How’s Your Billing, Financial Management & Reporting Going?

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With government and regulatory requirements becoming ever more stringent, there is an imperative for meticulous financial communication to prevent costly errors and ensure compliance. By empowering your staff to navigate financial intricacies with confidence and precision, you can ultimately translate that into improved patient care through streamlined administrative functions. It’s becoming critical to make that investment into your practice efficiencies and Best Practice needs to do our part by making sure we have fit for use courses to keep you in the know.

Are you are a Practice Manager who would like to understand more about the various reports available to you in Bp Premier, or a receptionist who has mastered the basics of the appointment book and looking for the next challenge? Even an accountant or bookkeeper who may need to know how to manage practice accounts without needing to use the appointment book would benefit, so join us as we show you how to create all different types of accounts (e.g. bulk billing, private billing, DVA, Workcover, third parties); take you through the full Online Claiming workflow from start to finish; and focus on the various reports available to audit your practice and pay your doctors correctly. Access the experts, have your questions answered.  

Accurate billing produces several key outcomes, including:

  • Reduces Medicare rejections
  • Seeks to enhance patient satisfaction through clear financial communication
  • Supports financial planning by providing insights into revenue streams and expenses
  • Facilitates cost control and informed decision-making
  • Seeks to minimizes human errors
  • Improves integration with other systems
  • Enables effective training and troubleshooting, thus ensuring the smooth and compliant operation of the practice

Please join us for our next session on 19th November 9:00am – 12:00pm (AEST). Click below for more information and to register. 

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The Power of Online Bookings: Increase Patient Satisfaction and Improve Practice Efficiency

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Have you ever woken in the middle of the night with a sore throat or an ear infection? You want to book the next available appointment with your local GP, but their reception doesn’t start taking calls until 8am. A common scenario.

In an increasingly digital world where convenience and accessibility are highly valued, patients are seeking digital solutions to find local healthcare providers and make appointment bookings. An online booking system may be the competitive advantage that your practice needs.

Prior to COVID-19, there was a general opinion that older generations may reject the idea of adapting to smart phone technology. Since COVID, most people have had no choice but to become familiar with QR code check-ins, online vaccine appointment bookings and telehealth appointments. Research undertaken by the Global Centre for Modern Aging in 2020 indicates that since COVID-19, 22% of Australian’s aged 60 and over have had an online consultation with a practitioner and 44% had a phone consult, with strong approval.

Some people expect a self-service option when booking their appointments across every industry, a sentiment shared particularly amongst the younger generation. If you are not providing online scheduling as an option, these patients are going to be more likely to switch to a practice that does.

Let’s explore 5 significant benefits that implementing an online booking solution may provide for your practice:

1.     Convenience is KING

One of the main reasons people appreciate online booking systems is the 24/7 convenience and access to your practice. Being able to make bookings on the go and after-hours is a BIG bonus. It grants the flexibility and freedom for patients to book appointments at any time of the day or night. Gone are the days of listening to hold music and being told that you are the 4th caller in the queue. It also empowers patients to facilitate their own healthcare journey and reschedule their appointments when necessary.

2.     Reduced Wait Times & No-Shows

For the majority of us that have come to expect service on demand, this is a hassle-free tool that simplifies the patient journey and closes the loop on patient scheduling. When patients are able to book appointments online, they can see the available appointment times of their preferred practitioner, and then choose the option that works best for them.

Automated appointment confirmations are a key feature that can significantly reduce the number of missed appointments – especially for those with busy lives or for the ones who just have a habit of forgetting important dates.

3.     Improved Patient Satisfaction

Happy patients, happy practice. A patient’s experience is essential to a successful practice. Online scheduling makes it easier and more convenient for patients to manage their own appointments using the web and smart phones. In the 2021 CommBank GP Insights Report, it was stated that out of the 38% of people who manage appointments though apps or websites, 56% reported that these online booking platforms effectively enhanced their overall experience.  Word of mouth is also important to consider, patients who have a positive and seamless experience with your practice are more likely to return and recommend your practice to their family and friends.

4.     Better Resource Management

Introducing an online booking solution can free up your reception staff, allowing them to focus on the patients presenting in front of them. Improved resource allocation can enable admin staff to focus on more pertinent tasks, rather than answering inbound calls and sending out manual appointment confirmations and reminders. According to an article posted by the RACGP in 2022, 60% of practice owners reported working over 40 hours per week and experience significantly higher levels of discontent with their work hours. This is likely a strong contributing factor to 40% of practice owners who state they find difficulty sustaining a good work-life balance.

