The address is www.health.vic.gov.au/generalpractice.

Under various subheadings you can find information on Aged Care, Child Protection, Disability Services, Drugs and Poisons, Immunisation, Infectious Diseases, Maternal and Child Health, Mental Health etc.

For example under Infectious Diseases I found the list of notifiable diseases and how to notify.  Also there was the school exclusion table so I can now confidently tell parents when their little ones can go back to school and kindergarden.

Under Mental Health I found the forms to request a person receive involuntary treatment from an approved mental health service.  I haven’t had to use such a form for years, but at least I now know where to find one.

Child protection issues fortunately don’t come up that frequently in my practice, but at least I know where to find the local contact number and how to make a notification.

The immunisation schedule has undergone a lot of changes in recent years, but the latest national immunisation schedule is there at your fingertips.

When I am confronted by a drug seeking patient, it is often difficult to remember all the rules and procedures, but there is a dedicated section for it, including the Prescription Shopping Information Service phone number.

So all in all, a very worthwhile website and although I may not use it every day, it will be comforting to know it is there.  I would suggest all GPs, Practice Nurses and Practice Managers put it into “Favorites” on their computer.

And by the way, while you’re at it don’t forget the similar local website that gives all the details of Ballarat Health Services that are relevant to GPs at www.gp.bhs.org.au.

Our web stats tell us that most of you are using Internet Explorer 7 or 8 or Firefox. These tips are for you.

If you’re still browsing with Internet Explorer 6 (you’ll know because there’s a big red message at the top of this page), go to your IT people and demand an update. Tell ‘em Julian sent you.

1) Open links in new tabs

The scroll wheel on your mouse also acts as a middle button. If you middle-click any web link, that link will open in a new tab. Really handy for opening a bunch of stuff you want to read later.

If your mouse doesn’t have a scroll wheel, you can right-click on any link and choose ‘open in new tab’.

2) See all your tabs at once

For Internet Explorer users only. Sorry Firefox fans.

Hit Ctrl+Q, and you’ll see a purdy picture of all your open tabs. Just click the one you want to open.

3) Fast switching between tabs

Ctrl+Tab cycles between your open tabs.

Also, Ctrl+1 opens the first tab, Ctrl+2 the second, and so on.

To open a new blank tab, hit Ctrl+T.

4) Open tabs you closed accidentally

Just closed a tab by mistake? I do it about fifty times a day. Ctrl+Shift+T brings it back for you.

(Internet Explorer 7 doesn’t support this. If you’re on IE7, you should update your web browser.)

5) Fast web search

We spend most of the time on the web looking for stuff. Hit Ctrl+E to jump to the search box, then just type in your search words and hit enter.

Government sponsored seasonal influenza vaccines are available to a wider target than ever before. The largest target group for influenza vaccination is people over 65 years of age.

Identification of this age group using the CAT is best done later in the vaccination program.

Identification of other groups can be performed using the CAT and following the steps set out in this 2010 Fluvax recipe.

In the busy life of a general practice, using your clinical software effectively can save time.

When pathology results are downloaded in HL7 format, Medical director users will notice lipids & HbA1C auto-population within the diabetes assessment & cardiovascular risk assessment tools.

CAT users will be able to easily identify patients who require:

• 45-49 year old health assessment (especially those at high risk of CV event)
• PAP smears (can even search according to date of last PAP)
• Completion of diabetes SIP

How to organise HL7 pathology download? It’s a simple matter of ringing your pathology companies to request – nothing needs to be changed at your end!

About HL7

HL7 is a standard for exchanging information between medical applications. It defines the format and the content of the messages that applications must use when exchanging data with each another in various circumstances.

For further information contact me on 5331 6303 or tanyag@bddgp.org.au.

My last count found there were 74 GPs using Zedmed. This simply wasn’t possible, but I didn’t keep the source data, so I don’t know how I arrived at that figure. My apologies to everyone who relied on that data.

The latest count (whose source data I have kept) breaks down like this;

Clinical package      Number of GPs
ZedMed Clinical       57
MedTech32             26
Medical Director 3    17
Medical Director 2    12
Locum                 5
Genie                 1

• A GP using the same package at more than one location is only counted once
• A GP using different packages at different locations is counted once for each package (hence the numbers adding up to more than our total number of GPs)

Cleaning your data means no more than ensuring information within patients’ clinical files is current, accurate and meets legislative and RACGP standard requirements (see below). This promotes continuity of care within the practice, so when you are away on your tropical holiday and a patient presents for an acute exacerbation of ‘whatever’, your locum/associates are aware of past treatment and outcomes.

Four ways to clean your data

1. Agree on a practice-wide definition for “active patients”, and start inactivating patients who don’t fit into this definition.

• The RACGP defines active patients as those who has been seen 3+ times in the last 24 months; thus excluding all new patients and those who attend irregularly due to good health. Consider a time-based definition.
• Remember, when inactivating patients, DO NOT DELETE THEM; while they might be able to be recovered, it is normally a more complicated process than reactivating a patient.

2. Update patient details: how annoying (and time consuming) is it when you are trying to contact a patient for reminder/recall/billing issues and their contact details are incorrect.  Do this at the same time as point 1 above.

