The Rise of Healthcare Consumerism

Healthcare Consumerism Blog Image

Healthcare consumerism is a concept that has existed for some time, but only recently has it really taken hold and started to significantly impact primary care.

There is perhaps no common understanding as to what constitutes healthcare consumerism, and discussions with providers and patients will likely yield two different sets of responses as to what it actually means.

Ask any provider that has had to contend with correcting the misconceptions of a patient’s self-diagnosis and treatment plan (often courtesy of Dr Google, WebMD or the Mayo Clinic) within the constraints of a few-minutes long consult, and you may be confronted by a somewhat less than flattering take on the subject.

However, as a patient, notions of patient empowerment through clinics and a shift towards patient centricity will likely feature very favourably.

Regardless of your individual view on this, in a consumer-centric society, consumerism was always going to find its way into the healthcare sector, and this will influence the sector in many predictable, but also some unexpected ways. The rate of this change has been accelerating as a result of the general societal changes brought about by COVID-19.

Broadly, consumerism itself has many defining features, but fundamental to it is the principle that the consumer is in control (though subject to marketing, social engineering influences and manipulation). They are in control of what they consume, and their patterns of consumption drive the choices that providers of products and services make about what gets produced and how it is produced. In theory, the more informed consumers are, the more their decisions are driven by knowledge.

It is, then, reasonable to conclude that patterns of consumer behaviour and expectations are responsible for the kind of product and service innovations that organisations like Amazon, Uber and Apple have brought about in their respective industries.

Given the level of disruption that has been brought about by the aformentioned powerhouses in their respective industries, one can only speculate about how much of an impact they would have if they turned their attention to serving the needs of the patient in an era of healthcare consumerism. Even if they don’t – they, and others like them have reset long-held, more traditional consumer expectations.

To compete in this environment, and to compete with the concept of healthcare consumerism itself, provider organisations will have to re-assess their entire value streams, and re-image how to leverage their people, processes and technologies in response to this consumer-centric landscape. 

Competing with Healthcare Consumerism

To develop an approach and response, one has to consider some of the behavioural changes brought about by this trend. It does, in essence, come down to the fact that patients’ expectations of care delivery have changed, and that they are taking an increasingly active role through a range of actions.

Patients are, of course, not a homogenous group, so their expectations and their responses to this will differ from one group to another. According to the Pew Research Centre, millennials now make up a larger portion of the population than baby boomers, and the long-term transformations of healthcare will be driven primarily by their needs. This generation has grown up in a technology-rich, consumer focused environment where transparency, rapid delivery and convenience is the norm.

A recent study into healthcare consumer expectations resulted in some startling findings:

Healthcare Consumerism Stats Infographic

As evidenced by the rise in social media, consumers have proven to be willing to share increasing levels of personal information for the sake of convenience across platforms – as a trend in consumer behaviour, this will likely apply in the context of healthcare as well.

It would be reasonable to expect that patients will want to share information between providers (evidencing a willingness to share), will want to have tools to aid this sharing of information (evidencing the importance placed on convenience), but will in all likelihood require more sophisticated consent and sharing models than what is the norm with some non-health related personal data.

Some of the other actions that patients are taking to meet their expectations include:

  • Shopping around, evaluating their options and generally expecting more from providers
  • Doing their own research about health issues, treatment options and providers
  • Taking deliberate steps to monitor and improve their health. The proliferation and increasing sophistication of wearable and home monitoring devices bears witness to this
  • Co-operating with providers to make treatment decisions and more freely sharing information with care providers
  • Taking cost and quality aspects into consideration in their decision making
  • Using technology for appointments, telehealth consults, online payments, prescription renewals and a host of other services

If we consider the expectations and consider the actions patients are taking to meet their expectations, a few things immediately become clear:

  • Patient loyalty will continue to decrease as millennials make up an increasing percentage of healthcare consumers
  • Providers will face new challenges in attracting and retaining patients, with less loyal patients being more likely to switch providers, and being enabled to do so with the ease provided by technology
  • This will have ramifications for health outcomes given the impact on continuity of care

So what’s the message in all of this?

The most logical outcome is that due to the rise of healthcare consumerism, it’s in the industry’s best interest to meet the demands of healthcare consumers by designing products and services that meet current and emerging patient needs.

Here at Best Practice Software, we are developing the next generation of healthcare systems that will not only meet the demands of our provider customers, but software that will deliver the tools and meaningful interactions with patients and other stakeholders to address the needs of future healthcare consumers.

Authored by:

Andre Broodryk Author Image

Andre Broodryk
Product Manager at Best Practice Software

Electronic Prescriptions – The Missing Link in Visibility of Patient Information

electronic prescribing timeline blog image

As the second wave of COVID-19 continues, clinicians remain acutely aware that the pandemic is far from over. Telehealth consultations and electronic prescriptions were two important digital health measures that helped clinicians provide life-saving support whilst protecting patients and staff against the risk of infection.

Telehealth consultations rose from pre-pandemic levels of 1.3% to 36% of all consultations last year as a result of their addition to Medicare from 13 March 2020. More than 30 million telehealth consultations were performed in Australia throughout 2020. More information on telehealth statistics can be found here, here and here.

Prior to the introduction of electronic prescriptions in 2019, the patient still needed a paper script. For the past twelve months, as a result of the accelerated national roll out of electronic prescriptions to deal with the pandemic, clinicians have had the option of providing patients with an electronic script via email or SMS rather than a paper script. This provided greater flexibility for patients and reduced the problem of lost or replacement scripts. In the twelve months since, ePrescribing has continued to gain traction, as shown in the following infographic.

electronic prescribing statistics infographic

Whilst delivering safe, private and efficient prescribing at a distance, Electronic Prescribing has also introduced new clinical benefits. One of the immediate impacts is that clinicians can now cancel an electronic prescription directly from Best Practice Software if the need arises, without having to retrieve the paper script or repeat.

