Telehealth Consultations 2.0 – Going Beyond Phone and Video

What is Telehealth | Blog Image Peter Birch from TalkingHealthTech

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

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

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

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

Phone-and-Video-Symbols

Healthcare 2.0: Remote Patient Monitoring, AI and Asynchronous Communication

 

I think there’s way more to it…

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

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

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

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

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

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

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

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

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

1. Using Wearables to Collect and Transmit Data

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

2. Using Artificial Intelligence for Decision Support and Triage

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

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

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

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

3. Utilising Technologies That Are Securely Integrated

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

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

4. Engaging With Patients Via Asynchronous Communication 

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

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

Some of the benefits of asynchronous communication in healthcare include:

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

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

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

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

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

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

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

Atrial Fibrillation Self Screening Blog Article Image

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.

Cybersecurity Best Practices – Keeping Your Data and Systems Safe

Cybersecurity | Password protection

Cybersecurity is the practice of defending servers, computers, mobile devices, networks, and data from malicious attacks. Cyber threats continue to evolve at a fast pace, with a rising number of data breaches each year. In fact, according to the Australian Cyber Security Centre’s Annual Cyber Threat Report from 2020, between the 1st of July 2019 and 30th of June 2020, the ACSC responded to approximately 164 cybercrime reports per day. That’s roughly one every 10 minutes.

Historically, medical Practices and public entities experience the most breaches. These sectors are more appealing to hackers because they regularly collect lots of personal information, financial records and medical data.

Following simple but effective cybersecurity best practices can ensure your data is safe from unauthorised access.

Different Types of Cybersecurity Threats

There are a wide range of methods that hackers can use to illegitimately gain access to your Practice’s information. Listed below are some of the more common methods which you may have heard of.

  • Ransomware – Ransomware is a type of malicious software designed to hold files or data ‘hostage’. Once a Practice’s computer system has been compromised, patient files are inaccessible until a ransom is paid. Paying the ransom does not guarantee that the data will be recovered.
  • Phishing – This is the practice of sending fraudulent emails that resemble emails from reputable sources. Phishing attacks often target individuals with emails that look like they’re from your bank or financial institution. The aim is to steal sensitive data like credit card numbers or account login information. It is the most common type of cyber-attack.
  • Social Engineering – Social engineering is a tactic that hackers use to trick you into thinking you’re speaking to a representative from a legitimate organisation, and then getting you to reveal sensitive information. Social engineering is often combined with the methods listed above to make you more likely to click on a link or hand over sensitive data.

IT Security Tips for Practices

The first thing you can do is establish a security culture within your Practice.

The weakest link in any computer system is the user. Protecting patient data through good security practices should be second nature, similar to the Practice’s sanitary measures. Ensuring that your staff are familiar with your cybersecurity measures and how to identify a cyber threat makes your Practice more secure.

Keep Your Practice Software Updated

Taking your entire system offline to perform software updates is a daunting prospect.

However, neglecting to get the latest version of your software leaves devices significantly more vulnerable to attack. Furthermore, any security patches that come with an update will be unavailable to you. Hackers will take advantage of complacency and can remain undetected in an out-of-date system far easier than in systems with the latest software updates.

Maintain Secure Access to Patient Data

You may have seen media reports of victims whose private information was stolen by hackers. Failing to keep your patient data secure can be catastrophic. Hackers can use data from your patient records to commit identity theft and access patient bank accounts.

It is important to control access to patient records and only allow authorised personnel to have access to their details. Have a system in place to audit your system, and regularly verify who accessed which patient records, and when. It’s also important to promptly remove system access from staff who have resigned, or have been terminated.

Computer System Maintenance

Over time, operating systems tends to accumulate and catalogue old information and redundant data unless regular maintenance is performed. Just as your medical supplies must be monitored for expiration dates, material that is out of date on a computer system must be discarded or archived.

Some things you can do to ensure you’re following cybersecurity best practices with regards to computer maintenance are:

  • Ensuring user accounts for former employees are disabled.
  • Computers and other storage devices that have had data stored on them are sanitized before disposal.
  • Old data files are archived for storage, or cleaned off the system if not needed, subject to data retention requirements.
  • Software that is no longer required is removed from the computer, this includes trial software and any outdated versions of software.

Installation and Updating of Anti-Virus Software

A common way that hackers can access a computer system in a medical Practice is through viruses or malicious software (malware). In addition, computers can become infected by seemingly innocent sources such as email links, USB drives, and web browser downloads. It is important to use a product that provides continuously updated protection, and ensure your staff know how to recognise when your anti-virus has detected something suspicious.

