meow

After Zoom overdose in 2020, this could be the thing that Makes Videoconferencing Awesome Again!

In 2020, I encountered three common groups of people online. The first were people who were trying to recruit me for work, despite my profile clearly showing that I work in my own practice and am actively building this up to serve the local community. The second group were the medical marijuana proponents. The following anecdote tells you all you need to know about them:

Me: ‘My patient is…’

Medical Marijuana Dealer (MMD), interrupting: ‘Medical marijuana will be great for that!’

Me: ‘My patient is, well…’

Medical Marijuana Dealer (MMD), interrupting: ‘Medical marijuana will be great for that!’

Me: ‘My patient is dead.’

pause

pause

Medical Marijuana Dealer (MMD): ‘Medical marijuana will be great for that!’

Photo by Vanessa Garcia on Pexels.com

The last group were the people who repeatedly said things along the lines of ‘Doctor, if you are not using video for online consultations, do you even care about your patients?’ This was said with no thought as to the:

Added friction of online video (just hark back to any time you have tried to use tech with an older relative);

Casual ignorance of privilege (I am typing this on my top spec computer with 100Mb internet, many of our patients are not so lucky);

The significant costs and scanty rewards of video consultations (large set up costs for marginal gain in most GP consultations, with no added rebate and patients unwilling to bear the costs)

So, given that (and I am sure all of these issues will be dealt with by time), lets have another look at the perils of video consulting, even with rich white males and top tier technology!

PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Breached as, bro

Once upon a time, as all the oldest stories start, data was kept in peoples brains. This data wasn’t clearly visible and could only be accessed via direct download from the source. The person had to tell you what was in their brain. This is how the oldest stories were passed on, with an oral tradition. There were secrets. Some things were private. There was value in this. Secrets have always been valuable – and many methods have been tried to extract this value, from persuasion, coercion, interrogation, and worse. Lots of secrets equals big value equals a big incentive to try some of these methods. That said, it’s a lot harder to use these methods to find a lot of little secrets in a lot of places, when you don’t really know where to look.

What if someone took a lot of secrets, including your secrets? What if that someone took those secrets and put them all in the same place? Is this sounding familiar? What we have in this situation is motive (lots of valuable secrets – data), opportunity (you know where it is – a big database), and then all you need is the means…

We all know that more mistakes can be attributed to stupidity than malice and I suspect poor systems have led to the situation below. Big health databases are big targets, and data breaches, where your data, your secrets, become public, are becoming more and more common. One big database belongs to Ambulance Tasmania.

The private details of every Tasmanian who has called an ambulance since November last year have been published online by a third party in a list still updating each time paramedics are dispatched.

Key points:

  • Ambulance Tasmania uses a paging system in initial communications between the dispatch team and paramedics on the ground
  • Pager messages dating back to November have been uploaded to a website, which is still live and continually updating
  • The health union has described the data dump as “horrific”

The breach of Ambulance Tasmania’s paging system has been described as “horrific” by the Health and Community Services Union, which has suggested the data dump could leave the Government open to litigation.

The biggest health database in this country is MyHealthRecord. The website states that ‘My Health Record lets you control your health information securely, in one place. This means your important health information is available when and where it’s needed, including in an emergency’. There are some issues with this – many hospitals and health service providers neither use nor access MyHealthRecord and, as I’ve said above, big databases have a big target on them. Hackers and criminals see this target. So do governments and non-criminals.

2018 saw the Federal Government quietly release its long-awaited framework for secondary use of information contained within the my health record. It was controversial. The release of the framework to guide the secondary use of My Health Record (MyHR) system data came just months before the participation rules for the Australian national health record change from opt-in to opt-out. Consent for secondary use is implied if consumers don’t opt out of the MyHR. In other words, people need to take action if they don’t want their health data to be used for purposes other than direct clinical care.

What does this all mean? For patients and individuals it means being mindful about your data. Only give what you need to give, for good reason, and consider time limits and limiting further usage of your data for unconnected reasons.

For doctors, consider clinically appropriate data entry – never forget who you serve and why, and work in and with good practices and practitioners who will take the same care and attention with patients data as you do.

For practices, good policies and solid hardware and software solutions are the key!

For a little bit of further reading:

John Stronner is a guru in this area – a Certified Data Protection Officer, and CEO of Loftus Technology Group. I had the pleasure and privilege of speaking after him on a recent podcast from This Pathological Life! Another podcast I found super useful was the story of the white hat hacker turned protector, Bastien Treptel of the CTRL Group.

Be mindful with your data and your health – we can help with both (with your medical data at least!). Just one little example of how your data can help you is here, where I explain how your GP can upload your immunisation details to MyHealthRecord, allowing you to prove your vaccination status – super important in 2021! You can make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Where to now?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

(TL;DR – Get a regular GP or General Practice and use them!)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Telemedicine | RACGP | PartridgeGP

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.

 

WATCH HERE

 

 

Topics to be covered:

·         Discussing the role of telehealth and the consent process

·         New MBS item numbers

·         Registrars working remotely

·         Undertaking paperwork when working remotely

·         E-prescribing Legislation

·         Combining telehealth with face to face consults

·         Rolling Q&A

Date:  Thursday, 16 April 2020

Time: 6.30-7.30 pm

Cost: FREE

Register in advance for this webinar:

https://racgp.zoom.us/webinar/register/WN_eGyo0yuBR-iLE0Pvh6YehA

Registrations close 5pm Thursday 16 April 2020.