The nation-wide launch of Australia’s first digital script list, called MyScriptList – more accurately referred to as a Department of Health conformant Active Script List (ASL) – also opens up substantial implications for reducing the administrative burden on practices. MyScriptList was launched in partnership by the two national prescription exchange services, eRx Script Exchange and MediSecure. It provides the third national means of access to electronic prescriptions, working alongside the two existing methods of paper scripts and digital tokens (the digitised script sent by a doctor to a patient’s email or phone, introduced in May 2020).

The main clinical benefit arising from the digital script list, or ASL, is that clinicians, patients and pharmacies can now view all of a patient’s current electronic prescriptions and repeats in one digital list. Clinical and administratively, this generates two important changes. Firstly, it removes problems associated with patients losing or not being able to locate the correct script, as their digital script list will always be current in real-time. This reduces the administrative load of re-issuing and re-sending scripts and repeats. Secondly, a combined digital script list makes it significantly easier for clinicians and pharmacies to support patients who have chronic health issues.

The successful rollout of Electronic Prescribing during the pandemic can be largely attributed to the twelve plus years of safe and secure electronic prescription transfer through eRx Script Exchange. eRx functionality, prior to the advent of electronic prescriptions, operated as a parallel electronic process to doctors’ paper-prescribing. eRx helps to ensure prescriptions are dispensed as the prescriber intended, reducing the possibility of misinterpretation or accidental dispensing errors. With more than 31,000 doctors and 5,500 pharmacies using eRx to handle 90% of prescriptions, the system has provided a proven and secure pathway to electronic prescriptions.

In the twelve years since, the prescription exchange service has become the backbone for a range of clinical tools that provide visibility of a patient’s current medication and treatment. Real-time prescription monitoring of Schedule 8 drugs is an example. This displays an alert if a patient’s interactions are at risk of causing an adverse event. According to the Victorian Coroners Court, Victoria’s real-time prescription monitoring, SafeScript, has contributed to reversing a 10-year trend of increasing prescription medicine overdose deaths (showing a reduction for the first time in 10 years, from 405 deaths in 2019 compared to 424 deaths in 2018).

Whilst more attention needs to be given to the follow up mechanisms that support patients once a red flag is identified, real-time interaction flags are a vital clinical tool to help protect patients with dependencies on monitored drugs – and the devastating toll that this takes on their families and communities.

Best Practice Software CEO, Dr Frank Pyefinch, has been an advocate of ePrescribing and sent the very first electronic prescription from our Bp Premier software back in 2009. “Electronic prescribing has come a long way since its early conception back in 2009, which initially focused on the reduction of medication errors from the manual entering of prescription data by pharmacists into their dispensing software. Now clinicians can send prescription data to their patients without the need for paper, making things like telehealth consultations and the good old, ‘I lost my prescription,’ workflows more efficient and safer for both practices and patients.” 

“The introduction of other initiatives like real time prescription monitoring (RTPM), under the electronic prescribing umbrella, have introduced additional important clinical safety measures and provided clinicians with important medication data at the point of care. We continue to see great innovation in this space, with plenty more planned changes on the horizon.”

Connecting to a prescription exchange service is fundamental to increasing the visibility of patient medication information, which increases your control over medications. Connecting all of your clinicians to a prescription exchange service is the start.

Co-authored by:

Dr Frank Pyefinch
CEO at Best Practice Software
&
Paul Naismith
CEO at Fred IT

8 Tips for Improving Workplace Communication in Your Practice

Improving Workplace Communication Blog Post Image

Working on improving workplace communication is paramount for any business, and Medical Practices are no exception.

As a Practice leader, you know that success in your role is dependent on your ability to effectively communicate. But just as important as the quality and value of your own words is the cultural commitment you make to internal communication within your Practice as a busy, high-profile workplace. So how do you make it part of everyday business, and embed it within Practice business strategy to make it “part of what we do around here”?

I recommend promoting the benefits of good workplace communication within your team by outwardly recognising that good communication is fundamental to the success of your Practice as a business. By making communication one of your ‘people pillars’, you’ll ensure less misunderstanding within your team – including Practitioners, Reception, Practice Management, and IT/business support team –, an increased commitment to change, a reinforced role of supervisor as leader, and more active participation in the Practice and its mission.

Think about adopting some shared communication principles within your Practice team, like:

  • Embedding in your team mission your commitment to open, honest, and meaningful internal communication – at all costs, including the potential to damage fragile egos. Embrace the concept that, as leader, you’ll set the highest standard in being transparent and authentic in your communication with the team and invite members to (respectfully) challenge you anytime they think you miss the mark.

  • Embrace face-to-face communication foremost while still recognising e-mail and intranet bulletins as a convenient, but ultimately more impersonal, workplace tool. Sunrise (before clinic) and Sunset (after clinic) personal team or individual briefings will always be more valued when they’re localised, purpose-driven, two-way, … and brief.

  • Utilise the communication tools already built into your business software/systems for instant messaging when you need to raise attention to an urgent or immediate matter – especially between Practitioner and Reception team. There is a great internal messaging feature built in to Bp Premier that many doctors and their Practice team use, providing a useful instant on-screen message if ever required.

  • Value meaningful two-way engagement with your Practice team, ensuring the team knows you will provide (and you welcome back) genuine and constructive feedback on team achievement towards individual and shared goals. Improving workplace communication is a lot easier when your team knows they’re being listened to.

  • Recognise the frontline role your Practitioners and Practice leadership team plays in team engagement – and let your Practice leaders know you expect they will make team communication the first and foremost part of their role as leader and use language which is familiar to and understood by their work group.

