Moving to Medicare Web Services – Is Your Practice Prepared?

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Please note that this article is for our Australian customers.

As you are aware, Services Australia is upgrading the current technology used by practice management software, to connect to critical digital health services such as Medicare/DVA Claiming, Eclipse and the Australian Immunisation Register. This new technology is referred to as Medicare Web Services (MWS).

A number of our products currently connect to Services Australia via a Medicare Client Adaptor, which utilises a Medicare PKI certificate also known as a site certificate. As per the new requirements, practice management software vendors will be replacing this Medicare PKI certificate method with a Provider Digital Access (PRODA) account, which will lead to the replacement of the current Medicare Client Adaptor technology.

What does this mean for your Practice?

For Bp Premier Customers:

  • We expect Saffron SP3 to be available towards the end of February 2022. This is the version of Bp Premier that contains all MWS changes needed to meet transition dates. We recommend that your Practice upgrades as soon as this is made available.

  • Prior to upgrading to Saffron SP3, you must ensure that your have registered and configured your PRODA account. If this is not completed prior to the upgrade being applied, your Practice will not be able to access any Services Australia business functions.

  • Bp Premier customers have also been granted a 3-month extension by Services Australia and now have until 19 June 2022 to upgrade to Saffron SP3. To take advantage of this extension, your Practice must ensure that they have received a new PKI Certificate and that this is installed and configured for existing Medicare functionality to continue to function after the original cut off date of 13 March 2022.

For Bp VIP.net Customers:

  • We expect the next version of Bp VIP.net to be made available in April 2022. This is the version of Bp VIP.net that contains MWS changes needed to meet transition dates. We recommend that your Practice upgrades as soon as this is made available.

  • Due to some of the complexities involved in implementing these important changes, we will not meet the original March 13 2022 deadline and have successfully obtained an extension to this date on behalf of all of our Bp VIP.net customers. As a Bp VIP.net customer, this means that your Practice will now have an additional 3 months to transition to our final Medicare Web Services enabled build. The new date for your transition deadline is now Sunday the 19th of June, 2022.

  • To take advantage of this extension, your Practice must ensure that they have received a new PKI Certificate and that this is installed and configured for existing Medicare functionality to continue to function after the original cut-off date of 13 March 2022.

  • Prior to upgrading to the Bp VIP.net release containing MWS functionality, you must ensure that you have registered and configured your PRODA account. If this is not completed prior to the upgrade being applied, your Practice will not be able to access any Services Australia business functions.

For Bp Allied Customers:

  • The next version of Bp Allied, V7 SP2, is due for release towards the end of February 2022.

  • This release will contain the changes needed to support the new MWS requirements.

  • As we leverage a third-party API to connect to Services Australia functionality, all Practices must apply the V7 SP2 update prior to the 12th of March 2022 to ensure that they can continue to access Services Australia business functions.

Moving to Medicare Web Services - what support is available?

  • Access your Bp Knowledgebase to review the steps required to register and configure your PRODA account, along with accessing other supporting information about Medicare Web Services such as renewing and configuring your PKI Certificate.

  • Review the Enablement Material our fantastic Training Team has put together to support our Practices through this change.

  • For Bp Premier users, register for our upcoming Saffron SP3 Masterclass Series here. Classes begin from the 23rd of February 2022!

  • For Bp VIP.net customers, keep an eye out for our planned April Masterclass Series.

  • Send our team an email if you have any questions or require any further information!

Authored by:

Jessica White Author Blog Picture

Jessica White
Head of Commercial and Government at Best Practice Software

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The New Generation of Practice Management Systems – From Interoperability to AI

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Early practice management systems (PMS) were born out of the need to provide better continuity of care for patients and more efficient operations for a GP/practice, both of which contribute to the improved quality and safety of care delivery. They have created significant and perhaps intangible benefits to individuals and society over the last several decades.

The new technology enablers, however, make it possible to transform PMS into more federated, better connected, and evidence-based systems by leveraging the emerging interoperability standards and Artificial Intelligence (AI) technologies.  This will make the new generation of PMS even more central to primary care systems within the overall healthcare care continuum.

This will enable future generations of Best Practice Software to bring many new benefits to patients, practitioners, and the community at large – contributing to a ‘more sophisticated and connected community healthcare management’, as mentioned in a recent Wild Health article.

Technology Enablers

The technology enablers include web-based and cloud infrastructure, now being used as the basis for the next generation of Best Practice Software, referred to internally as Titanium.

When used in conjunction with new interoperability standards such as HL7 FHIR®, cloud technology adds new mechanisms to the way various parties in the delivery of healthcare are connected, including support for patient engagement.

Through the cloud, AI solutions can be built leveraging huge amounts of data created by clinicians, including as part of collaboration with other clinicians, and in some cases, generated by medical devices. Such solutions can provide new insights to the clinicians and support new models of clinician-patient collaborations, with added emphasis on preventative and personalized health.

The Added Value of Interoperability

Architecting for interoperability adds dynamic and evolvable aspects to the way health systems of the future are connected, typically using APIs over cloud. This allows constructing and managing flexible event-driven clinical workflows supporting multiple participants, including hospitals, Aged Care facilities, community health centres, and patients.  This is not currently possible using HL7 v2 messaging integration approaches.

