HOSPITAL PASS: A MEDICAL HOME:
Transcription
HOSPITAL PASS: A MEDICAL HOME:
focus AUTUMN 2015 | EDITION 12 A MEDICAL HOME: Putting people at the centre HOSPITAL PASS: Community care to the fore PRIMARY FOCUS 2 PRIMARY NOTES It’s time to look forward. Another year is well and truly upon us, one that heralds significant changes in the coordination and delivery of primary health care not only for our region but right across Australia. From July this year the new Primary Health Networks (PHN) will be in place to act as facilitators and funders of primary health services, with our region being absorbed into a much larger PHN stretching from Cocoroc in the south past Lancefield in the north, and as far west as Bacchus Marsh. At the end of January we submitted a tender to the Federal Department of Health to operate the North Western Melbourne Primary Health Network, as the lead agency in the Melbourne Primary Care Network (MPCN) consortium. Bringing together the care networks and health system expertise of some exceptional partners, MPCN will champion a new focus on integrated, person-centred and GP led care. We are excited by the challenges ahead and are confident that together we can make a real difference to health in north-western Melbourne. We say ‘together’, because we couldn’t have got to this point without the wonderful support of our health community, especially our foundation and supporting partners and the individuals and organisations that provided us with formal letters of support. Contents 03 News 07 Member Profile 08 Medical Home 10 Hospital Pass 13 Focus On For now, we await the results of the PHN tender process, which the Department has advised should be announced by April. We will keep you informed as the process comes to its conclusion, but in the meantime it really is business as usual at Inner North West Melbourne Medicare Local: we’re still here to deliver better primary healthcare for our community until 30 June 2015, and hopefully for much longer as the North Western Melbourne Primary Health Network. Some of the ways we are doing that are showcased in this edition, with a focus on two areas of enduring importance: improving patient care and reducing costs by cutting avoidable hospitalisations; and supporting GPs to play the lead role in delivering person-centred, whole-of-life care to the community. You’ll also find articles on our new program in advanced care planning, an update on HealthPathways Melbourne and the latest on our burgeoning Immunise Melbourne campaign. Clearly there’s a lot happening already and we’re looking forward to much more to come as we march into 2015. ASSOCIATE PROFESSOR CHRISTOPHER CARTER CHIEF EXECUTIVE PRIMARY FOCUS 3 NEWS CARING IN ADVANCE Health professionals will have more support to discuss future care needs with their patients and clients through a new Advance Care Planning project being developed by INWMML. Advance Care Planning (ACP) is where people can consider and talk with those close to them – including their doctor or other health professionals – about what would be important for them if they could no longer make decisions for themselves. This can include nominating a substitute decision maker and writing down a plan about future health decisions. INWMML was one of three Medicare Locals in Victoria to succeed in a highly contested process for the Enabling State Wide Advance Care Planning project, an initiative funded by the State Government and facilitated by Networking Health Victoria to develop a system-wide approach to ACP in Victoria. INWMML CEO Associate Professor Christopher Carter said ACP is only going to become more important as our population ages and medical technology continues to advance. “Making sure everyone involved has a clear idea of what is important to a person, what type of care they want to receive, and under which circumstances, is a great way to provide peace of mind in their future care,” A/Prof Carter said. “It also helps loved ones and family members who will often need to make decisions for the person. Part of the ACP process can involve nominating a substitute decision maker and making sure that they understand the person’s wishes.” “We understand having these conversations and completing an advance care plan can be challenging, which is why this new project will have strong focus on support and training for health professionals involved”. “This will support other work being undertaken by the Health Issues Centre, which is focusing on how to best support community members.” The project will sit within the Inner North West Melbourne Health Collaborative, which has had strong success in developing coordinated care approaches in chronic disease and eHealth through its foundation partners Melbourne Health, cohealth and Merri Community Health Service. The project’s main focus will be on Priority Action Area 1 of the statewide strategy, which is about establishing robust organisational systems to support ACP. The main objective is to embed ACP within usual practice, and ensure the transfer of information between those involved in providing a person’s care. The project will also include partnerships with Royal District Nursing Service, the North West Metropolitan Palliative Care Consortium, Inner North West Melbourne Primary Care Partnership, and Medical Deputising Services. For more information about ACP, including links to key websites and current resources for patients and health professionals, visit our new Advance Care Planning webpage at www.inwmml.org.au DECISION ASSIST is an exciting program that is enhancing the delivery of advance care planning and palliative