  • Ensure your Practice team knows they will be briefed face-to-face on matters which affect their job, and you’ll set that standard yourself. If each employee can’t be consulted and involved in decision-making regarding their job before any major change occurs, they should at least be briefed in person on important matters which change what they do, or how you expect them to do it.

  • Preference communication that promotes action within your team and Practice. We’ve all sat in a meeting that should have been an email, so ensure any team assemblies have a clear and concise purpose (agenda), don’t linger longer than is necessary, and you note and distribute a summary of key action items and accountabilities before anybody leaves.

  • Outline to the team your minimum engagement opportunities. Perhaps make a commitment that, for instance, you’ll host supervisor briefings at least monthly, and supervisor-to-Practice team briefings every second day, and informal ‘toolbox’ chats on health and safety matters or reception/patient matters each Friday morning at 7:30am. This helps ‘lock in’ your time together, and shows you’re wholly committed to these engagements, even if you don’t have much news to share.

While these tips provide a good starting point on the topic, improving workplace communication needs and deserves follow through and actions that match your words, from the senior-most level to the people greeting and treating your patients. By sharing team news early and consistently you’ll help ensure your preferred (rather than speculative) message is heard by every member of your team.

Authored by:

Craig Hodges
Chief Corporate Officer at Best Practice Software

Tackle Australia’s Biggest Killer With the Heart Health Check Toolkit for Practices

Heart Health Check Toolkit

Coronary Heart Disease is Australia’s biggest killer. Approximately 2.5 million Australians are at a high risk of suffering a heart attack or stroke in the next five years, and more than half of these have not had an event previously.

Heart Health Checks support the specific assessment and management of absolute CVD risk in primary care for eligible patients 45 years and over (30 years and over for Aboriginal and Torres Strait Islander patients).

The Heart Foundation has launched the new Heart Health Check Toolkit. It is free and available online now to assist GPs, practice nurses and practice managers to streamline the assessment and management of absolute CVD risk. 

The Toolkit is a one-stop shop designed to assist general practice staff to easily assess and manage CVD risk in line with the latest guidance. It offers a range of tools and resources including assessment and management templates, quality improvement tools, patient engagement resources and much more.

By making the Heart Health Check easier to plan, recall and implement as per guidelines, more patients who are at risk of coronary heart disease in Australia will be identified and treated, ultimately lowering the morbidity and mortality of CVD.

“With a specific Heart Health Check item number, it is much easier to track heart health assessments and take a more proactive approach for our patients. The item number also allows us to leverage the use of our practice nurses to streamline the process.” – Associate Professor Ralph Audehm

Five Reasons to Check Out the Heart Health Check Toolkit

  • Pre-filled assessment and management templates make it easier for you to collect CVD risk factor information and support your patients to manage their risk.
  • The ‘quality improvement’ section of the Toolkit has all that your practice needs to kickstart continuous quality improvement as required by the PIP QI program.
  • Re-engaging with your patients about their heart health has never been so important. Our patient invitation templates, receptionist guide and data recall recipes can be used to identify and recall your at-risk patients.
  • Waiting room posters, animations and brochures will help you to engage with your patients about their heart health in an impactful way.
  • Thanking about setting up a heart health promotional event? Our step-by-step guide can be used by the entire team to help you prepare.

For a more information, you can download the Heart Foundation’s Heart Health Check Toolkit Promotional Pack here, which hosts clickable links to the various free tools available to you and your practice.

TARB-Ex: New Free Electronic Screening Tool for Identifying Risk

TARB-Ex Free Screening Tool for Bp Premier

TARB-Ex is a new FREE electronic screening tool for identifying risk of familial hypercholesterolaemia (FH) in general practice, and available now in Bp Premier.

It was developed by Professor Tom Brett, Dr Lakkhina Troeung and colleagues at the General Practice and Primary Health Care Research Unit at the School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia.

TARB-Ex has been successfully trialled in different Practices Australia-wide and a validated assessment has been undertaken to compare its performance against a GP using a manual approach. A paper1 on TARB-Ex has been published in Heart: Troeung L, et al, titled, ‘A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice’.

The extraction tool was used in the NHMRC Partnership Grant study (GNT 1142883) into improving the detection and management of familial hypercholesterolaemia in Australian general practice, involved 15 practices across Australia and was led by Professor Brett. Findings from the study have been accepted for publication in Heart Journal.2

TARB-Ex data extraction tool extracts routine clinical information from the practice electronic health records to derive a Dutch Lipid Score and identifies patients with potential high FH risk for clinical investigation. The extraction tool was developed using Structured Query Language (SQL) technology and written for Bp Premier clinical software.

The tool will isolate all patients seen at the practice over the past two years and who have blood lipids undertaken. You need to have the lipid level recorded to generate a Dutch Lipid Score. This will include patients currently or formerly on medications for lipid reduction and patients not on such medications.

TARB-Ex does not export any data from your health records.

After TARB-Ex data extraction, those patients with Dutch Lipid Scores generated can be prioritised from highest to lowest based on their Uncorrected Dutch Lipid scores. To do this, all patients with Corrected Dutch Lipid scores of 5 and above can be saved to Excel. The patient list can then be prioritised from highest to lowest. The best return for the reviewing GP or PN will be those with the highest Uncorrected scores.

Download this tool for free on our Bp Premier Downloads page here, scrolling down to the Utilities section.