The emerging HL7 FHIR® standard provides a common information model for representing digital health data (the so called FHIR Resource entities) and API interfaces, both of which support building interoperable and connected digital health systems, and many international vendors are now embracing it.  In some cases, this is in response to regulatory requirements, such as the US Office of National Coordinator (ONC) cure act Final Rule.  This rule was designed to give patients and their healthcare providers secure access to health information. It also aims to increase innovation and competition by fostering an ecosystem of applications to provide patients with more choices in their healthcare, in part through the standardized API interfaces.

Best Practice Software recognizes the many benefits that the FHIR® standard can bring in the context of cloud technologies and is currently establishing a long term FHIR® adoption roadmap as part of its strategic direction.

The Added Value of AI

In general, AI is a collection of interrelated technologies used to solve problems autonomously and perform tasks to achieve defined objectives without explicit guidance from a human being. AI adds value through automating many tasks typically involving human actions and decision making.

Examples of AI use in healthcare are in the interpretation of medical images, e.g., X-rays and MRI scans, in the personalized treatment of patients based on their medical history and genetics, and in the optimization of clinical workflows.

A key component of AI is machine learning (ML), whereby computers ‘learn’ without being explicitly programmed, making use of the large amount of clinical data collected over time (aka training data) and applying advanced computational reasoning techniques. This can be in the form of:

  1. statistical machine learning searching for a predictive function from the training data
  2. reinforcement learning approaches constructing AI algorithms with “rewards” or “penalties” based on their problem-solving performance, inspired by control theory approaches
  3. deep learning solutions based on the use of artificial neural networks.

Other AI applications are in natural language processing, computer vision, used in many clinical image processing applications, and robotics. Another area of use in health is knowledge representation, particularly used to document clinical knowledge in a computable form such as SNOMED-CT clinical terminology.

Many rule-based Clinical Decision Support (CDS) systems can also be regarded as a form of AI.  Best Practice Software has included since its initial release CDSs aimed at helping clinicians to provide safer and more personalized healthcare. For example, when prescribing, background checks are made for potential allergies, drug interactions, contra-indications etc.  The use of new AI approaches can add another level to CDS, leveraging data-based solutions, contributing to better evidence-based healthcare provision.

Best Practice Software is currently looking at AI technologies for its future products to advance the creation of learning health systems for primary health providers as part of connected health ecosystems. The aim is to support more effective, evidence-based, and personalized clinical care and adaptable clinical workflows, as well as more efficient administrative operations of practices, based on the large volumes of historic data that has been collected. Possibilities include analysis of previous investigations of patients to support predictive clinical actions, text mining of correspondence with specialists, hospitals, and other clinicians, to help better decision making in case of similar future symptoms and so on.

While interoperability delivers more connected and event-driven care, analytics and AI provide augmented decision making for clinicians.

Establishing Trust for Providers and Consumers - Guidance for Developers

An important consideration when discussing AI technologies is to ensure that clinicians trust the decisions that are made as a result of the use of the AI system. This is often referred to as an explainability problem, which requires mechanisms to support clinicians in understanding how AI systems make decisions.

There is a further element of trust, whereby that learning health systems need to ensure that personal and societal confidence in IT systems is preserved in the presence of the data proliferation and sharing. To this end special care needs to be taken to express rules related to privacy, policy and ethics.  These concerns were discussed at more length in the paper delivered by Best Practice Software at the recent AI in Healthcare workshop in Oct 2021, and highlighted next.

One way to create trust is to develop “explainable” AI, where developers can present the underlying basis for decision-making in a way that is understandable to humans and can demonstrate that the system is working as expected by clinicians.

Another part of the guidance for developers is related to the problem of expressing computable expressions of policies, such as obligations, permissions, accountability, responsibility, and delegation. These expressions can be implemented in code as part of any digital health application, including the AI solutions. For example, they can be used to encode rules associated with privacy consent, governing the rules of access to personal healthcare information, or with research consent, governing the rules of clinical research. 

Computable expressions of policies are also important when one needs to express responsibilities associated with passing of healthcare data between providers, taking into account various legal constraints such as data ownership or custodianship or regulatory constraints associated with privacy.

AI brings its own set of policy issues such as how one can go about specifying ‘responsibility’ of AI applications, e.g. in the case of safety concerns, is this a responsibility of the AI developer, the IT staff involved in deploying the system or of the users of the system such as the clinicians.

These are issues which are currently yet to be addressed as part of legal systems, but the computable policy framework should be a required prerequisite when building scalable AI in any healthcare organization.

Co-authored by:

New Generation of Practice Management Systems Author Headshots

Dr Frank Pyefinch
CEO at Best Practice Software
&
Dr Zoran Milosevic
Interoperability and AI Consultant at Best Practice Software

Footnote

The paper presented at the AI in Healthcare Workshop is available upon request. If you would like to obtain a copy, please contact Dr Zoran Milosevic here.

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Vaccine Hesitancy – Navigating the Three Cs

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This article was contributed by guest author Tracey Johnson.

Vaccine hesitancy, along with its potential scale and impact, has become a topic of national debate since the middle of 2021.  Fortunately, we saw a rapid take-up of vaccination across the country in the final quarter of last year.  Together with every practice, we are now facing the challenge of those patients whose reluctance to embrace the COVID vaccine jeopardises community safety, health system capacity and our own team’s wellbeing.

