Health in Sight: November 2024
 
 

November 25, 2024

Health in Sight: November 2024

MediRecords reads healthcare news from around the globe so we can be well informed on innovation, developments and decisions that may affect future delivery of care. Here are some of the items that stood out in the inbox recently.

Impatient experiences

A data dump from the Australian Bureau of Statistics has shown some Aussies are delaying or doing without healthcare because they can’t afford it. While two thirds of people surveyed (66.4%) could access their preferred GP when needed, 11% of people in disadvantaged areas had to forgo medication or delay it due to the costs involved. And one in five Australians delayed or did not see a mental health professional because they couldn’t afford it. Significant as it is, this data may underestimate the growing gap in access to care. The Patient Experience Survey only interviewed people aged 15 or older who were usual residents of private dwellings, with the effect that people experiencing homelessness, in temporary or public housing are unlikely to have been counted.

While the overall proportion of people surveyed who delayed or did not use health services when needed fell over the past year, this did not apply for people with long term health conditions, or people living in areas of most socio-economic disadvantage, who were more likely to forgo care.

The survey shows GPs remain at the heart of Australian healthcare, with the proportion of people who saw a family doctor up slightly to 82.6% in 2023-24, from 82.3% in 2022-23. In contrast, only 53% saw a dental professional and 39% a medical specialist in 2023-24. Numbers of people seeing a GP for after hours care (5.2%) or urgent medical care (8.8%) were very low, while 15.3% of Australians visited a hospital emergency department in 2023-24. In outer regional, remote or very remote areas, (presumably with fewer GPs and options for after hours care,) 20.4% of people sought care at their local ED.

Significant gender gaps on service usage suggests Australian men do not prioritise their health, with women more likely to present at all the healthcare services listed in the survey. For example, 87.3% of women saw a GP in 2023-24, compared to 77.7% of men. Use of telehealth fell, with the data revealing women are significantly more likely to use telehealth services than men.

To read more of the Patient Experience survey results, go to Patient Experiences, 2023-24 financial year | Australian Bureau of Statistics.

Housing-health linkages

On the subject of doing without, a Victorian Council of Social Service (VCOSS) Health and Energy Hardship project has sounded the alarm that utility bills are no longer affordable for some households, resulting in people living without heating or cooling. VCOSS says energy hardship has demonstrable impacts on health and lists signs for healthcare professionals to watch for here: Health and Energy Hardship | VCOSS

This project is an example of focusing on opportunities to improve health equity, rather than just outcomes data. Cleveland’s Metro Health Institute for Hope recently posted on this issue, suggesting that asking communities how to change health outcomes may be more effective than monitoring distressing data. More detail on the Institute’s logic can be found here: Why health equity’s goal shouldn’t be outcomes

Cultural connections count

With Australian governments generally failing to achieve progress towards Closing the Gap targets for the health and wellbeing of Aboriginal and Torres Strait Islander Australians (see Closing the Gap targets and outcomes | Closing the Gap), fresh approaches are clearly required. Recent University of New South Wales research may be a step in the right direction, with researchers finding that opportunities to practice culture on Country has a positive impact on “stress relief, inter-generational healing, and the journey to overcoming trauma, which in turn had a positive impact on … overall health and wellbeing.” Further details can be found here: The role of culture and connection in improving Aboriginal health :: Hospital + Healthcare

Season for change

The man who puts the flavour in demographic data, Bernard Salt, has added to the growing body of commentary suggesting the future of Australian Healthcare is in our own homes. Mr Salt told a Perth symposium that healthcare is about to be hit by the “baby boomer freight train” and “we will see the care sector redefined, re-imagined and repurposed” by this numerically and financially influential sector of our population. Health Services Daily reported the respected Mr Salt saying: “They will make it clear how their care should be delivered and the vast majority will want in-home care.” (Read more here: https://www.healthservicesdaily.com.au/future-of-care-is-in-the-home-salt/21895)

Spending to save

Whether you call them DNAs (Did not attend) or FTAs (failed to attend), a no show for a medical appointment means lost revenue and longer waitlists for patients who could have utilised the available timeslot. A partnership between Uber Health and Veteran Affairs in the US has made it easier for people to attend medical appointments by removing transportation as a reason for non-attendance. Veterans Health Administration report that 1.8 million appointments are missed annually due to transportation hurdles. Since inserting the Uber option, they say attendance has risen significantly, saving an estimated $196.7 million in missed appointments. (See VA finds medical transportation fix with Uber Health | TechTarget)

MediRecords at the coalface

As an access-anywhere cloud software system purpose-built for multidisciplinary care, MediRecords is used in a multitude of ways in Australian healthcare. These include use by paramedics; a remote mining camp; street, clinic and hospital care for people experiencing homelessness; Aboriginal health services; telehealth businesses; virtual emergency departments; alternative medication businesses and many more. Please reach out to us if you have a unique or innovative use of MediRecords you would like to showcase.

Tim Pegler

Senior Business Development Manager

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AI tools: What GPs think
 
 
 

October 22, 2024

AI tools: What GPs think

Most GPs believe innovation improves patient health outcomes, yet only eight per cent of them identify as innovators and 35 per cent as early adopters, a new report has found.

The RACGP’s Health of the Nation 2024 report revealed that while the majority of GPs regularly use digital technologies — such as electronic prescribing — only 13% felt well-informed about innovations within general practice.