care to older Australians, by providing education and support to GPs andaged care staff nationally. It includes an Advance Care Planning and Specialist Palliative Care Telephone Advisory Service for health professionals – 1300 668 908, specialised workshops, improved linkages between palliative care and aged care services and a dedicated website featuring the latest information and advice about advance care planning and palliative care. For more information, go to www.decisionassist.org.au. GROWTH CONTINUES FOR NATIONAL HEALTH SERVICES DIRECTORY The National Health Services Directory (NHSD) is consolidating its position as the leading directory for health services in Australia as monthly searches hit 4.6 million. Now featured on more than 80 websites nationally as well as being downloaded thousands of times as a mobile app, the NHSD allows users to search based on service type and location, with other filters including opening hours and bulk billing status. The NHSD widget available on the INWMML website is one of the latest versions, with enhanced functionality such as being able to search by languages spoken by the practitioner and their gender. INWMML eHealth Project Officer Gary Morris said the increasing popularity of the service means it’s more important than ever for local practitioners to start listing their services or update their existing service information. “With more than 40,000 practitioners listing over 150,000 services on the NHSD, it really is the one-stop shop for locating health services, and best of all it’s free,” Gary said. Service providers can email [email protected] and provide details of any changes required. Services will then be contacted by the NHSD Team to confirm their information. For further information please contact Gary Morris eHealth program officer INWMML on 93471188 or email [email protected] PRIMARY FOCUS 4 109 AND GROWING FOR HEALTHPATHWAYS MELBOURNE Momentum continues to build for HealthPathways Melbourne with 109 best-practice assessment, management and referral pathways now available to help local GPs treat a range of common conditions. One pathway soon to be released covers low back pain, a very common complaint in general practice that can have a range of causes and presentations. GP Clinical Editor Dr Debra Wilson said the nature of the condition means that it has taken 12 months to create and localise the pathway. Assessment and management of low back pain can include a wide range of diagnostic, allied health and specialist input and it has been important to bring together all those perspectives in the development of the pathway. The back pain pathway joins a range of others covering areas as diverse as gastroenterology, diabetes, cardiology and Ebola management. Acting as a memory jogger and supporting the expertise of the general practice community is one of the key goals of HealthPathways Melbourne, a joint project from the Royal Melbourne, Royal Women’s, St Vincent’s hospitals and Eastern Health, along with Inner North West Melbourne and Inner East Melbourne Medicare Locals. Localised referral information and the collaborative design process for the pathways between GPs, specialists and hospital networks is also helping to improve care coordination, making the local health system easier to navigate for doctors and patients alike. And while the project has reached its target of 100 localised pathways six months ahead of schedule, there is no sign of slowing down with another 50 pathways being actively localised. General practitioners in the inner north west and inner east of Melbourne can contact [email protected] for more information and to get access to this free system. With more than 100 pathways developed HealthPathways is helping to improve the patient journey in inner Melbourne. NEW PATHWAY TO HELP EASE BACK PAIN PRESSURE Better care for people with low back pain and shorter hospital waiting lists are possible following the development of a new HealthPathway on low back pain. The new pathway will focus on managing low back pain within the general practice setting, motivated by concerns from hospitals about inappropriate referrals and long outpatient waiting times. HealthPathways GP Clinical Editor Dr Debra Wilson said the combination of access and management issues in our region made the low back pain pathway particularly important. “It’s a really common thing – around 90% of us will have back pain at some point in our lives so it’s really important that we get treatment right,” Dr Wilson said. The multi-disciplinary pathway development team included at least 15 clinicians from four Victorian health services and across primary care, representing neurosurgery, orthopaedics, rheumatology, pain, allied health, pharmacy and general practice. The team, led by Dr Wilson, has worked for a year to bring the pathway to fruition. “Given that it’s not a disease it’s really difficult and complicated to determine a straightforward pathway for identification and management,” Dr Wilson said. “The two main things we have stuck very closely to are; what is the evidence telling us; and what will cause the least harm.” One thing the evidence shows is that less than 5% of people who present with low back pain will have a serious cause, with most back pain being related to simple, mechanical issues that should improve within two weeks with conservative management. “Then it comes down to managing expectations within the patient, who may not have gone back to what they were prior to their event of pain and they’re thinking there must be some more serious cause for that,” Dr Wilson said. Helping GPs to better explain