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Data Breaches and You – Keeping Your Practice Data Safe

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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.

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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.

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

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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

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Why is my Baby Irritable? – Six Points to Understanding Infant Sleep

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Irritable Baby Article Baby Sleeping next to Clouds

A common problem in primary care is to be asked for guidance on the care of an irritable baby. In this article I describe non-medical problems which, in my experience, actually dominate over medical problems.

As a GP I have focused on the care of mothers and babies for about 40 years and have seen well over 10,000 families. For the rest of this article, let’s assume that the irritable baby in question is less than 12 weeks old.

To oversimplify the situation, my experience is that in this age group two problems dominate – fatigue and hunger.

So, if you are faced with an overtired mother and an irritable baby who seems to cry excessively, a very simple algorithm is as follows. Exclude poor weight gain and take a simple sleep history.

In this article I am going to focus on fatigue, but in terms of ensuring adequate nutrition it is easy to measure weight, to calculate weight gain per day and percentiles.  For children under 12 weeks, I recommend measuring and graphing these three variables at every visit.

Weight or Hunger

Unfortunately, hunger is very common in our culture.  If weight gain per day is less than 30 gm per day, if percentiles are dropping, if the baby is irritable at the end of the feed, if feeding times are prolonged i.e., more than a total of 20-30 minutes then a feeding review is needed.  Do whatever is needed to ensure that the baby finishes all their feeds fully satisfied.  I can address hunger and feeding in more detail in a later article. Today, we are focused on sleep.

Sleep, Fatigue or Over-tiredness

Total sleep volume that is needed to be well in the first few months is almost always more than 16 hours per day. This varies with weight but only a little.  Heavier babies can cope with a little less sleep and light babies need more.  To put that point in its reverse, lighter babies become over-tired more rapidly and need shorter waking times.

I teach six main points which give a useful and practical understanding of infant sleep.

  1. Sleep is Cyclical
  • During a block of sleep it is normal and healthy to awaken and resettle multiple times.
  • For a newborn baby, these cycles are about 45 minutes long. The waking events will last generally 30-90 seconds. The majority should be silent, and you will be unaware that they occur.
  • In overtired babies they may waken at the 45-minute point and have trouble getting back to sleep. Thus, if your baby is calling for assistance every 45 minutes it may be a sign of fatigue.
  • In very overtired babies, sleep cycles can ‘break down’ to 20-minute cat naps.
  • In a block of sleep, a baby awakens and returns to sleep multiple times. What forces drive a return to sleep? To simplify very complex events, I identify two things:  Tiredness and ‘cues of sleep’.
  1. Cues of Sleep
  • It is useful to think of the sleep achievement event as being driven by a combination of tiredness and external cues of sleep i.e., the things which are going on around the baby at the time.
  • Again, to simplify these cues can be divided into parent dependent and parent independent.
  • When a baby or child is put to bed at the beginning of a block of sleep tiredness dominates. Cues of sleep achievement are outweighed by tiredness and they are more likely to achieve sleep efficiently.
  • As a block of sleep progresses tiredness reduces and cues of sleep become more important in achieving a return to sleep.
  • If a baby is put to sleep using parent dependent cues i.e., holding, rocking, patting, feeding then there is an increased chance that the baby will request those cues be repeated later in that block of sleep.
  • Cues of sleep which are parent independent are more useful. I use a term ‘parent-lite settling’.  So, we prepare a baby for sleep, but the final transition is achieved by the baby alone as often as is possible.
  1. Cues of Sleep are Learned
  • To make this point I use adult experience. Learning to sleep with a partner. Moving to a new suburb or street with different noises outside the home. Buying a new bed.  We have all had these experiences.
  • So, cues of sleep can be changed and relearned.
  • Babies actually do this very efficiently.
  1. Sleep Achievement and Sleep Maintenance are Usefully Regarded as Learned Skills
  • By combining two points i.e., sleep is in part cue dependent and cues are learned I develop a very important point.
  • Going to sleep and maintaining sleep are usefully considered learned skills.
  1. Fatigue Interferes With the Learned Skill of Sleep Achievement
  • This point may seem counter-intuitive but almost every single mother that you care for will agree that she has had a personal experience of becoming so tired that while she is desperate to get sleep her mind will not turn off. This is critically important for children.
  • Therefore, it is important to ensure the child does not become over tired.
  • A newborn can become overtired in 10 – 15 minutes.
  • Low weight babies are more prone to fatigue and heavier babies a little more resistant.
  • For the age group under discussion waking times need to be fairly short i.e., 20-30 minutes over-night and something like 45 minutes during day light. This time includes feeding, changing, cuddles and any social time.
  • To put it another way in the first month of life my ambitions for a baby are simply feed, sleep, and grow.
  1. Cues of Sleep Achievement That are Parent Independent are the Most Useful for Family Life
  • A baby who achieves sleep with parental care is preordained to request that care again at some point in the block of sleep. Minimise sleep transitions which involve parental assistance and allow a child to achieve sleep alone.
  • Adopt a ‘parent-lite’ approach to sleep achievement. Be there and be supportive but keep it minimal rather than the reverse. The baby needs to feel parental love and support but when it is time to be asleep leave them alone to finalise the last steps in sleep achievement.
  • A parent has a major and positive role to play when the baby is awake and maybe even when sleepy but once the baby is ready to be finally asleep these events are best managed by the baby alone. This is true from the time of birth.

