North East Valley DGP eNews

No 1331: September 11, 2013
eNews is a weekly electronic newsletter sent to all GP practices (with email addresses) within the NEV catchment. The aim is to provide up to date information relevant to GPs and to disseminate the latest activities and resources from the division. All feedback and enquiries welcome and should be addressed to Patty Marshall. You can also visit our website at: http://www.nevdgp.org.au/.
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In this issue:

Editorial                                                Shared Health Summaries of the PCEHR    

Chronic Disease Management            Diabetes Cycle of Care - Important changes from Oct 2013, Type 1 in the City – Complications

Professional Development                 CPD events   

Information Management                  Medical Director, Best Practice & General Computer Tips

Items of interest                                  Medicare Local slammed for excessive bureaucracy, GP Network News

News for Practice Staff                       Healthy Kids Check workshop, Latest APNA newsletter      

Women’s Health                                  Women's Health Seminar    

Positions vacant/wanted                  

Fun stuff                                              

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A Word from the Editor

Shared Health Summaries of the PCEHR

We note that there are 3 elements of the history component of the Shared Health Summary:

1.      Problems/Diagnoses: no distinction is made between summary/non summary or active/inactive items. It is a bit disappointing that Problems/Diagnoses don’t distinguish between past history (Summary + Inactive) and current history (Summary + active).

2.      Procedures: certain History coded items are coded as “Procedures”. You do not need to use the Procedures button in Progress Notes for items to end up as Procedures.

3.      Other Medical History: This includes all non-coded items as well as coded “administrative items” such as care planning, assessments, reviews and phone calls.

This means that very item from the Past History that has not been flagged as Confidential will be contained in this Health Summary. Without care this could be a long and messy list, full of duplications and trivial items!

 

We raise these issues because the structure of the Shared Health Summary is going to “punish” those GPs who have been diligent in keeping accurate histories which show there is a clear distinction between Current History (Summary box ticked plus Active) and Past History (Summary box ticked plus Inactive). The Shared Health Summary will “re-scramble” that good work. In addition the non-GP recipients of the Shared Health Summaries will find them, in many cases, to be a “dog’s breakfast”.  A suggested solution to this messy situation is:

1.      Change to a more meaningful structure for the Shared Health Summary (for a start, create a Current History and Past History distinction).

2.      Pay doctors to be trained in accurate recording of histories so they create meaningful Shared Health Summaries and so save the PCEHR from being useless.

3.      Make it an accreditation requirement that histories are accurate (new standards for PCEHR compliance), or at the very least that all GPs be made aware of the current RACGP recommendations for the recording of histories.
These include:

·         problem/diagnosis/procedures and clinical interventions use coded text

·         comments and free text to provide further detail as relevant

·         record so as to protect patient confidentiality (e.g. for HIV status, mental psychosis)

·         an indication of the date of onset. Date of resolution is desirable

·         it may be the case that there is no medical history to record. Record utilizing the functionality of the software: unknown; none; or not asked

 

We live in hope.

 

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Chronic Disease Management

Diabetes Cycle of Care - Important changes from Oct 2013

From October 1st The Department of Health and Ageing (DoHA) in consultation with Kidney Health Australia has decided to include an annual measurement of a patient’s estimated Glomerular Filtration Rate (eGFR) measurement as a requirement in the annual diabetes cycle of care. This will affect practices ability to claim PIP incentive payments, as an eGFR will now need to be recorded as part of the cycle of care for all diabetes patients. Click here for more information.

 

Type 1 in the City – Complications

This is another in the series of events, presented by Diabetes Australia – Vic, providing valuable and up-to-date information about living with diabetes. It also presents an opportunity to meet other people with type 1 diabetes living in your community. Associate Professor Alicia Jenkins (Endocrinologist) will be discussing type 1 diabetes and complications.

Saturday, 14 September 9:30am-1pm at The Royal Melbourne Hospital, Functions and Convention Centre, Charles Latrobe Theatre, Grattan Street, Parkville. Bookings are essential. Call 1300 136 588.

 

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Continuing Professional Development

Weight management

This education module outlines the evidence and practical strategies of a higher protein, low GI diet for achieving weight management and improving chronic disease risk factors. Click here.

 

Genetics & Medical Prevention in Cancer: Workshop for GPs

Tuesday 15th October 7-9pm at Rural Academic Health Centre, The University of Melbourne, 49 Graham Street, Shepparton. See here for more information and registration.

