MyHR…. opt out, opt in or just ignore?

Dr Raines gives another perspective on My Health Record!

rain0021

In case you haven’t heard, you will have to decide whether you want to opt-out of the Government My Health Record (MyHR) before the 15 October 2018 or you will be have one created for you.

MyHR is a great idea.

MyHR allows your GP to write a shared health summary and collates data from a disparate number of sources. These will eventually include blood tests, radiology reports, medication and allergy lists and discharge summaries. It is also a spot where track immunisations and keep your achievement diary!

I have one. For those living in North Queensland and the Blue Mountains you probably already have one too. Didn’t you recall getting a note from the Government that you could opt out about 2 years ago. Don’t worry a lot of people didn’t hear you had to either. I use MyHR for my patients several times a week. “I take those little blue…

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Today I am leaving my hat at the door – Dr Nicole Higgins

GPs wear many hats…sometimes we take them off 👍🏼

BridgeBuilders

I have a thing for Trilby’s. Old school. Usually pre-loved. I have quite a collection.

Wearing multiple hats becomes more common as we move up in the decision-making places of our careers. The good news – this creates a tapestry of knowledge and a depth of understanding, but it also increases the risks and conflicts of interest. One must become adept at treading lightly and not stepping on toes. Sometimes it feels like I am doing a clumsy ballet wearing steel cap boots.

We are more likely to find people in multiple roles when those people become important to organisations or groups due to their connections, skills and specific knowledge. That is exactly where potential conflicts of interest can do the most harm but also create an environment of collaboration. The difficulty is how to manage those real or perceived conflicts with transparency, openness and care. The challenge is how…

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Welcoming Dr Chrissy Psevdos to Partridge Street General Practice

dr chrissy psevdos at Partridge Street General Practice

Partridge Street General Practice welcomes Dr Chrissy Psevdos who has kindly agreed to locum with us while Dr Nick Tellis is on Paternity Leave. She is a quality GP with a Fellowship of the RACGP and many years of experience. She has a passion for people and can assist you with all of your health needs.

Her first day with us is Tuesday 24th July and you can book an appointment with her right here.

 

All of our doctors here at Partridge Street General Practice are fully qualified ‘Fellows’ holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.

Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.
We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at Partridge Street General Practice with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

She is keen to hit the ground running with the rest of our Great Team here at Partridge Street General Practice! We look forward to having Dr Chrissy Psevdos as part of our growing Clinical Team and sharing her experience with us and our valued patients.

 

 

 

 

 

 

 

Professional. Comprehensive. Empowering.

 

 

 

DR NICK TELLIS

 

Your Specialist In Life

DR NICK MOUKTAROUDIS

 

dr nick mouktaroudis at Partridge Street General Practice

DR GARETH BOUCHER

 

dr gareth boucher

 

DR PENNY MASSY-WESTROPP

 

 

Dr Penny Massy-Westropp

DR MONIKA MOY

 

 

Dr Monika Moy

DR CHRISSY PSEVDOS

 

dr chrissy psevdos at Partridge Street General Practice

My Health Record: Former digital transformation head raises concerns about security of online system – Politics – ABC News (Australian Broadcasting Corporation)

The man appointed by Malcolm Turnbull to transform the Commonwealth’s digital public services has said if he was Australian he would probably opt out of the Government’s controversial online health database.

http://mobile.abc.net.au/news/2018-07-18/my-health-record-former-digital-transformation-boss-has-concerns/10006788?pfmredir=sm

Learn more here!

Alternative…Patients – #kickback edition

Thanks George Forgan-Smith 😉

 

 

It’s the week after the RACGP AKT and KFP exams for some and before a busy week for others. You may be a little flat and the world may seem a bit chaotic at the moment so I thought I’d take a minute to remind us all of how good we have it in Australian General Practice.

 

What are some of the little things your patients have done for you? (#kickbacks 8-)) These are three that come to mind for me:

 

 

 

Sugar free, too 👍👍👍

 

 

 

When the person I squeezed in for an appointment because they were ‘really ill’ stopped the consult to give me a (sugar free 👍) lolly when I was coughing at the end of a long day with lots of sniffling kiddies.

 

 

 

A Series of Unfortunate Events

 

 

 

A lovely painting I got for ‘mates rates’ after helping someone through a ‘series of unfortunate events’ (see the main picture!)

 

 

 

Needs banana for scale 🍌

 

 

 

3. A fantastic steak dinner cooked for me when I was spotted sneaking out of the practice clutching a bag of chips on a big on call night.