5.     Superior Data Handling

Online systems eliminate the need for manual data entry and ensures that patient information is accurate and up to date. More importantly, online systems avoid awkward double-bookings, which usually means someone will end up waiting much longer than anticipated. This has the potential to delay the rest of your existing bookings for the day and inconvenience a lot of people that are short on time. However, awkward moments like this can soon be a thing of the past.

Is an online bookings platform the solution your practice needs? Convenience and accessibility reign supreme when cultivating a practice-patient relationship and online booking systems can significantly help improve overall patient satisfaction. Revising your scheduling system may enhance patient satisfaction, retention, and acquisition. It’s often the first interaction patients have with your practice and as we know, first impressions count.

Authored by:

Olivia Savage
Marketing & Communications Specialist 
at Best Practice Software

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5 Simple Ways Your Practice Can Boost Its Online Presence

These days, attracting new patients and retaining existing patients requires an impactful online presence. Looking awesome online will work wonders towards building a recognisable brand and reputation for your practice.

In the increasingly competitive healthcare industry, simply having a website is not enough – you need to be dotted across the internet to appear where your patients are searching. Patients now expect medical practices to have an online presence for sharing information, scheduling appointments, managing reviews, and interacting with patients. Here are 5 simple ways your practice can boost their online presence.

1. Put Your Practice on the Map with a Listing on Google My Business

You could have the best practice in the world, with no wait times and a free lollipop with every visit, but nobody would know if they couldn’t find you! Visibility is important.

Patients usually search for health professionals in their geographic area, so linking your practice to Google Maps is vital. This ensures that your practice’s name and location appear on the map when someone searches your city and “doctor” (or whatever your specialty might be).

There’s no denying that Google reigns supreme in digital marketing. Google My Business is a practice’s one-stop shop for directory listing optimisation. Subscribers’ business information appears on Search, Maps, Google+, and Google Places. 

And the best part is it’s free! Create a profile with Google My Business to claim your Google Maps listing. After logging in, you can edit your listing’s contact details, opening hours, photos, and description. You will also be able to see reviews that patients post about your practice and respond to them.

2. Never Underestimate the Power of Social Media

Many practices think they only need to post professional, business-relevant content. Realistically, fun content, relatable memes or photos of practice staff will more likely earn you organic and community-focused engagement. 

Aim to regularly post content that people want to ‘like’ or ‘share.’ Each interaction will expose your post to new potential patients. Remember, you’re trying to connect with patients, so your content needs to appeal to people outside the medical profession. 

Information on social media can directly influence a prospective patient’s decision to choose your practice or even a specific doctor.

Activity on your social media pages can influence where your site appears in Google searches. While the exact SEO impact of social activity is difficult to pin down, there are specific ways to increase your online presence through clever social media usage.

3. Doctor Review Websites = Reputation Management

Many people will search for patient reviews before choosing a new healthcare provider. Online reputation can make or break new patient acquisition. The effort you put into acquiring and managing reviews can lead to acquiring and retaining more patients as well as bringing overall business growth to your healthcare practice.

Online reviews help prospective patients understand the provider’s level of patient care, helping them determine which doctors they should select for their healthcare needs. Practices with a solid online reputation can also help curb a patient’s anxiety, providing reassurance that they are to be trusted with their care.

Encouraging patients to leave reviews is essential for boosting your online reputation. Since unhappy patients may be more likely to share their negative experiences while happy patients continue with their days, the simple act of asking patients for a review can help your practice acquire more positive online reviews.

You might discover your practice already exists on online directories, and people may already be talking about you. Doing a search online will help you find these listings and claim them so you can track what’s happening on them, respond to customer queries, and make any necessary updates. This also applies to some social networks such as Facebook, Yelp, and Google My Business, that allow users to create business listings.

4. Get Into Blogging

Another great way to improve your online presence is to create a blog. Publishing blog posts regularly is a great way to improve your search engine ranking. It also sets you apart by showing off your expertise, which increases your patients’ trust in your service. An engaging blog can also help establish yourself as an industry leader. 

When thinking about what to post, focus on content relevant to your audience and related to your area of expertise. You can add value to your content by targeting high-traffic keywords and building links from high-authority websites and credible bloggers. Another way to drive traffic to your blog is by promoting your blog posts on your social channels.

5. Your Practice Website

And finally, the big one – your practice website!

Having a website for your medical practice serves more than one purpose. It is the most concrete and customisable version of your online presence and can supplement how you care for your patients. Your website can be set up to highlight your teams’ areas of expertise and niches, provide patient resources, and streamline the scheduling of patient appointments.

