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Primary Aldosteronism: Not As Rare As Once Thought

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A Chance to Help People Living with Hypertension

For people living with hypertension, many endure high blood pressure for years, sometimes decades, before finding the right treatment. The reason? An underlying hormonal driver that is often overlooked because of its perceived status as ‘rare’: Primary Aldosteronism.

In most cases of hypertension, ‘essential hypertension’ is assumed and standard blood pressure lowering medications are prescribed, with more and more medications added when the blood pressure remains stubbornly high. However, for those patients unknowingly suffering from primary aldosteronism (also known as Conn syndrome), only when we specifically look for this condition can it be found. Once diagnosed, it can be treated with the appropriate medication to block the effects of aldosterone excess, and, in some cases, even cured with adrenal surgery.

Associate Professor Jun Yang, an endocrinologist specialising in primary aldosteronism at the Hudson Institute of Medical Research and Monash University, has experienced the effects of delayed primary aldosteronism diagnosis in her own family. Dr Yang’s own father struggled with uncontrolled hypertension for decades before he was screened and found to have this form of hormonal hypertension. Since then, his blood pressure has returned to normal using just one targeted medication, thanks to a diagnosis of primary aldosteronism.

Dr Yang’s father is certainly not the only one to experience a delay in receiving his diagnosis of primary aldosteronism. In 2018 the Australian Journal of General Practice reported it was common for patients to have had hypertension for over 10 years before screening occurred, meaning many had aldosterone-mediated end-organ damage by the time they were finally diagnosed. However, once the diagnosis is made and targeted treatment commenced, clinical improvement with lower blood pressure and reduced number of antihypertensive medications could be observed in all patients. Recent research has shown that around 1 in 7 patients with high blood pressure may actually have primary aldosteronism, when actively screened. A simple blood test to measure aldosterone and renin concentration which is then calculated as the aldosterone to renin ratio (ARR), can screen for primary aldosteronism, but is severely underutilised.

Primary aldosteronism is fundamentally different from ‘essential hypertension’ as it is driven by an excess of the hormone aldosterone. Aldosterone is an important hormone which regulates salt balance and blood pressure. Too much aldosterone can cause salt retention and hypertension that is difficult to control with regular antihypertensive medications. The excess aldosterone can be produced by an adenoma on the adrenal gland. In this case, surgery to remove the affected gland can lead to a cure of the disease. More commonly, both adrenal glands are affected. In that case, a tablet that specifically blocks aldosterone activity can effectively manage the condition.

Untreated primary aldosteronism carries with it a higher risk of adverse cardiovascular events, such as stroke, myocardial infarction and atrial fibrillation when compared to essential hypertension. This is due to the aldosterone excess which causes cardiovascular tissue inflammation and fibrosis, in addition to the damage caused by elevated blood pressure per se. So while it has long been considered rare, there are significant risks associated with missing a diagnosis of primary aldosteronism. Sadly, it has fallen prey to a vicious cycle: a condition which is considered rare is not sought; a condition not sought is not found; and a condition not found is considered rare.

A prospective study carried out in general practices in Victoria between 2017-2020 found that 14% of patients with newly diagnosed hypertension had primary aldosteronism. All these patients were screened by their GPs rather than specialists. The study indicated that GPs were able to play an important role in the early detection of primary aldosteronism in patients with early stages of hypertension, thereby preventing many from experiencing the end-organ damage that untreated aldosterone excess can cause. As effective as this study was in finding patients with primary aldosteronism, there was a lot of variability in which doctors screened their patients and which didn’t. Some doctors ordered the screening blood test regularly while others did not.

How Can We Improve Screening of Primary Aldosteronism in a Systematic Way?

The CONSEP trial was developed to increase the screening and diagnosis of primary aldosteronism in the general practice setting. This trial is looking at whether Education and Guidance Based Requesting software (GBR) for General Practitioners can increase Primary Aldosterone (PA) screening and diagnosis among patients with high blood pressure. By doing a high quality randomised controlled trial that is fully integrated with the GP clinic, we hope the results will show us just how effective our intervention may be for improving the detection of a common and potentially curable cause of hypertension.

The trial is currently recruiting general in Melbourne, Adelaide and Hobart. To participate in the trial or learn more, fill out the CONSEP contact form and visit the CONSEP website, or directly reach out to us via consep@monash.edu.