The report, in its eighth year, surveyed 3006 practising GPs.

This year, GPs were asked about their perceptions, attitudes, and behaviours regarding innovation in general practice, including:

  • adopting new care delivery methods, such as telehealth;
  • improved communication between healthcare professionals, including interoperable health records; and, 
  • new mechanisms to enhance patient care, such as patient enrolment schemes like MyMedicare.

GPs identified funding incentives as the most significant enabler of innovation in general practice, with 60% highlighting this factor.

While one survey respondent enthused, “Innovation has significantly enhanced general practice, particularly through technology”, 83% of GPs reported that they rarely or never use artificial intelligence tools.

GPs were asked, ”What new innovative practices or methods do you believe should be adopted to positively impact the care you provide?” They said:

  • electronic health records, which improve care coordination and reduce errors
  •  telemedicine, which increases accessibility
  • AI-driven tools 
  • systems that talk to each other/improved interoperability
  • streamlined administrative systems that analyse business data
  • new models of care
  • multidisciplinary care
  • a health status dashboard for patients to see what is recommended for their age
  • remote monitoring, including wearable devices and health apps that empower patients to monitor their health

“Overall, these advancements save time, enhance accuracy, and enable more personalised healthcare, ultimately improving patient outcomes and the efficiency of general practice,” a GP summarised.

Regarding using AI scribe tools, one GP expressed increased job satisfaction after adopting the technology: “A happy GP is a good GP, and I’m even reconsidering my retirement plans.”

Founder and CEO of MediRecords Matthew Galetto commented that the report’s chapter on innovation “notably omits discussion of cloud and related technologies as a key enabler of digital innovation in primary care practices”.

“The report also lacks mention of the government’s initiative to promote real-time information sharing using FHIR (Fast Healthcare Interoperability Resources) standards, which are essential for interoperability and seamless patient care,” Mr Galetto said.

“FHIR is also a key enabler of digital innovation.”

MediRecords is a leading digital innovator in healthcare, delivering cloud-based solutions built to FHIR standards across a diverse range of medical environments, from primary to tertiary care. Its recent integration of Heidi AI Scribe, an advanced AI tool powered by Heidi Health that streamlines clinical documentation, reinforces MediRecords’ commitment to digital innovation. Learn more about the partnership between Heidi Health and MediRecords here.

Experience Heidi AI Scribe in MediRecords

Reduce administrative burden and focus more on patient care with Heidi Health's AI-powered scribe tool, integrated seamlessly with MediRecords clinical dashboard.

Learn more here

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Aussies’ Sexual Health Trends: Insights for Sexual Health Month
 

September 20, 2024

Aussies’ Sexual Health Trends: Insights for Sexual Health Month

Sexual Health Month provides a timely opportunity to survey some of the recent research in the field of sexual and reproductive health — and report some news from the coalface.

Travellers

Travelling Aussies are mostly proactive about their sexual health before departure when they see a travel-medicine doctor or nurse, with 72% of those in the study requesting STI testing pre-departure.

Over 60s

A survey of 1840 people aged over 60 found patients want GPs to initiate sexual health conversations as part of routine care. It also found that barriers included patient embarrassment, uncertainty about finding solutions, and ageism. 

James Sneddon, co-founder of Stigma Health, said that while the largest age group accessing STI testing via his service is 20-30, the next biggest bracket is those aged 60-70, “with an influx of those who are pushing 80”.

Prostate cancer

Information on complications with sexual function following prostate surgery are the most commonly unmet need among men with prostate cancer, a study found. The researchers recommended sexual well-being discussions as standard care for all prostate cancer patients.

Women’s health

A special edition of the Australian Journal of Primary Health dedicated to optimising women’s sexual and reproductive health in primary care highlighted that:

  • There is a high level of unmet need for effective contraception in Australia and access barriers including the availability of services. 
  • The limited number of GPs who insert intrauterine devices presents a significant barrier to access.
  • Access to abortion care in Australia is inequitable, especially outside cities, and few publicly-funded abortion options are available in most states.
  • There is an urgent need for transparency around public abortion service availability and government commitment to expanding abortion care.
  • Most women did not receive in-depth contraceptive counselling antenatally or postnatally, but would have found this useful.
  • Women surveyed about over-the-counter access to the oral contraceptive pill were in favour, especially for repeat prescriptions.

Awkward

For sexual health month, the key message from Mr Sneddon is:  “Get awkward. Have a conversation with your mates or your partner about getting tested; the majority of STIs have no symptoms.” Among Aussies tested via Stigma Health, there has been a recent surge in Chlamydia numbers; it is 33% higher than the 5-year mean, Mr Sneddon said.

 

Further reading:

Ahmed, Z., Gu, Y., Sinha, K., Mutowo, M., Gauld, N., & Parkinson, B. (2024). A qualitative exploration of the over-the-counter availability of oral contraceptive pills in Australia. PloS one, 19(6), e0305085.

Bourchier, L., Temple-Smith, M., Hocking, J. S., & Malta, S. (2024). Older patients want to talk about sexual health in Australian primary care. Australian Journal of Primary Health, 30(4).

Charlick, M., Tiruye, T., Ettridge, K., O’Callaghan, M., Sara, S., Jay, A., & Beckmann, K. (2024). Prostate Cancer Related Sexual Dysfunction and Barriers to Help Seeking: A Scoping Review. Psycho‐Oncology, 33(8), e9303.