Conclusion to Assessing an Irritable Baby of Less Than 12 Weeks

  • Take steps to check that a baby is being well fed by whatever technique ensures adequate growth.
  • Avoid over-tiredness and the following points assist understanding.
    • Sleep is cyclical with blocks of sleep which include multiple short episodes of arousal followed by a return to sleep
    • Sleep achievement is in part cue dependent
    • Cues of sleep are learned can be altered and relearned
    • Sleep achievement and sleep maintenance are usefully regarded as learned skills
    • Avoid children becoming over tired as this interferes with the learned skill of sleep achievement
    • Minimise cues of sleep achievement that are parent dependent. Take a ‘parent lite’ approach.
  • It is my experience that ensuring complete feeding and avoiding over-tiredness linked to the learning of parent-lite cues of sleep will resolve that large majority of events where the presentation is an irritable infant aged 12 weeks or below.
Dr Brian Symon
This article was contributed by Dr Brian Symon. He has more than 30 years’ experience working with parents and babies experiencing problems of sleep, feeding, growth and behaviour. You can find out more about Dr Symon’s work at his website – The Babysleep Doctor.
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The Criticality of Staying Up-to-Date with Data Updates in Bp Premier

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Thanks to this great article we featured last year on debunking software myths and concerns, we’re all aware of why it’s so important to update our software when a new release is available – but what about keeping current with data updates in Bp Premier?

While new software releases add and improve features and functionality within Bp Premier, data updates (which are sometimes referred to as drug updates) ensure that the information in your Bp Premier database is correct and up-to-date. Downloading and installing these updates will ensure your Practice stays up to date with the latest PBS changes, MIMS medicine information, MBS fee updates, word processor templates, and management reports.

The medical industry is a fast-paced, ever-changing landscape, and it’s important to stay on top of the changes made available in these updates as they become available. Keeping your data updates current will ensure that the providers at your Practice are prescribing up-to-date medication, and that your Medicare claims are using current fees. This in turn, contributes to providing an overall higher quality of healthcare to your patients.

How Often Are New Data Updates Available?

They’re generally released at the beginning of each month, with occasional revisions released later in the month. There’s no need to worry about forgetting to download the update. We’ll always send an Elevate email notification to your Practice’s primary contact’s email address, or the email address you nominated to receive system update notifications as soon as a new update becomes available. A reminder message will also appear when logging into Bp Premier if your latest data update is over three months old, however we recommend that updates are installed monthly, as they’re released.

You can find out exactly what’s included in each update by visiting the What’s new in Data Updates page on the knowledge base. To access this page, select Help > Online from within Bp Premier to access the Knowledge base, then search for ‘data update’. 

To find out more, we encourage you to watch this short video clip.

Authored by:

Data Update Article Jennifer Stewart Author Profile Picture

Jennifer Stewart
Technical Writer at Best Practice Software

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Telehealth Consultations 2.0 – Going Beyond Phone and Video

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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.

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Atrial Fibrillation Self-Screening in Practices: A Trial in Early Detection

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Each year in Australia, February is recognised as Heart Research Month. On average, one Australian dies as a result of heart disease every 26 minutes, and recent research shows that heart attacks – often associated with older men – are increasingly occurring in younger people.

Prof Ben Freedman, the Deputy Director of Research Strategy at the Heart Research Institute in Sydney, in conjunction with several colleagues, has developed a method for patients to self-screen for risk of atrial fibrillation in General Practice. 

The following contains excerpts from the complete published study. A link is available at the bottom of this article.