Can your patients book an appointment at 10pm when they feel a sore throat developing? Including an online booking widget on your website will allow you the capture appointment bookings long after your reception staff have signed off for the evening. 

Building a practice website can seem like a big task, but it is well worth it in the long run. You can hire a professional to create your website or do it yourself. 

Whether the patient has recently moved to a new area or is switching practices for other reasons, people will naturally look online to see their options. If your practice does not have a website, you may be missing out on a precious opportunity to attract new patients.

Authored by:

Lucy Saul
Marketing & Communications Specialist at Best Practice Software

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R U OK? DAY 2022

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I was reading a recent interview with seven times world surfing champion Layne Beachley where she recounted a time when her husband, Kirk Pengilly (one of the multi-talented musicians from the uber successful band INXS) asked her that simple little question “R U OK?” (Lambert, 2022).  She described that question as the “absolute circuit breaker” which gave her a safe space to confidently express her feelings of depression.

What’s that you say? Someone with seemingly “everything” isn’t happy all the time?

Each year one in five Australian adults are formally diagnosed with a mental illness – a wide range of conditions defined as a “clinically diagnosable disorder that significantly interferes with a person’s cognitive, emotional or social abilities (COAG, 2017)

To put that into context, in an organization like Best Practice Software with over 250 staff, there could be 50 team members coping with all sorts of issues as a result of mental ill-health.  Anxiety, Depression, Affective Disorders, Substance Abuse etc – all very common, sometimes life-long challenges, but thankfully largely treatable and manageable. 

But while 1 in 5 is the official “diagnosed” statistics, the reality is that EVERYONE will experience some degree of mental illness, stress, unhappiness or negativity during their lifetime.  It is a myth that everyone is happy all the time.

Mental illness and impairment doesn’t carry the “stigma” as it did in the past.  It is just a part of being human. 

The R U OK? Website has a wealth of resources and links to services who can help anyone in distress themselves or concerned about someone they know. 

It provides some guidance on how you can confidently be that “safe space” to someone who is doing it tough.  If you are ready to ask that question – R U OK? – please remember that you are not a therapist – you are just a concerned friend who is prepared to listen without judgement. 

Authored by:

COVID-19 Vaccines Blog Article Lorraine Author Image

Lorraine Pyefinch
Chief Relationship Officer at Best Practice Software

Sources

COAG. (2017). The Fifth National Mental Health and Suicide Prevention Plan. Canberra, ACT, Australia: https://www.mentalhealthcommission.gov.au/Monitoring-and-Reporting/Fifth-Plan.

Lambert, C. (2022, September 7). “Listen up, it helps”. Courier Mail “Smart Daily”, p. 1.

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Prevention is Better Than Cure – My Journey With NCSR Integration

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Contributed by guest author Dana Tse of Campsie Medical Practice in Campsie, NSW.

When it comes to cervical cancer, Australia is fortunate enough to have the lowest mortality rate, and second lowest incidence rate in the world. While these are encouraging statistics, the success of our cervical screening program is heavily dependent upon the recruitment of women.

Higher rates of participation in cervical screening means that more women with precancerous abnormalities can be detected and treated sooner, which is necessary to achieve lower incidence and mortality from cervical cancer.

Cervical Screening Rates In Your Practice

What are the cervical cancer screening rates in your practice? More importantly, how do they compare to other practices in your PHN or the national average?

What, if any, have you found are the limitations in improving screening rates within your practice? Can you articulate the barriers to cervical screening in your practice? Is it perhaps a lack of patient education around the importance of cervical screening? Are there cultural barriers in place?

Is Preventative Healthcare Part of Your Practice's Workflow?

Nationally, cervical cancer rates are declining. Some drivers behind this include the widely available HPV vaccination, the option for cervical cancer screening self-collection, and the initiative to offer cervical screenings every 5 years. However, even with all the above, our national rate of screening is less than 50%; and I tend to be a glass half empty sort of person!

At our practice in Campsie, less than half of our female population were involved in cervical screening. We averaged approximately 30% for our PHN, compared to the national average of around 40%.

So naturally the question came to mind – what were some of the barriers that our women patients were facing? We decided to embark on a quality improvement activity with NPS MedicineWise Learning to ascertain how we could improve these rates.

The most welcomed upgrade and recently added feature in Bp Premier Saffron was the NCSR integration – or National Cancer Screening Register. Instead of having our nurses call and be on hold with the NCSR, we can now readily access information through Bp Premier. In fact, we’re able to do everything related to cervical screening directly within Bp Premier; from the utilities function, to searching the NCSR hub for most recent screening dates, results and even to check when women were next due, or if they were overdue and required a recall.