Consent to be Contacted Form – https://redcap.link/ywdjuab9
CONSEP Website – https://www.hudson.org.au/research-program/consep/
CONSEP Email – consep@monash.edu

CONSEP Article Image - Primary Aldosteronism

Authored by:
Linghan Jia at Monash University

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Enhancing Your Practice with AI: Lyrebird Scribe

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Are you looking for a partner that truly listens and enhances your practice? Meet Lyrebird Scribe, an advanced AI scribe designed to capture and transcribe patient consultations in real-time. This innovative tool listens in the background at your command and generates comprehensive clinical notes in seconds, significantly reducing the administrative burden on general practitioners and allowing more time for exceptional patient care. Lyrebird Scribe stands out by learning from the clinician’s style and voice, ensuring that the generated notes are both accurate and personalised. By taking care of the time-consuming task of documentation, Lyrebird Scribe allows you to focus on what you do best—caring for your patients.

With over 10,000 real-world consultations across general practice and various specialties, Lyrebird Scribe has proven its value. On average, clinicians save 2-3 hours daily on documentation, and the system boasts a 98% accuracy rate in note generation, eliminating the need for extensive review.

Lyrebird Scribe integrates seamlessly with Bp Premier versions Orchid SP2 and above, recording directly from and to the patient record. The AI Scribe generates clinical notes in a number of standard formats, which are written back into Bp Premier with a single touch at the end of the consultation, with indication of transcription.

Key features of Lyrebird Scribe include:

  • Automatic generation of patient notes, filtering out irrelevant information.
  • Email generated patient letters directly, keeping patients informed.
  • Easy generation of other clinical documents and referrals from patient notes, with one click copy into the Bp Premier word processor.
  • High customisation to match your documentation style.
  • Secure storage of patient consent options for future visits.
  • AES-256-bit encryption and Australian-based servers for maximum security and privacy.

Best Practice Software customers can enjoy a 30-day trial to experience the benefits of Lyrebird Scribe.

If you want to learn more on how AI technologies can assist you in your practice, as well as see a live demonstration of Lyrebird Scribe, click here to join us for the following webinar.

Best Practice and Lyrebird Scribe AI Webinar Graphic

Authored by:
Jay Rose – Lead Content Developer at Best Practice Software

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A Sprint in the Life of a Bp Premier Developer

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Bp Premier Developer Sprint Blog Graphic

Today’s Staff Spotlight piece comes from our Bp Premier Delivery Stream Leader, Eli. As a delivery lead, Eli is responsible for keeping multiple software development projects on track and ensuring they are completed on time and according to specifications.

Our story begins last month, with the introduction of our latest new feature in Bp Premier, aimed to improve how our users handle transactions for a more efficient payment processing experience. Behind the scenes, our developers are gearing up to tackle the new project.

In true software development spirit, no sprint is complete without its share of hurdles. Early beta testers report intermittent freezing in a payment integration, critical to the user experience and functionality of the software. An urgent fix was required. The team collaborated with Software Support, collating all the information and feedback they had received from our beta tester group and the wider customer base. Then, our Commercial Team to investigate and identify exactly where the bug was between our program and the third-party integrator software. Once the root cause was determined, a solution could be developed.

Amidst the chaos of racing to find the bug fix, the deadline to release the next monthly Data Update (DU) drew closer and closer. The unplanned infrastructure issues had thrown a wrench in our ability to build and test the new DU, forcing us to adapt. This agile response to changing priorities is an essential skill for a scrum team.

This sprint was not without its share of unexpected obstacles. Unplanned infrastructure issues hindered our ability to build and test the DU, forcing us to adapt our focus and pivot. This agile response to changing priorities was a testament to our team’s resilience and adaptability.

As the head of this development team, I must regularly relay information to other managers, executives, and various teams and streams across the company to ensure we are all working towards the same goal. This sprint wasn’t without its fair share of challenges and triumphs, but my team prevailed, demonstrating the true spirit of collaboration and innovation. Demonstrating the power of agile software development. We are proud to have overcome the obstacles and delivered a solution.

Definitions

Scrum Team:
A scrum team is a small and nimble team dedicated to delivering committed product increments. A scrum team’s size is typically small, at around 10 people, but it’s large enough to complete a substantial amount of work within a sprint.

Sprint:
A sprint is a short, time-boxed period when a scrum team works to complete a set amount of work. Sprints are at the very heart of scrum methodology, and getting sprints right will help your scrum team ship better software with fewer headaches.

Beta Tester:
Beta testers are “real” users and conduct their testing in a production environment running on the same hardware, networks, etc., as the final release. This also means it’s the first chance for full security and reliability testing because those tests can’t be conducted in a lab or stage environment.