Controlling Access to Patient Information

Familiarise yourself with role-based access permissions, where a staff member’s role within your Practice (e.g., doctor, practice manager, nurse) determines what information they have access to. Care must be taken to assign staff to the correct role within your Practice. Having well structured role-based permissions ensures that your staff can only access what they’re supposed to, which ultimately improves your Practice’s IT security.

Create Strong Passwords and Change Them Regularly

Passwords are often the first line of defense against unauthorised access to your Practice’s computer systems. Although strong passwords will not prevent attackers from trying to gain access to your network, it can slow them down and even discourage them altogether.

Using easy-to-guess passwords or sharing passwords between applications and logins significantly increases your Practice’s risk and vulnerability. Using the same password for multiple logins presents an incredibly high risk. If a hacker gains access to one account, they gain access to all of them. This can have a devastating flow on effect, not just for your Practice, but your staff’s personal lives as well.

Your staff should be aware that legitimate organisations will never ask for their password over email or messaging service. For maximum password security, employ the use of a reputable password storage system.

Strong passwords are ones that are not easily guessed. Hackers will use automated methods to try to guess a password, and so it is important to choose a password that does not have characteristics that could make it vulnerable.

Strong passwords should not include:

  • Words found in the dictionary.
  • Personal information such as birth date, your name, or pets’ names.

Some examples of strong password characteristics:

  • At least eight characters in length.
  • A combination of upper case and lower-case letters, one number, and at least one special character, such as a punctuation mark.

For many Practices, consistently reviewing and updating IT security measures can sometimes feel a little tedious. However, training your Practice in strong IT security habits is essential when it comes to protecting sensitive patient data.

While it may not be practical to enact all of the above cybersecurity best practices all at once, each of them can be implemented incrementally, and each of them will secure your Practice’s systems as you institute them.

Authored by:

cybersecurity best practices michael porter avatar

Michael Porter
Analyst & Developer at Best Practice Software

2020 Mental Health | COVID-19 – A Year In Review

Mental Health 2020 Blog Article Image

Our mental health is something that we’re all aware of, but far too often we don’t do enough to look after it. Mental health during COVID-19 has been something that deserves far more attention than many of us have given it.

If someone asked you to list five words that described how you feel about the year 2020, what would you say? How different would they be, compared to describing your feelings about previous years? Maybe you cannot settle on five words, you keep swapping out one for another as you go through the extent of what has occurred this year.

Twelve months ago, Australia was in the midst of fighting the most extensive bushfires in recent times, colloquially known as Black Summer. The expanse of devastation and death of one billion wildlife animals generated worldwide support and acknowledgement. Australians and International supporters rallied to raise money to assist those affected by the bushfires and frontline firefighters were the heroes of our nation.  The resilient Australian spirit kicked in and individuals, families and communities faced the mammoth task of rebuilding and hoping to return to a normal life. Towards the end of the bushfires, storms and flooding affected some parts of NSW, which was a relief for those suffering from some of the still-burning fires, but introduced more stress for communities that were already exhausted by the bushfire crisis.

Within a month of the flooding and weeks of the final fires being extinguished, the World Health Organisation declared COVID-19 a global pandemic, and Australia began shutdown measures. Australians began living under strict lockdown rules and restrictions that have not been experienced in more than a century.  International travel to and from Australia was limited with many people still trapped overseas. People were afraid of being locked in their homes without food and supplies so supermarket shelves were stripped bare due to panic-buying.  Non-essential services were closed which led to economic and social stress; this saw the cessation of all forms of entertainment, sport, pubs, cinemas, and houses of worship.

Travel within Australia was restricted by internal domestic border controls which caused distress and further strain on mental health during COVID-19 for people separated from their family and friends. Businesses were encouraged to work remotely where possible, and online commerce escalated. Schools were closed and all students were introduced to eLearning which suited some but caused many students and families additional stress. Frontline health care workers became the new heroes of our nation, while acknowledging the efforts of everyone involved in essential services such as emergency personnel, teachers, food supply chain personnel, and cleaning services.

Healthcare organisations and aged care residences restricted entry to visitors, so much so that children could not visit patients, family could not visit their elderly family and women who had birthed were not allowed visitors, including the other parent of the newborn. Not only did these restrictions heighten the strain on mental health already being felt by those affected, but people were also afraid to go to healthcare organisations, in case they became infected themselves.

