Medicubes

In this episode of the Medicubes podcast, Riwka Hagen and Kim Poyner join Tracy Johnson, Dr Tony Lembke, Simon Matthews from Practice Coach Australia for the second half of a discussion on voluntary patient enrolment (sometimes known as voluntary patient registration - VPR) in the primary care space.  

Jump back to the last episode of this show to hear the first part of this discussion.  

In this episode, we delve deeper into the complexities and challenges of implementing this model in the current healthcare system. We have a panel of experts with diverse perspectives and experiences, including GPs, psychologists, and healthcare administrators, who share their insights and concerns about the potential impact of VPE on patient care, physician burnout, and healthcare delivery.

Key Discussion Points:

• The concern that VPE may leave some patients behind, particularly those who are acutely unwell or have complex medical needs.
• The potential impact of VPE on physician burnout, given the high workloads and financial pressures facing primary care practices.
• The challenge of changing the current model of primary care, which is primarily based on independent practitioners working as micro-businesses.
• The potential barriers to implementing VPE, including resistance from independent practitioners who may not be willing to give up control over their patient-practitioner relationship.
• The need to rethink primary care delivery and create a new value proposition that is different from the current model.

Resources & Links:

• The Australian Institute of Health and Welfare: https://www.aihw.gov.au/
• Cubiko: https://www.cubiko.com.au/
• The Winston Churchill Memorial Trust: https://www.churchilltrust.com.au/
• The Australasian Healthcare Homes Program: https://www.ahha.asn.au/healthcarehomes
• The Primary Care advisory: https://www.aihw.gov.au/reports/primary-care/primary-care-advisory-committee-annual-report-2019-20/contents/about-the-primary-care-advisory-committee

In this episode of the Medicubes podcast, Riwka Hagen and Kim Poyner join Tracy Johnson, Dr Tony Lembke, Simon Matthews from Practice Coach Australia for a discussion on voluntary patient enrolment in the primary care space. This is the first part of a two-part series. The conversation explores the concept of the medical home, in which patients have a continuing relationship with a particular general practitioner (GP) and are supported by a team of healthcare professionals. The goal of the medical home model is to provide comprehensive, coordinated, and accessible care to patients, with a focus on quality and safety.

Key Learnings:

• Voluntary patient enrolment is relevant in the context of the medical home model of primary care. (4:00)
• The medical home model has been extensively studied and shown to be an effective and efficient way to provide primary care that is preferred by patients and providers. (4:30)
• The medical home model can lead to improved health outcomes, including better management of chronic conditions and reduced hospitalisation rates. (5:00)
• The medical home model relies on strong communication and collaboration between healthcare providers, as well as engagement and involvement of patients in their own care. (7:00)
• The medical home model can be implemented in various settings, including general practices and Aboriginal medical services. (9:00)
• Voluntary patient enrolment is a way for patients to formally express their preference for a particular GP or medical practice to be their medical home. (13:00)
• Voluntary patient enrolment is different from mandatory enrolment, which requires patients to be registered with a specific GP or practice. (14:00)
• Voluntary patient enrolment can help to improve the continuity of care for patients, as well as the efficiency and effectiveness of the healthcare system. (17:00)
• There are potential challenges to implementing voluntary patient enrolment, including issues related to funding, workload, and access to care. (20:00)
• The importance of voluntary patient enrolment may vary depending on the specific needs and preferences of patients and communities. (22:00)

Resources & Links:

• The Australian Institute of Health and Welfare: https://www.aihw.gov.au/
• Cubiko: https://www.cubiko.com.au/
• The Winston Churchill Memorial Trust: https://www.churchilltrust.com.au/
• The Australasian Healthcare Homes Program: https://www.ahha.asn.au/healthcarehomes
• The Primary Care advisory: https://www.aihw.gov.au/reports/primary-care/primary-care-advisory-committee-annual-report-2019-20/contents/about-the-primary-care-advisory-committee

In this episode, hear from Peter Birch - CEO & Founder of Talking HealthTech who work behind the scenes to power the Medicubes podcast.  

