases and technology platforms designed a couple of decades ago. The current state of healthcare data systems not only hinders efficient patient care but also creates additional administrative burdens on healthcare providers. By not setting clear eligibility criteria targeting these issues, the GP Grants Program will not bring about much-needed improvements in digital health and interoperability.

                  Unfortunately, there is a history in the Australian healthcare industry for key stakeholders and decision makers to listen to the voice of the ‘market share’, rather than the innovators, start-ups and disruptors looking to make a difference. It’s a chicken and egg scenario, no market share equals no influence, no influence equals no change. If only I had lobbied harder for change!

                  What could have been, should have been. Recommendations for Improvement

                  To maximise the potential of the GP Grants Program, the Australian Government should have considered the following recommendations:

                  1. Set clear eligibility criteria that prioritise funding for GP practices adopting cloud, security, FHIR and other interoperability standards to ensure a more connected healthcare system.
                  2. Encourage collaboration between GP practices and technology vendors to develop innovative solutions that address the challenges of siloed databases and improve data sharing.
                  3. Establish clear guidelines on how the grants can be used for enhancing digital health capabilities, including specific recommendations for addressing interoperability and data sharing challenges.
                  4. Look to other jurisdictions like the US, which have successfully modernised their digital health ecosystem. The US implemented the 21st Century Cures Act in 2016 which was well funded, mandated standards, promoted innovation, stimulated research and development and encouraged the use and uptake of web-based API’s. This had the effect of uplifting an entire ecosystem and encouraging a raft of new digital health entrants.

                  An Unintended Consequence: How the GP Grants Programme May Impede Digital Healthcare Reform

                  While the additional funding provided by the GP Grants Programme is undoubtedly beneficial for practices, there is a valid concern that it may have unintended consequences.

                  If practices invest grant money in outdated technologies, they essentially lock themselves into using these systems for the next 3-5 years, as assets typically depreciate over this period.

                  This potential outcome of the GP Grants Program could have a perverse impact on the government’s ability to implement much-needed digital healthcare reforms. By inadvertently supporting continued use of outdated technology, the Program may slow the adoption of innovative solutions such as cloud, security, API’s, FHIR and interoperability standards. In turn, this could delay the realisation of a truly connected and efficient healthcare system, which is an urgent priority.

                  It is disheartening to acknowledge that Australia is already lagging behind many other countries in terms of modern cloud-based digital health solutions. This funding, if not appropriately directed, will only serve to widen the gap between Australia and other nations leading the charge in healthcare innovation. The prospect of falling further behind should be a wake-up call for the government to re-evaluate the GP Grants Program and ensure it truly supports the advancement of digital health capabilities across the country.

                  It is never too late!!

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                    Communication the key to reducing hospital readmissions

                    Communication the
                    key to reducing
                    hospital readmissions

                    Can health tech help reduce hospital readmissions?

                     

                    According to a global research review, telehealth and virtual wards can certainly make a difference.

                    The Deeble Institute — the research arm of the Australian Healthcare and Hospitals Association (AHHA) — reviewed international research on the role of primary care in reducing hospital readmissions.

                    In its Evidence Brief no. 24, the Institute says telehealth can be used to boost general practice involvement in hospital discharges and subsequent multidisciplinary virtual care, resulting in fewer unplanned readmissions.

                    Unplanned readmissions are associated with poorer health outcomes, dissatisfaction with healthcare, increased costs, and bed blockages.

                    The report highlighted research that showed improved communication and coordination of care between GPs, hospitals and/or pharmacists is effective.

                    “Effective interventions included … electronic tools to facilitate quick, clear, and structured (health) summary generation… use of electronic discharge notifications; and web-based access to discharge information for general practitioners,” reported the Netherland’s Hesselink and colleagues.

                    Virtual wards are another way to reduce risk of hospital readmissions and improve outcomes during hospital-to-home transition, with research indicating these can be effective with specific disease cohorts but less so with non-specific, complex diseases.

                    The Evidence Brief contrasted virtual wards with Hospital in the Home (HITH). HITH is a form of remote hospital inpatient care whereas virtual wards facilitate transition from hospital care to home care.

                    “Compared to HITH, virtual wards typically have a higher degree of interdisciplinary care coordination and review, are simpler in design and implementation, and have a broader scope of activities,” The Deeble Institute reported.

                    “Transitional care is similar to virtual wards, but usually implemented within existing systems. Virtual wards typically require a completely new care pathway and potentially new organisations to manage its implementation.”

                    MediRecords Connect provides FHIR (Fast Health Interoperability Resources) and API options for connectivity with hospital systems, including patient administration systems (PAS). MediRecords is deployed as an ePrescribing system at two Australian virtual emergency departments and as an outpatient billing and claiming system for Queensland Health. New functionality enabling multidisciplinary case management and inpatient care will be released later this year.

                    MediRecords is also integrated with the Coviu telehealth platform for streamlined virtual consultations.

                    Top three Technologies that reduce hospital admissions:

                    Further reading

                    ‘A wonderful day’: telehealth to become permanent

                    Improving Patient Handovers From Hospital to Primary Care

                    Consumer adoption of digital health in 2022: Moving at the speed of trust

                    PARR++ is dead: long live predictive modelling

                    Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis

                    Applying the Integrated Practice Unit Concept to a Modified Virtual Ward Model of Care for Patients at Highest Risk of Readmission: A Randomized Controlled Trial

                    Effect of post-discharge virtual wards on improving outcomes in heart failure and non-heart failure populations: A systematic review and meta-analysis

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