The Psychological Consequences on Mental Health during COVID-19

The following emotions and numerous others may be experienced by people during the COVID19 outbreak: anger, annoyance, anxiety, confusion, depression, distress, distrust, fear, frustration, helplessness, hopelessness, isolation, loneliness, panic, sadness, uncertainty, and worry.

  • People:
    • In affected communities following the Black Summer bushfires were in a heightened state of anxiety and struggled with additional uncertainty, and were prone to more stresses on mental health during COVID-19.
    • Are afraid of infection, either getting themselves sick or infecting others, especially the elderly and vulnerable.
    • Worry about not having enough information, or being given the wrong information, therefore high quality, factual information should be accessed from a trusted source.
    • Experience a variety of stressors, such as financial stress from losing or having reduced employment or retirees’ superannuation funds decreasing; limited social contact leads to feeling isolated, lonely, and not socially connected.
    • Who are isolated or quarantined, including the elderly and vulnerable population, feel combinations of any of the emotions, particularly depressed, confusion, frustration, anger, boredom, lonely and become worried about having inadequate supplies.
    • Those with pre-existing anxiety disorders, depression, post-traumatic stress or health anxiety are at risk of experiencing higher anxiety levels and poorer mental health during COVID19, and may require additional psychological support during this time.
  • Health care workers have experienced increased anxiety and can feel overwhelmed due to possible direct contact with affected patients, lack of personal protective equipment, increased workload, and changing their care delivery from in-person to telehealth.
  • Students impacted by changing to and from online learning, as well as individuals working remotely from home can experience distress, anxiety, frustration, uncertainty, confusion, worry and become depressed.
  • Families have faced numerous challenges including working remotely while supervising children and students, being geographically separated, or denied contact with elderly family members. Family events have been impacted such as weddings being postponed and being unable to attend funerals. Family and domestic violence, and child abuse has escalated due to increased household tension, cabin fever, isolation, increased alcohol consumption, and stress. The pandemic is another barrier for people who are exiting abusive relationships, where women and children are forced to remain in violent and unsafe homes.

Think back to those five feelings of 2020 that you identified earlier, and which would you swap out regarding your hopes of 2021? Have you replaced distress with acceptance; fear with determination; isolation with feeling connected; fear with hope; or are you stuck and not optimistic about the future?

Looking After Yourself and Coping With the Rest of 2020

1. Look after yourself physically and mentally
After a year of challenges and uncertainty as to when the pandemic will end, current life in Australia is the new normal. At any time, restrictions and health directions may be lifted or imposed so here are some practical things that you can do to help your mood and reduce stress levels. You’ll cope better if you place importance on getting quality sleep, eating healthy, exercising daily, attending to physical health issues, having regular periods of relaxation, ensuring regular self-care and reducing alcohol consumption.

2. Live in the present
The uncertainty of the future and concerns whether life will return to pre-COVID normal, can cause varying levels of distress. Focusing on living in the present and taking each day as it comes will reduce the distress about the future and increase appreciation for current activities.

A simple mindfulness exercise is to notice what you are experiencing right now, whether it is doing a task or doing nothing, and using all of your five senses: sound, sight, touch, taste, and smell.

Take a few slow breaths and ask yourself:

What can I hear? (for example, clock on the wall, car going by, music in the next room, my breath)

What can I see? (for example, this table, that sign, that person walking by)

What can I feel? (for example, the chair under me, the floor under my feet, my phone in my pocket)

What can I smell? (for example, flowers in the room, air freshener, the soap on my hands)

What can I taste? (for example, my tea, a cracker, a grape, nothing)

Think of these answers to yourself slowly, one sense at a time and you will be mindfully present.

3. Allow yourself to grieve for what has been lost or what you wish you had
Border closures, restrictions on gatherings and physical distancing requirements mean a lack of freedoms that we took for granted pre-COVID. For many, this means separation from family and friends, an inability to travel, being unable to celebrate events how you would like, and feel lonely, isolated and disconnected.  It is normal to feel sad during this time as grieving for the loss of something or someone confirms that it, or they, are important to you.

4. Be flexible and creative
This year the Christmas and holiday period will not be the same as previous years due to COVID restrictions. At any time, restrictions and new health directions are enacted so expectations need to be flexible, which may be difficult to accept. Identify what is the most significant aspect of this time or event and find a way to maintain it. This might require some creative problem-solving such as moving an event outside, have multiple smaller gatherings or include a digital option.

