Leveraging My Health Record to improve practice workflow

Leveraging My Health Record to improve practice workflow Ben Cohn – Education and Clinical Use Lead Dr Laila Tabassum – Education and Clinical Use Lead Australian Association of Practice Management

ACKNOWLEDGEMENT We would like to acknowledge the traditional custodians of the lands we’re meeting on. I’d like to pay my respects to their Elders, past, present, and emerging, and acknowledge and extend that respect to other Aboriginal and Torres Strait Islander people and Elders from other communities who may be joining us today. Australian Association of Practice Management

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Who do you think this is? Someone tasked with overseeing the day-to-day administrative and operational functions of a business. Australian Association of Practice Management

Who do you think this is? Someone tasked with overseeing the day-to-day administrative and operational functions of a business. Definition of “Chief Operating Officer” in Investopedia https: //www. investopedia. com/terms/c/coo. asp Australian Association of Practice Management

During this presentation we will: • Discuss what the effective use of My Health Record may look like in your practice • Show the potential benefits of effective My Health Record implementation • Identify strategies to assist your practice embed My Health Record in your day to day workflow Australian Association of Practice Management

A case scenario – how My Health Record could help Australian Association of Practice Management

Introducing Trish has been a regular patient at your practice for the last 10 years. Lately she has been spending a lot of time in Orange, NSW where her only daughter is living. She became a grand mother for the first time 9 months ago and her main focus has been taking care of her granddaughter. Trish was diagnosed with early stage breast cancer 3 years ago. She had surgery and radiation. Trish is back in town to see her specialist and also celebrate her 75 th birthday with her friends. She visits her GP to get some scripts for her medications and a referral to a physio since her back pain has increased again. Australian Association of Practice Management

Trish’s care plan Trish has been in Orange for 9 months and has returned to Brisbane. Her back pain has increased and she requires some repeat scripts. Trish sees the GP, who starts the care plan. The nurse completes her part of the care plan and gives Trish her vaccine. The GP gives Trish her scripts and a referral to the physio. A copy of the care plan is given to Trish and faxed to the physio. The visit is finalised but the practice receives a claim rejection. Australian Association of Practice Management

Trish’s care plan Trish has been in Orange for 9 months and has returned to Brisbane. Her back pain has increased and she requires some repeat scripts. Trish sees the GP, who starts the care plan. The nurse completes her part of the care plan and gives Trish her vaccine. The GP gives Trish her scripts and a referral to the physio. A copy of the care plan is given to Trish and faxed to the physio. The visit is finalised but the practice receives a claim rejection. Services might have been provided by other GP. Australian Association of Practice Management

Has she seen other doctors? Australian Association of Practice Management

Trish’s care plan Has there been any changes in her medicine? Trish has been in Orange for 9 months and has returned to Brisbane. Her back pain has increased and she requires some repeat scripts. Trish sees the GP, who starts the care plan. The nurse completes her part of the care plan and gives Trish her vaccine. The GP gives Trish her scripts and a referral to the physio. A copy of the care plan is given to Trish and faxed to the physio. The visit is finalised but the practice receives a claim rejection. Services might have been provided by other GP. Australian Association of Practice Management

Medicines Information View – sorted by name / date Australian Association of Practice Management

Shared Health Summaries Australian Association of Practice Management

Trish’s care plan Has there been any changes in her medicine? Trish has been in Orange for 9 months and has returned to Brisbane. Her back pain has increased and she requires some repeat scripts. Services might have been provided by other GP. Trish sees the GP, who starts the care plan. The nurse completes her part of the care plan and gives Trish her vaccine. The GP gives Trish her scripts and a referral to the physio. A copy of the care plan is given to Trish and faxed to the physio. The visit is finalised but the practice receives a claim rejection. Has she received a flu vaccine this season? Australian Association of Practice Management

Did she receive a flu vaccine already? Australian Association of Practice Management