• Consider making this an annual or semi-annual event. How will you mark your database to avoid duplicating the process with individual patients?

3. Update your past medical histories and current medications.

• These can be inactivated/added/deleted as necessary.
• Remember: every time you do a referral or letter created with your clinical software templates this information is included in the document. These documents are not only a reflection of the patient’s health/demographic status; they also reflect your data accuracy systems.

4. Use the clinical record tool boxes to record biometric information.

• Clinical software provides a single data entry system. When data is entered in the correct place, it is also distributed to progress notes and other searchable fields.
• When creating letters/referrals in templates, data auto-fills to appropriate fields (assuming templates correctly configured).

Who will do the work?

We all have time constraints which can impact on the ‘extra’ tasks involved with improving data accuracy. Data cleansing need not be only one person’s job.

The whole practice can be involved in improving data accuracy AND it doesn’t have to be done all at once. By accessing your software help files you may even find some shortcuts.

Consider allocating every member of the practice team a goal (appropriate to their role/training) each month. Make it:

Specific
Measurable
Achievable
Repeatable
Timely

For example, Chris will inactivate 50 identified patients prior to the next staff meeting.

Answer these questions

• What do we want to achieve?
• When do we want to achieve it?
• Why are we doing it?
• How are we going to do it?
• Who is going to do which part of the task?
• When will it be done by?

The stick!

Medicare  legislation requires that:

G.15.1. PRACTITIONERS SHOULD MAINTAIN ADEQUATE AND CONTEMPORANEOUS RECORDS

This is found within the MBS, as are definitions for ADEQUATE and CONTEMPORANEOUS.

RACGP (3^rd edition) standard 1.7  includes criterion for (and information about):

• patient health records
• health summaries
• consultation notes

The Opera web browser has a feature built in called Opera Turbo. Opera Turbo compresses all of your web pages and images before they come down the line, so browsing over a slow connection becomes a much more tolerable experience.

(If you don’t know what a web browser is, you probably use Internet Explorer – the blue E – because it came with your computer. There are alternatives.)

'Normal' web browsing

Opera Turbo enabled. Chunkier, but much faster.

First, download and install Opera. After you’ve done this, you should have a nice big red ‘O’ icon on your desktop.  Open it and begin browsing as you normally would.

You’ll see a little clock icon in the bottom left corner, like this;

Click it to enable Opera Turbo.  That’s it!

Caveats

Firstly, Opera achieves this compression by routing all of your web traffic through their servers. This might be a privacy issue – they could effectively know where you’ve been and what you’ve been doing.

Secondly, Opera Turbo doesn’t work with every web page. Some sites, especially those that require you to sign in, might experience problems. Also, Opera Turbo only makes web pages faster, not other internet services like Skype, email, nor plug-in content like YouTube videos.

For those unfamiliar with the CAT, or just wanting to increase their knowledge of what can be done with the tool, visit the CAT web site.

Their web site also contains some ‘CAT recipes‘ – ways to analyse your patient data, including:

• Identify diabetic patients with No HbA1c recorded in the last 12 months
• Identify eligible females who have no pap smear recorded in the last 4 years
• Identify ALL outstanding Diabetes Cycle of Care items for each of the diabetic patients in the practice
• Identify currently undiagnosed patients with significant risk factors for chronic disease
• Identify patients with Allergy or Smoking Status NOT recorded
• Identify patients eligible for the Gardasil Immunisation program

For more information on CAT, email me at tanyag@bddgp.org.au.

ADDENDUM 3/12/09: the figures below are incorrect and are not to be relied upon

Clinical package      Number of GPs
ZedMed Clinical       74
MedTech32             36
Medical Director 3    32
Medical Director 2    18
Locum                 6
Genie                 1

A GP using the same package at more than one location is only counted once.

A GP using different packages at different locations is counted once for each package (hence the numbers adding up to more than our total number of GPs).

To view the online introduction video click here.

This pop-up add-on to clinical software is currently available for the following software:

• MD3 standalone
• MD3 + Practsoft3
• Best Practice clinical standalone
• Best Practice clinical and management
• Best Practice clinical + Practsoft3

When used with management software the DCP can alert you to potential EPC planning for patients while they are with you.

Screen Shot of the DCP popup panel which appears above the tray area of the desktop. Shows some of the range of prompts available. Headings are blue; items are coloured red if not done, yellow if overdue for repeating and green if up to date. Prompts are tailored to the individual patient.

The DCP can take the place of annoying preventative health prompts. Clicking the icon on your toolbar (bottom of your screen) will bring up a small screen with colour coded visual cues indicating preventative care measurements, tests, immunisations, medications appropriate for the individual patient based on the RACGP Red Book guidelines and standards of preventive care.

The DCP uses a set of configurable rules to determine whether prompts are shown and uses information in the database to determine status.  The DCP also allows printing of ‘data collection sheets’ and ‘Action lists’ for the day’s appointments. This allows staff to implement the data collection, which the doctor can simply enter into software at consultation. The DCP also creates reports on basic statistics.

The DCP is still in development. Utilisation of the DCP is growing at a rapid rate.