Everyone has been affected by the challenges of 2020, either directly or indirectly, so people need to acknowledge that everyone is feeling a degree of stress. It is important to not expect too much and be kind to yourself, also, think about what you value in life. Be kind and tolerant of others as you do not know how they have been affected by this year. If you maintain good physical and mental health during COVID-19, and accept the future for what is, the resilient Australian spirit will cope with adversity.

If at any point you feel overwhelmed and unable to cope, please contact Lifeline (13 11 14), Beyond Blue (1300 22 4636), your local GP, or a mental health professional for support and assistance.

Authored by:

Gina Clement Avatar Picture

Gina Clement (MProfPsych, MMid, BNsgInform, DipHlthSc(Nsg)
Provisional Psychologist and Product Manager at Best Practice Software

Active Areas of Implementation for ePrescribing

ADHA Active Implementation Areas ePrescribing

UPDATE: Please note as of January 2020, all Practices can begin using ePrescribing. ePrescribing has been turned on by default with our latest release, Saffron.

In partnership with the Australian Digital Health Agency (ADHA), Best Practice Software has been gradually rolling out Active Areas of Implementation for ePrescribing since August.

The table below provides a comprehensive list of all suburbs that have been deemed Active Implementation Areas for ePrescribing by the ADHA, as of 15 October.

This means that Practices within these areas are able to download the ePrescribing Utility File from our download page  and begin using eScripts within your Practice.

Active Areas of Implementation for ePrescribing

ion Region Definition of Active Geography Population
 Victoria n/a  All of Victoria  6,460,675 
Australian Capital Territory n/a  All of ACT  420,960 
New South Wales Armidale  The Armidale Regional Local Government Area  29,059
Newcastle  The suburb of Mayfield in Northern Newcastle  9,314
South Coast

The suburbs of: Bomaderry, North Nowra, Nowra, South Nowra, Terara and West Nowra. The suburb of Moss Vale & The Municipality of Kiama. 

 21,209
 Sydney The LGAs of: Bayside, Blacktown, Burwood, Camden, Campbelltown, Canada Bay, Canterbury-Bankstown, Cumberland, Fairfield, Georges River, Hornsby, Hunters Hill, Inner West,
Ku-ring-gai, Lane Cove, Liverpool, Mosman, North Sydney, Northern Beaches, Parramatta, Penrith, Randwick, Ryde, Strathfield, Sutherland Shire, Sydney, The Hills Shire, Waverley, Willoughby, Woollahra.
 4,574,994
 Queensland Central Highlands The Central Highlands Regional Local Government Area  29,650
 Brisbane  The suburbs of Camp Hill and Inala  31,669
 Bundaberg  The suburb of Bargara  7,485
Central Highlands The Central Highlands Regional Local Government Area 29,650
Brisbane The suburbs of Camp Hill and Inala 31,669
Bundaberg The suburb of Bargara 7,485
Townsille The suburb of Garbutt, Rowes Bay and Belgian Gardens 7,107
Hervey Bay and Marborough The postcodes of 4655, 4650, 4662 and 4659 79,355
 Townsville The suburbs of Garbutt, Rowes Bay and Belgian Gardens  7,107
South Australia  N/A  All of South Australia  73,836
Western Australia Metro Perth  The suburbs of Port Kennedy and Woodlands  17,922
Country WA The Kalgoorlie/Boulder Local Government Area and the Shire of Denmark  35,904
 Tasmania  Northern Tasmania The Central Coast,
Launceston and Devonport Local Government Areas
 81,974
Northern Territory Northern NT Palmerston City  33,695

Work From Home Arrangements: How to Effectively Manage Your Practice Team

Working From Home Arrangement Blog Image

You may never have contemplated work from home arrangements until 2020 – and all its challenges – arrived and interrupted our lives.  Businesses like ours – whether it be medical practice, allied health providers, medical specialists, or those businesses (like Best Practice Software) who support these medical professionals – haven’t traditionally embraced work from home options, but many are now exploring its benefits.  Well before the COVID-19 pandemic, though, members of the Best Practice team were well rehearsed to effectively work from home and prepared for a quick and seamless transition when it was no longer an option but a business requirement.

If you’re planning to shift your Practice team to work from home arrangements – due to responsible COVID-19 response planning, or for any other reason – you might find it helpful to have a simple, clear, and documented approach to how and why your team can shift to home-based work. I preface this with my opinion that good policy is not designed to help you find a way to say ‘no’ – instead, it’s there to help you protect your business by managing your risk so you can (responsibly) say ‘yes’ more often.