References and related papers

1. Troeung L, Arnold-Reed D, Chan She Ping-Delfos W, Watts G F, Pang J, Lugonja M, Bulsara M, Mortley D, James M, Brett T (2016) A New Electronic Screening Tool for Identifying Risk of Familial Hypercholesterolaemia in General Practice. Heart. 25 February 2016. doi:10.1136/heartjnl-2015-308824

2. Brett T, Chan DC, Radford J, Heal C, Gill G, Hespe C, Vargas-Garcia C, Condon C, Sheil B, Li IW, Sullivan DR, Vickery AW, Pang J, Arnold-Reed DE, Watts GF. Improving detection and management of familial hypercholesterolaemia in Australia general practice. Heart 2021 (In press)

3. Brett T, Arnold-Reed D. Familial Hypercholesterolaemia – a guide for general practice. AJGP 2019; 48: 650-652.

4. Brett T, Qureshi N, Gidding S, Watts GF. Screening for familial hypercholesterolaemia in primary care: time for general practice to play its part. Atherosclerosis 2018; 277: 399-406. Doi.org:10.1016/j.atherosclerosis.2018.08.019

5. Watts GF, Sullivan D, Hare D, Kostner K, Horton A, Bell D, Brett T, Trent R, Poplawski N, Martin A, Srinivasan S, Justo R, Chow C, Pang J. Integrated Guidance for Enhancing the Care of Familial Hypercholesterolaemia in Australia. Heart, Lung and Circulation. 2020. Heart, Lung and Circulation 2020; https://doi.org/10.1016/j.hlc.2020.09.943

6. Brett T, Radford J, Heal C, et al. Implications of new clinical practice guidance on familial hypercholesterolaemia for Australian general practitioners. Submitted AJGP 2021

7. Watts GF, Sullivan D, Hare D, Kostner K, Horton A, Bell D, Brett T, et al. Essentials of a new clinical practice guidance on familial hypercholesterolaemia for physicians. Internal Medicine Journal 2021 (In press)

8. Brett T, Radford J, Qureshi N, Pang J, Watts GW. Evolving worldwide guidelines on lipid management and implications for Australian general practice. AJGP 2021 (In press)

9. Martin AC, Hooper AJ, Norman R, Nguyen LT, Burnett JR, Bell D, Brett T, Garton-Smith J, Pang J, Nowak K, Watts GF.  A pilot study of universal screening of children and child-parent cascade testing for familial hypercholesterolaemia in Australia. Submitted J Paeds and Child Health 2021.

10. Watts GF, Sullivan D, Hare D, Kostner K, Horton A, Bell D, Brett T, et al. Synopsis of Integrated Guidance for Enhancing the Care of Familial Hypercholestolaemia: an Australian perspective. Amer J Prev Cardiology. https://doi.org/10.1016/j.apc.2021.10051

11. Familial Hypercholesterolaemia and Cascade Testing in General Practice – Lessons from Covid-19. Garraghy E, Brett T, Watts GF, Heal C, Hespe C, Radford J. AJGP 2020; 49: 859-860

12. Pang J, Sullivan DR, Brett T, et al. Familial hypercholesterolaemia in 2020: a leading Tier 1 genomic application. Heart, Lung, Circulation 2019), https:// doi.org/10.1016/j.hlc.2019.12.002 

13. Brett T. Case 2: Zehra has vague chest discomfort. Check: Genomics. 2019; 557: 11–16.

COVID-19 Vaccine Rollout – Preparing Your Practice

COVID-19 Vaccine Rollout Blog Image Vaccine Vials Floating Blue Space

With the 1B COVID-19 Vaccine Rollout beginning across Australia this week, Practices have a lot of moving pieces that need to be considered to support the rollout of the vaccination program at their Practice.

To assist with this process, let us take you through some of the key items for consideration by your Practice.

Vaccine Rollout Setup and Configuration

Ensuring that you are ready to start taking bookings for the 1B COVID-19 Vaccine Rollout is the first step for any Practice. Some key points to focus on:
 
  • Are you using our latest data update?
    The March data update is a pre-requisite for managing COVID-19 vaccinations. We encourage you to check that you have installed the March data update at your Practice. The April data update (when released) will contain COVID-19 vaccination Reasons for Visit and the COVID-19 vaccination consent template.
  • How are your patients making their bookings?
    It is important to consider the different workflows a Patient may use to book an appointment (e.g., in-person, via the Commonwealth Booking Platform and directly via your online appointment vendor) and ensure that you have a consistent booking process implemented. This will guarantee that patients have gone through the required eligibility check, pre-screening and have booked an appointment with the appropriate provider at your Practice. It is also important to consider stock control measures and how you are managing this as part of the appointment booking process.
  • How is your Practice managing the bookings?
    There are a number of ways to configure Bp Premier to support a vaccination clinic. The following options could be considered:
    • Setting up a specific COVID-19 Location
    • Adding dedicated users (in this instance, some Practices have looked at setting up COVID-Dose 1 and COVID-Dose 2 so they can prioritise returning patients if stock levels run low)
    • Adding a new Appointment Type
    • Adjusting Appointment Length
    • Using a new Appointment Book layout
  • How are you managing your patients’ second dose?
    In some instances, a patient may be prompted to make their second booking for their COVID-19 vaccination at the time of making their first booking. It is important to consider how your Practice may manage this scenario to ensure you have adequate stock levels and the required reporting measures in place to ensure they attend their appointment. We recommend checking in with your online appointment vendor to better understand any possible booking workflows and patient follow up/notification procedures as well as establishing your own internal reporting and follow up process using the tools available within Bp Premier (for example Bp SMS recalls and reminders etc.).
  • How are you handling patient consent?
    Patient consent can be obtained in both verbal and written form. The COVID-19 consent form will be made available in Bp Premier as part of the April data update, alternatively this is available on the national COVID-19 website here. We recommend that Practices discuss their preferred process internally and come up with a ‘whole of Practice’ approach.