What We Know About Vaccine Hesitancy

Vaccine hesitancy is complex.  It varies across time, place and vaccine type.  Many patients who are choosing to delay their COVID vaccination are already vaccinated for many other conditions and illnesses, and often do not consider themselves “anti-vaxxers”.  It is this group who are more likely to be influenced to adopt the jab.  Those whose stance on vaccination is long entrenched and underpinned by deep suspicions of science and institutions will continue to read extremely biased social media content and turn out to protests which only serve to reinforce their views.

So, what do we know about the more malleable and open vaccine hesitant patient?  The ‘Three Cs’ determine to what extent our public health efforts might be successful.

vaccine hesitancy venn diagram

Complacency

With Australia’s closed borders and public health measures such as mask wearing, social distancing and lockdowns, much of the population had not experienced the realities of widespread COVID transmission within the community.  Many believed that lockdowns and economic turmoil were in fact worse than COVID itself.  This is complacency in action.  Images of exhausted healthcare workers in the US, over-run hospitals in India and a mounting death toll from waves of COVID in the UK started to shift the perception by the middle of 2021.  No longer was it easy to dismiss COVID as a disease with limited and acute potential in older populations, and deaths in nursing homes.

A state like Queensland, which has only recently experienced major uncontrolled outbreaks, remained home to many complacent communities.  Late in 2021, when a COVID positive case holidaying in Townsville led to no community transmission, many held a bolstered optimism that COVID was a “city thing”. The variation in vaccination rates between metropolitan locations, and regional and rural areas which have never reported cases is stark. 

Then – COVID arrives in towns like Goondiwindi, or indigenous communities like Wilcannia.  Suddenly, there are frantic calls for vaccination.  Complacency can be overturned when figures near to the community, or with whom the community identify, speak to the ever-present danger of COVID.  Localised campaigns by community leaders in various ethnic communities have shown that complacency can be overcome if knowledge is shared by trusted figures and imminence is emphasised.  We have been working closely with our PHN to share video case studies and engage community leaders.  We even ran a shared medical appointment model involving an interpreter and community leader to kick off our vaccination drive in the Somali community in our South-East QLD suburb of Inala.

Confidence

Confidence should be easy to build in a vaccine launch environment unlike any we have ever seen.

Having worked in drug discovery, I have personally attested to groups of our patients how “drug development as usual” occurs.  Months waiting for grant applications to be reviewed, months more waiting for ethics applications to be approved, study launch hoping to attract a few willing volunteers meeting strict criteria, data analysis and reporting leading to the next grant.  The cycle repeats year after year.  Even when data is great, years are lost waiting for government food and drug agencies to consider new drug registration and reimbursement applications.  The time lost to waiting for money and approvals can easily account for half of the time.  

When it came to developing a vaccine for COVID – money was poured at the problem.  Scientists worked around the clock with growing teams.  They built on drug platforms discovered years before and applied them to COVID.  Governments prioritised consideration of drug registration applications and pre-purchased drugs even before they were fully validated.  With over 3 billion people now vaccinated, speedy adverse event reporting and timely data on deaths from vaccination versus outcomes for the unvaccinated, data is our friend in building confidence in the science. 

vaccine hesitancy quote Tracey Johnson

We keep our COVID resources in a shared clinical drive so that the latest information is at the fingertips of our entire team.  Active discussion on our “teams” channel rapidly disseminates great statistics to combat vaccine hesitancy.  The University of Queensland produced a tool highlighting your chances of getting struck by asteroids, cracking a double yoke egg and all sorts of other meaningful comparisons to highlight the advantages of vaccination.  Such tools are great to use with patients, as they offer a somewhat light-hearted take on the very real statistics that they’re often concerned about.

Convenience

Convenience is the final pillar.  Queensland Health has done, and continues to do a great job in getting access to jabs in schools, Bunnings carparks, on weekends and promoting vaccines available in pharmacies.  Since September of 2021, there has always been a vaccine option available.  Sadly, many in our community do not tap into traditional media, so boosting knowledge around these vaccination options requires our teams’ letting patients know what they can do.  We have used social media, our team encouraging patients to walk into nearby pharmacies and promoting the free sausages available at Bunnings.  This has ensured that our already full vaccine clinics did not create a waiting list amongst patients in our own community.  Given the unattractive remuneration we receive from vaccination, our team did not hesitate to encourage patients to take up other options if it meant getting vaccination earlier.  Where we had spare vaccine doses available on the day, we administered them to vaccine hesitant patients whilst they were still committed.

Our own vaccine clinics ran from 7am until 9am for many months and still operate on Saturday mornings to ensure working and school age patients have access.  With access now so easy, we have scaled back our vaccine delivery to sessions during weekdays so that our nurses are more available to complete chronic disease and preventative health work.

With the QLD borders now open, we look closely at our patient records to assess who still needs a prompt to get vaccinated.  Our region has one of the lowest rates of vaccination in all South-East Queensland, despite our practice being one of Brisbane’s early movers to launch vaccination.  With data extraction tools like Cubiko, we have been able to identify patients whose charts indicate an absence of vaccination.  We continue to use these reports to track vaccination status in our patient population.  In the past we benefitted from Cubiko being able to tell us which patients were eligible for AstraZeneca when vaccination was staged or were no longer eligible when age restrictions were brought in.  This saved our already overwhelmed reception team many hours of searching through lists.