We could finally update our database to reflect our true cervical screening rates and actively recall women who were due for screening. This was particularly important post-lockdowns, where ‘less important’ things like screening may not have been front of mind. I believe our cervical screenings rates are now higher than before, due to information previously being missing, incomplete or out of date.

Bp Software provides several SQL queries that have proven useful for us in accomplishing this task.

NCSR Integration - Where To From Here?

Quality improvement is something that exists on a timeline. It can’t be set and forget. As for our practice’s approach:

  • We plan to revisit our cervical screening every 6 months to capture any data that is missing
  • We plan to include cancer screening records for all new patients when they meet with our nurses
  • We would like to tackle bowel screening rates
  • We look forward to the NCSR integration with Breast Screen
  • We would like to see NCSR reminders in Bp Premier generated as a list, without having to enter the reminders ourselves

We are fortunate and privileged to live in a country that offers free screening for prevention of these cancers, most of which have great treatments if identified early.

As the adage goes; prevention is better than cure.

Authored by:

NCSR Integration Article Author Blog Image

Dana Tse
Practice Manager at Campsie Medical Practice

Dana has previously contributed an article to the Bp Newsroom on Effective Practice Management.

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

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

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

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

Technology Enablers

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

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

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

The Added Value of Interoperability

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

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

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

The Added Value of AI

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

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

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

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

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

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

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

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

Establishing Trust for Providers and Consumers - Guidance for Developers

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

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

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

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

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

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

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

Co-authored by:

New Generation of Practice Management Systems Author Headshots

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

Footnote

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

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Vaccine Hesitancy – Navigating the Three Cs

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This article was contributed by guest author Tracey Johnson.

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

What We Know About Vaccine Hesitancy

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

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

vaccine hesitancy venn diagram

Complacency

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

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

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

Confidence

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

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

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

vaccine hesitancy quote Tracey Johnson

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

Convenience

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

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

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

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

Remain Positive - Remain Committed

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

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

Language Is Your Ally

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

Vaccine hesitancy tracey johnson quote 2

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

Looking Ahead

In the future, will vaccination rates remain high? 

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

Authored by:

Tracey Johnson Blog Author Image

Tracey Johnson
CEO at Inala Primary Care

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

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COVID-19 Vaccines and Pandemic Planning – A Retrospective

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

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

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

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

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

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

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

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

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

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

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

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

Lorraine Quote Covid-19 Vaccine article

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

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

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

Authored by:

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Lorraine Pyefinch
Chief Relationship Officer at Best Practice Software

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Australia’s ePrescribing Rollout: Lessons Learned

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Contributed by guest author, Tracey Johnson.

It’s been a little over a year since Australia fast tracked its ePrescribing rollout.

Paper referrals, paper scripts, sending faxes between providers…these are all so yesterday!  The Australian Digital Health Agency (ADHA), in collaboration with many stakeholders, spent the last few years designing new, paperless and portable solutions which will make medicine use safer and more transparent.

A core component of this effort was the ePrescribing rollout.  For once, Covid-19 was our friend, accelerating plans for launch to accompany the introduction of telehealth.  Each state Health Department legislated ePrescriptions and the e-tokens behind them as a recognised form of accessing medication in June and July of 2020.  Inala Primary Care saw our first patient use an e-script on the 5th of August, just a few days after ePrescriptions were legal in Queensland.  So twelve months on, what are our reflections on the ePrescribing rollout?

ePrescriptions were one of the simpler workflow changes our doctors made in the last 12 months.  Best Practice Software consulted with our team on the early design of the interface.  The click through options are intuitive and easy to navigate.  Since we launched ePrescriptions we have had four new doctors join our team.  Each has simply received an introduction to ePrescriptions within their orientation to Bp Premier, so no additional induction was required.

Twelve months ago the scenario was very different.  We circulated the fact sheets produced by the ADHA and gave our doctors a patient visit as admin time to read the information.  This occurred in advance of two lunchtime sessions we ran outlining the ePrescription process.  We used videos produced by the ADHA and Best Practice Software to show doctors where ePrescriptions fit within the digital health agenda, and how Bp Premier had been adapted for the ePrescribing rollout. 

In preparation, we spent some weeks liaising with pharmacies nearby.  We were very disappointed by their awareness of ePrescriptions.  The region had been identified as a Community of Interest by the ADHA and additional resources invested in pharmacy readiness in the months prior to launch.  Two of the independent pharmacies were ready and worked with us to test the system.  More than half the pharmacies frequented by our patients took more than two months to get organised.  Within four months all were finally on board!