and implement appropriate pain management strategies could help limit costly and potentially unnecessary hospital referrals for MRI testing. PRIMARY FOCUS 5 New mum Emily knows immunisation is the way to go for her family. LOCALS JOINING THE FIGHT AGAINST INFECTIOUS DISEASE Local parents are sharing their positive immunisation stories to help others make the right choice when it comes to immunising their kids and preventing further outbreaks of diseases like whooping cough and measles. Reported cases of whooping cough jumped by more than 50% last year in Victoria, including steep rises in Melbourne (55 cases, up 77%), Yarra (59 cases, up 26%), Moonee Valley (36 cases, up 44%) and Moreland (62 cases, up 59%). Doing her bit to stop a resurgence of dangerous diseases was behind Emily’s decision to be part of the Immunise Melbourne campaign, which aims to boost immunisation rates for children aged 0-4. The Glenroy local’s story is one of several from local parents across the region featured in the campaign, explaining why she made the choice to fully immunise her child. “I have a science background and wanted to make a truly informed decision, so I did my research,” Emily said. “I read lots of papers and studies and eventually came to the conclusion that immunising our daughter was not only in her best interest, but also our social responsibility.” The motivation for Airport West mum Krissi was even more personal, after she came into contact with a child with suspected chicken pox while pregnant. “My close contact with this child and his mother meant I had to have blood tests and be monitored in case I contracted chicken pox, as this could affect my baby,” Krissi said. “Thankfully, as it turned out, this child had another illness. All the stress and worry that we went through – not to mention the extra medical costs and the time of the midwives and doctors, was totally avoidable.” For working mum Lidia, having the support of a well-informed GP helped overcome any initial concerns she might have about immunisation. “My GP is fantastic and I chose to listen to her, and I listened to my obstetrician too,” Lidia said. “They are experts who study these things in depth, and are paid to know all the details. My GP is particularly thorough in explaining the potential risks, side effects and benefits of each vaccination. “That’s been extremely important to me, particularly when I was a new mum who was a little uncertain about vaccinations.” Inner North West Melbourne Medicare Local (INWMML) along with the Melbourne, Moreland, Moonee Valley and Yarra councils are backing the Immunise Melbourne campaign, responding to a small but increasing trend of non-immunisation in the inner Melbourne region. “These stories show the real human face of immunisation – it’s about people making an informed decision to protect themselves, their families and their communities,” INWMML CEO Associate Professor Christopher Carter said. “Hundreds of rigorous studies have conclusively shown immunisation is responsible for saving millions of lives and is the safest and most effective way we can protect our children from infectious diseases.” The campaign has struck a chord with the community, at a time when controversy over a now cancelled visit to Australia by antivaccination campaigner Dr Sherri Tenpenny has regularly put immunisation in the news. The Facebook page for the campaign has ballooned to over 1,000 followers since the controversy began in January, becoming a hub for parents to share pro-vaccination stories and support. An Immunise Melbourne stall at the recent Pregnancy, Babies and Children’s Expo at the Melbourne Exhibition centre was also well attended, with further stalls at upcoming community events and festivals planned. You can see all the stories and get more information about immunisation at www.immunisemelbourne.org.au, or join the conversation at the Facebook page www.facebook.com/immunisemelbourne Immunise Melbourne is also looking to expand the campaign with more real stories from more parts of Melbourne, so if you have a positive immunisation story to tell get in touch at the Facebook page or email [email protected] PRIMARY FOCUS 6 MOMENTUM GROWING FOR VIDEO CONSULTATIONS People living in residential aged care facilities (RACFs) in our region are getting better access to care through an INWMML supported program of video-based GP consultations. 16 supported consultations have taken place between GPs and residents of participating RACFs since the trial went live last year as part of the Australian Government’s Better Health Care Connections program. Consultations are conducted between the GP’s office and the RACF using a videoconferencing system such as Skype™, with all necessary equipment and support provided by INWMML. The initial consultations have been used for scheduled reviews and catch ups, but the program has identified that it may also be useful for both scheduled and unscheduled sessions; regular reviews related to chronic disease; and for GPs who are not at their practice full time. One GP has now progressed to conducting the consultations independently with her three RACF residents, and two more RACFs with over 200 beds between them are soon to come on board. INWMML Program Coordinator Samantha Milford said the recent growth was a positive sign and she was looking forward to seeing what benefits broader use of video consulting can provide for RACF residents, staff and GPs caring for older adults. THE HEPATITIS B STORY NOW AVAILABLE IN MULTIPLE LANGUAGES A plain English language teaching tool for discussing care and management of chronic hepatitis B (CHB) is now available in a range of targeted community languages. The hepatitis B story, developed in partnership between INWMML and St Vincent’s Hospital Melbourne, uses informative images and plain text to help health professionals when discussing care and management of CHB with people who have low health literacy. Melbourne’s inner north west region has a higher than state average number of people living with CHB. CHB is the main cause of liver cancer and is the fastest increasing cause of cancer death in Australia. In 2013, approximately 43% of people living with CHB were unaware they had the disease, and only five percent of those that had been diagnosed were receiving treatment. Strong uptake of the Hepatitis B Story as a tool for educating people who have CHB has precipitated the translation of the resource. The Hepatitis B story is now available as an animated video with voice over in Vietnamese, Mandarin, Karen and Cantonese as well as a take home booklet in these languages. Infectious diseases expert Dr Nadia Chaves said the Hepatitis B story has been a fantastic resource for clients and providers. “I use it with all my patients with hepatitis B and also with their families,” Dr Chaves said. “I just wish it was available for other diseases.” All of these resources are available on the INWMML and St Vincent Hospital websites: www.inwmml.org.au/hepb www.svhm.org.au/gp/clinics/Pages/ Gastroenterology.aspx Video consultations are offering another way for GPs to keep in touch with their patients. PRIMARY FOCUS 7 FOCAL POINT Dee Wardrop Speech Pathology and Occupational Therapy Services WHAT IS IT THAT YOU DO? We provide a range of Speech Pathology and Occupational Therapy services for children and adults. We offer clinic based sessions (Thornbury and Seddon) and also a mobile service for our clients at their home, kindergarten/day-care, school, or nursing homes. Our speech pathologists have expertise in all areas of speech, language and communication. We support clients with a range of delays and disorders, including early language development, feeding difficulties, stuttering, voice, literacy and reading skills, autism spectrum disorders, hearing loss and learning difficulties in children, and acquired/progressive neurological conditions of language, cognition or swallowing in adults. Our occupational therapists are paediatric specialists, supporting children to improve their performance in everything they do – including early play skills, handwriting and self-care, socialisation, participation, self-regulation and sensory integration. WHO IS THE SERVICE FOR? Assessment and Individual Therapy Services are the main part of our practice. These services are provided to any client requiring support for their speech, language, swallowing or communication difficulties, or difficulties with any aspect of their participation in home or school life. Clients can be referred directly via a primary care provider, or self-refer. We also provide a group therapy program for children to support a range of goals; including social skills, friendship, communication, handwriting, literacy or a combination of sensory integration and early language development. Diagnostic and funding assessments, communication check-ups, talking time playgroups, music, movement and language groups and education/ training services are some of the other things we provide. We love what we do and we are passionate about providing the best care we can for every client. When we get emails like this from our clients – we know we’re getting it right. “I just felt really compelled to email and let you know how much we love our speech therapist. She’s such a pleasure to work with and my son really responds so well to her. It’s great seeing someone doing a job that they love and to see her develop such a lovely rapport with children just by being herself.” WHY DO CLIENTS CHOOSE YOUR SERVICE? Clients often come to us by word-of-mouth or referrals from other health professionals who we have worked with in the past. Our reputation for excellence, our team of communication specialists and the length of time we have been operating are the biggest drawcards for our clients. Since adding our Occupational Therapy services in 2011, we have found even more clients choosing our practice because of the convenience of having all their needs met in one clinic. One of the most exciting parts of working in private practice is the opportunity to innovate. Clients choose us because we’re prepared to think outside the square to offer the best service we can. Practice Principal Dee Wardrop at her Thornbury practice. WHAT DO YOU SEE AS THE BENEFITS OF BEING A MEMBER OF INWMML? By being an active part of INWMML, our practice remains up to date on new services and initiatives within our local community. This benefits our team by providing opportunities to be involved, provide information to our clients and to innovate with new programs or services that align with the needs identified in the INWMML catchment. For example, upon reading about the lengthy waitlists for speech pathology assessments in our local area in 2013, we developed our low cost Communication Check Up Service and were able to offer this as a way of giving families some immediate input about their child’s speech and language needs. Above all, we really enjoy working within the collaborative model of INWMML. We love networking with general practice teams to promote our services, and we work to support local primary care providers, such as GPs and practice nurses, to remain informed about the assessment and treatment options available in our team, and