These lists over-sample patients as until recently there was limited capacity to draw down data from the Australian Immunisation Register (AIR).  One of the silver linings of the pandemic is that Medicare Web Services is now working actively with software providers like Best Practice to link AIR History directly to a patient record.  What a boon that will be for vaccination planning, automatic recalls, and practice reminder systems!  Expect this improvement from midway through 2022.

Remain Positive - Remain Committed

Remaining positive throughout the pandemic has been the hardest thing for all healthcare providers.  However, positivity has been shown to have greater impact than just on team morale.  The media has been replete with stories around the often vocal 10% of the population that are staunchly remaining unvaccinated.  Research has shown the community responds far more favourably if the approximately 90% who are vaccinated is celebrated.  Acknowledging how common vaccination is amongst your patients can help push conservative patients over the line.  They will want to join the herd!

Working as a team is important for all healthcare provision.  This is especially important when it comes to requests for exemption from vaccination.  Our doctors and nurses agreed months ago to strictly follow the exemption process to the letter.  With shared commitment it was impossible for patients to short-circuit vaccination by appealing to the compassion of their healthcare team.  Everyone had the one message; vaccinate now.

Language Is Your Ally

In the early days our team were so polite when speaking to patients exhibiting vaccine hesitancy, even charming in the way they explained the risks of the disease and benefits of vaccination.  It did not take long for their language to harden.  We often hear accounts now of doctors telling their elderly, multi-morbid patients with many risk factors that what they know is that it is almost certain they will die if they get COVID.  

Vaccine hesitancy tracey johnson quote 2

Finally, we remain grateful for the stance taken by government that even private healthcare providers need to have all staff vaccinated.  Like many practices, some of our less educated team members were concerned about vaccination.  Highlighting to them that they will be at the front line when COVID becomes endemic ensured most were willing to get vaccinated.  We had one very reluctant team member.  The government edict around healthcare workers finally saw them book Moderna at a pharmacy just in the nick of time to meet the deadline.  Loss of rights to earn, go to restaurants and clubs did the trick!  We have seen a similar cascade amongst our younger patients and those working in sectors with vaccination mandates.

Looking Ahead

In the future, will vaccination rates remain high? 

That really depends upon government edicts and how successfully we continue to address the ‘Three Cs’. We have much we can control at a practice level to support maintenance of vaccination status.  How long key public health messages continue to emphasise the importance of vaccination will be central to our success.  The emerging science on how regularly we need boosters will be important as annual vaccinations might be resisted due to inconvenience.  If the edicts and campaigns melt away, we will probably see vaccination rates via boosters fall to levels similar to those for flu, insufficient to create herd immunity.  That means our practice systems and commitment to public health will need to fill the gap by prompting patients to get vaccinated.

Authored by:

Tracey Johnson Blog Author Image

Tracey Johnson
CEO at Inala Primary Care

Tracey Johnson is CEO of Inala Primary Care, a large general practice serving one of Queensland’s poorest suburb, located in Brisbane’s west.  

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Displaying Patient Vaccination Status in Bp VIP.net

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With cases of the Omicron variant of COVID-19 surging in Australia, and recently reaching the shores of New Zealand, the desire to quickly and easily view a patient’s vaccination status when booking an appointment, or providing specialist care for a patient has never been more front of mind.  Vaccination rates across both sides of the Tasman Sea have been steadily on the rise, with over 93%, of the adult population double-vaccinated in both countries. 

Bp VIP.net is highly customisable to your practice’s individual needs, and the ability to easily record an individual patient’s vaccination status is just one of the many possibilities in your software.   One of the best places to record this information is within your UDFs, where you can create additional fields to capture quickly and easily all of the desired, and up-to-date information that you require for your patients.  COVID vaccination status is one possibility, or you may even wish to add some other additional fields such as Gender Identity, or Preferred Pronouns.  Fields like these can be added with selection lists using the Pick List function in the Form Designer, but the possibilities for customising your UDFs are endless.

One other possibility is the option to record your patients’ COVID vaccination status directly within the Patient Details UDF screen, usually accessed by hitting the F3 key (pictured below).

By capturing the COVID vaccination status of your patients within the Patient Details screen, this enables you to use this information in other areas of Bp VIP.net, such as an Autotext creation in the Appointment Book showing the vaccination status and date of vaccination.

Patient vaccination status screen in Bp VIP.net

There are some points to be aware of when customising your UDFs in Bp VIP.net. When adding a new field to your Patient Details UDF, be sure to select the Field Type of ‘Patient’. This ensures that the value entered into the field will stay in until it is manually changed. Do not add fields to your Patient Details UDF that have the field type of ‘Medical’ as these fields are designed to only capture information on one visit date, and often cause saving issues if the field is replicated on the Medical Desktop and updated by multiple users from various areas of the software.

For detailed, step-by-step instructions on how to add fields for COVID vaccination status to your Patient Details UDF, or any other additional information, be sure to access our newly published article on our Knowledge Base.

With Bp VIP.net UDFs, the possibilities for you and your practice team to customize how your software works for you are endless.  Today, we’ve been looking through the lens of COVID vaccination statues, but the same steps can be applied to recording any other information of your choosing.  If you’re interested in finding out more, be sure to access our Knowledge Base for detailed instructions, simply open the Help menu from within Bp VIP.net and click Online to be taken directly there. Our team of Training Specialists are also here to support you with timesaving tips and tricks just like this one.