Trish’s care plan Has there been any changes in her medicine? Trish has been in Orange for 9 months and has returned to Brisbane. Her back pain has increased and she requires some repeat scripts. Services might have been provided by other GP. Has the item number already been claimed? Trish sees the GP, who starts the care plan. The nurse completes her part of the care plan and gives Trish her vaccine. The GP gives Trish her scripts and a referral to the physio. A copy of the care plan is given to Trish and faxed to the physio. The visit is finalised but the practice receives a claim rejection. Has she received a flu vaccine this season? Australian Association of Practice Management

Has this item number been claimed before? Medicare Overview – From: 01 Dec 2018 to 21 -Sep-2019 21 Sep 2019 TRISH TAYLOR Do. B 2 Mar 1944 (75 y) SEX Female IHI 8003 6086 6670 1594 4 Apr 2019 11: 57+1000 0000023 professional attendance by a general practitioner at consulting rooms (not being a Chris Javad service to which any other item in this table applies), lasting less than 20 minutes and including any of the following that are clinically relevant: (a) taking a patient history; (b) performing a clinical examination; (c) arranging any necessary Investigation; (d) implementing a management plan; (e) providing appropriate preventative health care; for 1 or more health-related issues, with appropriate documentation each attendance No 14 Jun 2019 10: 15+1000 0000723 attendance by a general practitioner to coordinate the development of team care Chris Javad arrangements for a patient (other than a service associated with a service to which any of items 735 to 758 apply) No Australian Association of Practice Management

What are the impacts of this case? • Financial • Inefficiency • Patient safety • Continuity of care Australian Association of Practice Management

Are these issues familiar in your practice? Issue Manifestation Practice focussing on using My Health Record for e. PIP compliance Panicked uploading of Shared Health Summaries days before end of e. PIP period Nurses trying to keep a log of Shared Health Summaries uploads Only 1 or 2 clinicians responsible for Shared Health Summaries uploads Staff not accessing information in My Health Record Front desk staff chasing Discharge Summaries Item numbers rejected by Medicare e. g. frequency of claiming health assessments Time finding patient immunisation data Incomplete/unknown patient medications and allergies and adverse reactions Australian Association of Practice Management

Are these issues familiar in your practice? Issue Solutions Practice focussing on using My Health Record for e. PIP compliance Make uploading Shared Health Summaries BAU at your practice ü All clinicians involved in uploading Shared Health Summaries at the practice ü Select a patient cohort to target for uploading of Shared Health Summaries Staff not accessing information in My Health Record Encourage providers to access My Health Record for important patient information including: ü Discharge Summaries ü Medicines View ü AIR data ü Medicare item numbers Australian Association of Practice Management

Are these issues familiar in your practice? Issue Manifestation No/incomplete information available for new patient Patient has trouble recalling medications Patient has no information about recent hospital admission Patient cannot recall which specialist provider recently cared for them Your patients are out of area and require medical attention No Shared Health Summaries uploaded for the patient so other providers do not have basic clinical information including medications and allergies and adverse reactions Australian Association of Practice Management

Are these issues familiar in your practice? Issue Solutions No/incomplete information available for new patient Providers can access My Health Record for: ü Medication and allergy and adverse reactions information ü Recent discharge summaries ü MBS information showing the provider of the service Your patients are out of area and require medical attention Encourage providers to upload Shared Health Summaries for patients who are travelling so other healthcare providers can access vital health information Australian Association of Practice Management

Implementing Change Australian Association of Practice Management

Change Communication Pathway Awareness Are all your staff members aware of your practice participating in My Health Record Understanding Have they had a chance to ask questions? Eg: attended an education, information session Acceptance Have all your staff received one on one or group training about their roles and responsibilities Embedding Do staff members know what their role is individually and have started interacting with it Commitment Is there something to celebrate? Australian Association of Practice Management

My Health Record Practice Workflow

My Health Record role of the Practice Manager For My Health Record to function seamlessly, the Practice Manager performs these roles

The My Health Record patient journey Patient arrives at the practice

The My Health Record patient journey Patient sees the practice nurse Note: Uploading Shared Health Summaries is allowed by RNs but not by ENs or EENs