Authored by:

 

Eli Brighton
Delivery Stream Manager at Best Practice Software

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How To Save Time With Bulk Verifications In Bp Premier

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Leverage Bp Premier’s Bulk Verifications to reduce administrative burden and cut down on Medicare rejections due to incorrect Medicare Card details.

Best Practice integrates directly with Medicare for several functions, one of which is verifying your patients’ card details. You can individually verify your patients, but why perform individual checks when you can verify Medicare details in bulk? This feature is easy to use, will check all your patients for the day and could save you a lot of time.

So, how do I use it? From the appointment book screen, select Utilities > Bulk patient verification, and you will see this screen.

Bp Premier Screenshot

On this screen, you will select the parameters for the patient appointments you are searching for.

For example, you might like to run this utility at the start of the day for all of today’s appointments. In that case, you would click Select All to tick all your providers and make sure today’s date is selected in the calendar picker. Once you have chosen your parameters, click OK.

Bp Premier Screenshot

The next screen you see will give you a list of patients with appointments, and you can click Verify. Bp Premier will then connect to Medicare Web Services, check the Medicare card details for each patient in the list, and return a response.

If the patient’s card details are correct, no action is required. If their card details are incorrect, you can right-click on a patient in the list and click view details to open their patient demographics and record an appointment note. Appointment notes will pop up when arriving the patient, so we can get their Medicare card from them and update their details when they arrive at the practice instead of having to chase them. Sometimes, you will see a response from Medicare that looks like this.

Bp Premier Screenshot

If you do see this, it means that the patient’s details were not an exact match, but Medicare was able to match the details we have with the correct patient and has returned this updated card number to us. This might happen in cases where a Medicare card has expired, and just the last digit has changed. This is a super convenient feature; we can tick the box next to Medicare No and click update, which will open the patient demographics and automatically update the Medicare card for us! We can then click save in the patient demographics window, which will save the details and let us know if other patients in our database are on the old Medicare card we just updated. 

Bp Premier Screenshot

We will see this screen if other patients are on the same outdated Medicare card. From this screen, we can review the patients and click update to update an entire family on the new Medicare card in one click. This excellent time-saving feature ensures your patients have the correct details recorded.

Ultimately if you are bulk billing, you will get rejections from Medicare at some point. However, utilising the bulk patient verification utility will ensure that you have accurate data recorded and greatly reduce the number of rejections you receive from Medicare. This will save you time and ensure you receive rebates from Medicare as soon as possible.

Authored by:

Xanthe Kapczynski
Training and Deployment Specialist at Best Practice Software

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Mastering Chronic Disease Management: A Look At Practice Benchmarks And How To Grow

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Chronic Disease Management Blog Graphic

Delving into the realm of Chronic Disease Management (CDM), the past two years have seen remarkable progress in practices, with a focus on mastering the intricacies of this vital aspect of healthcare provision. Through the lens of Cubiko’s general practice benchmarking, we uncover the evolution of strategies and outcomes in managing chronic conditions. From utilising templates within Best Practice Premier to exploring innovative tools like the Actions feature for enhanced patient care, this exploration aims to equip Practice Managers with insights and benchmarks to elevate their CDM practices to new heights.

Introduction to Chronic Disease Management

Importance of Effective Chronic Disease Management

Effective Chronic Disease Management (CDM) is crucial for enhancing the quality of life for patients, reducing the progression of diseases, and optimising the use of healthcare resources. With a growing number of individuals living with chronic conditions, the burden on the healthcare system intensifies. Implementing robust CDM practices can lead to improved health outcomes by ensuring regular monitoring and tailored care plans. Moreover, CDM items such as the 721, 723, 732 are well funded by the government and can have a positive impact on a General Practitioner’s billings. With the right management protocols in place, practices can also ensure compliance with healthcare standards and improve patient satisfaction. Ultimately, effective CDM is not just about managing symptoms, but also about empowering patients to take an active role in their health.

Evolution of Chronic Disease Management

Chronic Disease Management (CDM) has evolved significantly, shifting from reactive to proactive and patient-centered care. Traditionally, the focus was on managing acute flare-ups rather than preventing them. However, the past years have seen a transition towards a more holistic approach that includes prevention, early detection, and comprehensive management. The integration of technology into healthcare has been a game-changer, with data analytics playing pivotal roles in identifying patients who may be eligible for services. Furthermore, there has been a greater emphasis on multidisciplinary teams collaborating to provide care, which has been shown to improve outcomes for chronic disease patients. Patient education and self-management are now recognised as essential components of CDM, empowering individuals to take control of their health and reducing long-term healthcare costs.