Recording the COVID-19 Vaccination

It is mandatory to upload all COVID-19 vaccinations to AIR (Australian Immunisation Registry) within 24 hours of the vaccine being administered. Some key points to consider:

  • Check the patient’s COVID-19 vaccination history
    We recommend accessing the patient’s My Health Record or using PRODA to access AIR to verify their current COVID vaccination status.
  • Entering the vaccination
    Users can enter the COVID-19 vaccination information into the standard immunisation Window available in the Bp Premier Clinical Record. It is important to remember to record the expiry date and batch number as these are both mandatory fields.
  • What about the vaccine serial number?
    At this stage, the serial number field is not mandatory – nor do we have enough information about this data field to provide further instructions on how it should be recorded. We are expecting further information on the serial number, including options for scanning the number into our software, in the coming weeks and will distribute a communication containing detailed instructions as soon as this information is made available.
  • Uploading records to AIR
    A reminder that it is mandatory to upload all COVID-19 vaccines to AIR within 24 hours of the vaccine being administered. We recommend that you upload your immunisation lists to AIR daily to ensure that you are meeting these mandatory requirements.
  • Adverse events following immunisation (AEFI)
    Health professionals must manage and report adverse events to their relevant state or territory following an AEFI. As each state and territory has slightly different reporting requirements, please contact your local public health unit for more information.

Billing and Reporting

There are new MBS items and incentives available for the COVID-19 vaccine rollout.

  • COVID-19 MBS items
    These items are available in the March data update, so please ensure that this has been applied at your Practice. MBS incentive items such as 10990 or 10991 are already incorporated in the item value and will not be automatically added to the invoice during billing.
  • PIP eligibility is based on the patient receiving their second dose of their COVID-19 vaccination
    We recommend that Practices run regular reports (using MBS search criteria) to keep track of patients that may not have returned for their second dose.

What Else Should I Know About the COVID-19 Vaccine Rollout?

  • Managing an influx of new patients
    As your Practice will be seeing a number of ‘new’ patients who may attend for vaccination purposes only, it is important to consider how this may impact your Practice Data Set. We recommend tagging these patients using the Record No. field so that they can be archived if needed. Alternatively, you could also use one of our supplied queries to locate patients who have only been to your Practice for the vaccination and archive them this way.
  • Engaging with your online appointment provider
    As your Practice works through the COVID-19 vaccine rollout, it is important to notify your online appointment vendor if any configuration changes are needed. This will ensure that your phone/in person booking process mirrors the process used when making an online appointment.

We appreciate that this vaccine rollout requires Practices to manage lots of moving pieces. 

To assist you, we’ve made a recording of our recent COVID-19 Vaccine Rollout Webinar available on our Vimeo channel or view it below, and further information on the rollout can be found on the Bp Premier Knowledge Base, which is accessible from within Bp Premier by selecting Help > Online.

Authored by:

Jessica White Author Blog Picture

Jessica White
Manager of Commercial & Customer Enablement at Best Practice Software

Prescribing Medication by Active Ingredient – 8 Weeks On

Prescribing medication by active ingredient article calendar on red background with date marked as 8 weeks with AIP

It’s now been approximately 8 weeks since the Australian government mandated that those prescribing medication needed to include the active ingredient names when preparing a prescription.

The introduction of active ingredient prescribing from the 1st of February 2021 presented many doctors with considerable changes to the way they were prescribing medication. The legislation requires prescriptions to include a medication’s active ingredient first, then optionally followed by the brand name. This means that prescriptions can no longer only have the brand name listed, unless they are included in the “List of Excluded Medicinal Items” (LEMI).

A significant amount of groundwork was required for software vendors to implement the changes. Medical Practices across Australia had to upgrade their prescription generating software to ensure they were meeting their legislative obligations.

Prescribing Medication by Active Ingredient

Prescribing Medication by Active Ingredient - Dr. Fabrina Weighs in 8 Weeks On

 

Most Practice management software solutions provide easy and seamless processes to prescribe new medication and re-prescribe existing medication. The new legislation now requires doctors to add additional steps to their existing workflow when prescribing medication if they want their patient to have a specific brand dispensed by the pharmacist. As with all systemic changes, major or minor, there were significant challenges faced by doctors with the introduction of this change.

In the early days of the changeover, it was common to omit the additional step to check the “Print Brand Name on Script” field and as a result, prescriptions that should have had the brand name listed only had the active ingredient printed. This posed potential dangers especially for medications such as insulin with a narrow therapeutic window, and for the combined oral contraceptive pill with multiple brands with the same active ingredient that are not necessarily interchangeable. While these medications are not in the aforementioned “List of Excluded Medicinal Items” (and therefore software vendors could not automatically print the brand on the script), they are included in the government’s “List of Medications for Brand Consideration” (LMBC). The LMBC is a list of medications the government has deemed that, due to safety reasons, should be prescribed by brand name.

In Bp Premier, when prescribing medication, there is now a warning message that highlights if a brand name should be considered – this is based on the LMBC list mentioned above:

Prescribing medication in Bp Premier brand name warning

This change has obligated doctors to have discussions with their patients about their medication, the active ingredient name and if there is a clinical or non-clinical reason why they should be taking a specific brand. 

Some common clinical reasons why a brand should be prescribed can include, but are not limited to; medications that are not bioequivalent such as Eltroxin and Eutroxig/Oroxine; different medication formulations such as extended release or immediate release; drugs with different dosing frequency, for example, certain oestrogen patches; allergies or intolerances to other additives such as gluten or lactose; and patient specific idiosyncratic reactions. 

Non-clinical reasons why doctors may wish to prescribe by brand name for certain populations such as those with low literacy rates, disabilities or those coming from culturally and linguistically diverse backgrounds who may find it easier to identify their medications by its packaging.  If there are no compelling reasons to continue with a specific brand, we should discuss the option to switch to a generic brand thereby facilitating informed decision making by the patient.

Although generic medications have been available in Australia for many years, some patients still have misconceptions regarding perceived poor quality and therefore reduced efficacy and safety of generic medication. It should be stressed that generic medications are not akin to “home brand” items found in supermarkets as these medications have been approved by the TGA and are deemed to be bioequivalent and just as safe and efficacious as their brand-named counterparts by clinical studies. While these discussions naturally add to our consult time, they are important to aide in patients overall understanding of their condition and treatment plan when prescribing medication.