Here are five quick policy ideas to support a successful transition to work from home arrangements: 

  1. Acknowledge which roles are suited, and which are not.
    Your policy might identify that some patient-facing, team/product/project-leading, clinical, and executive roles are not suited to work from home arrangements due to the nature of the duties and the need to participate within, and contribute to, the clinic/work environment. But it should identify your process in assessing the nature of the work to be undertaken, the role priorities and required project outputs, the likely effects on work teams, patients, customers, product, and support services, and the skills/abilities of the employee to support a successful work from home arrangement. 
  1. Ensure a review of the suitability of the home-base environment.
    Your policy should identify that the home-base is an extension of work, and your process should enable the employee to self-assess and submit (for your approval) a documented review of the appropriateness of their home office – ensuring it’s a safe, healthy, and productive work environment. Provide your employees with a checklist of minimum requirements, including a dedicated private workspace, appropriate chair, minimum internet speed, safe environment free from trip and electrical hazards, etc. This is not an administrative or record-keeping exercise – but a way to extend your sensible business approach to employee health, safety, and wellbeing. 
  1. Outline the expectations and responsibilities of the home-based employee. 
    Working from home responsibly requires both parties cooperating fully, and your policy should identify the responsibilities of the employee to make this arrangement work. I believe it all starts with good communication. Clearly outline your requirements for regular (preferably sunrise/sunset) briefings, forward work plans, escalation protocols, and mechanisms to support productivity and accountability, and your expectation that people regularly engage with their leader on important work matters. Ensure your people understand your expectations on the submission of project updates and timesheets, and their connectivity to your network, and their availability for your patient/customer/vendor enquiries, and for active participation in regular team meetings. 
  1. … but also outline your responsibilities as a sensible employer. 
    That two-way commitment to making working from home a success also means your policy should outline the appropriate business and connectivity tools you’ll provide the home-based worker, including the minimum standard PC and peripherals, hardware, software, and network connectivity according to the role type. You should also outline your approach to reimbursing reasonable employee expenses incurred in the arrangement – for instance, whether you’ll reimburse internet service fees and data use. Also consider how you’ll support their printing, copying, and shredding costs, and your expectations on minimum home contents insurance to cover your PC equipment. 
  1. Protect your existing security, privacy, and data protection commitments. 
    If you already adopt a strict security, privacy, and data protection approach across your Practice/business (which you should), I’d ensure you extend this approach to approved home-bases. That is, your policy should apply your data privacy principles which might govern steps to protect records of a restricted, sensitive, proprietary, or confidential nature to extend to the home office, and outline your requirement that PC equipment has an activated firewall and anti-virus definitions up to date before leaving your building, and sensitive records are kept locked and protected if away from the office. It’s a good idea to also stipulate that any breaches of your security, privacy, and data protection policies and procedures should be reported/escalated immediately to ensure appropriate business response.

Above all, I believe that effective work from home arrangements are based on mutual trust between employer and employee, and good communication. However, if you’re questioning whether an employee will be productive while working from home, you probably need to question whether they’re just as productive while at work and sitting outside your office.

You’re very welcome to connect with or follow me at https://www.linkedin.com/in/craigahodges/, where I share my insights on organisational governance, leadership, engagement, and business strategy.

Authored by:

Craig Hodges
Chief Corporate Officer at Best Practice Software

Putting the Puzzle Together – The Role of a Product Manager in Software Development

Blog Header Image - Shar

I often get asked what it is that I do for a living. Ordinarily, when I answer that I’m a Product Manager, most people give me a blank look – and I realise that I need to explain the role of a Product Manager – who we are, and what we do.

Product Management is an essential part of the software development process. While we might not be the captains of the ship, we have a hand in the steering of it. If you like puzzles and solving problems, then it’s possible that Product Management is a role you may enjoy.

Most of the time, I find myself trying to figure out how to get the puzzle pieces to fit together to create a viable release. Some days I feel like I am trying to squeeze that last item into the back of the car before a road trip.

Product Manager Car Stack
It can feel a bit like this sometimes.

We are the touch-point between the Commercial, Support and Development teams in our business.  We are listening out for industry news, looking forward to where we can take our product next. We are listening to our customers, looking to see what you need and what we might be able to do to make your working day easier.  Maybe there is a pain point in the software that needs some love. We’re constantly looking to find out if there something new in the marketplace that our users would like to see in our software, or if we can introduce something new to the market.