Dev, T., Buckingham, P., & Mazza, D. (2023). Women’s perspectives of direct pharmacy access to oral contraception. Australian Journal of Primary Health.

Haas, M., Church, J., Street, D. J., Bateson, D., & Mazza, D. (2023). How can we encourage the provision of early medical abortion in primary care? Results of a best-worst scaling survey. Australian Journal of Primary Health, 29(3), 252–259

Li, C. K., Botfield, J., Amos, N., Mazza, D. (2023) Women’s experiences of, and preferences for, postpartum contraception counselling. Australian Journal of Primary Health 29(3), 229-234.

Mazza, D., & Botfield, J. R. (2023). The role of primary care in optimising women’s sexual and reproductive health. Australian Journal of Primary Health, 29(i–iii).

Power, A., Tuteja, A., Mascarenhas, L., & Temple-Smith, M. (2023). A qualitative exploration of obtaining informed consent in medical consultations with Burma-born women. Australian Journal of Primary Health, 29(3), 284–291.

Srinivasan, S., Botfield, J. R., & Mazza, D. (2023). Utilising Health Pathways to understand the availability of public abortion in Australia. Australian Journal of Primary Health, 29(3), 260–267

Warzywoda, S., Fowler, J. A., Debattista, J., Mills, D. J., Furuya-Kanamori, L., Durham, J., … & Dean, J. A. (2024). The provision of sexual and reproductive health information and services to travellers: an exploratory survey of Australian travel medicine clinicians. Sexual Health, 21(1).

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.

 

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Meditations on a National Conference with a conscience
 
 

August 30, 2024

Meditations on a National Conference with a conscience

The theme for the Catholic Health Australia National Conference that wound up in Sydney this week was ‘Rejoice Reimagine’. MediRecords has attended numerous innovation-focused gatherings over the years, but none where faith and belief have been so central to proceedings.

The theme for the Catholic Health Australia National Conference that wound up in Sydney this week was ‘Rejoice Reimagine’. MediRecords has attended numerous innovation-focused gatherings over the years, but none where faith and belief have been so central to proceedings. Here are four take-aways from the event.

Keynote speaker Dr  Gill Hicks  spoke with amazing grace about the events that led to her being critically wounded in a London terrorist attack and hospitalised for six months, initially labelled by rescuers as ‘one unknown, estimated female’. Dr Hicks said there is always opportunity in adversity; she used the loss of her legs as her chance to become taller, through longer than recommended prosthetic limbs. She said the thought of not being able to make a natural footprint on Australian soil had been confronting until she realised ‘how we leave each other’ is of more lasting importance.

Australian Government Department of Health and Aged Care Secretary Blair Comley said that in developing a strategic map for health and aged care nationally, the department was aware it should be thinking 15 to 30 years ahead. He said the strategy had four key priorities:

  1. Prioritise prevention and early intervention.
  2. Address health and aged care inequities.
  3. Enhance system integration, in part through private sector engagement.
  4. Leverage available health and digital technology.

Australian Medical Association federal president Professor Steve Robson said the recent introduction of electronic medical record (EMR) technology that was non-intuitive and complex for users had been a catastrophe. The transition period had been “really awful”, and several senior colleagues had left healthcare due to added stress and workload. Professor Robson urged politicians to spend less time cutting ribbons and announcing tech projects, when the focus should be on systems that enable patient-centred care.

Operations Manager at St Vincent’s Health Network Sydney Katya Issa spoke of how prison accelerates aging and exacerbates existing illnesses. Older people often enter prison without medications, mobility aids and glasses, and can face long delays getting these. She said St Vincent’s Health needed to keep advocating for sentencing reform, age-specific facilities and more transitional services for people leaving prisons.

Senior Peer Worker at the NSW Justice Health & Forensic Mental Health Network, Andrew Padayachy, who was arrested, charged and then had all charges dropped after several months in prison, spoke of the humiliation of being wheeled into a public hospital for a brain scan, handcuffed by hands and feet to a wheelchair. Mr Padayachy also called for greater support for people being released as many had become dependent on the justice system, having forgotten how to live in the community.

MediRecords welcomes opportunities to work with faith-based and social justice organisations. An alternative to larger EMR vendors, our interoperable, secure, cloud-hosted Electronic Health Records system provides a longitudinal view of care in the community and hospitals. Our new Admissions module, built to support 200 beds managed by the Australian Defence Force, includes electronic prescribing, progress notes, handovers, charting, and assessments. Medication management and a new patient portal are in development.

MediRecords welcomes opportunities to work with faith-based and social justice organisations. An alternative to larger EMR vendors, our interoperable, secure, cloud-hosted Electronic Health Records system provides a longitudinal view of care in the community and hospitals. Our new Admissions module, built to support 200 beds managed by the Australian Defence Force, includes electronic prescribing, progress notes, handovers, charting, and assessments. Medication management and a new patient portal are in development.

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Homelessness Awareness Week: The housing-health nexus
 

August 06, 2024

Homelessness Awareness Week: The housing-health nexus

Tonight almost 122,500 Australians will have nowhere safe and secure to sleep, the most recent census data shows. One in seven of them will be children under 12.