As predicted by the Department of Health, this change will achieve several benefits to both patients and taxpayers. It is envisaged that active ingredient prescribing will increase consumer health literacy and make communication less ambiguous thereby reducing the risk of patients doubling up on medications or omitting to take them by mistake. There will also be a significant reduction in the cost of medications to patients and improvement in the financial sustainability of the PBS and RPBS with the increased uptake of generic medication.

The use of active ingredient prescribing is already implemented in hospitals nationwide and the extension to primary and community-based care was inevitable. While patients, doctors and pharmacies faced some hurdles initially, for the most part these have been overcome with diligence.

For more information, read our article discussing what active ingredient prescribing means for you.

Authored by:

Dr Fabrina Avatar

Dr. Fabrina Hossain
Clinical Advisor at Best Practice Software

Data Breaches and You – Keeping Your Practice Data Safe

Data Breaches Article Dam Water Overflowing

Most conversations around data breaches normally start with, “you won’t believe what just happened”. It could be that a CD with patient data goes missing, or it could be a laptop stolen from a parked car.

These data breaches can be devastating, particularly within the health sector. Patient medical records can be sold or used for identity theft, fraud, or to illegally obtain prescription drugs. Not to mention the potential financial, legal, and ultimately reputational loss that a medical Practice could be exposed to.

According to the latest report released by the Office of the Australian Information Commissioner (OAIC), human error has been identified as a leading cause of data breaches in Australia. There were 539 data breach notifications between July and December 2020. Of those 539, 23% of these notifications came from health service providers, which was the highest recorded number of data breaches for any singular industry.

Data Breaches 101 Blog Image

Data Breaches 101: Tips for Keeping Your Practice Data Safe

 

Data breaches are a severe type of security incident where the release of personal information or confidential data, such as medical records or financial data that is held by an organisation, is released into a public domain where other people can gain access to it.

Data breaches may occur due to:

  • Lost or stolen laptops, tablet computers, mobile phones.
  • Human error where personal information is mistakenly given to the wrong person.
  • Malicious activity such as hacking of the organisation’s email accounts or databases.

The Notifiable Data Breach Scheme applies to any organisation that the Privacy Act of 1988 covers. These organisations must notify the OAIC and any individuals that are affected by a data breach where it is likely to result in serious harm to the individuals to whom the information relates. Examples of serious harm may include identity theft, loss of money through fraud, physical and psychological harm or the harm done to an individual’s reputation.

It is important to remember that some of these incidents can happen through human error and honest mistakes, but they can also occur through carelessness and lack of procedure. This is why your Practice must have a suitable data protection policy in place and that all staff are aware of their responsibilities.

During your assessment of a suspected data breach, the following should be considered:

  • The facts surrounding the breach and what happened?
  • What sensitive information was involved? For example, medical records or financial data?
  • The number of individuals affected.
  • Assess the severity of the breach – will this cause individuals serious harm?

It is expected that during the assessment of a data breach, organisations undertake remedial action to reduce the potential harm to individuals. If remedial action successfully prevents serious harm to affected individuals, notification is not required.

An eligible data breach occurs when the following are met:

  1. Where there has been unauthorised access to personal information, unauthorised disclosure of personal data or loss of personal data has occurred.
  2. Where the data breach is likely to result in serious harm to one or more individuals
  3. Where the Practice has not been able to prevent the likely risk of serious harm with remedial action. If the Practice has undertaken remedial action but has not reduced the likelihood of serious harm, this constitutes an eligible data breach.

If an eligible data breach has occurred at your Practice, you should take immediate measures to contain the data breach limiting further access or dissemination. Individuals need to be notified of the risk of serious harm, and the OAIC must be notified as soon as possible by using the Notifiable Data Breach Form.

It is possible to minimise the risk of a data breach by following a few best practices:

1. Implement a data breach response plan

  • Having a plan for your Practice can significantly reduce the negative impact a breach can have on individuals, reduce the costs of dealing with a breach and minimise reputational damage to your Practice. The OAIC provides assistance with preparing a response plan for data breaches here.

2. Implement a strong password policy

  • Weak passwords are one of the most common causes of a data breach. A strong password policy that includes regular rotation and a high complexity level may stop attackers from getting easy access to sensitive data.
  • With our Saffron version of Bp Premier, Practices can now implement a minimum password length, set user lockout thresholds, set a lockout wait period, set a maximum password age, indicate a password reuse interval, and enforce a strong password complexity.
  • More information on this can be found on our knowledge base. From within Bp Premier, select Help > Online, and then search ‘manage password and access security’.

3. Adhere to the ‘principle of least privilege

  • The principle of least privilege is the idea that any user, program, or process should have only the bare minimum privileges necessary to perform its function.
  • Information on user permissions is available on our Knowledge Base. From within Bp Premier, select Help > Online, and then search ‘user permissions’.

4. Educate staff on security awareness

  • Employees have an essential role in keeping their organisations secure; however, they can be the weak link in the data security chain. Without security awareness and effective training, they present a significant vulnerability. This is why it’s vital to have regular security awareness training to remind employees of any evolving security threats. This will allow your staff to be alert on data breach attempts and learn techniques to protect information when communicating.

Further information:

OAIC Data breach preparation and response:

Ideally, your Practice won’t ever have to deal with a data breach. But it’s crucial to have a plan in place in case anything were to happen. We recently featured an article on Protecting Patient Data, and many of the important messages from that article translate here; while being prepared to handle a data breach may seem like unnecessary work that you won’t ever need to use – it’s much better to have the preparation and not need it, than to need it and not have it.