Learn about Pete’s background in healthcare management including his first job phoning GP clinics chasing up medical reports for life insurance applicants, his own experience running GP clinics across the country including the technical and people challenges he faced and how he overcame them, as well as the power of podcasting and what’s next for Talking HealthTech.

Stacy Kambouris General Manager, Education and Innovation and QIP Consulting LinkedIn Profile 

Accreditation tips: 

• Relax! This is not a pass/fail process.  
• Take your time - start preparing early (recommend 8 months from due date to start regularly working on accreditation preparation)
• Use a team-based approach and share the workload
• Use the resources available to you via your accreditation provider
• Ensure the team understands their role & responsibilities
• Tailor templates to practice-specific processes. Avoid [insert your details here] text in your Policy & Procedure Manual
• Build a strong practice ‘quality’ culture - create buy-in to the process at all levels of the practice
• Implement a Review/Audit/Train cycle. 
• Accreditation is an opportunity to identify improvements, even where no ‘non-compliances’ exist. 
• Surveyors are not ‘looking’ for non-compliances! Use the survey visit as a learning opportunity. 
• Understand the notion of ‘meeting the intent of the Standards’ to provide flexibility in how evidence is provided. For example - staff meeting notes or minutes structure

Why do practices undertake accreditation? To ensure patient safety & quality care measures are embedded in everyday actions and activities. It is a pathway to high performance primary care. It also provides funding access Practice Incentives Payment Program PIP, Workforce Incentives Payment Program WIP, and participation as teaching practices 

RACGP 5th edition standards 

The Australian Commission on Safety & Quality in Healthcare Advisory kit GP18/04 notification of sig risk. 1. Pt identification 2. Reusable instruments (inv proc) 3. Medicines storage 4. Management of temperature sensitive medicines 5. Follow up of significant tests.

NSQHS Standards Primary & Community Health Care Services

RACGP Accreditation Resources

For experienced practices - consider looking at other Standards for elevating performance such as the NSQHS Primary Health Care Standards.

Today’s podcast is brought to you from the Medicubes team, a panel discussion on tackling the primary care workforce challenges, optimising team based care and ensuring financial viability. We discuss the right person to provide the right role, scopes of practice and diversification of roles to enhance streamlined care and improve our patient experiences and outcomes.

Episode Details

• Nurse Led Clinics APNA clinic budget tool
• APNA Nurse led clinics
• Case conferencing Allied Health MBS items
• Women wellness cervical screening service
• e-Learning Medical Business services - Nurse Led Clinics - Use coupon code aapm for 15% discount until 15 October 2022
• Exercise is Medicine group example - Springs Medical
• Exercise is Medicine group example - Mullumbimby
• Huddles in Primary Care
• MBS item 10997
• Quality Improvement framework
• Teen Clinics

Questions from the Audience

• Jenny from SA asks :- How do we set up a wound care clinic in our practice?
• David from NT asks:- How do we set up a Satellite site, putting a team or a clinic offsite due to infrastructure limitations?

Today’s podcast is bought to you from Mount Beauty Medical Centre/Falls Creek Medical Centre with Practice Manager Pat Ryder and Rural GP Laura Zagorski.

Pat obtained her Certificate of Health Economics, Monash University in 1998 followed by her Diploma in Practice Management, University of New England in 2002. Pat gained her Fellowship of the Australian Association of Practice Managers in 2014.

Pat commenced work at the Mount Beauty Medical Centre in 1986

Pat has expertly guided the accreditation of both practices with General Practice Accreditation. She has also completed Management, University of New England in 2002. Pat gained her Fellowship of the Australian Association of Practice Managers in 2014.

Pat commenced work at the Mount Beauty Medical Centre in 1986

Pat has expertly guided the accreditation of both practices with General Practice Accreditation. She has also completed accreditation of both practices with the HDAA as Radiology Service Providers.

Laura is a GP with 11 years experience working in Falls Creek and Mount Beauty. She completed MBBS at UWA in Perth, graduating in 2007. She received her fellowship of the RACGP in 2013 and has completed various other postgraduate studies.