 

 

 

 

 

What little things have your patients done for you? 

 

 

Sunset at Glenelg

 

 

Take a moment to have a think and feel grateful – we really do have the best job in the world!  👍

 

Dr Nick Tellis is passionate about great general practice. He’s a proud GP, beachside Adelaide practice owner, and a happy new father. He blogs at www.partridgegp.com when not administrating on GPDU.

 

Contact Dr Nick Tellis at drnt@partridgegp.com.au or 0882953200 if You would like to be:

part of a great team where everything is set up to help you help others

helping great patients

near the beach

working fewer hours and earning more with private billing

 

 

join the team

GPs want clinical handovers, not discharge summaries

Partridge Street General Practice is all about professional, comprehensive, and empowering General Practice care by our GPs. When we refer our valued patients for treatment elsewhere we promote the same high standards, values, and communication  that we provide. A letter, referral, or phone call is just part of the standard Partridge Street General Practice service – it’s good clinical handover. Dr Nick Tellis recently collaborated with some excellent GPs in writing an article for the Medical Journal of Australia’s online Insight Blog on ways to improve communication during these times and stressing the importance of better clinical handover. It’s another one of the ways Partridge Street General Practice provides Better Healthcare for our valued patients. Read on.

 

This is the third article in a monthly series from members of the GPs Down Under (GPDU) Facebook group, a not-for-profit GP community-led group that is based on GP-led learning, peer support and GP advocacy and was originally published at the Medical Journal of Australia (MJA) Insight Blog here

 

“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The topic of safe and effective clinical handover comes up repeatedly in discussions on GPDU.

 

It is apparent that the impacts from delayed or poor clinical handover on patient care across the country are significant, under-reported, and have a profoundly negative effect on the care patients receive.

 

Dropping the baton

 

First-hand accounts of treatment delays, duplication of testing, medication errors, and unplanned readmissions are frequently discussed by GPs. Recent clinical case discussions have included a patient in palliative care being transferred to a hospice on a Friday afternoon with no clinical handover, and a 3-month delay in the completion of a discharge summary for a truck driver who was admitted with a myocardial function.

 

The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?

 

Rules of the game

 

The National Safety and Quality Health Service Standards (NSQHS) and the Australian Commission on Safety and Quality in Health Care (ACSQHC) define clinical handover as; “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group”. Appropriate clinical handover is a requirement of the NSQHS. The ACSQHC notes the importance of “transition of care” that “ends only when the patient is received into the next clinical setting”. The Australian Council on Healthcare Standards EQuIP National Standard 12, in particular, specifies the planned provision of transfer information, including results of investigations.

 

Breakdown in the transfer of clinical information has been identified as one of the most important contributing factors in serious adverse events, and is a major preventable cause of patient harm.

 

Why is clinical handover from hospitals to GPs done so inconsistently for patients transitioning from our major private and public institutions? The benefits of passing the baton smoothly are clear. It’s time to coach the team to get it right.

 

Timing is everything

 

Health services continue to debate the appropriate timeframe for communicating with the GP who is continuing the patient’s care. Timeliness of clinical handover is a topic that comes up frequently. Hospital targets for transfer of care communications vary widely. A recent discussion on GPDU identified several targets within one small geographical area, ranging from “at the point of discharge”, “48 hours after discharge” and “5 days after discharge”.

 

GPDU dragon head-3

 

The reality is that few patients leave hospital with an effective clinical handover. Some will be received within the hospital’s current targets; however, many clinical handovers are not received for weeks, months or, as one post highlighted, years after the patient care is transferred. Some never occur.

 

Many GPs are asking whether these targets are consistent, appropriate, acceptable or safe. A robust discussion took place after GPs were approached to complete a survey that included a question asking what conditions should warrant a discharge summary on discharge, and what the acceptable timeframe for receiving a discharge summary should be.

 

The overwhelming consensus was that the gold standard should be clinical handover on discharge for all patients. Many were frustrated that this question even needed to be asked. Some GPDU members wondered whether this was a trick question aimed at moving the goalposts further away from quality patient care.

 

Services promoting clinical handover to GPs on discharge were highlighted. The Sunshine Coast Hospital and Health Service was identified as a provider that was actively trying to effect positive change. They received plaudits from the wider GP community simply by having a discharge summary management policy specifying complete discharge summaries available at the time of patient discharge.