My favourite part of this job is solving a pain point for our Practice users and making a workflow easier for them to use. We take that pain point and see what is missing, or what we have that can be enhanced to improve outcomes.

Product and Feature Requests

Reviewing enhancement requests that our users send through is another significant part of my role.  On average, I receive 3-5 requests daily for feature enhancements, or for totally new features. Of these requests, some are straightforward, and it is clear as to what the user wants to achieve.  Other times, I know our software does what the user is asking for, so I assist by explaining the process.  Depending on the request, I might organise to speak with a Practice directly to better understand the issue.

Each enhancement request is reviewed by a wider team to see if the work is viable, and to determine how beneficial it would be to our user-base. At this point, the ticket is either accepted, and the feature is added to an upcoming release, or it may be rejected. It might also be bundled with a number of other similar requests to help enhance a feature overall.

From here, I organise meetings with the Development team and break the requested feature down into smaller, more bite-sized tasks.  The Development team look at it and figure out what needs to be done, and how long it will take to do it.

Then I start to arrange the puzzle pieces and work out which features are going to be included in an upcoming release.  A release is generally made up of a number of features – some requested by our users, others driven by government.  They can be time-critical, where we are required to build a feature to a deadline.  They also can be driven by environmental factors – like the current COVID-19 pandemic.

The challenge, then, is to work out the priorities of those items within the release. These are aligned with the following areas of our business:

Product Manager Graphic

I then do some more planning, and then just for something different, I plan some more.

Our development team then take the reins, and they work off the priorities set by the Product Manager.  The work is organised into two-week blocks that we call sprints.  We have a daily stand up meeting to touch base, update the team and look at any immediate priorities that have come up in the interim. There can be any number of sprints in a release.  Historically, we have had larger releases, but we are currently aiming to re-focus on shorter releases.

The Testing Cycle

Once we reach the end of the development period, we send a build out to a group of practices who install it in their Practice and put it through its paces in a live environment. They will let us know if any issues arise from the build.  We call this the Beta cycle.

This cycle can be short or quite extensive, depending on how many issues are identified in the beta build of the release. As we fix each bug in a build, we push a new beta build out to Practices until we’re confident that the release is functioning without issue.

The last stage before public release is to produce what is known as a Release Candidate (or RC for short). The RC process is generally quicker, as by this stage we hope to have all major kinks ironed out. This build is then a candidate for release.

While this is all happening, we are working with other teams within the business to make sure that our internal team is trained in any new features, our marketing for the release is on track, our sales and support teams are ready and our training is organised and documentation prepared.  The role of a Product Manager involves a lot of puzzle pieces.

I keep the team updated on the progress of our Beta/RC builds so that everyone is aware of when a release is scheduled.  Even with the best laid plans, I still need to juggle what makes it into the finished products. I need to balance time and resources to determine what can reasonably be included.  Sometimes, a feature might be more complex to implement than initially thought; other times we’ll have priorities change at very short notice – meaning we may have to bump a feature into our next build.

While this is all happening, I’m constantly looking forward to the next 3-6 months to see what is coming up and what needs to be planned for future releases.

So, what’s the takeaways from all of this?

To fill the role of a Product Manager, you need to be able to balance many different requirements, and be acutely aware of your users to ensure you’re providing them with a product that they are happy to use.  The role of a Product Manager is a challenge, but if you’re cut out for it, a challenge well worth the effort.

Authored by:

Shar Trewben
Product Manager at Best Practice Software

Software Updates: Debunking Myths and Concerns

Debunking Software Myths

As a support team, we understand many of the challenges faced by Practices in order to keep current with software updates. In fact, at time of writing, only 36.4% of Bp Premier customers are running on Jade SP2, the latest version of the software.

All too often we hear similar reasoning as to why Practices aren’t taking the important step of updating their software. Today we’ll go through a few of the common myths and concerns we get surrounding updating Bp software, and provide some insight into why they may not always be correct.

Myth: Software Upgrades Cost Money!

While occasionally true in rare instances, such as a Practice needing an IT professional to assist with an upgrade, the majority of users should be capable of installing an update with the assistance of a simple upgrade document which is available on our Knowledge Base. Our software updates also come at no cost to your Practice – they are completely free!

Most of the time, the only thing an update requires is a bit of patience, and the following of a step-by-step guide.

Myth: An Update Isn’t a Priority – It Can Wait for a While.

Again, this is true in some cases but it’s important to make an informed decision. By regularly reviewing the Release Notes available on our Knowledge Base, you’ll be able to identify the features, fixes or regulatory changes which may positively benefit your Practice. It’s important to note minor issues may not be listed in our release notes.