In 2022-23, 273,600 people were assisted by homelessness services, with another 108,000 unable to be assisted due to insufficient staff, accommodation or resources. In the group who could not be supported by overstretched services, 80 per cent were women and children, many of whom were fleeing domestic and family violence, according to the Australian Institute of Health and Welfare.

This week, Homelessness Awareness Week, the national peak body for homelessness, Homelessness Australia, is calling for the changes that could turn the tide of homelessness, including:

  • Increasing social housing to 10% of all housing;
  • Increasing funding to homelessness services to meet need; and
  • Increasing income support payments to at least $80 a day.

This week also serves as a stark reminder of the health difficulties faced by people experiencing homelessness (PEH). Studies in Australia and internationally have found about 60% of PEH have a long-term physical condition or long-term mental health conditions – higher than the population who do not experience homelessness.

The health disparities of PEH and a revolving hospital door — PEH are 43% more likely to reattend emergency departments within 28 days — reflect the social circumstances that have contributed to the experience of homelessness.

A wide-ranging review study this year, led by Jean-Phillipe Miller at St Vincent’s Hospital Melbourne, argued that while PEH were often viewed by healthcare services as “hard to reach”, it is the services themselves that are difficult to access for this vulnerable group. 

By bringing healthcare directly to those in need, outreach programs, such as primary healthcare service outreach programs, offer a promising solution. A UK study found they can help bridge the gap between the homeless and essential health services. 

Homeless Healthcare in Perth is one such service, providing outreach health care to PEH on the streets, along with fixed site clinics and a 20-bed inpatient facility.

CEO Alison Sayer said Homeless Healthcare provides services where they are most needed, creating an alternative to busy public emergency departments.

She said Homeless Healthcare supported over 2500 people in 2023, many of whom had multiple health conditions.

Ms Sayer said, “People experiencing homelessness have an average life expectancy of less than 50 years, a stark contrast to the average Australian who can expect to live into their 80s.

“This disparity largely exists due to the many barriers preventing people experiencing homelessness from accessing healthcare. Health problems are among the most significant factors leading to and perpetuating homelessness.” 

MediRecords is proud to support the work of Homeless Healthcare as the electronic health record system for inpatient and outpatient care.

You can help make a difference by donating to Homeless Healthcare today – donate here. 

Sources and further reading:

Australian Institute of Health and Welfare. (2023). Health of people experiencing homelessness. https://www.aihw.gov.au/reports/australias-health/health-of-people-experiencing-homelessness

Homelessness Australia. (2023). Home. https://homelessnessaustralia.org.au/

Kopanitsa, V., McWilliams, S., Leung, R., Schischa, B., Sarela, S., Perelmuter, S., Sheeran, E., Mourgue, L., Tan, G. C., & Rosenthal, D. M. (2023). A systematic scoping review of primary health care service outreach for homeless populations. Family Practice, 40(1), 138-151. https://doi.org/10.1093/fampra/cmac075

Lee, S., Thomas, P., Newnham, H., Freidin, J., Smith, C., Lowthian, J., Borghmans, F., Gocentas, R. A., De Silva, D., & Stafrace, S. (2019). Homeless status documentation at a metropolitan hospital emergency department. Emergency Medicine Australasia, 31, 639–645.

Miller, J. P., Hutton, J., Doherty, C., & Holmes, C. (2024). A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare. BMC Health Services Research, 24(492). https://doi.org/10.1186/s12913-024-10971-8

Morrison, D. S. (2009). Homelessness as an independent risk factor for mortality: Results from a retrospective cohort study. International Journal of Epidemiology, 38(3), 877–883. https://doi.org/10.1093/ije/dyp160

Queen, A. B., Lowrie, R., Richardson, J., & Williamson, A. E. (2017). Multimorbidity, disadvantage, and patient engagement within a specialist homeless health service in the UK: An in-depth study of general practice data. BJGP Open, 1(3). https://doi.org/10.3399/bjgpopen17X100941

Wood, L., Wood, N. J. R., Vallesi, S., Stafford, A., Davies, A., & Cumming, C. (2019). Hospital collaboration with a housing first program to improve health outcomes for people experiencing homelessness. Housing, Care and Support, 22(1), 27–39.

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What’s happening in health?
 
 
 

July 9, 2024

What's happening in health?

As one of the biggest industries on the planet, there’s always something happening in healthcare. Here’s what has captured our attention recently.

Industry news

Private hospitals are facing tough times as costs of doing business keep rising while a major source of their revenue – private health insurers (PHI) – are seen to be holding tight to profits. The ill-will between PHI and private hospitals is best demonstrated by the battle between the St Vincent’s group and NIB, which is at breaking point.

Suggestions of a crisis in the private hospital sector are underlined by key players co-operating with a Federal Government review. Health Services Daily reports that, “79 facilities — including day surgeries, endoscopy centres, private hospitals, wound care centres, cosmetic surgery centres, dental centres, respiratory and sleep disorder clinics, dialysis clinics and mental health centres — have either closed or revoked their declaration as a private hospital since 2019”.

Internationally, post-pandemic use of telehealth has fallen and major retail chains who leapt into healthcare are back-pedalling. American companies Walmart and Walgreens winding back their health businesses (see What retail titans might do next on health care (axios.com)), makes us wonder how Healthylifeis going for Woolworths, locally.