Chronic Disease Management: A Two-Year Benchmark Review

Insights From The Last Two Years

Over the last two years, Chronic Disease Management (CDM) has seen considerable growth and innovation. Data from Cubiko’s Touchstone Report reveals an uptick in the adoption of GP management plans, indicating a broader acceptance of structured CDM strategies. Practices are leveraging technology like never before, utilising tools for better patient identification and follow-up. These insights showcase not only the commitment of healthcare providers to elevate CDM but also the tangible benefits such advancements bring to patient care and practice efficiency.

Recent data from Cubiko’s Touchstone report indicates a modest rise in both CDM-related billings and health assessments over the last two years, signalling a brighter spotlight on structured management strategies. Specifically, CDM’s share of billing averaged 10.59% in 2023, with health assessments contributing 2.63%. However, it’s important to note a downward trend in nurse-led services’ billing share, which decreased to 0.42% in 2023 from the previous year’s 0.56%.

Understanding Cubiko's General Practice Benchmarking

Cubiko’s general practice benchmarking offers valuable insights by aggregating data across various practices to identify trends and best practices in Chronic Disease Management (CDM). This benchmarking serves as a powerful tool for Practice Managers, providing a clear picture of how their practice compares to others in terms of CDM performance. It includes key metrics such as the number of care plans initiated, reviews conducted, and patient outcomes. By analysing this data, practices can pinpoint areas of strength and opportunities for improvement. Benchmarks also facilitate goal setting and progress tracking over time. Understanding these benchmarks is critical for practices aiming to enhance their CDM strategies, as it provides a data-driven foundation for making informed decisions and implementing targeted interventions that can lead to better patient health and more efficient practice operations.

Utilising Templates for CDM Plans

Benefits Of Using Templates In The Word Processor

Using templates in the word processor for Chronic Disease Management (CDM) plans can significantly streamline the process for healthcare providers. These templates allow for a standardised approach to creating management plans, ensuring that all necessary information is consistently captured and nothing is overlooked. They also save time for general practitioners and practice managers by reducing the need to start from scratch for each patient plan. Templates can be customised to include practice-specific goals, interventions, and follow-up schedules, which helps maintain a high standard of care. This consistency in documentation not only improves the quality of patient care but also aids in compliance with healthcare regulations. Furthermore, templates facilitate easier sharing of information within a multidisciplinary team, leading to better-coordinated care and improved patient outcomes.

How To Effectively Use Bp For CDM Plans

Using Bp, or Best Practice Software, effectively for Chronic Disease Management (CDM) plans involves leveraging its full suite of features to create comprehensive and personalised care plans. Bp’s template feature allows for the creation of detailed CDM templates that can be easily adapted for individual patient needs. Within Bp, you can access a patient’s complete medical history, ensuring that the CDM plans are informed by the latest and most relevant information. It is also possible to set reminders for regular reviews and follow-ups, which are critical components of effective CDM. Additionally, Bp integrates with other healthcare systems, enabling seamless communication and coordination among different healthcare providers. By maximising the capabilities of Bp, Practice Managers can ensure that their practices deliver high-quality, consistent CDM, while also improving efficiency and reducing the administrative burden on healthcare professionals.

Utilising Templates for CDM Plans

Adding Notifications To The Clinical Record

Adding notifications to the clinical record is a powerful way to enhance Chronic Disease Management (CDM). By utilising the Actions feature in healthcare management software, practices can set up alerts for clinicians when they open a patient’s record. This can include reminders for necessary tests, follow-up appointments, or updates to a CDM plan. These notifications act as prompts, ensuring that important tasks are not overlooked and that the patient’s care plan is adhered to meticulously. For patients identified as eligible for certain CDM activities, this feature can streamline the process of providing timely interventions. Moreover, integrating these notifications within the clinical workflow can improve the efficiency of care delivery without adding to the administrative load. Effectively using the Actions feature helps maintain a high standard of patient care while optimising the use of clinician time.

Using Clinical Reminders For Patient Engagement

Clinical reminders are a key tool for patient engagement in Chronic Disease Management (CDM). With the Actions feature, practices can set up reminders not only for healthcare providers but also for patients. These reminders can prompt patients about upcoming appointments, medication refills, or necessary lifestyle changes. By actively involving patients in their own care, these reminders help increase their commitment to managing their condition. They also enhance communication between patients and the practice, building a relationship of trust and support. When patients receive timely and personalised reminders, they’re more likely to adhere to their management plans, which can lead to better health outcomes. The ability to automate these reminders ensures consistency and reduces the likelihood of human error, contributing to a more efficient and patient-cantered approach to CDM.

