The RACGP SA&NT in conjunction with SA Health and a local panel of presenters, will be presenting a webinar update on Telemedicine, discussing tips and tricks related to undertaking telehealth in your practice.
Those bits of paper your GP gives you to get medications from your Pharmacist are changing. Scripts are now DIGITAL!
GPs can now send prescriptions to pharmacists electronically as an interim solution during the pandemic.
As part of the COVID-19 National Health Plan telehealth model, the new interim measure allows GPs to send prescriptions electronically to pharmacists without having to mail out a physical copy of the original paper prescription with a GP’s wet-ink signature.
Patients can then have their script filled and medication delivered to their door, helping to minimise the risk of virus transmission in accordance with social-distancing measures.
‘It’s certainly going to make it easier for practices, because they are being inundated with pharmacists asking them to post prescriptions to them,’
‘I know at my practices it’s causing substantial concern.
‘We’re getting calls every day from pharmacists saying, “I can’t dispense unless you send me the hardcopy paper”, and we’re saying, “We don’t have the resources to keep running out and buying stamps, and it’s just not safe to put staff in that position”.
‘So we’ve had a bit of a stalemate for the last few weeks and this is a great outcome in the short term.’
As outlined in guidelines issued by the Department of Health (DoH), GPs will be required to do as follows:
Create a paper prescription during a telehealth consultation. This will need to be signed as normal or using a valid digital signature
Create a clear copy of the entire prescription (a digital image such as a photo or PDF including the barcode where applicable)
Send via email, fax or text message directly to the patient’s pharmacy of choice
Schedule 8 and 4(D) medicines such as opioids and fentanyl are not part of the interim arrangement.
While not legally required, the DoH encourages practices that are able to continue sending the original script to pharmacies to do so as soon as possible. All other practices must retain the paper prescription for a period of up to two years for audit and compliance purposes.
This is a great step forwards!
Changes have been made to Commonwealth legislation to recognise an electronic prescription as a legal form to allow medicine supply. This provides prescribers and patients with an alternative to paper prescriptions. Paper prescriptions will still be available.
Electronic prescribing will not fundamentally change existing prescribing and dispensing processes. It provides patients with greater choice and patients can still choose which pharmacy they attend to fill their prescription.
Under the Australian Government’s National Health Plan for COVID-19, electronic prescriptions are now being fast-tracked to support telehealth and allow patients to receive vital healthcare services while maintaining physical distancing and, where necessary, isolation.
A significant amount of work has already been done to ensure that necessary upgrades to both pharmacy and prescriber software can be done quickly and electronic prescriptions are expected to be available from the end of May.
Electronic prescriptions are an alternative to paper prescriptions which will allow people convenient access to their medicines and will lessen the risk of infection being spread in general practice waiting rooms and at community pharmacies.
The solution being fast-tracked will see a unique QR barcode known as a “token” sent via an app (if you have one), SMS or email. The token will be sent to you from your doctor, which is then presented or sent to a pharmacy, to supply your medication.
The token will be scanned by your pharmacist as a key to unlock the electronic prescription from an encrypted and secure electronic prescription delivery service.
If you have any repeats of a prescription, a new token will be sent to you when the prescription is dispensed. You will need to keep the token to send to your pharmacy when you need to get the repeat filled.
Active Script List
By the end of this year, more functionality will be available and in addition to the token, there will also be an option for your pharmacy to have a list of your active prescriptions in their software, so you don’t have to forward it on.
To get your medicines you will need to prove your identity to the pharmacist and provide consent for the pharmacist to view your prescriptions.
Steps to take in preparation for using an electronic prescription
Ensure your address, email address and mobile number are up to date with your doctor and pharmacy.
Check that your pharmacy can take an electronic prescription and are delivering medicines.
When you apply to join, this is the message you will receive – have your information ready and await a message from your friendly GPDU administrators on Facebook Messenger.
Thank you for for the information provided with your request to join GPDU, Australia & New Zealand’s closed Facebook group for learning, peer support and advocacy.
We consider GPDU to be a ‘National Park’, open to all Australian & New Zealand primary care doctors.