By ensuring that you’re ready in the event of an unexpected data breach, you have already done a lot to ensure that you’re minimising the financial, emotional and reputational damage that may affect your Practice and staff.

Medical Recruitment in 2021 – 3 Ways to Improve Your Hit Rate

Recruitment Hit Rate Article People Standing in Shape of Magnifying Glass

There’s little doubt that times have been trying in the employment market – and medical recruitment is no exception – as the pandemic that we’ve all come to know so well continues to wreak havoc on multiple aspects of our lives.

While the recovery process is certainly under way, there have been some unique challenges now facing businesses relating to attracting talent. While the economic recovery means that businesses are now ramping back up into growth mode, competition between companies is heating up to hire the best people on the market.

Specifically, healthcare has been identified as one of the three sectors that will experience the most significant increase in demand for critical role vacancies in 2021; this means it is more important than ever for medical Practices to deploy a clear and concise recruitment strategy that will give you the best chance possible to sell your business as a great place to work, help keep prospective candidates engaged in the recruitment process, and giving you the best chance possible to hire an in-demand candidate!

Recruitment Tips for Attracting Top Talent Amongst Stiff Competition

Recruitment Tips for Attracting Top Talent Amongst Stiff Competition

 

In this blog post, we’ll provide some key medical recruitment tips for Practices that can help ensure the hiring process is one that is efficient, candidate-friendly, and thorough.

Tip One: Set Out a Clear Understanding of the Role, Starting With the Job Description & Advertisement

This step sets the foundation for the entire recruitment process, and it is crucial that both are linked.  Conducting a thorough job-scoping process that involves all relevant stakeholders involved in the role will ensure that all the current gaps are identified which the new hire will need to fill. Conversely, if the role is replacing an incumbent employee, review their initial job description and make sure any changes are made if needed. The Fair Work Australia website has job description templates available to use, which cover key requirements to consider when crafting a description.

Once this is complete, and there is a plan to source the candidate from the open market, an engaging job advertisement should be written. This should closely replicate the job description, which will ensure that the right candidates are drawn to the role as well as set clear expectations for those that do apply. Attracting the wrong candidates not only means more work for your recruitment and hiring team sorting through unsuitable applications, but also detracts job seekers from exploring roles more suited to their skills.

Tip Two: Communicate with Applicants at Every Step of the Recruitment Process

Communication is pivotal – it not only enhances the overall candidate experience, but it also helps to build trust between the organisation and prospective employee. It means that there is less likelihood for the hiring party to be ‘blindsided’ by a candidate taking another offer without warning. For those who progress to interview but aren’t successful, an open and honest interview process can resonate with them, and a LinkedIn study found that 87% of respondents who experienced a positive interview experience, irrespective of the outcome, would recommend that company to other job seekers.

The communication process should begin at the shortlisting stage, clearly stating to each applicant what to expect at every stage of the interview process. This can be done whilst phone shortlisting, or even sending an automated email to each applicant detailing what the usual application process entails. Once a candidate is engaged in the interview process with other members of the business, your HR team should be in touch after every stage to field any questions, and gauge any thoughts or feelings they are having towards the role or the medical recruitment process in general.

Tip Three: Don’t Just Rely on Job Boards for Applicants

In markets where there are ‘candidate shortages’ – which means a shortage of qualified candidates actively seeking employment, as is the case in healthcare – companies need to be proactive in the ways that they find suitable applicants. With roughly 75% of job seekers qualifying as ‘passive candidates’ , which simply refers to those open to moving jobs but aren’t actively applying to roles, relying solely on avenues such as SEEK to find candidates will drastically reduce your pool of potential new hires.

Two ways companies can proactively source talent and find these hidden candidates, is by using LinkedIn and offering incentives for referrals from existing employees. Referral programs are often underutilised, and current employees not only know the business and culture already but can assist HR and Hiring Managers in selling the role and getting an applicant over the line.

These tips are straightforward ways that you, as a Medical Practice, can ensure you get ahead of the curve in 2021 and be prepared for what looks to be a vastly competitive market for medical recruitment this year!

Authored by:

Bp Blog Author Image Jordan Keays

Jordan Keays
People, Culture and Capability Partner at Best Practice Software

Telehealth Consultations 2.0 – Going Beyond Phone and Video

What is Telehealth | Blog Image Peter Birch from TalkingHealthTech

Telehealth consultations enable clinicians to see patients via a phone call or video chat, and they are claimable under Medicare.

As we know, throughout the pandemic we have seen an increase in telehealth consultations performed in Australia, and the Medicare billing items that have been created are likely to stay for the long term.

Telehealth consultations are here to stay, and the stats say that GPs are largely ‘believers’ in telehealth.  In a recent survey by the RACGP, more than 50% of GPs think that up to a quarter of their consults can be done via telehealth post pandemic.  35% of GPs even think that as much as half of their consults can safely and effectively be performed by telehealth.

As most GPs have adopted telehealth, the industry has done well to replicate the traditional ‘in clinic’ physical consult that we all know and love.  But is that all there really is to telehealth – shifting an in-clinic consult to a virtual setting?

Phone-and-Video-Symbols

Healthcare 2.0: Remote Patient Monitoring, AI and Asynchronous Communication

 

I think there’s way more to it…

The telehealth we see today in General Practice, is effectively Telehealth 1.0.  We are striving to replicate the delivery of healthcare the only way we know how – by providing the waiting room and the consult room of a clinic, but just doing it virtually, on the phone or computer.

The problem with that is, it only gets us so far.  Now don’t get me wrong, Telehealth 1.0 was a great stopgap solution for when the country needed to quickly implement a safe way to see patients, using the tools we had at our disposal.  We saw many nimble technology providers roll out enhancements, updates and addons to their products in record time to enable GPs to perform telehealth consults in their clinics.  Also, it is the next logical step to progression, but I feel like there is more work to do.