how we can all work together to help each client or family to achieve their best outcomes. If you would like to be profiled in a future edition of Primary Focus, please contact Julie Sucksmith on (03) 9347 1188. PRIMARY FOCUS 8 Technology is driving a new era of person centred care. THE PERSON CENTRED MEDICAL HOME – A MODEL FOR THE FUTURE OF CARE WHAT IS IT? The person centred medical home (PCMH) is a model of primary healthcare that is personcentred, comprehensive, team-based, coordinated, accessible and focused on quality and safety. Developed in the US, the model focuses on the potential of an effective primary health care system to improve health outcomes and costs while improving the care experience for patients. It works by enhancing the core values of traditional general practice of providing comprehensive, coordinated and integrated care with a holistic approach to patient illness and wellness supported by the whole general practice team. New health technology plays a key role in enabling general practices to become PCMHs, with electronic health records and usable patient data allowing GPs to better respond to the needs of their patient cohorts, and electronic decision support applications and patient care reminder systems improving care quality. The medical home is not a destination – it is a model for continually moving towards realising the vision of care provided in the right place, at the right time and in the manner that best suits a patient’s needs. HOW DOES IT HELP? The PCMH model aims to reduce fragmentation of care by better integrating all the services a patient needs around their core general practice provider. It is especially important in both the prevention and management of chronic disease, helping general practices to organise patient data to highlight current and future areas of need and to respond by offering appropriate interventions. PRIMARY FOCUS 9 Professor Rick Kellerman from the University of Kansas School of Medicine says the PCMH model has an important potential role in Australian general practice for patients with limited access to medical care. “On a broader scale, such a model has the potential to facilitate team care arrangements for patients with chronic disease, and to reduce fragmentation of medical records and the associated patient safety issues that occur from incomplete medical information,” Professor Kellerman said. The PCMH model has also been associated with reduced costs for both health funders and service providers, through reduced hospitalisations and by improving the efficiency and utilisation of the entire general practice team. THE MEDICAL HOME IN ACTION The PCMH model of primary care has been implemented in a range of public and private health markets in the US, and a there is a growing body of evidence that it is having a positive impact on health costs and improved use of the health system. A systematic review by the by the Australian Primary Health Care Research Institute’s Centre for Research Excellence in Primary Health Care (CRE) showed the PCMH could improve a range of health outcomes, including access to care and management of chronic and complex diseases. The RACGP is a major supporter of the PCMH model, and a number of health organisations and providers, including INWMML, are using the model to inform the delivery and structure of their programs and services. “The medical home model is known as a positive advancement in primary care delivery and for delivering better health outcomes for patients at a lower economic cost to government,” RACGP President Dr Liz Marles said. “The CRE’s focus on the medical home concept supported by the development of improvement tools for general practice adds further weight to the benefits of implementing a medical home concept in Australia.” More than 75% of Australian GPs surveyed by the AMA also support the introduction of the PCMH model, provided linkages are voluntary and reversible and fee-for-service is maintained. BRINGING THE MEDICAL HOME CONCEPT TO NORTH WESTERN MELBOURNE As the lead organisation in the Melbourne Primary Care Network consortium, the Person Centred Medical Home (PCMH) is one of the key models that underpins our vision for the future of primary health care in the North Western Melbourne Primary Health Network. A better connected, coordinated and integrated health system, centred around enhanced and fully supported general practice, has huge potential to deliver the better quality, lower cost health care required to meet future demand. We’re already moving to provide general practices with the tools and support they need to become PCMHs, by improving patient and population data, increasing their uptake and use of eHealth services and systems and connecting GPs to best practice information on managing a range of common conditions. Increased use of the PEN Clinical Audit Tool (PENCAT) has been one key focus, allowing practices to better identify both individual needs and broader population trends in their patient cohort, leading to a number of practices offering new or refined services that better reflect demand. This push for better quality and access is further supported by work to increase the number of local people signing up for a Personally Controlled Electronic Health Record (PCEHR), with over 10,000 new users signed up directly by INWMML in the first six months of 2014. In addition to bringing on thousands of new users, we also surveyed over 500 health providers, including 130 general practices, about their eHealth awareness and readiness to identify any knowledge and usage gaps. From there we’ve been moving from ‘knowing