The Future Of Chronic Disease Management

How Cubiko Is Shaping The Future Of CDM

Cubiko is at the forefront of shaping the future of Chronic Disease Management (CDM) by providing advanced analytics and benchmarking tools tailored for general practices. These tools help practices to identify potential patients eligible for care, streamline operations, and ultimately provide better patient outcomes. Cubiko’s dashboards give real-time insights into patient populations, enabling practices to be proactive in their CDM approaches. With predictive analytics, Cubiko can assist practices in identifying patients at risk and ensure timely interventions. By leveraging Cubiko’s capabilities with Bp Premier, practice managers can lead their teams with confidence, knowing they are backed by robust data and are utilising the latest innovations in healthcare management to enhance their CDM strategies. 

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How Best Practice Can Help You Move From Bulk Billing To Mixed Billing

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Mixed Billing Blog Graphic

The recent Touchstone report from Cubiko, a practice intelligence platform that integrates with Bp Premier, shows a sizeable shift in the healthcare landscape in Australia. In 2022, the number of GPs that were predominantly bulk billing patients was 60 per cent, but that figure has since dropped to only 26 per cent at the end of 2023, indicating a growing preference for mixed billing.

The Touchstone General Practice Industry Report draws from data spanning 811 practices across Australia, offering insights into industry trends, helping analyse practice performance and supporting informed decision-making in the General Practice landscape.

Despite the introduction of the triple bulk billing incentive in November 2023 leading to a noticeable increase in billings per hour, only one in four practices are now predominantly bulk billing. This represents a steep decline over the two years of data included in Cubiko’s report.

As of February 2024, Cubiko’s touchstone dataset is made up of predominantly 5-9 GP FTE and 75% predominantly mixed billing practices.

Interestingly, the introduction of the triple bulk billing incentive had a small yet measurable effect on the percentage of concessional patients who were bulk billed. This suggests that the incentive is working as expected, but it’s not enough to reverse the overall trend toward mixed billing.

Medical practices have also increased their fees over time, with the average private fee for a consultation rising from $72.92 in 2022 to $81.21 by December 2023, due to ongoing cost pressures.

There has been a slight increase in chronic disease management items, but a decrease in nurse-led billings and no-show rates have slightly increased for bulk billing practices, while slightly decreasing for mixed billing practices.

As expected, online appointment bookings have seen a modest rise from 17.5% to 24% between January 2022 and December 2023.

It’s clear that general practices are shifting towards mixed billing, and as the practice landscape continues to change, it will be interesting to monitor how this trend develops. But how can Bp help you move from predominantly bulk billing to mixed billing?

Using Cubiko and Bp Premier empowers your practice to perform at its best. Cubiko provides vital practice data, benchmarking this data for reporting capabilities to guide business decisions on bulk billing, mixed billing, mitigating risk, and maximising potential practice revenue.

Authored by:

Jesse Maddren
Content Developer at Best Practice Software

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Introducing Our New CEO

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The founders of Best Practice Software have announced their appointment of Mr Craig Hodges as the company’s new Chief Executive Officer.

Dr Frank and Lorraine Pyefinch, who formed Best Practice in the regional city of Bundaberg in 2004, have elected to concentrate their strategic efforts on steering the company at a Board level as Chair and Board Director, respectively.  It is a logical next step for the couple who are widely regarded as early pioneers of the Australian digital health industry, having originally developed Medical Director and then Best Practice during their esteemed careers.  Dr Pyefinch used his experience as a successful and respected General Practitioner, and Mrs Pyefinch her prime business acumen and nursing skills and experience, to pioneer medical software design and develop Best Practice into one of Australasia’s leading and most popular group of e-health products and services.  The company operates successful software products including GP software leader Bp Premier, medical specialist software Bp VIP.net, allied health software Bp Allied, the Best Health app, and upcoming Best Practice Mobile applications.

Mr Hodges first joined the company in 2012 as its foundational General Manager and has worked over the past 12 years in a variety of strategic and operational leadership roles within the business including being the group’s Chief Operating Officer, working closely with Dr Pyefinch as a key advisor, deputy, and understudy. 

“Craig has been an integral member of our senior leadership team for many years and he knows and understands our business, its people, and our customers intimately”, Dr Pyefinch said.  “He shares our empathy for Clinicians and their operational pressures and has helped position our business to best support our users, guiding various initiatives that have reshaped our business and our products over this past decade.  His permanent appointment to the role of Chief Executive evidences our confidence in his vision for our business and how aligned he personally is with our values and beliefs”.