The My Health Record patient journey Patient sees the GP

PDSA Cycle for increasing the number of Shared Health Summaries to My Health Record Question: How can we achieve a more systematic uploading of Shared Health Summaries in our practice? Identify all areas of improvement and incorporate in the next cycle Check the number of Care Plans vs the number of Shared Health Summary uploads. Act: What changes are we going to make based on our findings? Study: What were the results? Plan: What exactly are we going to do? Do: When and how did we do it? Upload a Shared Health Summary for diabetes patients scheduled for a care plan in the next 4 weeks Identify patients for recall, finalise care plans and upload Shared Health Summaries Australian Association of Practice Management

Tips for leveraging My Health Record to improve practice workflow Improved efficiency Improved patient safety Business enhancement Trusted partnership with patients Australian Association of Practice Management

Tips for leveraging My Health Record to improve practice workflow TIP – Educate front desk staff in My Health Record and have patient collateral to save clinician time discussing My Health Record Improved efficiency Improved patient safety TIP - Ensure all healthcare providers are accessing My Health Record for key patient information Business enhancement Trusted partnership with patients Australian Association of Practice Management

Tips for leveraging My Health Record to improve practice workflow TIP – Educate front desk staff in My Health Record and have patient collateral to save clinician time discussing My Health Record Improved efficiency Improved patient safety TIP - Ensure all healthcare providers are accessing My Health Record for key patient information Business enhancement TIP – streamlining My Health Record roles in the practice ensures a better use of all staffs’ time TIP – Easy way to check MBS Item Numbers and AIR data Trusted partnership with patients Australian Association of Practice Management

Tips for leveraging My Health Record to improve practice workflow TIP – Educate front desk staff in My Health Record and have patient collateral to save clinician time discussing My Health Record Improved efficiency Improved patient safety TIP - Ensure all healthcare providers are accessing My Health Record for key patient information Business enhancement TIP – streamlining My Health Record roles in the practice ensures a better use of all staffs’ time TIP – Easy way to check MBS Item Numbers and AIR data TIP – Upload Shared Health Summary for patients to improve continuity of care Trusted partnership with patients TIP – Let your patients know you are a My Health Record practice with signage Australian Association of Practice Management

Tips for leveraging My Health Record to improve practice workflow TIP – Educate front desk staff in My Health Record and have patient collateral to save clinician time discussing My Health Record Improved efficiency TIP - Ensure all healthcare providers are accessing My Health Record for key patient information TIP – Access Medicines View for patient medications and adverse reaction Improved patient safety Business enhancement TIP – Viewing PSMLs valuable for elderly or patients with multiple medications TIP – streamlining My Health Record roles in the practice ensures a better use of all staffs’ time TIP – Easy way to check MBS Item Numbers and AIR data TIP – Upload Shared Health Summary for patients to improve continuity of care Trusted partnership with patients TIP – Let your patients know you are a My Health Record practice with signage Australian Association of Practice Management

Resources Australian Association of Practice Management

Software simulators and summary sheets On Demand Training A sandbox environment (simulation) for interacting with a fictional patient’s My Health Record Summary Sheets Step-by-step instructions with screenshots for viewing information in a patient’s My Health Record and uploading to it through clinical software www. digitalhealth. gov. au > Using the My Health Record system > Training Resources Australian Association of Practice Management

Fact Sheets and Online CPD E-learning modules My Health Record Fact Sheets https: //www. myhealthrecord. gov. au/for-healthcare-professionals/howtos/factsheets-and-guides My Health Record CPD e-learning modules https: //www. myhealthrecord. gov. au/for-healthcare-professionals/howtos/elearning -modules Australian Association of Practice Management

“We cannot change what we are not aware of, and once we are aware, we cannot help but change. ” Sheryl Sandberg, COO Facebook Australian Association of Practice Management

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For further information and support My Health Record Web: www. myhealthrecord. gov. au My Health Record Help line: 1800 723 471 (select 2 for providers) Australian Digital Health Agency (ADHA) Web: www. digitalhealth. gov. au Email: help@digitalhealth. gov. au Australian Association of Practice Management

Australian Association of Practice Management