Leaving or not prioritising updates can end up burning more time in a variety of ways. You may miss out on things like Medicare adjustments, bug management or new features and functionality. The best course of action is to stay up to date and have the latest drug update installed.

Myth: Only Need to Patch My Software Once.

Patching occurs in a combination of data updates and product updates, and is the fluid process of updating ever-changing security and regulatory requirements, in addition to bug fixes. We suggest patching as often as possible to ensure your system has the latest features, information and fixes.

Myth: It’s Only a Small Update, So It’s No Big Deal If I Miss It.

Small or large, all updates should be reviewed to see how they may benefit your Practice. Remember that an update may look small, but could make a meaningful difference to the day to day functioning of your Practice.

A good example of this is our upcoming Jade SP3 update. While Service Pack (SP) updates are typically fairly small, SP3 includes ePrescribing functionality, which is anything but minor! If you were to dismiss SP3 as ‘only a small update’, you’d be missing out on this crucial functionality.

Myth: Nobody is Available to Help Me Upgrade!

Best Practice Software offers a variety of update documentation on our Knowledge Base. For any additional update queries, our Support team is here to help.

We have 53 Support Specialists spread across three locations that are ready and willing to assist you with updating your software, or to help resolve any issues you encounter along the way. On average, our Support Specialists answer 8,759 enquiries each month, so you’re in very capable hands!

You can contact our Support teams by calling us at 1800 401 111 or emailing support@bpsoftware.net.

What is Sunsetting?

Best Practice Software regularly provides new releases of our software. These new releases include mandated regulatory requirements and a range of software improvements including updates to functionality and security, and fixes to known software issues.

However, regular software releases present an increasing challenge to our Support team who continue to support customers using older versions of Bp Premier.

As a result of this, we have introduced sunsetting – which is ending support for previous versions of our software in an effort to remain knowledgeable on up-to-date versions.

If you have any further questions regarding updating your software, please get in touch.

Have a question? Need assistance with a software update? Call us on 1800 401 111 or email support@bpsoftware.net.

Authored by:

Michael Toulsen
Lead Support Specialist at Best Practice Software

Time to Take Your Blood Pressure Pills!

Blood Pressure Medication

Historically, when single dose blood pressure medications were commenced, patients were advised to take them in the morning. This is because blood pressure follows our natural sleep cycle and dips when we are sleeping and rapidly rises in the morning when we get up. It was thought that taking medication in the morning would provide the most benefit as it would reduce that initial increase in the morning.

At the end of 2019, the results of a large study that looked at bedtime dosing of blood pressure medication were published in the European Journal of Cardiology [1]. The study looked at 19,000 patients in Spain in a primary care setting, and it compared the cardiovascular outcomes between those who took their medication at night and those who took it in the morning, with a mean follow up of just over 6 years. The study found a significant improvement in the outcomes of those who took their medication at bedtime with a reduction in the number of heart attacks, strokes, and heart failure in that group.

The study itself was quite comprehensive and had a good follow up period of 6 years. It is important to note that they only included patients in the study if they did not have any history of pre-existing kidney failure, heart failure, retinopathy, abnormal heart rhythms or alcoholism, and they did not include shift workers. They also did not include pregnant patients or those with secondary hypertension. The authors split the groups in half and had one group take all of their medications in the morning, and the second group take all of their medications before bed. 

Patients’ blood pressure control was monitored during their GP visits in addition to doing an annual 48-hour ambulatory blood pressure test. This test involves wearing a blood pressure monitor for 48 hours with BP check every 20 – 30 minutes to get a good picture of the blood pressure fluctuations over a 48 hour period.

The authors found that those taking their medications at night had overall better control of their blood pressure in addition to needing fewer medications to keep to the recommended targets. The study also found that there was a 45% reduction in cardiovascular events such has heart attacks, angina, strokes and heart failure in the group who took their medications at night. Moreover, they did not find any adverse events to occur in that group.

There have been some other smaller studies that have also looked at morning versus bedtime dosing of blood pressuring lowering medications [2], which showed better blood pressure control without any adverse effects of taking blood pressure medications at night. However, there have been a number of small ophthalmological studies that have shown a detrimental effect for those with certain eye conditions if their night-time blood pressure drops too low [3], or if they take their blood pressure medications at night [4].

To date, there have not been any changes to the current Cardiology or Heart Foundation guidelines to routinely recommend changing patients over to bedtime dosing. However, for some patients the benefits would clearly be substantial.