You can find out more, or get in touch with us at our website.

Authored by:

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Johanna Monson
Training & Deployment Specialist at Best Practice Software

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Save Time In Your Day with Default MBS Items

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Depending on the type of practice you’re working in, you might find that you’re often billing the same MBS item over and over again.

If this is the case, you will likely benefit from setting up default MBS items for your practitioners. Setting up default MBS items can save precious time when searching for the correct MBS item to bill at the end of a consult.

For example, perhaps you are regularly performing telephone consultations, and are finding yourself having to manually add the correct item number at the end of each and every consult.

Default MBS items are easy to set up and can be customised for each practitioner. Simply navigate to Setup > Users, select the practitioner who you wish to add a default MBS item for and click Edit.

Add the MBS item you wish to use by default to the Default Item no: field on the right-hand side of the screen and click Save.

Next, you will need to enable the default MBS item number. Select Setup > Preferences, and make sure the practitioner whose default MBS item number you wish to enable is selected from the User name: field at the top of the screen.

Tick Use the default MBS item in the Finalise window and click Save and close.

The next time the provider finalises a visit in the patient record, the default MBS item will appear under Items to bill. If the provider needs to select a different MBS item number for a consult, they can easily overwrite the default item number with a new one.

Default MBS Items screenshot

If your consults don’t necessarily require the same MBS item, an alternative option is to have Bp Premier calculate the MBS item required based on the visit length. This option can again save time searching for MBS items when finalising a consult.

To set automatically calculated MBS items, select Setup > Preferences, again making sure that the correct practitioner is selected. Tick Calculate the MBS item in the finalise window and click Save and close.

The next time the provider selects Finalise visit in the patient record, the calculated MBS item will appear under Items to bill.

For more information, be sure to access our Knowledge Base for detailed instructions.

Simply open the Help menu from within Bp Premier, and click Online, and search for ‘default item’. Our team of Training Specialists are also here to support you with timesaving tips and tricks just like this one. You can find out more, or get in touch with us at our website.

Authored by:

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Jennifer Stewart
Content Developer at Best Practice Software

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Covid-19 and Mental Health – Tools to Help Support Struggling Patients

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Covid-19 and mental health challenges are, unfortunately, terms that have gone hand-in-hand over the past 2 years. Ongoing economic hardships, an alarming spike in syphilis cases and the drastic changes in drinking habits during extended lockdowns have all been put under the microscope as examples of the kinds of toll the pandemic has taken on our mental wellbeing.

Bp Premier features a number of clinical tools which can help. Let’s review some of them, and how they can assist you in supporting patients struggling at this time.

Depression Anxiety Stress Scales (DASS 21)

The latest release of Bp Premier includes the DASS 21 Depression Anxiety Stress Scales (DASS) form, under the Clinical dropdown menu. (This is also where you can access the MMSE Mini Mental State Exam, and the Audit-C questionnaire.)

“DASS is a set of three self-report scales designed to measure the negative emotional states of depression, anxiety and stress. It was constructed … to further the process of defining, understanding, and measuring the ubiquitous and clinically significant emotional states usually described as depression, anxiety and stress.”

Covid-19 and Mental health DASS 21

Clinical Use of the DASS

“The principal value of the DASS in a clinical setting is to clarify the locus of emotional disturbance, as part of the broader task of clinical assessment. The essential function of the DASS is to assess the severity of the core symptoms of depression, anxiety and stress. It must be recognised that clinically depressed, anxious or stressed persons may well manifest additional symptoms that tend to be common to two or all three of the conditions, such as sleep, appetite, and sexual disturbances. These disturbances will be elicited by clinical examination, or by the use of general symptom check lists as required.”

“The DASS may be administered and scored by non-psychologists, but decisions based on particular score profiles should be made only by experienced clinicians who have carried out an appropriate clinical examination. It should be noted also that none of the DASS items refers to suicidal tendencies because items relating to such tendencies were found not to load on any scale. The experienced clinician will recognise the need to determine the risk of suicide in seriously disturbed person.”

Click here for a full overview of the DASS.

Recording Alcohol Use

When using Bp Premier to record alcohol use, in the Family and Social history tools > Alcohol heading, there are additional resources available to you to assist with diagnosis of alcohol dependency.

The CAGE questionnaire is a list of four simple questions to check for signs of alcohol dependence. The results are recorded in the Comments box on this screen:

  • Have you ever felt you needed to Cut down on your drinking?
  • Have people Annoyed you by criticising your drinking?
  • Have you ever felt Guilty about drinking?
  • Have you ever felt you needed a drink first thing in the morning (Eye-opener), to steady your nerves or to get rid of a hangover?

The AUDIT-C (Alcohol Use Disorders Identification Test) is an alcohol screen that can help identify hazardous drinkers, or those who have active alcohol use disorders. It can also identify at-risk drinkers (e.g. binge drinkers) who may not be alcohol-dependent. It generates a score from 0-12, and there is a button to access explanatory notes to discus with your patients. You can also monitor changes over time.

