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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    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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      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

      Looking to stay updated with the latest from MediRecords?

      Sign up to the newsletter

        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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