to doing’, focusing on helping practices to become eHealth ready and make meaningful and consistent use of the PCEHR as part of their regular clinical practice. As well as using eHealth to help practices identify issues and access better quality patient information, we’re also supporting their ability to take the lead role in managing an ever increasing range of conditions through the HealthPathways Melbourne program. HealthPathways provides best practice and localised information to assist GPs with assessment, management and where necessary referral for a range of common conditions. More than 100 pathways are now available, including everything from neurology, to diabetes care and management and cardiovascular disease. Taken together these programs are helping to form the structure of the PCMH model for GPs in the inner north west of Melbourne, and potentially a broader region once Primary Health Networks are instituted from July this year. To find out more information about Primary Health Networks and INWMML’s focus for the future, visit www.inwmml.org.au/phnnews PRIMARY FOCUS 10 TAKING A Hospitals like the Royal Melbourne are centres of medical excellence, but aren’t always the best place for chronic care. HOSPITAL PASS Hospitals have come a long way since they were seen as being only for those too poor to afford to be treated in their own homes, or where the sick would go to die. While many hospitals have now become centres of medical and scientific excellence, it remains true that they aren’t always the best place to receive medical care: especially when it comes to the prevention and management of chronic disease. Seven percent of all hospital admissions in Australia in 2011/12 were considered to be potentially avoidable, driven mainly by admissions for vaccine-preventable diseases and chronic conditions that could have been avoided through more effective community based care. As well as taking patients out of their communities, hospital care is often also the most expensive treatment option, with avoidable admissions placing a strain on the system that will only grow as chronic diseases become more prevalent. Reducing the pressure on hospitals isn’t as simple as cutting hospital treatment for chronic disease – many potentially avoidable admissions are necessary by the time a patient presents at a hospital. The opportunity to prevent these admissions comes earlier, by identifying prevention, management or treatment needs and providing targeted services that stop those needs going unmet and resulting in hospitalisation. Hospitals themselves are playing a key role in keeping people healthy in the community, with Hospital Admission Risk Programs (HARP) being supported by major hospital networks across Victoria. HARP provides specialist treatment, care planning, education and support to help people with chronic and complex health issues to self-manage at home and reduce hospital admissions. PRIMARY FOCUS 11 Royal Melbourne Hospital HARP General Physician Dr Amira Mahboub says it’s about providing a seamless transition from the hospital to the community for people who are at risk of readmission, rather than continuing to see the hospital as the centre of all care. “Now I think that sort of view has changed and the hospital is just a sort of hiccup in their journey, and we’re supposed to get them back to their normal baseline in the community,” Dr Mahboub said. Dr Mahboub works with a range of HARP clinicians and other community practitioners in areas as diverse as nursing, allied health and pharmacy to ensure that patients have access to all the services they need and their GP is connected throughout. As well as improving the delivery of care, programs like HARP are becoming increasingly important for their ability to lower health expenditure by potentially avoiding acute care episodes. “I think with healthcare costs it’s not feasible anymore to keep people in hospital for weeks at a time, and there are really simple things that can be done that can keep people out.” Mental health is one area where the shift from an institutional focus to a community based model has long been established. However preventing avoidable hospitalisations in this area, particularly emergency department presentations in crisis situations, can often be quite challenging. The Inner West Police and Clinician Emergency Response Service (Inner West PACER) is one way local emergency mental health services are looking to meet this challenge, working with police to provide an effective model of care for responding to mental health crises in the community. Operated by the Royal Melbourne Hospital Emergency Mental Health Team, Inner West PACER operates in the afternoons and evenings seven days a week, providing early intervention and assessment in response to a behavioural event in the community that has necessitated police attendance, and which may involve a person with a mental illness or condition. As well as responding to the initial crisis, follow up care and coordination of services is a crucial part of the program, especially where a person receives a PACER interaction and is not immediately referred to an inpatient unit or emergency department. INWMML has provided funding to support care coordination in these circumstances, including provision of information to the patient’s usual general practitioner (where possible and with patient consent) to ensure continuity of care. INWMML General Manager of Primary Care Services and Clinical Psychologist Julie Borninkhof says supporting communication between the different services involved is vital to ensure the individual receives