Covid-19 and Mental Health Audit-C Screenshot

There is also a button to open a pop up a list of standard drinks sizes for beer, wine, and spirits, plus of course, Fact Sheets (button next to Preventative Health) and Patient Information leaflets (‘professor’ icon in shortcuts toolbar) where you can search by topic and print information and further resources for your patients.

Domestic Violence - Further Support Available for Patients at Risk

Also in the Family and Social History tools, if your patient responds “No” to the question, “Do you feel safe in your own home?” a pop up window will be displayed with contact details for 1800Respect confidential support service.

1800RESPECT will continue to operate as usual during COVID-19, and is open 24 hours to support people impacted by sexual assault, domestic or family violence and abuse. Patients can visit www.1800respect.org.au or call 1800 737 732 at any time.

Ordering Pathology - Setting Up Groups of Tests in Bp Premier

An unexpected event during the Covid-19 crisis has been an alarming spike in Syphilis cases in Australia, so GPs in some areas may be encountering a higher number of patients requiring sexual health checks.

You can save time by setting up ‘favourite’ groups of tests in Bp Premier. To access this, from the main menu, under the Setup dropdown menu > select Preferences > Pathology.

It is very simple to create groups of tests with a single shortcut, so you can generate a pathology request very quickly, e.g. for sexual health checks. To do this, first choose the name for the group, e.g. “STI Check”, then ADD each of the tests you wish to include. A routine STI screen might include these six common STIs detectable through blood and urine analysis: Chlamydia, Gonorrhoea, HIV, Syphilis, Hepatitis B and Hepatitis C.

Pathology Request

Recording Covid-19 Vaccinations Given Elsewhere

Another feature you may wish to use is recording Covid-19 vaccine status of your patients. To record vaccines given elsewhere, so they are listed in the patient record, click on the Immunisations heading under Clinical Tree, and ADD a new vaccine. Select which Covid vaccine your patient has received, then under Billing provider dropdown, select “Not given here”.

Vaccines recorded in this way will not be uploaded to AIR from your practice. You do not need to include batch number details, but you can note the date given for each vaccine in the series, and use the comments section to record where the vaccine was administered, e.g. at a Pharmacy or vaccine hub location.  You may wish to look at the patient’s vaccine certificate to verify details before recording information in their record.

Vaccination Screen Image

For patients returning from overseas, click here to provide them with information from Services Australia on getting help adding your overseas COVID-19 vaccinations to the Australian Immunisation Register (AIR).

Further Information

Though a return to relatively normal life may be in sight for many of us, Covid-19 and mental health continues to be a focus for people still struggling for many reasons, including the ones we’ve touched on today.

Below are a number of helpful links that provide more information around these topics.

Authored by:

Stephanie Beames Blog Author Image

Stephanie Beames
Deployment & Training Specialist at Best Practice Software

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Managing Appointment Cancellations in your Practice

Managing Appointment Cancellations

Managing appointment cancellations is part of every practice’s daily tasks.

Bp Premier has some useful features to assist you in managing replacements for cancelled appointments and reducing their impact to your practice with our Waiting list for cancellations functionality.  This is built into the appointment book, and as of the Saffron SP 1 release, there have been some further enhancements to this functionality.  The benefit of using the cancellation list is that when an appointment is cancelled, you can quickly and easily replace this with another patient who has been added to the list.

There are two ways to add patients to your practice’s cancellation list, they can be added directly to the list, or added when booking an appointment for the future.  Let’s explore both of these in some further detail now.

Adding a Patient Directly to the Waiting List

If you are running Saffron SP 1 (released in June 2021) or later, a new feature has been introduced allowing you to add patients directly to your waiting list for cancellations without the need for a future booked appointments.  Simply open your practice’s waiting list from the Appointment book > View > Waiting list for cancellations, and click the Add to cancellation list button in the bottom left of the window.

To add this patient to the waiting list, simply:

  • Select an existing patient in your database (or add a new patient record)
  • Select the provider and location
  • Choose the appointment type and length
  • And specify the date required by
  • Click Add when information is complete.

Once added, this patient will remain on your waiting list for cancellations until the ‘Date required by’ that was specified.

Adding a Patient to the Waiting List When Booking a Future Appointment

In addition to manually adding a patient to the waiting list, you can also add a patient to waiting list at the same time as creating an appointment for the future. When adding the future appointment, after selecting and entering all of the relevant details, there are two checkboxes that you can use:

  • ‘Add to the waiting list for cancellation’ to add the appointment to the waiting list
  • and ‘Will see any provider for cancellation’ to indicate if the patient is willing to see any provider, not just the doctor that they are booked with, in the event that a cancellation occurs.
Managing Appointment Cancellations Image 1

Using the Waiting List for Cancellations

Patient appointments that have been added to your practice’s waiting list can be used to quickly replace cancelled appointments. Your practice staff can easily view the contact details for the patients on the waiting list, and immediately fill those vacancies from cancellations.  You can view all of the patients on your waiting list at any time from the Appointment book > View > Waiting list for cancellations.

Managing Appointment Cancellations Image 2

To streamline the process of managing appointment cancellations and save your team even more time, you can set the Patients awaiting cancellations screen to appear whenever an appointment is cancelled. This way, when an appointment is cancelled, your team will immediately a list of patients who may be eligible to replace that appointment, and are able to quickly access their contact information and replace that cancelled appointment. Incorporating this automation to the workflow gives your staff a chance to review the waiting list and fill in the available timeslots as soon as they are made available.