 

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Information Management

Medical Director Tip - What goes into the Shared Health Summary of the PCEHR

It is worth mentioning at this point that none of your consultation notes are ever uploaded to the PCEHR, rather what is extracted is key summary information from the patient's record:

·         Basic Demographics

·         Allergies

·         Medications

·         Problems/Diagnoses = Coded items from Past History

·         Procedures = Coded items from Past History

·         Other Medical History = Un-coded Items from Past History plus minor administrative items

·         Immunisations

Please Note:

4.      Problems/Diagnoses: no distinction is made between summary/non summary or active/inactive items. It is a bit disappointing that Problems/Diagnoses don’t distinguish between past history (Summary + Inactive) and current history (Summary + active).

5.      Procedures: certain History coded items are coded as “Procedures”. You do not need to use the Procedures button in Progress Notes for items to end up as Procedures.

6.      Other Medical History: This includes all non-coded items as well as coded “administrative procedures” such as care planning, assessments, reviews and phone calls.

7.      Every item from the Past History that has not been flagged as Confidential will be contained in this provisional Health Summary. Without care this could be a long and messy list!

 

If the patient's MD record is up-to-date as far as current medications and an accurate history list goes, then uploading the Health Summary should be very straightforward.

 

This week’s MD problem - I haven’t created a patient’s eHealth record yet?

Question:  I am worried that I haven’t yet created an eHealth record for any patients?

Answer: I wouldn’t be too worried about this until the political argie bargie has been sorted out – a positive step was made in late August whereby GPs were permitted to charge a longer consultation to complete the PCEHR. I think your immediate major concerns are to make sure your histories are accurate – get rid of the junk because every major or minor event, coded or non-coded, Active or Inactive, Summary or non-Summary goes into the Shared Health Summary.

My major concern is that there are going to be a lot of poorly executed Shared Health Summaries!

 

Best Practice Tip - Indenting the address lines

When sending out letters (such as Recalls) you will most logically use windowpane envelopes so you don’t have to print out and stick on labels (or worse address the letters by hand). The problem is the patient name and address lines are obscured when you fold the letter and stuff into the envelope. You need to move these lines to the right so they can be seen through the windowpane. Open up the LetterWriter template (Templates >Edit templates).

1.      Highlight the Patient’s name and address fields.

2.      On the left of the ruler you will see two triangles sitting on top of each other – the top triangle is the left hand margin, the bottom triangle is the 2nd (and subsequent) line indent.

3.      Click on the bottom of the triangles, hold down the mouse button and drag to the right to about 1.5 centimetres.

The address should now be in a position to be seen. You may have to adjust the vertical positioning of the letter so the address lines are in the right position when you fold the paper.

 

General Computer Tip - Setting tabs in a table

1.      Create a table as per normal.

 

 

 

 

2.      Add tabs inside the ruler at top of screen (as shown below).

3.     

Insert the cursor in the first cell of the table – to jump the cursor to the first tab setting, hold down the CTRL key and press the Tab key.

Note: If you don’t hold down the CTRL key and only press the Tab key, the cursor will jump to the next cell.

 

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Items of Interest

Medicare Local slammed for excessive bureaucracy (from 6 Minutes)

A Medicare Local, Goldfield Midwest Medicare Local in WA, has been accused of “stunning” bureaucracy after hiring PricewaterhouseCoopers to examine applications by GP practices for after-hours funding. But Dr Brian Morton, chair of AMA council of general practice, wrote in an AMA newsletter: “It seems to me that one of the biggest winners from the government reforms ... has been consultants.” He added: “[It is] a stunning example of how well intentioned policy has been completely bureaucratised. Practices have gone from a relatively simple application form under the old PIP system to a burdensome process that will disenfranchise many general practices and see GPs walking away from after hours services...[It] will be hard to get them back.”

 

GP Network News

This week’s edition includes: From the chair – Medicare Locals and after hours care; Big gaps in health policies from major parties; First-rate Defence personnel getting second-rate health service coordination; AMA Indigenous Peoples' Scholarship winner wants to close the gap in health inequalities; Continued Dispensing by Pharmacists.

 

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News for Practice Staff

Healthy Kids Check workshop

Tuesday 17th September 10am – 4pm at GPV Offices, Level 4 Meeting Room, 458 Swanston Street, Carlton. Aimed at practice nurses and other interested health professionals working with 4 year old children. This session covers the theoretical and practical components of the Health Kids Check as well as general information about caring for children. Click here.

 

Latest APNA newsletter

Click here.