The pressure to be profitable means most hospitals are searching for ways to reduce the costs of delivering care. Managing patients in their own beds may be cheaper than hospital beds and so the cash-strapped UK National Health Service has committed to scaling up virtual care.

If the NHS needs a success story to use as inspiration, the ever-innovative Cleveland Clinic is hailing its acute hospital care in the home program a success for patients and staff, while acknowledging further improvements are possible. For details, see Lessons from Cleveland Clinic’s 1st year of ‘hospital at home’ (beckershospitalreview.com).

Melbourne’s Austin Hospital has also committed to virtual wards as business as usual, particularly for cardiac and haematology patients.

And the Federal Government is funding virtual careto chip away at a barriers to accessing mental health inpatient care, (partly caused by a shortage of accessible psychiatrists).

Keeping it real on artificial intelligence

Investors seeking share-market alchemy remain bullish on Artificial Intelligence while potential end users want ethical, regulatory and security assurances to precede introduction of these potentially very useful new tools. The American Medical Association offers sensible tips on technology adoption here: In the push for AI in health care, avoid EHR rollout mistakes | American Medical Association (ama-assn.org)

As to the smorgasbord of AI news, here is an aperitif:

 

Source: Future Health Index 2024 Better care for more people

We're all healthcare consumers

We also keep a close watch on consumer health news, in the interest of all of us avoiding hospitalisation. Here are some insights aimed at keeping our engines running:

Evidence is mounting that good gut health boosts mental health and ability to handle stress. Stress: Could a healthy gut microbiome make you more resilient? (medicalnewstoday.com)

Multivitamins, however, might only contribute to expensive and colourful urine. Another Study Finds No Life-Extending Benefit From Multivitamins (healthday.com)

In other product news, the old advice (or excellent marketing) that taking aspirin reduces risk of heart attack appears to have been debunked – unless you have previously had a stroke or heart attack. American Adults Warned Over Aspirin Use Despite Risks – Newsweek

Stanford University research, published in the journal Nature Medicine, has identified six different types of depression, which has implications for better treatment and management of mental ill-health. 6 types of depression identified in Stanford study | CNN

And there are clear reasons to avoid COVID19 because the long form of the illness is particularly nasty. Report: More than 200 symptoms tied to long COVID | CIDRAP (umn.edu)

The last word

Police, prisons and hospital emergency departments are often the professionals most likely to be dealing with people experiencing acute mental ill health. Here’s a good news story of how technology and faster access to treatment can successfully divert people from EDs and custody – https://www.healthcareitnews.com/news/outfitting-police-telehealth-ipads-mental-health-program-saves-government-62m?

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Feeling the heat at
Burning GP
 
 

June 17, 2024

Feeling the heat at Burning GP

MediRecords joined the sun-starved throng flocking to the Tweed for the Wild Health Burning GP conference last week.

Here are 10 takeaways from two days of robust and enlightening conversations.

1. GPs are divided on the impact of Urgent Care Centres (UCC)

Are nascent UCCs an attempt to woo voters in outer suburban marginal seats, a means to divert a few people from crowded hospital emergency departments… or an example of government spending that would be better invested in primary care? The Royal Australian College of General Practitioners (RACGP) past president Adj Prof Karen Price also pondered whether UCCs are turning away “non-urgent” patients and referring them back to their family GPs.

2. There’s a great divide between GPs and hospitals

Healthdirect Australia is trialling a way to send NSW hospital discharge summaries to GPs and patients and Queensland discharge summaries are uploaded to The Viewer … but the data disconnect between primary and tertiary care remains vast*.

Associate Professor Alam Yoosuff, the Rural Doctors Association NSW vice president, said GPs were often left in the dark about hospital outcomes for their patients.

“We don’t always know if person has died, been discharged, or been sent home with only six (tablets)… We know the system is not right. It may be better than other countries, but we know it should be even better, given what (governments) are spending.” 

– Associate Professor Alam Yoosuff, the Rural Doctors Association NSW vice president

Judging by the overall vibe at Burning GP, GPs feel much of the government cash spent on shiny new hospitals could be better spent on disease prevention led by community-based primary care practitioners.

3. Workforce scaling

The RACGP warned Australia has a “whole of health” workforce crisis, exacerbated by insufficient medical students coming through, so we’re going to have to import doctors, nurses and specialists from overseas. (The ever-resilient Health Department Assistant Secretary Medicare Benefits and Digital Health, Mr Daniel McCabe, said he preferred “critical juncture” to crisis, triggering a running joke for the entire conference.)

Grampians Health Chief Strategy & Regions Officer Dr Robert Grenfell said the shortage of GPs in western Victoria was so acute he was planning based on having none. He said: “If we have (GPs) I will use them” but it was now prudent to make alternative plans.

4. Medicare misery is multiplying

Several conference panels highlighted the challenges of determining the correct, optimally reimbursed Medicare item codes for complex consultations. Mr McCabe conceded all billable items are due for review, with an aspirational goal of improving access to healthcare for people who can least afford it.

5. Telehealth – supplementary or threat?

If young and tech-savvy consumers keep opting for online access to quick prescriptions, medical certificates and more, community GPs will be left with older, sicker, more complex clients, including those with mental ill health. Whitebridge Medical Centre owner Dr Max Mollenkopf said GPs needed to understand why consumers are switching to digital health companies such as Eucalyptus and adapt fast. He said, “Our old patients who love us will die off and all the young ones will be (Eucalyptus patients) unless we do something different.”