We don’t mind if you are RACGP, ACRRM, RNZCGP, VR or non-VR, full-time or part time, urban or rural, trainee or Fellow. We are however passionate that we do our utmost best to ensure that members are registered with AHPRA or the NZ medical board, and working in primary care.
🔸Can you please provide a screenshot (or photo) or your RACGP dashboard (visible when logged in to the RACGP website. ACRRM RRMEO page, or RNZCGP membership profile.
If not already submitted, can you also please provide:
🔹A screenshot/photo of your AHPRA registration certificate (or link to webpage)
🔹Information linking you to your practice, this may include a copy of a business card with you name and the practice address, training confirmation letter or link to a website with your profile and name.
We appreciate that this may seem like a lot to ask and thank you for your assistance in providing the information requested in a timely manner. Please be aware that the GPDU admin team are all busy GPs who take on the admin role on a voluntary basis.
Any concerns/questions, or if you are battling with technology and struggling to figure out how to do all of this please let us know. We are more than happy to help out.
Thank you – we look forward to having you on board soon!
When you get the message from admin, send three screenshots back! RACGP/ACRRM/NZ college info, AHPRA info, practice info with you in it and You. Are. In!
We look forward to seeing your application, your Facebook Messenger replies with the required information, and finally and most importantly, your ongoing and valuable contributions to the National Park of learning, peer support, and advocacy that is GPDU!
Doctors are people too. Is this a controversial statement? I’m going to go further and say doctors are people first. I bring this up because some doctors are amazing but they are still only human. There’s a special respect from me for our rural doctors including rural generalist GPs. To me, they are Superhuman! I look at what I do now, and what I used to do as a rural doctor (within 30km of a major Australian city), and, to quote a popular film it’s not the same game. It may not even be the same sport.
I’ll move to some other popular culture. A guilty secret of mine is that I like comics. One series I really liked (and beware this is a NSFW comic and not for children) is Irredeemable. It’s the story of an alien superman (The Plutonian) who becomes a superhero on Earth. He’s super resilent, can fly, has superhuman endurance…you know, those usual rural generalist abilities. The series opens with a family running for their lives. Heat beams target them. Their house is reduced to rubble. Spoiler Alert – they die. Hovering in midair over their bodies is The Plutonian. What happened?
Prior to the above events, the Plutonian was doing his thing, saving people. It’s what he did. Day in, day out, with never a day of rest. He stops a nuclear bomb going off in a packed sports stadium. The crowd goes wild. He stands there, letting his adrenaline drop down. One voice comes to his ears amongst the adulation of the crowd.
‘What a poser’, or words to that effect. Only a few words, only one person, and buried in a sea of praise. But they were enough. They were too much. Superhumans are human too. Perhaps they are human first too? He snaps and flies off.
I think 14 doctors committed suicide in the last 12 months. I could be wrong about this number. I’m not wrong when I suspect the number that had contemplated suicide was probably much higher. I don’t know the answer but being kind is a good start. Please, be kind. That is all.
I would love to hear other views on this. We are all professionals or patients or both and we can always improve. Let me know here on the blog (or on our website) – or, if you’re a GP, on the fantastic GPDU FB Group
PS: In the same vein, #besuperkind with the RACGP elections coming up – three GPs have thrown their hats into the ring so far – I wish them all the best of luck, a fair hearing, and look forward to the RACGP elections as a beacon of probity and ethical behaviour rarely seen in our country’s elections.
We’ve just celebrated the Chinese New Year – the Year of the Dog. People born in Dog years display loyalty and honesty amongst many other good qualities. However it is said that they can also be critical – maybe overly so. Segueing to another Chinese concept, we meet Qi, the vital life force that flows through the body. Let’s put these together.
A wise man once told me that the three pillars (the vital life force) of general practice are quality, service, and finance. All three of these come together in the form of the Practice Incentive Payments (PIP) scheme. You can read about this here but in summary Accredited General Practices are paid amounts of money for reaching certain quality measures. These include planning the management of a proportion of patients with diabetes and asthma, and ensuring women are screened for cervical cancer. There are also Incentive Payments for managing aged care and quality in prescribing.
