Medicare Local eHealth

Adam McLeod

What are Medicare Locals?

• Medicare Locals are primary health care organisations responsible for coordinating primary health care delivery and tackling local health care needs and service gaps.

• While government funded, Medicare Locals are independent organisations, not government bodies.

• Our approach is to actively build on our GP and primary health care provider strengths, expertise and knowledge.

Our objectives

IEMML’s main objective is to improve primary health care in our community.

Our four key areas of focus are:– after hours care– aged care services– mental health– population health planning– eHealth

Support from IEMML

Awareness Readiness Adoption Meaningful Use

Telehealth in Aged Care

Telehealth Program Overview• Support Residential Aged Care Facilities (RACF) in

hosting Telehealth consultations between residents and specialists, both supported and unsupported

Chances of a specialist visiting a RACF are (almost) zero.

Specialist visits can often take a full day for residents, particularly if ambulance transportation is required

Transport costs can be expensive and taxis are difficult if you’re frail

Elderly people are frequently dependent on family members or RACF staff/volunteers for transport to specialists

How are IEMML doing it?

FOCUS is not on the technology.

• Contact RACF

• Conduct technical audit and site visit

• Get the RACF visiting GP list

• Contact the GPs

• Get the specialist list from the GP

• Get in touch with the specialists

• Get the consultations happening.

• RACF - Very large buildings /multiple wings

• No NBN

• Limited 4G

• High contention

Specialists

• Keen but too busy

• Not computer literate

• Unaware

• Confusion about billing

Telehealth Issues

Regardless…. Working now

ML Data

ML Data

How we use our data?

Service planning• After hours

• Informed decisions regarding which clinics to fund

• ED data

• Used ED data to target reduction programs / avoidance, Asthma more of an issue than Diabetes.

• GP Data

• Used GP data to look at effectiveness of interventions – back pain & opioids.

ML Data Philosophy

Is about:

• Collaboration

• Partnership

• Sharing

• Learning

• An evolving solution

Outcomes:

• Better services & outcomes for our communities

• Working together cooperating for the greater good.

PCEHR

eHealth record: Information sources

Healthcare Provider

Shared Health Summary

PCEHRKey roles of MLs: Awareness Meaningful Use

- Signed up practitioners 125 GP practices / 750 GPs 28 Pharmacies 20 Physio Practices

- Recruit patients 30,000 consumers recruited.

- Secure Messaging 98 practices connected, Healthlink, Argus.

- Electronic Transfer Prescriptions 125 practices turned on

Allied eHealth

IEMML Allied Health Engagement

Two streams of work:

• Broad Allied Health Awareness Raising - multidisciplinary

• eHealth for Allied Health Project – pilot with physiotherapists

eHealth for Allied Health Project

Pilot project• Aim for 20 private physiotherapy practices (70 clinicians)• Two cohorts:

• 14 are “paper-based”• 4 are “computerised”, meaning they already use

electronic clinical notes

Paper Based Get them using a clinical system.Computerised PACS, Secure Messaging, Telehealth

All Signed up for PCEHR, HSD / HealthDirect.

eHealth for Allied Health Project

Results:

- All 18 practices started using a clinical system - 90% continuing- All signed up for PCEHR- 4 started using PACS- Successful using ‘Basecamp’ as a ‘social support program’- Positive evaluation- Now looking at replication across other disciplines.

Discharge and Referral

Discharge and Referral

Acute – Eastern Health, discharge summaries for about 5 years.

‘Rapid Integration Project’ – CDA Discharge summaries - PCEHR.

Referrals into Eastern Health – Almost happening…

Future

Where to next…

- Embed PCEHR- Across sectors

- Referral and Discharge – CDA.

- Health Pathways / Decision Support

- Predictive software for primary health

… open to ideas…

Thankyou

Adam McLeodamcleod@iemml.org.au