You can configure the automatic display of the cancellation list by completing the following steps:

  1. Select Setup > Configuration from the main Bp Premier screen.
  2. Select the Appointments tab.
  3. Tick the Show Cancellation list when an appointment is cancelled

In summary, the waiting list for cancellations is a fantastic tool that may help to fill vacant appointment slots when managing appointment cancellations, and can quickly provide you and your team the necessary information to allow you to do so. If you are interested in learning, access the Knowledge Base (Help>Online in Bp Premier), and search for ‘waiting list’.

Authored by:

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Bec Bland
Training & Deployment Leader at Best Practice Software

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COVID-19 Vaccines and Pandemic Planning – A Retrospective

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By the time Christmas 2021 arrives, it will be roughly two years since the first appearance of COVID-19 in Wuhan. For most of us, this has been a very long, frustrating, and unfamiliar two years. But it is a time that our generation should never forget. Change – both planned and spontaneous – is always a challenge.

Many won’t be aware that planning for pandemics has been the focus of many health professionals and governments departments for decades. Way back in 2009, I was part way through my four-year term as the Mayor of Bundaberg Regional Council. While that term was such an incredibly busy time for us, I remember holding regular planning meetings in preparation for the expected arrival of Swine Flu into Australia – and subsequently into the Bundaberg region.

The things we were planning for, even in a small Regional Council in Queensland, included the logistics of setting up testing and vaccination hubs, temporary field hospitals and working out how to staff them, how to limit individuals (perhaps already infected) from entering our community and potentially spreading disease and unfortunately, planning for the inevitable need to quickly open up new cemeteries and crematoriums to accommodate casualties.

Thankfully, Swine Flu dissipated quickly and didn’t really take off in Australia. However, planning work had been going on for years because everyone working in Government Health circles knew that there would one day be another global pandemic – which due to the ubiquity of modern international travel, would spread like wildfire.

It has been fascinating watching how authorities and individuals around the world have responded, in both encouraging ways and otherwise, to this real-life global emergency. Here in Australia, and our cousins across the ditch in NZ, have been incredibly lucky to live in countries surrounded by water – creating a natural barrier to infected travellers – and with access to great technology. We are also fortunate to have universal health care systems run by skilled professions and access to a range of safe and effective COVID-19 vaccines

There continues to be a lot of debate, confusion and in some instances, hesitancy about the emergency roll out of COVID-19 vaccines. One commonly heard objection to receiving COVID-19 vaccines is that they were ‘developed too quickly’. It is important to understand that many of these vaccines have been decades in the making. In fact, some of the new vaccine technology rolled out for COVID-19 was built on research originally done for other Coronaviruses such as SARS in 2003, and MERS in 2012. Since that time, many researchers have been working on developing a more universal Coronavirus vaccine that could quickly be adapted for new variants like COVID-19.

Decisions made around the world to legislate fast-tracked testing and emergency rollout of vaccines in early 2020 would not have been taken lightly and would have been made in response to horrific scenes emerging from countries hit hardest. Tens of thousands of new infections daily, overwhelmed health services, lack of basic supplies and equipment, and the stark reality of exponentially climbing death rates.

In our corner of the world, we had a bit more time up our sleeves because decisions, while sometimes unpopular and inconvenient, were made quickly to isolate us from the potential spread of the virus. But with borders planning to reopen in the next few months, we are still quite vulnerable as vaccination rates in some areas are low.

It is so important to understand that an emergency rollout of a new vaccine does not in any way compromise the testing schedule of these vaccines. Normally, scientists would have to wait for years to secure funding to continue their work. Once COVID-19 hit, massive amounts of funding were diverted to COVID-19 vaccine research. Universities and researchers – who often worked in relative isolation – were freely sharing data, techniques, and findings to push forward their work collectively.

Approval was given to run the normal testing phases testing phases to run concurrently. Instead of waiting for Stage 1 testing to be completed and the results reviewed, approval was given to begin Stage 2 testing BEFORE Stage 1 had ended. If at any time Stage 1 failed, then Stage 2 immediately stopped and work on that particular vaccine candidate would be abandoned. Another important thing to consider is that “normal” testing of vaccines involve a limited, but “sufficient” number of volunteer recipients. At time of writing, nearly 3 billion individuals around the world are now fully vaccinated with two jabs of the most appropriate vaccine available to them, with around 7.15 billion doses administered altogether. This is a far greater number of vaccine recipients than any normal vaccine trial would need to pass the normal testing requirement. If these vaccines carried a risk of widespread and significant side effects, they would have surfaced by now.

Potential side effects are now well documented and while most are relatively minor, if reported early, even the most serious can be effectively treated – leaving recipients with few or no long term issues or concerns.  On the flip side, we are witnessing a significant shift in the number of unvaccinated people who require ICU support, and the long-term impacts of long COVID are yet to be determined.  Time will tell if those suffering long COVID will not only endure a poorer quality of life, but also a shorter life expectancy. The vast majority of COVID-19 patients in ICU today are unvaccinated and unfortunately many will subsequently die. The unvaccinated are more than 10 times more likely to die from COVID-19 (and twenty times more likely to pass it on) than those who have been vaccinated.  Sobering thoughts.

