Practice Connect #51

Welcome to Practice Connect, a fortnightly update for practice managers, nurses and practice administration staff on relevant issues, upcoming events and education.

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Immunisation update

WA Immunisation Schedule updated

The WA Immunisation Schedule has been updated effective from 1 August 2018.

Changes include

DTPa-IPV vaccine schedule point has reverted to 4 years and no longer from 3.5 years
Children aged 5 to <15 years who have not received a dose of Men C are eligible for one dose of 4vMenCV (blue text under childhood schedule)
Influenza vaccine for ≥5 years to 17 years and ≥18 years is available for individuals who are Aboriginal and/or medically at risk

HealthPathways update

EMHS GP update: Pain, Perioperative and Referral Pressure Points

Presented by the East Metropolitan Health Service in partnership with WA Primary Health Alliance and HealthPathways WA. This event has 40 Category One QI&CPD points.

Date:                Saturday, 8 September 2018
Time: 8.30am – 3.30pm (8.00am – Registration)
Venue: Royal Perth Hospital, Bruce Hunt Lecture Theatre, 197 Wellington St, Perth WA 6000
Cost:                 Free. Morning tea and lunch provided
Register:        To register, please visit here.

Program topics include:

Working together to ensure our patients are fit for surgery - Anaesthetics and haematology
Doc, it hurts when I move! - Orthopaedic workshops including examination techniques, diagnostics and optimising non-surgical treatment
Taking the pain out of pain management
Referral pressure points - workshops on Urology and Plastics
GPs, Hospital clinicians and WAPHA - panel discussion on how we can work better together to improve care for our patients

Protecting Brains and Bones: What a GP Needs to Know

Presented by Osborne Park Hospital in partnerhsip with WA Primary Health Alliance and HealthPathways WA. This event has 40 Category 1 QI&CPD points.

Date: Saturday, 10 November 2018
Time:    8.30am – 3.30pm (8.00am – Registration)
Venue:   University Club, UWA, Crawley WA 6009 (free parking available at Entrance 1, Carpark 3)
Cost: Free. Morning tea and lunch provided
Register:   To register, please visit here.

Education sessions include:

Early diagnosis and management of Parkinson's Disease by Dr Barry Vieira
Early diagnosis, differential diagnosis and management of dementia by Dr Brendan Foo
Acute stroke and TIA, early diagnosis and management by Dr Kien Chan
Diagnosis and management of osteoporosis by Professor Charles Inderjeeth
Geriatric residential outreach service summary by Dr Charmaine Chua

My Health Record update

Resources for General Practitioners

The best way to get clear on your obligations as a GP around My Health Record is by attending a training session. A My Health Record trainer can provide an education session at your practice, at a time that suits you best. Please email myhealthrecord@wapha.org.au to arrange a time with one of our trainers or book a workshop via the RACGP. For more information on this exciting project, please go to www.myhealthrecord.gov.au

Things to remember when talking to your patients about My Health Record

With opt-out now in full swing, be prepared to have conversations about uploading shared health summaries with your patients, ensure that your clinical software data is accurate and your patients understand what they will be able to see through My Health Record.

Be aware your patient might have no pre-knowledge of My Health Record.
Remember the benefits of My Health Record when talking to your patients to correct the misinformation in the media. You might emphasis the existence of privacy and access controls that are in the hands of the patient. You might want to highlight that only health professionals involved in their care have the right to access your information.
A patient can control which healthcare provider can access their record by setting a "Record Access Code". They will have to provide the code at the time of their appointment.
A patient can lock certain documents in their My Health Record by protecting it with a "Limited Document Access Code" which means the provider can only see that document once the code has been provided by the patient.
A patient can set up to 6 SMS notifications to notify them via their phone (1) When a healthcare organisation opens the My Health Record for the first time (2) When a healthcare organisation opens the My Health Record in an emergency i.e. Break Glass (3) When a new Shared Health Summary is uploaded (4) When someone new is able to access My Health Record (5) When an Advanced Care Plan changes (added/removed/reinstated) (6) When a Nominated Representative opens their My Health Record

Some helpful links for GPs

Digital Health update

New update available for CAT Plus

A new update is now available for CAT4 and Topbar for August 2018.

This update contains additional graphs to identify MBS items for Telehealth consultations and Nurse Practitioner items, as well as several bug fixes for Topbar and updated clinical items.

To download these updates for CAT4 follow the menu options below. Please be aware you will need to run updates on each user installation as well as on the data server. Topbar automatically updates daily as required. For assistance, please contact the Pen CS support team on 1800 762 993.