Atrial fibrillation is the most common arrhythmia in older adults, and is associated with thromboembolic disease in major vascular beds. Stroke is also identified as the most debilitating condition associated with atrial fibrillation, with around one-third of ischemic strokes being caused by atrial fibrillation. These are often more disabling or fatal, and the arrhythmia may also lead to other morbidities such as heart failure, cognitive impairment and systemic embolism. Approximately one-third of patients with the condition are asymptomatic, and asymptomatic atrial fibrillation offers a similar stroke risk as symptomatic disease. Unfortunately, a fatal or debilitating stroke may be the first presentation of the condition.

Prof Ben Freedman, leader of the Heart Rhythm and Stroke Group at the Heart Research Institute in Sydney, said that opportunistic screening for silent atrial fibrillation is recommended in guidelines to reduce stroke, but screening rates are sub-optimal in the context of general Practice. His group hypothesizes that patients being able to self-screen while waiting for their appointment may improve screening rates and ultimately, the detection of atrial fibrillation. When atrial fibrillation is found and treated, this should reduce the number of strokes related to atrial fibrillation.

How Does Self-Screening Work?

The study, lead by Dr Katrina Giskes, tests a purpose-designed atrial fibrillation self-screening station which records a lead-1 ECG. This station then seamlessly integrates with Bp Premier in order to deliver the results of the screening to the patient’s electronic medical record.

  • The software automatically scans the Practice appointment diary for eligible patients – 65 years or older, with no current atrial fibrillation diagnosis
  • If a patient makes an appointment for a consultation, it will send eligible patients an automated SMS reminder, just prior to their scheduled appointment
  • The software creates a QR code which is printed out at Practice reception, and is handed to patients upon their arrival. They then scan the QR code at the self-screening station
  • The screening station has an ECG device (Kardia Mobile), where patients place their fingers. The device transmits and ECG rhythm strip to the iPad attached to the station
  • Once the self-screening has been completed, the ECG and diagnosis is imported directly into the patients’ electronic medical record in Bp Premier
Atrial Fibrillation Self-Screening Station | Best Practice Software

Between 5 and 8 general Practices in New South Wales will participate in the trial, with the aim of having 1,500 patients undertake self-screening.

The outcomes measured will be the proportion of eligible patients that undertook a self-screening, the incidence of newly-diagnosed atrial fibrillation, and patient and staff experience of the self-screening process. From there, de-identified data will be collected using a clinical auditing tool, and further interviews will be conducted to determine patient and staff acceptability of the process.

An automated self-screening station where patients can undertake a screening prior to the GP appointment is a potentially feasible solution to improving detection of undiagnosed atrial fibrillation in patients. Dr Nicole Lowres suggests that if the trial is initially well received, an upscaling of this system may enable the widespread implementation of the atrial fibrillation screening guidelines, and may achieve higher screening rates, thereby potentially reducing the personal and economic burdens of preventable stokes.

To read the complete study, please click on the link below.
Atrial Fibrillation self screening, management and guideline recommended therapy: A protocol for atrial fibrillation self-screening in general practice

Best Practice Software would like to thank Katrina Giskes, Nicole Lowres, Jialin Li, Jessica Orchard, Charlotte Hespe and Ben Freedman for access and use of this study in the publishing of this article.

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When Disaster Strikes: Choosing a Strategy for Protecting Patient Data

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Protecting patient data is a crucial responsibility in any medical Practice. As a result, unexpected, large-scale data loss is one of the scariest things that can happen, even more so when you aren’t prepared. 

Consider for a moment that you’re running a Practice that has just experienced significant data loss, and ask yourself the following questions:

  • Can you afford to lose your patients’ records?
  • Do you have the time to re-key even one day of patient notes, results, accounts, etc.?
  • How much will this cost the Practice in IT costs and operational downtime?
  • What is the effect that this will have on your ability to provide patient care?

Data loss can happen to anyone at anytime, and is a real risk for medical Practices. Data loss can occur due to human error, hard-drive damage or failure, viruses, malware, natural disasters, or theft, and we’ve seen Best Practice Software customers lose up to eight months of patient data due to weak backup practices. 

For this reason, it’s critical every Practice regularly backups their database to protect patient data. Good backup practices are also important as they should form part of your business continuity and disaster recovery plan. It’s far better to be proactive before you are forced to react to a data loss emergency.

How Can I Be Sure I’m Protecting Patient Data Effectively?