The implementation of telehealth consultations has certainly been successful – we’ve seen mass adoption, and it’s proven to be safe and effective.  But if there is going to be transformational change made in primary care to help more patients across the country that need it most, then one could argue we need to do things differently, or else it will all stay the same.

With Australia’s increasing burden of chronic disease, ageing population, access issues for rural and remote or disadvantaged communities, and let’s not forget the impending tsunami of healthcare issues that GPs will be hit with in the coming months and years from those who put off routine screening – some GPs might be thinking about more tools enabled by technology they could have at their disposal to face these challenges ahead.

There are a number of opportunities that get unlocked when telehealth gets combined with other more progressive forms of healthcare delivery – including remote patient monitoring.

Remote patient monitoring can add depth and perspective to telehealth, and we’ve tried to describe a few scenarios as to how this might work in practice. But first…

What is Remote Patient Monitoring, and How Does It Influence Telehealth Consultations?

Remote patient monitoring is a subset of telehealth and is inclusive of the collection, transmission, evaluation, and communication of relevant patient data by the use of electronic devices. Some of these devices are implanted equipment, wearable sensors, and handheld instruments.

Below are 4 elements of remote patient monitoring that could take telehealth consultations even further than just episodic video or phone calls:

1. Using Wearables to Collect and Transmit Data

Wearables are devices that people wear that collect the data of users’ personal health and exercise.  As technology improves, these consumer devices are becoming increasingly considered as potential to be clinical grade monitoring tools for patients. More purpose-built medical devices are now also available to allow patients to measure, monitor and transmit their latest results to their healthcare provider, allowing patients to be more engaged with their care, resulting in better outcomes.  It is also a cost-effective and efficient way for those in rural and remote areas to reduce the need to travel hours into a clinic for something that can be done remotely. Wearables are cost effective and have potential to be the ‘eyes and ears’ to give clinicians access to current patient information, hopefully avoid patients deteriorating and reduce unnecessary clinic visits.

2. Using Artificial Intelligence for Decision Support and Triage

Artificial intelligence in healthcare is the use of complex algorithms and software, to analyse vast data sets in order to efficiently predict health outcomes and inform decisions with minimal human intervention.

It is exciting to think of the potentials and theoretical use cases for artificial intelligence in healthcare, particularly when it comes to those AI tools that have a diagnostic claim.  There is still time for those tools to become mainstream in medicine, as the TGA grapples with the concept of regulating AI software that acts like a medical device.  In the meantime, AI can be used in other ways in healthcare on a day to day:

  • Clinical Decision Support – by analysing large sets of data, AI can suggest to a clinician what diagnosis to look out for based on the data available, and also what recommendations to consider.  This pattern recognition takes an element of cognitive load off clinicians in the diagnosing and decision stage to allow more focus time on the treatment and communication with a patient about their results.

  • Triaging – much like in an emergency department where a nurse might triage a patient to determine the level of severity of their injury or illness, AI could be used as a triaging tool in a GP Practice in the future.  With large numbers of results and messages coming into a clinic, knowing what to focus on can be overwhelming and costly.  By utilising AI tools to help with this process it again allows clinicians to focus on more value adding tasks.

3. Utilising Technologies That Are Securely Integrated

Requiring patients to connect with a GP when they are not physically in the same place, requires the patient and GP to be utilising some form of technology to do that.  The choices of technology platforms to enable communication are vast.  When it comes down to it, a common critical factor that many GPs might use to decide on a piece of technology is how well it connects or integrates with the clinic’s Practice management system.  There is little point having a super slick and easy communications platform for patients if GPs cannot securely and easily access the information – wouldn’t it be neat if you could just flick images and share videos with patients via WhatsApp or messenger, just like we do in normal life, complete with gifs and reactions?  Unfortunately, it does not quite work like that…

Health data is sensitive, and decisions are complicated, so unfortunately many consumer and mainstream communications platforms don’t make for ideal choices for transmitting health data… and they don’t integrate with GP clinic software.  So, if a GP was looking for a piece of technology in addition to their Practice management system, we would recommend doing research to confirm how well it integrates securely and appropriately with the clinic’s Practice management system.

4. Engaging With Patients Via Asynchronous Communication 

Asynchronous communication is where you transmit a message and don’t expect an immediate response.  An example of asynchronous communication is sending an image for review, awaiting the response, and then receiving it once ready.

Thinking about opening up some forms of asynchronous communication as part of the engagement with patients, brings new ideas on how healthcare can be delivered – patients can share notes as they think of them, results can be transmitted and only surface when they are issues.

Some of the benefits of asynchronous communication in healthcare include:

  • It can help ensure more accurate documentation
  • It allows a GP to manage multiple tasks at once, not having to wait for a response but at the same time not being overwhelmed with competing priorities
  • Asynchronous communication promotes thinking more about patient outcomes as opposed to purely about episodes of care
  • Patients could be more likely to be honest about their health concerns when they have the time and privacy to craft a message to their GP rather than sit in an unfamiliar room and discuss it live in person

As we move to the next stages of telehealth, asynchronous communication will be interesting to watch as it develops.  As there is currently no Medicare funding for asynchronous communications with patients, the likelihood of it being adopted widely is low, at least for the time being.

As telehealth consultations become ‘the norm’ in clinics around Australia and are embedded seamlessly into clinic workflows, we watch with interest as additional technologies and approaches like those mentioned above get included in the mix to provide a more engaging experience for patients and a more efficient and effective process for GPs. 

Peter Birch is the founder and host of Talking HealthTech, which began as a podcast in 2018 and has since expanded to a membership community and media company focused on healthtech. 

Talking HealthTech recently hosted a panel from Best Practice Software for a discussion on Active Ingredient Prescribing. Listen to that episode of the Talking HealthTech podcast here.

You can find out more about Talking HealthTech by visiting their website.