Presenters:

Dr Emily Kirkpatrick – Deputy Chair, RACGP SA&NT & SA Health COVID-19 GP Liaison Team

Dr Daniel Byrne – SA Health COVID-19 GP Liaison Team

Dr Alvin Chua – RACGP SA&NT Council member

Dr Nicholas Tellis – GP, Owner PartridgeGP

Electronic Prescribing at PartridgeGP

You bet!

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.’

Dr Nathan Pinksier – GP

As outlined in guidelines issued by the Department of Health (DoH), GPs will be required to do as follows:

  1. Create a paper prescription during a telehealth consultation. This will need to be signed as normal or using a valid digital signature
  2. Create a clear copy of the entire prescription (a digital image such as a photo or PDF including the barcode where applicable)
  3. 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.

Yes!

This is a great step forwards!

Electronic Prescriptions

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.

Quick links

Information for prescribers 

Information for dispensers

Tokens

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.

Your GP at PartridgeGP

Your Pharmacist at Bayside Village Pharmacy

MyHealthRecord – Opt Out Here

We’ve written about the Patient Controlled Electronic Health Record (PCEHR or MyHealthRecord) before – you can have a look at the links below.

 

e-health warning

pay for performance

why i will not use the pcehr

the australian pcehr – success or failure

Info for Best Practice using GPs here

 

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Also – see MJA Insight right here!

 

 

Today we’re going to talk about how NOT to have a MyHealthRecord. Perhaps you don’t think it’s private, perhaps you’re opposed to it for some reason. Perhaps you just don’t want one. Read on.

 

 

The Australian Government is expanding My Health Record for all Australians in 2018.

 

 

By the end of 2018, a My Health Record will be created for every Australian unless they choose not to have one.

 

 

How can I opt out?

 

If you decide that you don’t want a My Health Record created on your behalf, you will have the opportunity to tell us during a three-month period.

 

This period will run from 16 July to 15 October 2018. It’s not possible to opt out of having a My Health Record before this period starts on 16 July 2018.

 

 

Opt Out Here!

 

 

 

 

book online at Partridge Street General Practice

Partridge Street General Practice is all about quality – professional, comprehensive, and empowering General Practice. You can make an appointment with us right here.

 

join the team

 

Want to be part of the Partridge Street General Practice team? Contact Dr Nick Tellis at drnt@partridgegp.com.au or 0882953200

 

 

 

 

 

 

 

 

 

GPs Down Under #GPDU

If you are an Australian or a New Zealand GP looking for peer support, advocacy, or learning, GPDU (GPs Down Under) is THE place for you on Facebook!

 

 

Find us here!

 

 

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!

 

GPDU Admin

 

 

Apply to join GPDU right here!

 

TL;DR

 

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!

 

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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!

 

 

GPDU.jpg

Be Super Kind

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?

 

 

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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.

 

Irredeemable-7-6.jpg

 

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.

 

#bekind

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.

 

Election info here

Voting info here

Dr Karen Price

Dr Chris Irwin

Dr Ayman Shenouda

 

For Patients – Get a Great GP!

(Here’s some we made earlier)

Dr Nick Tellis

Your Specialist In Life

Dr Nick Mouktaroudis

Dr Gareth Boucher

Dr Gareth’s Cycle of Care

Dr Penny Massy-Westropp

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Monika Moy

Dr Katherine Astill

Dr Katherine Astill 1

We look forward to seeing you soon!

 

Qi at Partridge Street General Practice

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.

 

 

But!

 

 

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:

Asthma Incentive

Quality Prescribing Incentive

Cervical Screening Incentive

Diabetes Incentive

General Practitioner Aged Care Access Incentive

 

The six PIP Incentives that continue to remain unchanged are:

eHealth Incentive

After Hours Incentive

Rural Loading Incentive

Teaching Payment

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:

 

 

Quality – Time and Presence with Our Valued Patients

 

Service – Charging a private fee to those who can pay, allowing us to be charitable to those who cannot

 

Finance – Running Practices efficiently and well, with clinicians as owners steering the course of patient centred practices.

 

 

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 – where GPs are invited to a festival of education and collegiality (#FOAMed – #GPDU18) May 30 – June 1! My last quality ltip – for personally better Qi – is below!

 

Get a Great GP!

(Here’s some we made earlier)

Dr Nick Tellis

Your Specialist In Life

Dr Nick Mouktaroudis

Dr Gareth Boucher

Dr Gareth’s Cycle of Care

Dr Penny Massy-Westropp

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Monika Moy

Dr Katherine Astill

Dr Katherine Astill 1

We look forward to seeing you soon!

How to take a good (medical) selfie

1 Corinthians 13:12 King James Version (KJV)

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!

The ABC recognises the medical selfie and here at PartridgeGP we see and take many medical photos.

There are many benefits:

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!

PartridgeGP is proud to provide excellence in General Practice Skin Cancer Medicine and Surgery – and great Clinical Photography is part of this. We look forward to helping you with regular skin checks and any treatment you may need. Book your skin check right here.

Skin cancer check risk dr Nick Mouktaroudis

You can see any of our Great GPs right here:

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

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