6. The numbers speak for themselves

The Australian National University Associate Professor (and GP) Louise Stone highlighted a 42% pay gap between men and women GPs. She said this was compounded by women GPs shouldering a majority of longer, underfunded consultations with complex patients, (who may have been released from hospital prematurely to reduce bed blockages).

7. But metrics may deceive

Associate Professor Stone cautioned that ‘evidence-based solutions’ in healthcare may not be what they seem. Analysis had shown the typical participant in clinical trials is a privileged white male, the researcher is likely to be a white urban male and even the average lab rat is a white furred male. This means clinical metrics may not be representative … and AI tools risk exaggerating biased data even further.

Evrima Technologies CEO and Founder Charlotte Bradshaw said that 80% of clinical trials are delayed in Australia because eligible people can’t be found and paired with researchers.

8. The My Health Record (MHR) will grow exponentially

Mr McCabe confirmed legislation is imminent to mandate sharing diagnostic imaging and pathology with the MHR. The government will also “push very hard” for every medication event – prescribing and dispensing – to be uploaded. The CSIRO-led Sparked community will need to lead the software industry to a FHIR (Fast Healthcare Interoperability Resources) standard to achieve this. Mr McCabe said Australian healthcare was hamstrung by “a lot of technology built in the 1990s that is not fit for purpose”. The recent MediSecure data breach showed, “We need to make sure we set the bar a lot higher than it is today”.

9. Technology knowledge is variable

When you’re a time poor GP, technology is rarely top of mind. You just want it to work. GPs still need reassurance from healthcare influencers that cloud technology is as safe (or safer) than server-driven desktop tech and that switching brings cost and time savings on hardware, hosting, back-ups, security, software patches, electricity and more. As one GP said to us, “You mean I can sack my IT guy?”

As for innovations such as Artificial Intelligence (AI), there’s a sense that while there are time, safety, revenue and efficiency gains to be made, the early adopters and innovators will be waiting a while for their conservative colleagues to join them.

10. Summing up

Based on our conversations and observations at Burning GP, community general practitioners feel underfunded, overworked, undervalued, and under siege from telehealth providers and pharmacists. They’re a resilient mob though, and still passionately defending their role as number one for longitudinal patient care.

*MediRecords new Admissions module means we can provide a longitudinal record connecting primary and tertiary care in one secure, cloud-hosted software system. We can send Discharge Summaries from our Admissions module and store them against the central patient file. Please reach out to us at sales@medirecords.com if you’re trying to solve these types of connectivity problems!

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Solve Healthcare Challenges with MediRecords APIs
 
 

June 13, 2024

Solve Healthcare Challenges with MediRecords APIs

Effective management and secure sharing of clinical data are essential ingredients for providing safe, high-quality patient care.

However, healthcare providers often encounter challenges, from incompatible software systems to co-ordination issues among healthcare teams. In an effort to break down these barriers, MediRecords has developed a comprehensive suite of APIs to streamline data sharing processes and help improve patient outcomes.

FHIR APIs: Elevating data management in healthcare

MediRecords’ FHIR APIs give you better access to and control of your clients’ clinical data by facilitating the management and sharing of patient records. From encounters to prescriptions, allergies to immunisations, these APIs offer a robust way to handle diverse sets of patient information. By enabling interoperability between systems, FHIR APIs ensure that critical data is accessible whenever and wherever it’s needed.

Connect APIs: Seamless integration for enhanced patient care

Complementing our FHIR APIs, MediRecords’ Connect suite of proprietary REST APIs offers a tailored solution for managing patient administrative data and other crucial information. From appointments to practitioner sessions, these APIs facilitate seamless communication and coordination among healthcare providers, resulting in more efficient care delivery.

FHIR & MediRecords APIs

FHIR is the future standard for health data interoperability. MediRecords has enabled FHIR as a mechanism for secure data exchange, including with hospital systems.

MediRecords has various APIs, including:

Patient

Securely exchange patient data with 3rd party systems, import patient records or notes into your database, create surveys and web forms to update the patient database, and update patient files from remote hardware devices or services.

Appointments

Our platform offers medical integration & scheduling with 3rd party booking systems & the ability to sync multiple clinicians' calendars to improve patient flows. We also provide reporting software integration for recurrence & patient 'no-shows'.

Correspondence

Easily filter & arrange correspondence in MediRecords and third-party applications. Initiate reporting, create actions or follow-ups, and use webhooks to push correspondence triggers.

Configuration

Utilise 'custom fields' in patient records to introduce additional patient identifiers. You can also create, update, and delete tags to categorise patient records and improve searching and filtering.