Further information on each of the updates is as below:

New MBS graph for reporting of Telehealth and Nurse Practitioner consultations - see user guide here
Fasting Blood Glucose (FBG) categories have been updated for guidelines to include >=5.5 to <=6.0 and >6.0 to <7.0. These categories are now also supported for Topbar prompts
Diabetes SIP graphs now include Medication Review where possible
Cervical screening prompting has been included in Daily CAT view to enable practices to create Topbar prompts
MD Preferences now provides for Program Locations configuration in addition to Practice Pracsoft Locations
nKPI June 2017 Reporting updates - (1) PI22 cervical screening updates (2) Exclusion of deceased patients
Topbar Bug Fix - Patient Health Summary App to display allergy status "No known allergies" (currently only displays Allergies recorded)
Topbar Bug Fix - MBS App to exclude GP MHTP for patients with Dementia

Cervical Screening Scholarships for WA nurses and midwives

The WA Cervical Cancer Prevention Program is providing scholarships to nurses and midwives working in private and publicly funded sectors that are committed to delivering cervical screening services.

The scholarships cover the cost (theory and clinical practicum components) of attendance at Sexual Health Quarters (SHQ) Cervical Screening for Nurses courses (theory delivered 26 -29 November 2018 in Perth, clinical TBC with SHQ). For more information visit here.

Applications close Friday 28 September 2018. For more information visit the WA Health website or email cervicalscreening@health.wa.gov.au

Royal Perth Hospital GP notify further problems

Delivery of GP notifications has been interrupted by a further issue. Work is underway to resolve this as soon as possible. On recommencement, some delayed notifications will automatically send. Please check the date of the admissions, discharge or death in the first paragraph of the notification. Some notifications may not be able to be resent.

Please note that the faxing of discharge summaries to GPs has continued, although some were delayed due to a critical issue in the fax-server that sends the discharge and emergency summaries for WA public hospitals. Secure electronic transmission has continued as usual. Transmission of discharge summaries by secure electronic messaging is preferred to fax. Please refer to Discharge Summaries here if you would like to change to secure messaging for inpatient discharge summaries (secure messaging is not available for GP Notify).

Many thanks to those GPs and practices who have responded to the request to re-register for GP Notify. RPH has received a huge response and these are being processed as quickly as possible. Notifications will not start until the registration is processed and the system is fixed. If you are still to respond, please ensure that you can include all relevant details as we have had a number of imcomplete responses. GPs and practice staff can phone the GP Notify Coordinator on 9224 2810, fax 9224 2860 or email RPH.GPN.Coordinator@health.wa.gov.au

Please accept our apologies for any inconvenience.

Ending of Decision Assist

The Decision Assist project has now ended and the associated website resource and phone advisory line are now closed. The website resources that were developed for the project and those that were held within the Decision Assist website have now been transitioned to the palliAGED website (palliative and end of life care) and Advance Care Planning Australia website (ACP and advance directives).

We would like to recommend that you remove reference/URLs to these resources and replace them with a selection of current, high quality, practice oriented evidenced based information and resources for primary health care providers from the following national project sources:

WA Practice Nurses Association membership

Membership renewals due by 31 August 2018

Membership of the Association is open to all nurses registered with The Australian Health Practitioner Regulation Agency (AHPRA), who are employed in doctors' surgeries (whether general practitioners, specialists, pathology practices or private outpatients clinic), or nurses and other persons with an interest in this area of nursing, including students of nursing, who may be invited to become members. Affiliate membership is now open to an individual, corporation or incoporated body interested in the work of the association. Registration is only $50 a year or $130 for 3 years.

If you wish to apply for membership, please download a copy of the membership application form here.

PBS changes for combination therapy

Changes to the PBS restrictions of some respiratory medicines came into effect on 1 August 2018

In summary, the PBS changes are:

ICS/LABA - Restriction level being elevated from Restricted Benefit to Authority Required (Streamlined)
LAMA/LABA - Addition of clinical criteria to the current restrictions, allowing their use in patients who have not been previously stabilised on a combination of LAMA and LABA medicines, but who have failed ot have their symptoms controlled by either
For all COPD (and asthma ICS/LABA medicine) - Administrative advice (or 'Notes' as they appear on the PBS website) updated as per recommendations made by the PBAC in August 2017.

Full details of these changes can be found on the Schedule of Pharmaceutical Benefits (Summary of Changes).

Sepsis: Know the Signs

Sepsis, a life-threatening condition that occurs when the body's response to infection injures its own tissues and organs, is estimated to contribute to 6 million deaths globally each year. In Australia, at least 18,000 people are treated for sepsis in inensive care units (ICU) annually, with 5000 losing their lives. This is likely a significant underestimate, as most sepsis deaths are attributed to the underlying infection (for example, pneumonia or influenza) and are therefore not accurately counted.