Mr Hodges said he was honoured to take up the new permanent role as Chief Executive, but honoured the legacy left by Dr Pyefinch’s retirement from the role.  He said “Frank really has contributed so very much to the Australasian healthcare community and his care, attention, and positive attitude towards supporting GPs, surgical specialists, and allied health professionals will always guide and influence me.  He is a brilliant doctor and wonderful advocate and supporter of our medical community, and I will be forever grateful for his guidance and support”.

Mr Hodges said he was looking forward to working with Dr & Mrs Pyefinch in their new board roles and felt confident their personal values would continue to be honoured in the care Best Practice demonstrates for its people, customers, and community.  “I’ve had a wonderful opportunity to work for and alongside Frank and Lorraine for 12 years and closely understand their deep care for the healthcare community and that passion for supporting our users will never diminish.  But I will be putting my own unique stamp on the role and our team, and that work commences now.”

Before joining Best Practice, Mr Hodges worked in a variety of financial and strategic leadership roles across the public and private sector and has volunteered his time in a variety of community support missions.  He is a Non-Executive Director of the Australasian College for Emergency Medicine, has served on the board of a large Queensland hospital and health service, and dedicated his time and efforts over two decades to various healthcare advisory, clinical support, and tertiary medicine training committees and programs.

We kindly request that all media enquiries be directed to marketing@bpsoftware.net.

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Bulk-Billed Genetic Carrier Screening: GPs’ Vital Role in Antenatal Patient Care

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The introduction of bulk-billed Genetic Carrier Screening for cystic fibrosis, spinal muscular atrophy, and fragile X syndrome to the MBS in November 2023 was a welcome addition for both patients and doctors alike. It helped raise awareness of this important screening and increased accessibility for Australians who would not have been able to afford it otherwise.

As carrier screening is ideally performed before conception to offer greater reproductive choice, this has highlighted the important role GPs play in preventative antenatal care. GPs are ideally positioned to discuss Genetic Carrier Screening early on, before a woman conceives, during the planning stage of her pregnancy journey. Ordering the screening for patients is easy, as it is hosted as a template in Best Practice, under the name “Genetic Carrier Screening Request Form.”

If screening is performed before pregnancy, this allows more time for counselling and discussion about other reproductive choices, such as pre-implantation genetic diagnosis through IVF, using donor eggs (or donor sperm for CF and SMA), donor embryos, or adoption.

While it is recommended that testing be completed prior to pregnancy so that this essential information is known early, is it still vital that women in the first stage of pregnancy are tested as well. This ensures they have the opportunity to make informed decisions for their family.

RECOMMENDED BY CLINICAL GUIDELINES

Genetic Carrier Screening should now be a routine part of pre- and early-pregnancy clinical management by GPs and specialists, as it is recommended in both RANZCOG and RACGP guidelines that this screening be offered to every woman and couple who are planning or in the first stage of pregnancy, regardless of their risk factors.

If a patient has had one or more unaffected pregnancies but was never offered genetic carrier screening in the past, it is still important to offer the screening before any subsequent pregnancies, as she may be a carrier and not know it.

MEDICARE-REBATABLE CONDITIONS

Bulk-billed Genetic Carrier Screening covers the three most common inherited conditions: cystic fibrosis (CF), spinal muscular atrophy (SMA), and fragile X syndrome (FXS). One in 20 people are carriers of at least one of these conditions, and 90% of carriers have no family history.

Cystic Fibrosis (CF)
CF is a severe autosomal recessive genetic condition that causes lung and gastrointestinal problems. Approximately 1 in 25 individuals are carriers of CF, and CF affects about 1 in 2,500 people. Clinical Labs’ CF screening covers more than 75 common mutations in the CFTR gene.

Spinal Muscular Atrophy (SMA)
SMA is an autosomal recessive inherited neuromuscular disease historically associated with high morbidity and mortality. Approximately 1 in 35 individuals are carriers of SMA, and SMA affects about 1 in 6,000 people. Clinical Labs’ SMA screening identifies deletions of the SMN1 gene (one copy), which account for approximately 96% of the mutations in this gene.

Fragile X Syndrome (FXS)
FXS, an X-linked condition, is the most common inherited form of intellectual disability. Approximately 1 in 330 individuals are carriers of FXS, and FXS affects approximately 1 in 3,600 men and 1 in 6,000 women. FXS carrier screening is recommended for females, as it is inherited in a different way to CF and SMA.