the best possible care. “Having information available about each incident and any interventions that may have been provided is really important for consistency of care, especially for the person’s GP who is working with them on a regular basis,” Ms Borninkhof said. Another field where consistency of care and a community based approach are of primary importance is aged care. Older people are more likely to live with multiple chronic conditions and be at risk of hospitalisation than the general community, with 49.6% of people aged over 65 having two or more chronic conditions. Conversely older people often do not cope well with hospitalisation, particularly people living in Residential Aged Care Facilities (RACFs) who Dr Amira Mahboub. may find the process of going to hospital especially difficult. “Older people deteriorate very quickly when they come into hospital,” Dr Mahboub said. “They might be very independent at home and the minute they come into hospital they decline very rapidly.” To help keep RACF residents well and out of hospital where possible, St Vincent’s Hospital Residential In-Reach (RIR) services bring hospital like care into RACFs, providing assessment and management of acute medical conditions. Staffed by hospital-based nurses and doctors and supported by INWMML, RIR services often reduce the need for hospitalisation of a resident. RACF staff who responded to a survey on the RIR program were extremely positive about its benefits for residents, many of whom are frail and require complex, ongoing care. “In-Reach has made a big difference to the care delivered [to] our residents,” one respondent said. “Transfer to ED has been avoided many times. Also, the services around End of Life decisions and discussions have been of great benefit.” These programs represent just a few of the many services seeking to keep people well in their own community and in their own homes. And while there are many changes emerging in the way primary health is coordinated and delivered in the coming year, keeping people healthy, independent and out of hospital where appropriate will always remain a priority. ADVERTISEMENT Merrilyn, 30 Coburg local I study and work I’m involved in our local community and I immunise. Find out why @ immunisemelbourne .org.au INWMML would like to acknowledge the Immunisation Alliance WA, which has granted approval for use of their I Immunise concept for this campaign. © MPCN 2014 All rights reserved PRIMARY FOCUS 13 FOCUS ON: MUSCULOSKELETAL CONDITIONS Each issue we profile a treatment, condition or practice management tool. This issue we look at musculoskeletal system conditions, with assistance from Arthritis and Osteoporosis Victoria. ABOUT Musculoskeletal conditions, including arthritis, osteoarthritis, osteoporosis and other conditions, affect more people in Australia than any other type of chronic disease – surpassing rates of cancer, diabetes and heart disease. 29 out of 100 people in our region (ASR) are affected by a musculoskeletal condition, and across Australia more than 6 million people are estimated to have some type of musculoskeletal disease. While musculoskeletal conditions such as arthritis can often be seen as ‘older person’s diseases’ or a natural part of ageing, in fact more than half of people living with such conditions are aged between 25 and 64 – the prime working age population. The A Problem Worth Solving report by Arthritis and Osteoporosis Victoria estimates that by 2032, as the population ages, the number of cases of arthritis and other musculoskeletal conditions in Australia will increase by 43% to 8.7 million, affecting 30.2% of the projected 2032 population of 29.1 million. IMPACT In terms of total economic impact, it was calculated that arthritis and other musculoskeletal conditions resulted in a $55.1 billion cost to the Australian community, comprised of $9.2 billion direct health costs (including hospitalisation, pharmaceuticals and aged care), $11.7 billion other financial costs (including $7.4 billion productivity cost) and $34.2 billion burden of disease. Following the launch of A Problem Worth Solving in 2013, the Victorian Department of Health established the Musculoskeletal Clinical Leadership Group with the purpose of providing expert guidance and advice to develop a coordinated approach across all health settings to improve outcomes for Victorians with, or at risk of, musculoskeletal conditions. For further information about Arthritis and Osteoporosis Victoria, its work and the report A Problem Worth Solving, please refer to the website www.arthritisvic.org.au MANAGEMENT IN OUR REGION HealthPathways Melbourne is developing a range of best practice clinical assessment, management and referral pathways to assist GPs to better manage musculoskeletal conditions in the community. The first of these pathways covers low back pain, and is due to be released in the next couple of months following more than a year of development by leading specialists from the Royal Melbourne Hospital, St Vincent’s Hospital Melbourne and Eastern Health, in conjunction with general practice and community allied health professionals. The pathway supports diagnosis and treatment at the primary care level where possible, with the aim of providing better patient care and reducing unnecessary referrals and hospital outpatient waiting lists. You can read more about the low back pain pathway on page four, and GPs can obtain a username and password for the site by contacting [email protected] PRIMARY FOCUS 24 IN ONE EAR twitter.com/inwmml YOUR PRACTICE Keep up to date with Your Practice, our fortnightly newsletter