She enjoys all aspects of rural GP particularly women’s health, mental health, lifestyle medicine and attending to sports injuries. She spends a large portion of each winter working at Falls Creek Medical Centre where she combines her interest in managing snowsports trauma with her love of downhill skiing.

Episode Details:

●     An overview of the Falls Creek Medical Centre, location & services & relationship to MBMC

●     A typical day in snow season look like

●     Specialist equipment do you us and  training do GPs and staff require

●     Similarities & differences to traditional GP services (relationship to hospital services)

●     Billing structure (& notion of 'unique' service development)

●     Attracting staff to work in quite remote locations.

●     The best/most challenging aspect of this work?

Key Messages:

Diversity in practice keeps doctors ‘interested’

General practice training can take you anywhere you want it to. 

George Sotiris has almost 15 years of health industry experience as a Workplace Relations Specialist helping thousands of private practices in Australia. As the Director of Health Industry Employment Services (HIES), he is passionate about working closely with medical practices, allied health practices and dentists across Australia to reduce employment risk.

We discuss:

• Some of the HR trends you have seen in the past few years? (Stress, Burnout & Bullying claims, increase in difficult patients and pay/wage disputes)
• Fair Work is talking a lot about salaried arrangements and the Better Off Overall Test (BOOT)
• Practical tips that will assist practices with managing Award compliance and staff pays and tools that may help?
• Recruitment and retention - What are the hot tips?

We answer Audience Questions:

Barb from Western Queensland had a HR Question - “Do you see anything different in HR between city practices and regional and remote practices - both from a legal and payroll sense but also practice culture” 

Jamie from Sydney asked “Where do I go to find out what I need to do and how to stay up to date with everything HR?”

Links:

Free Staff Review Template

Better Off Overall Test (BOOT)

This episode was recorded life at the Australasian Society of Lifestyle Medicine conference in Cairns on the 30th July 2022. 

The Australasian Society of Lifestyle Medicine (ASLM) is an interdisciplinary society working towards improved prevention, management, and treatment of chronic, complex and lifestyle-related conditions.  ‘Lifestyle-related’ includes environmental, societal, behavioural and other factors. ASLM members include GPs and medical specialists, allied health practitioners, public health physicians, educators, scientists, researchers and healthcare executives.

Hear Chris, Riwka and Kim reflect on all things advocacy, policy and prevention in primary care.

Links:

1.    Australasian Society of Lifestyle Medicine

2.    RACGP Healthy Habits App

3.    10997

4.    10987

5.    Behaviour change training Wellcoaches and research

6.    APNA

7.    Healthily

8.    Weight & Lifestyle management – Murrumbidgee PHN program

9.    CDM in Covid times

10. Workforce

11. Shared medical appointments & yarn ups

12. Aboriginal round table discussions | Waminda

13. Optimising workforce

14. MBS for shared medical appointments (Normal consultation items apply with existing item descriptors and requirements)

15. Case conferencing

16. Learn more about Case Conferencing – eLearning module

17. Heart health check (HHC) item 699

18. Heart foundation Heart Health Check Toolkit

19. Team roles

20. QCI & accreditation overlap with prevention activities

21. Attendances & Heart Health Check

22. Measuring outcomes for policy change

23. PDSAs (Plan-Do-Study-Act)

24. PREMS, PROMS, PAIS

25. Coop Wonca

26. Where lifestyle medicine fits in

27. Practice systems & processes

28. Effective systems for workforce attractions

29. Health coaching example Dr Cheryl Wilson

30. ‘Hand up, not hand out”

• Chris Smeed

• Recap of essentially no indexation. Ie - fees are not keeping up with CPI increases 20 year history, reducing practice viability etc.

• How will you manage still low Medicare rebates if not moving to private billing

The Medicubes team bring you a monthly panel conversation of exciting and challenging topics in primary health care, answering listener questions and invited guests to the discussions.

Subscribe now and catch the first episode really soon!