Key challenges MediRecords can address through APIs
  1. Integrated appointment booking: You can eliminate scheduling conflicts and incomplete calendars by enabling patient booking and appointment management across systems. For example, external booking software can be used to populate your MediRecords appointments calendar.
  2. Secure communication of clinical information: Ensure effective and safe communication of clinical information through secure sharing of patient material, including referrals and medical certificates, with data clinically coded to SNOMED standards, aligning with industry best practices.
  3. Unified patient identifier: Overcome the challenge of duplicate patient records by sharing a unique patient identifier across systems, thus ensuring synchronized and accurate patient information. This identifier becomes the key to making sure systems and data are in synch.
  4. Consolidated patient record data: Provide a consolidated view of extended patient details by integrating patient demographics, allergies, conditions, and family history across systems. For example, if a patient’s details are updated in MediRecords, you can use APIs and webhooks to make sure these same details are updated in a separate client management system (CMS).
  5. Closed-loop medication ordering: Enhance medication management by monitoring orders from prescription to dispensing, thereby minimising errors and disruptions in patient treatment plans. An example is the sending of evidence of prescription from MediRecords into a hospital enterprise system, creating a single source of truth for medication history. MediRecords has done this at Northern Health in Melbourne, to support Victorian Virtual Emergency Department prescribing workflows.
  6. Integrated case management and shared care: Improve collaboration among healthcare teams by integrating episode of care details, ensuring a more coordinated approach to patient management. Updating the status of allergies and investigation requests, for example, can increase safety and reduce risk of duplicated procedures.
  7. Flexible data capture and retrieval: Offering flexibility in capturing and retrieving custom data through custom fields within MediRecords, tailored to specific practice needs. 

Learn more about the problems MediRecords APIs can solve here.  

MediRecords’ APIs represent a significant step forward in addressing the complex challenges faced by healthcare providers today. By offering robust solutions for data management, communication, and collaboration, these APIs empower healthcare teams to deliver safer patient care in an increasingly interconnected healthcare landscape. With a commitment to innovation and efficiency, MediRecords will continue to expand our means of securely sharing the data needed for the future of healthcare delivery.

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The power to prescribe:
Who should have it?
 
 

May 22, 2024

The power to prescribe:
Who should have it?

A couple of weeks ago at a media conference, a Pharmacy Guild representative was photographed wearing a stethoscope over his white smock. The image triggered an adverse reaction among GPs; some asked how a pharmacist would use the instrument, others whether the event was a costume party.

The heated response suggests the national conversation over whether pharmacists should be able to extend their limited prescribing rights is gaining heat, rather than cooling. So what’s the debate all about? Let’s look at the key parties and what they say is at stake.

Party one: Pharmacists (represented by The Pharmacy Guild of Australia and Pharmaceutical Society of Australia)

Many pharmacies already offer vaccination services and support for chronic disease management. Trials have been conducted in several states, focused on providing assistance to people with conditions such as urinary tract infections (UTIs).

Pharmacists believe they can do even more to assist Australians who need help with common conditions and will be coming to them to collect medications anyway.

Backed by the Queensland government, the Guild initiated the North Queensland Pharmacy Scope of Practice Pilot, pencilling it for December 2023 and kicking it off in April 2024. Under the pilot, conditions pharmacists can now treat include acne, hay fever and eczema. For the full list, see About the pilot | Queensland Health. 

The Queensland Government has since moved to make the North Queensland pilot statewide.

Party two: Governments

Governments are trying to solve a supply and demand problem. It’s hard to get a GP appointment just about anywhere — and generally harder the further you are from a state capital.

Queensland Premier Steven Miles said: “Our Government is committed to making sure Queenslanders can access good quality healthcare, no matter where they live across the state.

“We know our hardworking pharmacists are more than capable to deliver these services – for common health conditions – and divert people away from our emergency departments and GPs.

“I am really proud that Queensland is leading the nation with this initiative.”

Queensland Health states: “Pharmacists are highly qualified and trusted members of our healthcare teams. Providing pharmacists with additional clinical training and supporting them to practice to their full scope, will enable them to help and support their local communities.”

Party three: General Practitioners (represented by the Royal Australian College of General Practitioners (RACP) and Australian Medical Association)

Doctors say that medications cannot be safely prescribed without a holistic, longitudinal view of the patient’s medical history, as best understood by their usual GP. They say the pilot puts vulnerable people at risk and that a previous trial allowing pharmacists to prescribe antibiotics for UTIs led to incorrect diagnoses and serious conditions going untreated, increasing overall healthcare costs.

Party four: Healthcare consumers (represented by you and I)

While most people prefer a long term relationship with a GP who knows you and your family, getting an appointment when you need it isn’t always easy or affordable. Some people go to hospital emergency departments (or virtual versions) for free help.

Other consumers are opting for convenience, using telehealth providers that offer quick access to scripts and more, but might not have time to hear your health history, (if you can remember it). For this group of consumers, getting help from the pharmacy you’re going to anyway, may be a no-brainer. However, the services are not free. Fees of up to $55 per pharmacist consultation may limit take-up.
Those with multiple or complex conditions are likely to have to wait for the next available appointment with their GP and hope for a cancellation to get in sooner.

Sparring partners

Back in March, the Medical Software Industry Association promised a ‘ding dong battle’ between the Guild, the RACGP and government, placing three key representatives on stage together in Melbourne.

Pharmacy Guild Victorian president Anthony Tassone said the prescribing issue was not about “pharmacists being GPs. It’s about pharmacists being the best professionals they can be…. solving problems for patient benefits.”

RACGP past president Dr Karen Price said she was concerned about the ‘taskification’ of general practice, which hindered longitudinal care. Dr Price said it can take 45 minutes to explore a patient’s medication history before writing an appropriate script. She said a UTI is a “retrospective diagnosis where there may be other issues that can’t be picked up by a pharmacist”.