These payments were due for a change on May 1st 2018. Were they promoting the vital life force of General Practice, were they tick box exercises for busy GPs, or were they overly critical of General Practice, not focusing on true quality? Enter QI – Quality Improvement. Rather than Qi, QI may be an altogether different beast.
The Department of Health has confirmed that the Practice Incentive Program Quality Improvement Incentive will now occur from 1 May 2019.
From their press release:
The Practice Incentive Program (PIP) has been a key driver in quality care in the general practice sector and the PIP QI Incentive will continue to build on this important work, further strengthening quality improvement in primary health care. The additional 12 months will enable the Department, with the support and advice from PIPAG, to ensure that any implementation issues are identified and addressed and that general practices have adequate opportunity to prepare. It will also allow the Department to continue to consult with stakeholders on refining the design of the PIP QI Incentive.
The changed time frame will mean that the following five incentives which were to cease on 1 May 2018, will now continue through to 30 April 2019.
The five incentives are:
Quality Prescribing Incentive
Cervical Screening Incentive
General Practitioner Aged Care Access Incentive
The six PIP Incentives that continue to remain unchanged are:
After Hours Incentive
Rural Loading Incentive
Indigenous Health Incentive
Procedural General Practitioner Payment
What next? Will the new QI beast be reflective of quality in General Practice? Will the measures align with what we as General Practitioners believe is high quality Great General Practice care? Or will it aptly be launched in the Chinese Year of the Pig in 2019?
For what it’s worth, here are my measurements of quality, service, and finance in General Practice – the Qi of GP:
12 For now we see through a glass, darkly; but then face to face
Selfies. We’ve all done it. Some good, some bad, some downright embarrassing. However, there are some embarrassing pictures you may want to see the light of day – with your doctor. That funny rash that goes away, that cut you weren’t sure needed stitches or that mole you’ve been keeping an eye on.
(Unlikely to be a medical issue)
Smartphones and cameras are in our bags and wallets and people are using them!
We can clarify the lesion/area/rash of concern to You
We can document changes over time or with treatment
We can use the images to obtain a second or subspecialist opinion
We can use the images for teaching and training
Of course, we provide the same great high quality service for clinical photography as we do for all of the work in General Practice and so we are guided by information like this.
We also MUST get Your informed consent for all of this! We will ask You whether you are happy with clinical photography, and You can specifically consent to any or all of the above uses. No posting to Facebook!
We live in an instant world and we seek convenience. How can technology give you more of what you want while Your GP gives you more of what you need?
We never want to lose the doctor patient relationship in General Practice. It’s the most valuable part (and the most rewarding part) of our vocation and service as GPs. If we can have technology in the background rather than in the way, I think we can strengthen this. Facebook is one example.
Here’s another. Step one: buy a gaming keyboard. Step two: Program some macros. Step three: Spend more time with Our Valued Patients and less with our technology and medical software!
Here’s me cutting my login time to zero. It’s one small step for Dr Nick….
What do you think?. Is this part of the future? Too soon?
Not so long ago it was quite hard to contact Your GP. You had to phone the practice to make an appointment (some waiting), come to the practice (more waiting), and then sit in the waiting room (more waiting). We live in an instant world and we seek convenience. How can technology give you more of what you want while Your GP gives you more of what you need? Try this!
More and more of our valued patients are choosing to book online but You can still call Partridge Street General Practice and we’re always happy to talk to you. You can also email us or contact us here for non-urgent inquiries, remembering that email is not a secure form of communication.
Imagine if you could ask some simple questions of Your GP, without waiting on the phone or sitting in the waiting room. Simple questions that have been asked of me in the past:
When should I come in to see you next?
I lost my script, what do I do?
I was discharged from hospital, what next?
We never want to lose the doctor patient relationship in General Practice. It’s the most valuable part (and the most rewarding part) of our vocation and service as GPs. If we can add to it, by improving communication before a face to face consult, I think we can strengthen this. We have a trial project with free access to a secure app where you can speak with me (not Facebook!). It’s not for urgent consultations! It’s free to sign up – you only pay if you use it.
What do you think – tell me here (or on the app!) about what you think. Is this part of the future? Too soon? Not what you want? Let me know. In the meantime, we’re all still here for you at Partridge Street General Practice, face to face, IRL 😎