 

It is well known in GP circles that starting late ensures that you will run late all day. Timely discharge summaries aren’t late. Timing is everything when you want to be a frontrunner.

 

Don’t fumble the handover

 

The consensus among GPs is that well timed, efficient, effective and safe clinical handover, at or before the point of transition of care is essential. Alternative strategies risk adverse outcomes. Clinical handover must be a standardised process between clinicians.

 

Returning to the athletics track, we can see a clear difference between a handover, a throw, and a drop. Highly trained athletes accept nothing less than a smooth handover – nor should highly trained clinicians. Delegating the handover to non-clinicians, including nurses and medical students, is not good enough. Supervision and ongoing coaching of clinicians is vital.

 

The baton is passed between people not machines

 

Imagine the difference electronic systems could make to this smooth handover. Sadly, this smooth electronic handover exists only in the imagination.

 

In the real world, GPs are grappling with being thrown links to hospital electronic records through systems such as “The Viewer”. Investigations are likely to be uploaded (after a delay) to MyHealthRecord. These are raw data, unfiltered and disorganised, and more of a throw than a handover. Being thrown raw data and being expected to catch them in this way is akin to a hospital doctor being given the login to the GP clinic’s patient management system and being expected to extrapolate a referral.

 

Personal bests are set; medals are won

 

The late Sir Roger Bannister ran the 4-minute mile and reset the expectations for all that followed him. GPs and their discussions can highlight outstanding clinical handovers and applaud initiatives and hospitals that are doing it right. Feedback and constructive criticism can be passed back to hospitals that are raising the bar. Medal-winning performances show the possible and provide a model for future improvement. GPs are uniquely placed to spot the talent and report the score widely and rapidly.

 

Eyes on the prize: what’s the next goal?

 

If we can normalise the clinical handover to young GPs who are the future of general practice, it will encourage them to demand it of their hospitals.

 

Hospitals are incredible places, but the aim is for patients to return home to their communities and trusted GPs. They come home. Their GPs are waiting, willing and able. We can do better, and we will. We extend an open hand to our amazing hospitals. Pass us the baton – we won’t drop it.

 

clinical handover

 

Dr Katrina McLean is a Gold Coast-based GP, Assistant Professor in the School of Medicine and Health Sciences at Bond University, and a GPDU administrator.

 

Dr Michael Rice is past-president of the Rural Doctors Association of Queensland, an educator of students and registrars, a long term resident and rural GP in Beaudesert. He’s a keen user of social media.

 

Dr Nick Tellis is passionate about great general practice. He’s a proud GP, beachside Adelaide practice owner, and a happy new father. He blogs at www.partridgegp.com when not administrating on GPDU.

Contact Dr Nick Tellis at drnt@partridgegp.com.au or 0882953200 if You are a Great GP and want a Better Place to practice great medicine!

 

join the team

 

Partridge Street General Practice is Proud to be a Teaching Practice

Quality accredited by AGPAL

 

Partridge Street General Practice is an accredited General Practice and is further accredited by our Regional General Practice Training Provider GPEx and our local Medical School at Flinders University.

 

 


 

 

This means that the GPs at Partridge Street General Practice are teaching the Doctors and Medical Students who will be the future of medicine in Australia. It’s a big responsibility and a privilege we take very seriously.

 

 

Teaching Practice of the Year

 

 

All of our doctors here at Partridge Street General Practice are fully qualified ‘Fellows’ holding a specialist qualification with either the Royal Australian College of General Practitioners (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) or both (3-4 years of full time study and 3 exams on top of an undergraduate university medical degree and supervised trainee ‘intern’ year in a hospital). This is our minimum specialist standard and we may have other qualifications and skills.
Our Fellows provide supervision and advice to our Registrars and you may find that they are called in to consult with the Registrar on your case. ‘Registrars’ are qualified doctors who have completed their hospital training and are now embarking on their General Practice training. Some may already have other qualifications in medical or other fields.
We also supervise and teach Medical Students from Flinders University. They are still studying to become doctors. All of us – Fellows, Registrars, and Medical Students – make up the Clinical Team here at Partridge Street General Practice with our excellent Practice Nurses. We all uphold the highest standards of privacy, confidentiality, professionalism, and clinical practice.

 

 

Professional. Comprehensive. Empowering.

 

See just how we do it here.

 

Good luck to all the fantastic GP trainees out there!

 

 

Contact Dr Nick Tellis at drnt@partridgegp.com.au or 0882953200 if You are a Great GP and want a Better Place to practice great medicine!