Representing the Federal Department of Health and Aged Care, First Assistant Secretary (Medicare Benefits and Digital Health Division) Daniel McCabe said Australia faced “acute workforce challenges” and governments were trying to unlock the full potential of professionals who could deliver, “true multidisciplinary care”.

Dr Price said multidisciplinary care was great in hospitals and, while desirable, underfunded and challenging in general practice where, “the people who most need care can least afford it”.

Mr Tassone said doctors and pharmacists were all on ‘Team Patient’ but he and his peers were not rewarded for being part of multidisciplinary teams. “Are we part of the team or are we on the bench to make up the numbers?”

He said: “Patients don’t care. They care about getting care when they need it.”
It seems this conversation is far from finished.

Skin in the game

MediRecords provides secure, cloud-hosted electronic health records and prescribing functionality to healthcare professionals across Australia delivering face-to-face and virtual care.

Further reading:

Rollout begins for Australian-first pharmacy pilot – Ministerial Media Statements

What we know about Queensland’s pharmacy prescribing pilot – Medical Republic

The Pharmacy Guild Australia QLD (pharmacyfullscope.com.au)

Unlocking pharmacist’s potential in the QLD Scope of Practice Pilot – Pharmaceutical Society of Australia (psa.org.au)

Queensland Community Pharmacy Scope of Practice Pilot | Health and wellbeing | Queensland Government (www.qld.gov.au)

Queensland Community Pharmacy Scope of Practice Pilot | Queensland Health

North Queensland Pharmacy Scope Practice Pilot will put vulnerable patients at risk, doctors say – ABC News

RACGP – Pharmacy pilot a ‘solution’ that would only cause bigger problems

RACGP – Media releases

Unleashing-the-Potential-an-open-and-equitable-health-system.pdf

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Female-Friendly Federal Healthcare Budget
 
 

May 15, 2024

Female-Friendly Federal Healthcare Budget

Australians can look forward to a price-freeze on medicines, 29 new Medicare Urgent Care Centres, 61 walk-in Medicare Mental Health centres and a raft of cancer, HIV and women’s-health measures, as part of a $2.8 billion health package in the 2024 Federal Budget. 

More virtual care and hospital outreach services are also planned to avoid unnecessary hospital admissions — and enable older patients to be discharged sooner into medically supported, safe, comfortable environments. 

 Older Australians will also benefit from an extra 24,100 Home Care Packages, which are intended to reduce wait times to an average of six months and provide greater access to in-home aged care. 

 Other big-ticket items from the Federal Budget include: 

  • More affordable medicines via a price-freeze on Pharmaceutical Benefits Scheme (PBS) medicines to beat inflation: $318 million 
  • Life-changing and life-saving medicines added to the PBS, reducing costs to consumers: $3.4 billion 
  • Conversion and expansion of 24 existing Head to Health services into 61 walk-in Medicare Mental Health centres across Australia: $163.9 million 
  • 29 new Medicare Urgent Care Clinics, aimed to reduce waiting time at hospital emergency departments: $227 million 
  • Military veterans’ claims processing is prioritised with an additional $186 million for staffing and $8.4 million to improve case management and cyber security. The Government will also provide $222 million to overhaul legislation covering veterans’ compensation and rehabilitation. It will direct a further $48.4 million to Veterans’ Home Care and Community Nursing programs, and $10.2 million to fund medical treatment for ill and injured veterans waiting for liability claims to be processed. 
  • Free bowel cancer test kits for Australians aged 45-49, allowing them to join the over 50s ($39 million) 
  • New Medicare-benefit-scheme tests, including for suspected heart failure and rare cancers, to reduce waiting times and catch health problems sooner. A skin cancer prevention initiative is also included. ($25.3 million)  
  • Improved preventative health measures such promoting health and fitness, including $132.7 million for grassroots community and school sport to encourage participation. 
  • Spending of $44 million will further Australia’s goal of eliminating HIV (human immunodeficiency virus) transmission by 2030. Federal Health and Aged Care Minister Mark Butler said Australia aimed to be the first nation to wipe out HIV. 
  • A boost for alcohol treatment and prevention services, better nutrition programs and organisations supporting people with chronic conditions. 
  • $314.5 million in close-the-gap efforts include $164.3m towards First Nations health infrastructure projects, $54.3m towards training up to 500 First Nations health workers, $45m towards boosting renal services, and water infrastructure works.    

Women’s health is prioritised, including funding for breast cancer treatment subsidies, contraception training for practitioners, and development of a virtual contraception decision-making tool. Other initiatives aimed at women’s health include:   

  • Medicare: Longer consultations provided for complex gynaecological conditions like endometriosis, reducing out-of-pocket costs for women. 
  • Menopause Training: $1.2 million for health professionals’ training to manage women’s health during menopause. 
  • Breast cancer: Cutting the cost of a specific treatment from around $100,000 to $31.60. 
  • Funding for research on menopause, pregnancy loss, and fertility: $53.6 million over four years  
  • Miscarriages and sexual/reproductive health: $8 million for developing data sets 
  • Enhanced antenatal and postnatal care, including mental health screening: $56.5 million over four years 
  • Miscarriage: public awareness program, with support for affected women and families 
  • First Nations Women’s Health: Investments in prevention work for preterm births, stillbirth action plan, and free period products for First Nations communities. 

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