Female patients who have the gene change (number of CGG triplet repeats) in the FMR1 gene are found to be at risk of having a child affected by FXS, as the abnormal gene may expand over generations. The size of these CGG triplet repeats determines the chance of the FXS gene failing to function in a normal way and, therefore, the clinical presentation.

MEDICARE ELIGIBILITY CRITERIA

Bulk-billed genetic carrier screening is now available to determine a couple’s combined risk of having a child with a genetic condition. Testing is available for all individuals, even those with no symptoms or family history.

New items 73451 and 73452
The patient who is planning pregnancy or already pregnant should be tested first under MBS item 73451 prior to testing the reproductive partner patient under MBS item 73452 to ensure an informative and clinically relevant test result is obtained in the relevant gene.

73451
Testing of a patient who is pregnant or planning pregnancy to identify carrier status for pathogenic or likely pathogenic variants in the following genes, for the purpose of determining reproductive risk of cystic fibrosis, spinal muscular atrophy, or fragile X syndrome:

a) CFTR;
b) SMN1;
c) FMR1.

One test per lifetime.

73452
Testing of the reproductive partner of a patient who has been found to be a carrier of a pathogenic or likely pathogenic variant in the CFTR or SMN1 gene identified by testing under item 73451, for the purpose of determining the couple’s reproductive risk of cystic fibrosis or spinal muscular atrophy.

One test per condition per lifetime.

UNDERSTANDING THE TEST RESULTS

PATIENT is a CARRIER
If the PATIENT is found to be a CARRIER for CF or SMA, then testing of the reproductive partner is RECOMMENDED for that specific condition.

PATIENT is NOT A CARRIER
If the PATIENT is found to be a NON-CARRIER for CF or SMA, then testing of the reproductive partner is NOT REQUIRED.

PATIENT and REPRODUCTIVE PARTNER are BOTH CARRIERS
If the REPRODUCTIVE PARTNER is also found to be a CARRIER for CF or SMA, then genetic counselling is recommended. For positive cases (tested by Clinical Labs), Clinical Labs offers one genetic counselling session per couple at no cost.

PATIENT is in the PRE-MUTATION or FULL MUTATION RANGE for FXS
If the patient is found to be in the pre-mutation or full mutation range for FXS, then genetic counselling is recommended. For FXS testing with Clinical Labs, only pre-mutation and full mutation cases are offered genetic counselling.

Clinical Labs’ Genetic Carrier Screening Request Form for CF, SMA, and FXS is hosted as a template in Best Practice. It can be found under the name “Genetic Carrier Screening Request Form.”

For more information on Genetic Carrier Screening test options and other antenatal testing services offering by Clinical Labs,
please visit antenatal.clinicallabs.com.au/doctor

Authored by:
Assoc. Prof. Mirette Saad
National Director of Molecular Genetics Australian Clinical Labs

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Should I Let Patients Self-Book In? – The Novelty and Convenience of a Self-Service Economy

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Self-service booking blog image

Across America, pink, LED-illuminated ATMs can be found affixed to streetside walls. Customers with cravings for sweet treats queue night and day, patiently waiting for their turn to swipe their bank cards. Rather than dispensing crisp dollar bills, however, these ATMs cut out the middleman and serve up freshly baked cupcakes. Open 24 hours a day, The Cupcake ATM has some of the best, freshest cupcakes to satisfy the cravings of sweet tooths; no matter the time of day. To stand out, these magical machines resemble what bank ATMs might look like if Barbie was their head of design.

However novel the idea of these machines may have been at their inception, they have now been around for over a decade. They, along with the now universal self-checkout isles at grocery stores, are just another sign of the rise of the self-service economy. This begs the question: should you enable online self-booking for your practice?

The short answer is yes, an online booking solution provides tangible benefits to both your business and your patients. The long answer is a tad more nuanced, and let’s sort out the details…

Cupcake ATM

Helping Patients Help Themselves

Late-night sugar cravings aside, have you ever woken up in the wee hours of the morning thinking about the appointment you forgot to book the day before? One of the top reasons to enable online booking is to capture appointments when your admin team is off-the-clock. Like you, most of our patients are also working 9-5, offering your patients the freedom to book their appointments is one of the clearest ways that you can help your patients help themselves.

In addition, it’s possible to do just about anything from a mobile device – order food, order a taxi, buy a plane ticket. It’s only natural that we also want the convenience of getting an immediate answer from a business, right? Even when a patient calls and leaves a voicemail, no appointment has been booked or confirmed. Nine times out of ten, you’re probably going to have to call them back. People want to be able to solve things by themselves. More and more people like the autonomy and freedom that self-service provides.