Before changing over to bed-time blood pressure medication dosing, it would be a good idea to discuss with your GP or Cardiologist if this is suitable for you.

Authored by:

Dr. Fabrina Hossain
Clinical Advisor at Best Practice Software

 

References

[1] https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz754/5602478
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091949/
[3] https://pubmed.ncbi.nlm.nih.gov/8172267/
[4] https://pubmed.ncbi.nlm.nih.gov/22424547/

Enhanced Secure Messaging – the Path to Interoperability

Secure Messaging Interoperability

A core part of healthcare in Australia today is communication between healthcare providers. However many of these sensitive communications are taking place via unsecure channels, or through channels that aren’t compatible, leading to a breakdown of communication, poor health outcomes and inefficiencies.

To solve this challenge, a national initiative has been introduced to transform the way health information is exchanged in Australia. A key goal of the initiative is to equip healthcare providers with the ability to communicate with other professionals utilising secure messaging via their integrated practice management system. This will result in reduced dependency on unsecure channels such as paper-based correspondence, fax machine or post.

Here’s what you need to know about secure messaging – what it is, why it’s important, how it will impact practices and the timeline for implementation.

What is Secure Messaging?

Secure messaging enables the encrypted electronic exchange of patient healthcare information between healthcare providers. Point-to-point delivery of messages such as discharge summaries, referrals, requests and results represent the typical use case.

The electronic message is encrypted by the sender and decrypted by the receiver and therefore cannot be read if intercepted in transit.

Software vendors and their solutions, built to facilitate secure message delivery, are well established in Australasia, some with over 25 years in the market.

It’s fair to say that the majority of practices have had some exposure to secure message service providers (eg, Telstra Health Argus, Healthlink, Medical Objects and ReferralNet) and may even have more than one service enabled.

Why Does Secure Messaging Matter?

In a shared care environment, where it is necessary to exchange healthcare information, secure messaging ensures that the highest level of security and privacy is maintained. Protecting a patient’s sensitive, healthcare information and in alignment with the Privacy Act 1988. In addition, the benefits of exchanging data electronically and securely include speed, efficiency, lower risk and reduced cost.

A collaborative, nationwide approach to unify secure messaging providers is crucial to providing a seamless healthcare journey for patients, and for enabling simple and easy communication amongst healthcare providers.

Isn’t Secure Messaging Already In Place?

Imagine for a moment if our telephone service providers weren’t interoperable, for example your phone network wasn’t able to call someone you know who subscribes to another phone network. How effective would our telephone system be if this were the case? To date, we are in somewhat of a similar situation with secure messaging.

Despite the widespread adoption of secure messaging, the individual secure messaging service providers have approached messaging differently, resulting in incompatibility in many instances. The lack of interoperability has resulted in fragmented systems and communication.

Furthermore, messages and referrals generated by practitioners are often limited to providers listed in their local address book or directory, making it time consuming to locate contact details for providers outside their normal referral network. The above method also relies on the provider information being kept up to date by the practice, often leading to inaccurate information, possibly even providers that are no longer in operation.

What is Changing?

The Australian Digital Health Agency is leading a program of change, to enhance interoperability standards for secure messaging. This initiative is in direct support of the National Digital Health Strategy, to reduce barriers to using secure electronic exchange of health data and ensure interoperability between technologies. Two key changes will take place as part of this initiative.

First is the introduction of a federated provider directory capability, enabling clinical information systems and secure messaging delivery systems to search cross-directory to find accurate, trusted and validated healthcare provider electronic addresses.

Second, software providers are enhancing the message exchange format to meet an agreed standardized specification for message content – streamlined to improve interoperability across disparate service providers and clinical systems.

How is Best Practice Software Getting Involved?

Best Practice Software has actively participated in the collaboration between software providers and government bodies, to define interoperability standards for secure messaging solutions.

The development to enhance secure messaging and be conformant to the ADHA specification is currently in testing phase and the enhanced functionality will be available in Bp Premier Saffron and VIP.net Ruby SP3 in the coming months.

When Will Enhanced Secure Messaging be Available More Widely?

There are 42 software organisations taking part in the ADHA secure messaging enhancement initiative, the change program is scheduled to conclude this October so there are certainly exciting times ahead for improved data workflows and efficiencies!

Authored by:

Monica Reed

 

 

 

 

 

Monica Reed
Manager, Commercial & Customer Enablement at Best Practice Software