Best Practice Software recommends that you back up your data daily using the backup utility that’s supplied with Bp Premier. You can manually back up your database at any time, but it’s good practice to set up a scheduled backup to run overnight, or during a time of minimal server activity.

‘What if I use a third party backup utility?’ I hear you ask.

There are a multitude of third party utilities that can provide a backup solution for SQL and Windows OS, however not all features may work without approved access to your databases. Secondly, our Bp Support team members are trained on the supplied utility, and they can utilise this to restore your site more quickly to working order, in the event your IT provider is not contactable, or your third party solution has failed.

Once you’ve backed up your data, how confident are you that your backup is valid and in working order? Having a separate test server would allow you to regularly test your backups to ensure their validity. If you do implement this, please ensure the test server is not connected to your network or internet. This will prevent it from causing any potential conflicts with your live systems and services used by Bp Premier.

Implementing a test server has two main benefits:

  • You can regularly test that your backups are working
  • It provides a fallback should your main server fail

To ensure consistency across your test and live environments, you should always try to keep the Bp Premier installation on your test server current with the version of Bp Premier that you’re running in your live environment. Your test server will also need to have the same version of SQL as your live server. You should aim to perform a test restore of your backed up data at least once per month. This ensures that protecting patient data isn’t being entrusted to a corrupted backup.

Local backups are adequate to recover from small errors. But what if your Practice was completely destroyed due to fire or theft?  The 3-2-1 backup rule should be considered as part of your Practice’s disaster recovery measures.

The 3-2-1 rule is:
Keep at least three separate copies of your data, store two copies of your backups on different storage media, with at least one of those backups located in a secure offsite location.

Automatic Scheduled BackupsManual BackupsScripted Backups
  • Can be scheuled to occur at a time that is convenient for the Practice – e.g. multiple times a day, or outside of business hours
  • It can be backed up locally, or to a network location
  • Can be performed as a compressed or uncompressed backup
  • Previous backups can be deleted as more recent backups are created
  • Notifications can be provided to selected users who use Bp Premier to advise of a failed backup
  • Once started, is unable to be cancelled
  • Can be run at any time of the day
  • Has both compressed and uncompressed options
  • The utility to perform manual backups is provided free with Bp Premier
  • Manual backups are done via a simple process that can be used when impromptu backups are required – e.g. incoming bad weather
  • Manual backups can be cancelled once started
  • SQL backups can be performed through utilising commands in the command prompt
  • Scripted backups can be simple – e.g. backing up a single file from the set
  • Or they can be performed in a more complex way – e.g. complex queries targeting specific datasets
  • Can be executed through the Windows task scheduler
  • Uses the BPSBackup user
  • Uses the Practice’s database password

Things You Should Consider When Backing Up Data

How can I tell if my backup is working?

    • Each time a backup is performed, a record is written to the log file, simply titled log. This file can be found in the C:\ProgramData\Best Practice\Log\directory
    • Check backup location – Is there a new backup file(s)? Is it slightly larger than the previous day?
    • Regularly test restore on a ‘backup server’

Should I run a compressed or uncompressed backup?

Pros Cons
Compressed Backups
  • Creates a single ZIP file containing a file for each Bp Premier database
  • Backing up to one file ensures that the entire backup is in one location, and there is no chance of missing data
  • Much slower to perform than an uncompressed backup
  • Compressed backups require space on the C: drive equal to three times the size of your database
Uncompressed Backups
  • Much quicker to perform than a compressed backup
  • A suitable option if you have limited disk space on your C: drive
  • Creates an individual file for each Bp Premier database, so you need to ensure that all files are stored in the same location if a restore is ever required

How Often Should I Backup My Data?

We recommend backing up your date daily – as a minimum. When asking yourself how frequently you should backup your data, consider how much data you’d be willing to re-enter if a server failed during the day

Further information on backing up your data in Bp Premier is available on our Knowledge Base, which can be accessed from within Bp Premier by selecting Help > Online. Search for ‘Backup and Restore Bp Premier’, or ‘Backup Troubleshooting’, for assistance on backing up and protecting patient data.

Protecting patient data via the methods outlined above can, at first, seem like a lot of work. While it does require some planning, the effort required to keep your Practice data safe pales in comparison to the monumental task of attempting to rebuild a database that has been corrupted, stolen or otherwise disrupted.

As the saying goes – prevention is better than cure.