covering all our upcoming events as well as the latest news and information from across the primary health care sector. Subscribe to Your Practice through [email protected] or read it online at www.inwmml.org.au ACKNOWLEDGEMENTS We acknowledge the Wurundjeri people and other peoples of the Kulin nation as the Traditional Owners of the land on which our work in the community takes place. We pay our respects to their Elders past and present. Medicare Locals gratefully acknowledge the financial and other support from the Australian Government Department of Health. Missed out on the big tips? Here’s our news in 140 characters or less. Make sure you catch everything next time by following us at twitter.com/inwmml INWMELBMEDICARELOCAL @INWMML • FEB 11 New @AusHealthcare report highlights importance on healthcare collaboration, praises @INWMML program http://inwmml.org.au/news/fxnews.cfm?loadref=6&id=121… INWMELBMEDICARELOCAL @INWMML • FEB 4 Are you an #ImmuneHero? Great information for students, parents and everyone at http://immunehero.health.vic.gov.au/ @BetterHealthGov INWMELBMEDICARELOCAL @INWMML • JAN 27 DISCLAIMER This magazine is provided for information only. Although every effort is made to ensure accuracy of information, it is presented without warranty of any kind either expressed or implied. The reader assumes the entire risk as to the use of the magazine and the material in it. The views expressed in this magazine are those of the authors and do not necessarily reflect the official position of Inner North West Melbourne Medicare Local. Time to #RethinkSugaryDrink? Check out these tips from @NutritionAust http://www.rethinksugarydrink.org.au/go-free INWMELBMEDICARELOCAL @INWMML • JAN 17 ICYMI: RT @AusHealthcare: Find out how @INWMML is providing a helping hand to young ppl doing it tough in #Melbourne: http://goo.gl/41qCa7 INWMELBMEDICARELOCAL @INWMML • JAN 14 INNER NORTH WEST MELBOURNE MEDICARE LOCAL ‘100 day cough’ making a comeback in Melbourne – pertussis on the rise in the city @melbtimes @MelbourneLeader http://inwmml.org.au/news/fxnews.cfm?loadref=6&id=118… ABN 95 153 323 436 INWMELBMEDICARELOCAL @INWMML • JAN 9 Telephone: (03) 9347 1188 Fax: (03) 9347 7433 Street address: Level 1, 369 Royal Parade, Parkville, Victoria 3052 Postal address: PO Box 139, Parkville, Victoria 3052 Email enquiries: [email protected] ADVERTISE WITH US Standard advertising rates for the magazine (excluding GST): NON- MEMBER INWMML MEMBER •Quarter page $450 •Half page $800 •Full page $1,500 $225 $400 $750 All material is subject to editorial review. Please contact Julie Sucksmith on (03) 93471188 for more information. This comic strip sums up why vaccines are so important @sciencecomic @thenib – https://medium.com/the-nib/vaccines-work-here-are-the-facts5de3d0f9ffd0 INWMELBMEDICARELOCAL @INWMML • JAN 8 The #Hepatitis B Story education tool is now online in plain Karen language – funded by @INWMML with @StVincentsMelb http://vimeo. com/114616160#t=0s INWMELBMEDICARELOCAL @INWMML • DEC 23 Some fantastic news to end the year… http://www.inwmml.org.au/news/fxnews.cfm?loadref=6&id=115… #Melbourne #healthcare INWMELBMEDICARELOCAL @INWMML • DEC 18 Great article in @AusHealthcare ‘#Health Advocate’ on @Youth_Projects program in #Melbourne #homelessness PRIMARY FOCUS 15 EVENTS www.inwmml.org.au/events The Manipulative Patient – GP Mental Health Series 17 March, 6:30–9pm Secure Messaging 19 March, 6:30–8:30pm Cervical Screening 19 March, 6:30–8:30pm Asthma Update and Inhaler Devices 14 April 2015, 6.30–9pm Care Plans and Coaching The Melbourne Clinic, 130 Church St, Richmond RSVP 10 March Dr Michael Moloney, Director of The Melbourne Clinic Drug and Alcohol Rehabilitation Unit, will explore the how to recognise manipulative behaviours and develop strategies to assist in dealing with these patients. Speaker: AJ Williams-Tchen The Treacy Centre, 126 The Avenue, Parkville RSVP 11 March Level 1, 369 Royal Parade, Parkville RSVP 12 March The Treacy Centre 126 The Avenue, Parkville RSVP 7 April The Treacy Centre, 126 The Avenue, Parkville 24 March, 6.30–9pm UPCOMING EVENTS • CPR update – 15 April • Alcohol and Drugs – LGBTIQ sensitivity and cultural competency training – 28 April • Family Violence – 7 May • Advance Care Planning – April (date tbc) RACGP: 4 category 2 points Are you considering secure messaging to enhance your business. Do you want to learn more about the benefits of secure messaging? Do you have Argus but not currently fully utilising it? Then this event is for you. For practice nurses: Join the discussion with expert Kirsten Hausknecht and learn about the importance of screening for cervical cancer, and the current renewal of the National Cervical Screening Program. For GPs and practice nurses: This update covers the essentials of best-practice asthma and respiratory management for primary care health professionals and includes an interactive demonstration on the correct use of inhaler devices. For GPs and practice nurses: Help your patients identify goals and improve their confidence to self-manage! Improve medical compliance in patients with cardiovascular disease! Training also includes a revision of the MBS item requirements for GP Management Plans, Team Care arrangements and Reviews. MORE INFORMATION For more information and registration visit www.inwmml.org.au/events OR make sure you read our fortnightly newsletter, Your Practice. Feedback: We welcome your feedback about our events, email [email protected]. Sponsorship: If you would like to sponsor an INWMML event call Julie Sucksmith on (03) 9347 1188. 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