My family and I are all fully vaccinated and my elderly mum will soon be lining up for her booster as soon as she is due – followed closely by the rest of our family – not only to protect ourselves, but to reduce the risk to her and our other older and/or immunosuppressed family members and friends. 

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Advice that you receive through social media posts may not necessarily be the information you should be considering when you are weighing up your options in what may be one of the most important decisions for you, your friends and family, and ultimately – your community.

I mentioned earlier that we were incredibly fortunate to be living in Australia and NZ. The challenges we’re facing are first world problems when you compare our situation to countries who do not have the wealth or advanced health systems that we have access to. As COVID-19 continues to circulate in these poor and underprivileged communities, we will continue to see more disease, death and unfortunately the likelihood of new COVID-19 variants – perhaps becoming even more virulent than the current Delta strain. Former NZ Prime Minister Helen Clark has issued a strong statement on the matter.

COVID-19 Vaccines have a relatively short shelf life, and much of the supply we have here in Australia and NZ is starting to expire. It would be a great shame if these precious doses were wasted. So – if or when you do decide to book in and get your jab – please don’t skip the appointment. The last thing we need to see is vaccines being tossed down the sink.

Authored by:

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Lorraine Pyefinch
Chief Relationship Officer at Best Practice Software

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New Aboriginal and Torres Strait Islander Health Check Templates in Bp Premier

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Best Practice Software has now adopted the National Aboriginal Community Controlled Health Organisation (NACCHO) & RACGP recommended activities for Aboriginal and Torres Strait Islander health checks. These will take the form of health check templates, and they’ll be available in the December update of Bp Premier.

There will be five new age-based templates:

Infants and Preschool (birth - 5 years old)

Aboriginal and Torres Strait Islander Health Check Infant Template

Primary School Age (5-12 years old)

Aboriginal and Torres Strait Islander Health Check Primary Children Template

Adolescents and Young People (12-24 years old)

Aboriginal and Torres Strait Islander Health Check Young People Template

Adults (25-49 years old)

Aboriginal and Torres Strait Islander Health Check Shop Template

Older People (50+ years old)

Aboriginal and Torres Strait Islander Health Check Older People Template

These updated templates can support your team to identify patient health goals and priorities and to plan for follow up of identified health needs.

The three existing templates available in Bp Premier will remain available until March 2022 to support a smooth transition phase.

For more information, we encourage you to access the NACCHO-RACGP Resource hub which includes resources to support quality health checks.

We welcome your feedback on the updated templates.

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Bp VIP.net Knowledge Base Improvements

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There’s good news for users of the Bp VIP.Net knowledge base! A couple of months ago, the Training and Deployment team acknowledged the gaps in the online help knowledge base, and worked out a plan to fill those gaps, particularly the various claiming channels for Australian practices as they begin their preparations for migrating practices to Medicare Web Services in 2022.

We’re very happy to announce that two dozen new articles have been published to the Bp VIP.Net Knowledge Base in the last couple of weeks, with another dozen ready to publish by end November. We appreciate your patience while we improve the learning resources we offer.

To access the Knowledge Base, select Help > Online from the menu inside Bp VIP.Net and select a button or just type into the search bar to start. User feedback is welcome at any time! Just scroll down to the bottom of any article and provide your feedback in the text box provided. The documentation team regularly reviews user feedback and will action any request for new or updated information.

System Configuration and Printing

VIPServices is the scheduling service that manages investigation results and appointment book reminders for Bp VIP.Net. A comprehensive new article aimed at administrators explains how to set up, stop, and restart this service for new installations or to troubleshoot an existing practice after an upgrade. Also included is a new article on setting workstation printing preferences for letters and templates, so that users don’t have to select a printer or paper source every time they print a script or appointment list, saving valuable time. Printing preferences also include automatic settings for RSD messages in New Zealand, and automatically populating recipients for letters that are sent out with multiple copies.

Just open the knowledge base and search for ‘vipservice’ or ‘printing preferences’!

Prescribing Setup

Prescribing workflow setup and defaults have received a boost in the knowledge base, with new articles on:

  • Combining multiple medications into a single medication protocol that can be prescribed together, saving time
  • Adding a medication route not supplied with the system
  • Inserting a record for medications prescribed elsewhere
  • Saving the dosage and frequency defaults for a patient’s medication, so they do not have to be reselected when represcribed
  • Prescribing workflow preferences for prescribers.

Not to mention information on Real Time Prescription Monitoring, introduced way back in Ruby and recently updated for all Australian states in Topaz Revision 2. Get up to speed with the status of RTPM in your state!

Open the Knowledge Base and select Setup > Prescribing.

Medicare, DVA and Health Fund Claiming

End-to-end instructions for all major claiming channels for Australian practices are now live, with new Health Fund billing for No Gap, Gap, and Gap Cover claims, complete with short and sharp video tutorials. Existing guidance on Bulk Bill and Patient claims, including in-hospital procedures, has been revised and updated to the latest version of Bp VIP.Net.

Select Management > Medicare and DVA Claiming or Health Fund Claiming to access the new articles.

While you’re there, don’t forget to search for ‘mws’ to see all of our preparation materials for your migration to Medicare Web Services, which becomes compulsory for all electronic claims in March 2022. If you haven’t already, now’s the time to start registering PRODA accounts for key personnel to get ready!

Authored by:

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Jay Rose
Lead Technical & Content Writer at Best Practice Software

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