There were just a couple of issues our end.  Our NASH certificate was coming to an end and had to be updated just as we were about to launch.  We also found the lack of a patient information campaign by the government meant our doctors had to take time to explain the system to each of their patients.  Once information was provided, patients were usually happy to embrace ePrescriptions, even those on S-8 Medications. 

Moving patients from paper scripts to an Active Script List (ASL) is a bigger exercise.  ASL consolidates multiple medications into one list removing the need for multiple tokens associated with the issuing of each script.  It will benefit doctors as they can see what a patient has had dispensed and when.  The patient needs to engage their pharmacist to set up ASL.  Once in place, patients can give consent to any pharmacist to access their ASL to dispense medications.

We still have a large group of older patients who prefer either a printed QR code or a traditional printed script to take to their pharmacy.  They have not used ePrescriptions to engage with e-delivery when lockdowns occur, even with several local pharmacies offering a home delivery service.  Some lack smart phones and confidence in using them.  To address that, we ran a morning tea for a group of our patients aged 65 years and over, and showed them how the system worked.  It helped to boost some confidence.  Others were happy for the outing but have still asked for scripts to be left with reception for collection – even during lockdowns!  Change takes time.

For family members managing the medications of parents, children and loved ones, ePrescriptions have been popular.  It saves holding many pieces of paper and makes dispensing anywhere so much easier.  E-reminders when the next script is due have also been praised.  ePrescriptions will hopefully encourage more patients to build a relationship with a pharmacy.  This should mean better access to education, active monitoring of what they are taking and education about drug interactions.

We have noticed interest in ePrescriptions wax and wane in line with Covid-19 outbreaks.  Over time and with more government and pharmacy education about the benefits, we believe ePrescriptions will be widely embraced.  This will vastly improve the accuracy of dispensing, GP knowledge of medications in use and how compliant patients are with taking medications.  Less time stocking rooms with script paper will be a very welcome outcome of the new world!  We believe medication safety is everyone’s business. ePrescriptions add to our toolkit, and in Covid-19 times have been a boon in terms of keeping our team safe and streamlining workflows.

Best Practice Software’s Training team have developed a comprehensive list of resources which were made available during the ePrescribing rollout, which you can explore here.

Authored by:

Tracey Johnson ePrescribing Rollout Author Image

Tracey Johnson
CEO at Inala Primary Care

Tracey Johnson is CEO of Inala Primary Care, a large general practice serving Queensland’s poorest suburb located in Brisbane’s west.  The practice has a history of digital innovation uploading the first record to the My Health Record system and more recently co-founding Cubiko, a practice dashboard solution which delivers insights to practice teams each day.

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R U OK? Day 2021 – A Reflection on Mental Health

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Each year R U OK? Day reminds us to stay connected, have meaningful conversations and encourage more people to ask R U OK? at work, school and in the community. The website includes suggestions for simple steps that could save a life:

  1. Ask
  2. Listen
  3. Encourage action
  4. Check in

There are conversations tips, videos of how to ask and resources including how to find professional help if needed if the conversation becomes too big for family and friends.

Lifeline provides a directory of free or low cost health and community services available in Australia for areas such as domestic violence, family and children’s services, financial assistance and mental health services at lifeline.serviceseeker.com.au

The BeyondNow suicide safety plan app helps create a safety plan in crisis and distress for those in need, ideally with support us, as health professionals, or someone they trust, to work through when they are experiencing suicidal thoughts, feelings, distress or crisis. The app is available to download and to read further about the app, see beyondblue.org.au

moodGYM is an online self-help program that has been available since 2001, using cognitive behaviour training to develop skills to manage depression and anxiety symptoms. The program allows real-time self monitoring of problem moods, thoughts and behaviours via mobile phone or computer. Those using the programme monitor three symptoms of their choice or three recommended to them by myCompass through answering the profiling questionnaire ( eg stress, depression, confidence, worry, irritability, motivation, diet and medication use) See moodgym.com.au

myCompass is a self-help tool for mental health, providing proven techniques to help manage stress, anxiety and depression.

Here are some of the agencies that offer good support to those in need:

  • Lifeline, 1311 14 for 24/7 crisis support, the Suicide Call Back at 1300 659 467
  • kidshelpline at 1800 55 1800 for counselling to young people under 25 years
  • Griefline on 1300 845 745

Authored by Dr Lisa Surman

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