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My Health Record in Bp VIP.net – A Preview of Upcoming Enhancements

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Our newest exciting release for Bp VIP.net – Topaz – is nearly ready to be released. It is currently undergoing a stringent beta testing process to ensure the new My Health Record enhancements are functioning correctly.

My Health Record in Bp VIP.net has been available for a number of years, however new functionality will make it easier for your clinic to view, download and upload patient clinical information.

You will be able to view uploaded letters, shared health summaries, prescription and dispensing records, pathology and diagnostic imaging overviews for your patients if they have opted in to My Health Record and they have given other providers their consent to share their clinical information.

My Health Record in Bp VIP.net screenshot

Similarly for you as a health provider, if your patients consent to the uploading of information to My Health Record, you will be able to upload your specialist letters through My Health Record, and prescribing records using the eRx gateway.

If your clinic is wanting to access My Health Record in Bp VIP.net, please contact Health Professional Online Services (HPOS) to apply for the new NASH PKI certificate. This will give you access to both My Health Record, the Online Provider Directory and Secure Messaging, if you use HealthLink as your Secure Messaging Provider.

Topaz also introduces new functionality to save images externally to the Bp VIP.net database on SQL. This functionality is already in place for sites who have been transitioned to Bp VIP.net from 2016. You can still view, import and attach images (including incoming scanned documents) as you are currently able to do, but an external image folder ensures the growth rate of your database is reduced significantly. 

It is imperative that you engage your IT personnel to ensure you are following all pre-enablement steps included in the new Knowledge Base article ‘Transfer Images from Database’. This article will be available with the release of Bp VIP.net Topaz. Search the Knowledge Base for ‘Images Folder’ for assistance in setting up the folder where images will be stored going forward.

We look forward to releasing Topaz shortly and offering you these exciting My Health Record integration enhancements that come with it.

Authored by:

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Johanna Monson
Training and Deployment Specialist at Best Practice Software

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It’s All About You! – Customising Bp VIP.net

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What is so different about Bp VIP.net that makes it attractive to specialists of varying disciplines? How is it that we can make one product fit different specialties and a diverse set of workflow requirements? In this article, we’ll focus on how customising Bp VIP.net can make it work exactly the way you need it to.

The ability to customise Bp VIP.net is what sets it apart from other Practice management systems tailored to specialists.  In this article, we’ll explore how it can benefit your clinic.

It’s not uncommon to hear that some providers offer customisation in their product.

But what does that actually mean? For us, customising Bp VIP.net means flexibility in how we enable you to capture information about your patients, as we recognise that every clinic has different needs in this area.

Being at the forefront of new Bp VIP.net sales, as well as project managing new Bp VIP.net deployments, I regularly engage with our new users to discuss their unique requirements.

Customising Bp VIP.net can be achieved in a few different areas:

  • Medical desktop screens (where consultation notes are recorded)
  • Patient demographics screens
  • Provider details screens
  • Organisation details screens

To make this level of customisation possible, we use custom screens that can be linked together to form a comprehensive data capturing tool. We call the various screens user-defined forms – or UDFs.

Let’s look at medical desktop screens first.

Medical Desktop Custom Screens

Multiple UDFs can be designed to capture unique information relevant to each clinician’s speciality.

For example, an Ophthalmologist could create a medical desktop screen that records visual acuity and macular degeneration information from the front page, and sub-pages might include fields for recording pre and post-surgery information for cataract surgeries.

An Endocrinologist could create a medical desktop with diabetes-related fields as part of the front page, with sub-pages for cardiovascular risk assessment.

A Gastroenterologist could create a medical desktop with endoscopy and colonoscopy related fields as part of the front page, with sub-pages for recording number, size, type of ulcers, polyps etc. A Cardiologist would have their own data capturing requirements such as ECG, Echo etc.

Custom fields within each form can be added as radio buttons, tick boxes, drop down lists or free text, depending on the clinician’s needs. Each of the fields can be set up to allow only a certain type of data input (such as numeric or text), and each provider in the same Practice can have their own unique set of screens that will load automatically when they log in to the system.

Another significant benefit of custom fields is that they can be reported on. An example of such a report would be to check how many patients with a certain condition, e.g. inter ocular pressure/ulcer type/cholesterol level, in a specified age group were examined by the clinic in a chosen period of time. Also of note is that any data entered into a UDF can automatically populate your letter or report back to a patient’s referring providers, reducing the time you spend creating these reports and eliminating data inaccuracies caused by transcription errors.

Some examples of customised medical desktop screens are displayed below.