 

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Women’s Health

Women's Health Seminar

Saturday 12 October 8am: registrations, 8:30am - 1.45pm: Women's Health Seminar, 1:45 - 3:15pm: CPR (optional) at Law Building, University of Melbourne . See here for more information and registration.                 

 

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Positions vacant/wanted

Please note: only new ads or resubmitted ads will be posted here. All other ads can be found on the website

 

Positions vacant

Doctors

Bundoora - Practice Nurse DV 1, required for a busy family practice, to work with nursing team. Position - maternity relief and holiday leave cover, Thursdays and Fridays 8 - 4.30. Experience in triage, wound care, childhood immunisations and health assessments required. Moderate computer skills necessary. Commence October. Call Jan Allen 9467 1444 or email janeta@andrewplaceclinic.com.au.

 

Craigieburn - GP's needed for brand new medical centre in large new shopping complex.  F/T or P/T. Great modern facilities and support.  Nursing, on site Pathology and Allied Health services.  Contact Leanne on 0407 528 288 or craigieburncentralmedical@gmail.com.

 

Heidelberg - busy family friendly practice is looking for a part- time/full time VR GP. The practice is computerised, fully accredited, with a practice nurse and supportive, friendly staff. With on-site pathology, dietician and psychologist and a sessional paediatrician and psychiatrist  consulting on a regular basis. Working hours and terms are flexible. Please contact Dr Jean McMullin on 9459 1100 or email, mtstmedical@bigpond.com

 

Keon Park - Doctors wanted. Southern Cross Care Macleod is relocating to a new 96 bed facility in Keon Park. They are seeking GP’s with an interest in aged care to join their team. They are offering consulting room, medical director available, nursing staff to assist you and accompany you when you visit, designated visiting times. Please call Barbara Stacpoole Manager 9434 4555/0419 165 758 if you wish to discuss further or would like to view the facility.

 

Mill Park - PVCH GP Super Clinic - Plenty Valley Community Health is requiring Full time/Part Time VR Female or Male GPs to join our brand new family orientated bulk billing clinic. This modern purpose built clinic is supported by friendly practice staff, nurses, allied health and on site pathology. For more information, please contact our Practice Manager, Cathy on 0419 314 839 or via email cathy.damos@pvch.org.au.

 

Montmorency - Busy, long-established practice seeks a full-time or part-time GP for GP owned family practice. Fully computerized, mixed billing, accredited, practice nurse support and friendly staff. Pathology services on site. Hours negotiable, with Saturday morning roster. No after hours or public holidays. Contact: Kay 9435 1144, Email: srmc@netspace.net.au. Website: www.sherbourneroadmc.net.au.

 

Watsonia - Rosanna Medical Centre is seeking a PT/VR GP. A computerised, accredited, mixed billing, long established practice. Friendly supportive team. Please call 9435 1191.

 

Practice staff

North Coburg - General Practice Nurse RN (Div 1) – Full time or part time. Energetic proactive PN required with experience in recalls, health assessments, chronic disease management, EPC’s and general treatment room duties including sterilisation of instruments and cold chain management. Experience is also essential in Childhood Vaccination and Wound Care. Must be organized and computer literate; an understanding of Best Practice and Practice 2000 preferred. To apply please email your CV to kalandah@bigpond.com.au.

Positions wanted

Medical receptionist - looking for work. With 20 years customer service experience in current employment as a Personal Banker at Westpac. Recently completed Certificate III in Business Administration Medical at NMIT Preston. Please contact Micki Ewing on 0434 382 342.

 

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Humour

There was a tradesman, a painter called Harry, who was very interested in making a penny where he could, so he would often thin down paint to make it go a bit further.

As it happened, he got away with this for some time, but eventually a church decided to do a big restoration job on the painting of one of their biggest churches.

Harry put in a bid and, because his price was so low, he got the job. And so he set to erecting the trestles and setting up the planks, and buying the paint and, yes, I am sorry to say, thinning it down with the turpentine.

Well, Harry was up on the scaffolding, painting away, the job nearly completed, when suddenly there was a horrendous clap of thunder, and the sky opened, the rain poured down, washing the thinned paint from all over the church and knocking Harry clear off the scaffold to land on the lawn, among the gravestones, surrounded by tell-tale puddles of the thinned and useless paint.

Harry was no fool.  He knew this was a judgment from the Almighty, so he got on his knees and cried: "Oh God!  Forgive me! What should I do?"

And from the thunder, a mighty voice spoke...

"Repaint! Repaint!

And thin no more!"

 

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And remember

 

            You should not confuse your career with your life.