Telephonobia - It's A Thing, And It's More Common Than You Think.

What is telephonophobia? Also known as phone anxiety, telephonophobia refers to avoiding conversations over the phone. Talking on the phone can be daunting because of the absence of all other social cues – including gestures, body language, and eye contact. People can often feel self-conscious of the sound of their voice and choice of words. This phenomenon is most notable among younger adults, who grew up with texting and rarely had to make phone calls. People are increasingly becoming more reluctant to use their phone as a phone. Without an online booking solution, you might be doing your patients a disservice by leaving them with no other choice than to call you. 

When a patient can look at all the available options and book their own appointment at a time that best suits them, you are minimizing the communication gap with your customers. Look, select, book – easy as pie. Plus, with the added benefit of automated text message or email reminders, you can expect to see fewer patient no-shows in your practice. 

An online booking system for a doctor’s practice provides convenience, enhancing patient experience, much like online restaurant reservations have revolutionized dining. Just as diners can conveniently book a table from their phones at any time of day – regardless of whether the restaurant is open or not – patients can have the same ease in scheduling medical appointments. With an online booking system, patients can select appointment times that fit their schedule without any back and forth over the phone.  

Give 'Em The VIP Treatment

Best Practice Bookings, when paired with Bp Premier, you can opt not to share your online booking page publicly, and instead reserve it for your most trusted and loyal customers. It’s a little bit like a VIP pass for people who are already familiar with your practice.

Doctors on different schedules? No problem! You can configure your settings to their individual schedules. For example, Doctor Pyefinch does script refill appointments every Tuesday between 3 – 5 pm, and a skin check clinic every 2 weeks on a Monday between 9 – 11 am.

From automated Cupcake ATMs to online booking platforms in your practice, self-service technologies have revolutionized the way we interact with businesses and services. Is online patient bookings the automation that your practice is missing? Best Health Booking by Best Practice Software might be the icing on top of the cupcake that your practice needs! 

Authored by:

Lucy Saul
Marketing Specialist at Best Practice Software

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Dictate with Confidence and Implement Strategies to Improve Practice Efficiency

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VoiceBox IT Blog Image

The ever-evolving landscape of healthcare is being significantly reshaped by technology. Gone are the days of overflowing inboxes, and mountains of paperwork and invoices. Today, a wave of innovative apps and software solutions are empowering healthcare professionals to streamline their workflows and maximise efficiency. These digital tools are not only saving valuable time, but also improving accuracy, communication, and overall patient care. Let’s explore how using a smartphone app helped to optimise the dictation and transcription for an Australian practice.

This large, well-established specialist practice had an admin team of 11 with two senior medical secretaries taking on the bulk of the practice typing. As the number of specialists grew, it became necessary to bolster the typing pool. The practice engaged an overseas typing agency with poor quality transcripts, lack of local nuance, and the idea that data visible outside of Australia potentially contravened Australian Privacy Principles.

The practice persevered with this inefficient, substandard overseas transcription solution as it was hard to find local typists who could work on a similar budget. Despite their competent secretarial team, the practice couldn’t keep up with the volume of letters and the practice manager knew the overseas typing agency was far from ideal.

After an in-depth review of their internal business processes, it was uncovered that sound files, data, and documentation were being double handled at multiple levels across the practice. The current process was very manual and administration-heavy, the practice identified that it could be eased with the use of an intelligent transcript app. The app enabled a complete end-to-end transcription process that removed many administration touchpoints within the practice.

The doctors in the practice uploaded VoiceBox Intelligent Transcript to their mobile devices to easily dictate letters in a consistent format with transparent workflows. It is no surprise that investing in technology can empower healthcare professionals to reclaim their time, reduce stress, and provide more time for their patients.

By leveraging technology with the VoiceBox Intelligent Transcript app, the practice was able to reclaim their time to focus on what matters most – their patients.

Technology and digital platforms are supporting busy healthcare professionals to optimise their efficiency and elevate patient care. These innovative tools offer a powerful solution to help ease the burden of administration, freeing up valuable time for direct patient interaction and improved health outcomes. By embracing digital tools like VoiceBox Intelligent Transcript, doctors can streamline workflows, ensure data accuracy, and enhance communication, ultimately creating a more efficient practice and a more positive experience for both themselves and their patients.

VoiceBox IT

Scenarios in this publication are based on Avant claims experience to date. Certain information has been de-identified to preserve privacy and confidentiality.

Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant and Avant Practice Solutions are not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published. © Avant Mutual Group Limited 2024.

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