A medical desktop for a Cardiologist:

Customise Bp VIP.net - Screenshot of a Cardiologist Medical Desktop

A medical desktop for an Orthopaedic Surgeon:

Bp VIP.net - Screenshot of a Medical Desktop for an Orthopaedic Surgeon

A Technician screen (sub-page) for an Ophthalmology Practice:

Patient Demographic Custom Screens

In a similar vein to medical desktop screens, customising Bp VIP.net through patient demographic screens allows a clinic to record additional information when compared to standard demographic screens. Additional information includes data such as warnings, language, smoking or alcohol use, excess and co-payments for health insurance, etc. It can also be used to capture data for marketing purposes – such as how a patient heard about the clinic.

Data from customised patient demographic screens can be used to collect information for clinical research purposes. Multiple sub-screens can also be created to capture and group relevant information together.

Some examples of this are displayed below.

Financial sub-page (Australia):

Customising Bp VIP.net - Screenshot of a Financial Sub-Page Australia

Financial sub-page (New Zealand):

Customising Bp VIP.net - Screenshot of a Financial sub-page (NZ)

Provider Custom Screens

Sometimes, a clinic would like to record additional information about a provider  – such as an application form, or information about a provider’s history, education or family. All of this and more can be recorded in a customised screen in the provider’s section of the system.

An example of a customer provider screen is displayed below:

Customising Bp VIP.net - Screenshot of a Custom Provider Screen

Organisation Custom Screens

Various organisations that are recorded in the Bp VIP.net system (e.g. hospitals, workover entities, employers or insurance providers) may require the ability to capture multiple entries of contact information, policies, procedures and the like. Customising this section of Bp VIP.net allows users to do this.
 
An example of a customised organisation screen is displayed below:
Customising Bp VIP.net - Screenshot of a Customised Organisation Screen
Customising Bp VIP.net through the editing of custom screens can, at first, appear to be a complex undertaking. However, once you learn the basics, you’ll find that it’s actually quite easy, and the possibilities are endless!
 
Some of our users take particular pride in creating their own designs which they are more than willing to share with others – one such user is the Barossa Eye Clinic in South Australia. We recently featured them in a Bp VIP.net case study.
 
For additional information on how to create UDFs, search for Creating a UDF in the Bp VIP.net Knowledge Base.
 
While the initial customisation of Bp VIP.net for newly deployed clinics is included in the data configuration costs, further customisation for existing clients can be performed by following articles and videos available in the Knowledge Base. Alternatively, customisation can be carried out by Best Practice Software as a paid service.
 
I hope this article has been useful in explaining the wide range of options available when customising Bp VIP.net, and hopefully you’ve already got some ideas on how these customisations can help your Practice.
 
If you’d like to know more, do not hesitate to browse our Knowledge Base for more information, or contact us on 1800 401 111 (Australia), or 0800 401 111 (New Zealand). You can also email us at sales@bpsoftware.net to discuss your options.

Authored by:

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Lucja Nowowiejski
Bp VIP.net Account Specialist at Best Practice Software

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A Discussion With the Talking HealthTech Podcast on Active Ingredient Prescribing

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Talking HealthTech is a large and interactive community of healthcare technology providers for Australian healthcare professionals.

The podcast’s host, Peter Birch, has more than 15 years experience in healthcare technology leadership roles, and began the Talking HealthTech podcast in November 2018 as a personal project born out of his passion for healthcare technology. It has now grown to be his sole endeavour, and he recently recorded his 100th episode. This isn’t the first time Best Practice Software has featured in an episode of the podcast; Peter interviewed Best Practice Software founders, Dr. Frank and Lorraine Pyefinch, for episode 23 in November 2019.

Recently, Peter reached out to Best Practice Software and invited us to take part in an episode discussing the changes to Active Ingredient Prescribing, which began on February 1st – the episode is aptly titled: Active Ingredient Prescribing: The myths, legends and reality.

Featured on the Talking HealthTech episode was a panel comprised of Frank and Lorraine Pyefinch, Clinical Advisor Dr. Fabrina Hossain, and Product Manager Will Durnford.

The episode provided listeners with a wealth of knowledge around what Active Ingredient Prescribing is, how Practices have been affected, the exceptions that exist, and what prompted the change to open the way for this new method of prescribing.

Listen to the Active Ingredient Prescribing episode of Talking HealthTech featuring Best Practice Software using the player below, or check out the full show notes from the episode here.

If you found this episode interesting, you can listen to more episodes at the Talking HealthTech podcast page.

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