In 2016, a national awareness survey found 60% of Australians had not heard of sepsis, and only 14% could name one of its symptoms. Sepsis is an unpredictable and time-critical condition requiring rapid recognition and treatment with antibiotics. For each hour that medical care is delayed, the risk of death increases by around 8% and with approximately 70% of cases originating outside of hospital, low public awareness of sepsis in Australia leads to delayed recognition and treatment, and a higher likelihood of death or disability for patients.

For people who survive sepsis, up to half are left with impaired phsyical or mental function, or permanent disability. Many sepsis survivors face limb ambutations, cognitive impairment and ongoing health issues. Up to two-thirds report suffering post-traumatic stress disorder (PTSD).

The cost of sepsis to the Australian healthcare system and community is unkwown. Preliminary research puts the cost of treating sepsis in ICUs at $846 million annually, but this does not account for the costs of treating sepsis outside ICUs, or the ongoing treatment of survivors and costs related to loss of earnings and productivity. The total financial burden of sepsis is estimated to exceed AU$1.5 billion.

The Australian Sepsis Network is working to reduce Australian deaths and disability from sepsis, by increasing public and healthcare worker awareness. Please view awareness poster here.

Education and training

Visit our Webinars & Workshops page at www.practiceassist.com.au for more events in your area.

These events are often in high demand, so we recommend registering as soon as possible so you don’t miss out!

The new guidelines: Family abuse and violence - 21 August

RACGP Aboriginal and Torres Strait Islander Health will be hosting a complimentary lunchtime webinar session for GPs, Aboriginal and/or Torres Strait Islander health practitioners, healthcare workers, practice nurses and practice managers who would like to learn more about the prevention of family abuse and violence in primary healthcare services.

Date:                Tuesday, 21 August 2018
Time: 10.30am – 11.30am
Venue:            Live via webcast
Cost:                Free
Register:   To register, please visit here.

Maintaining continence in people with dementia - 21 August

Providing continence management to people living with dementia can be challenging, requiring us to look at how the dementia is impacting on their continence. This session will look at addressing continence assessment and management to improve our clients and carers quality of life and wellbeing.

Date:                Tuesday, 21 August 2018
Time: 6.00pm – 7.00pm (5.30pm – Registration)
Venue:            The Theatre, Technology Park Function Centre, 2 Brodie Hall Drive, Corner Hayman Road, Bentley WA 6102
Cost:                 Free
Register:        To register, please visit here.

A paradigm shift in COPD management - 29 August

In Australia, COPD is the second leading cause of avoidable hospital admissions and remains the fifth leading cause of death. This meeting will give you an opportunity to understand the latest management options and new advances in pharmacological strategies for moderate to severe COPD patients.

Date: Wednesday, 29 August 2018
Time: 6.30pm – 9.00pm
Venue: Rydges Kalgoorlie, 21 Davidson Street, Kalgoorlie 6430
Cost: Free
Register: To register, please visit here.

Mental Health: Understanding Personality Disorders Seminar - 30 to 31 August

The aim of this program is to provide nurses with up-to-date education about mental illness that relates to more complex and challenging conditions, such as personality disorders, including early identification and assessment, signs and symptoms, diagnosis and ongoing management.

Date:                Thursday, 30 August – Friday, 31 August 2018
Time: 9.00am – 4.15pm (8.30pm – Registration)
Venue:            Holiday Inn Perth City Centre, 778 – 788 Hay Street
Cost:                 $398 for one day, $520 for both days
Register:        To register, please visit here.

Immunisation Education Sessions - 4 to 18 September

The Immunisation Education Sessions will be presented by Metropolitan Communicable Disease Control and WA Primary Health Alliance (WAPHA). Also included in these sessions are updates from Diabetes WA and WA Cervical Cancer Prevention Program. For more information, view here.

Date	Time	Location
Tuesday, 4 September 2018 (Registrations closes 28 Aug)	12.00pm – 2.30pm	Currambine Community Centre,64 Delamere Ave, Currambine 6028
Wednesday, 5 September 2018 (Registration closes 29 Aug)	12.00pm – 2.30pm	WAPHA, Rooms 6&7, 2-5, 7 Tanunda Dr, Rivervale 6103
Thursday, 6 September 2018 (Registration closes 30 Aug)	12.00pm – 2.30pm	Fyre Park Pavillion, Clifton St, Kelmscott 6111
Tuesday, 11 September 2018 (Registration closes 4 Sept 2018)	12.00pm – 2.30pm	Stirling Community Centres – North Beach (Charles Riley), 7A Kitchener St, North Beach 6020
Wednesday, 12 September 2018 (Registration closes 5 Sept 2018)	12.00pm – 2.30pm	Winthrop, Piney Lakes Enviro Centre, Leach Hwy & Murdoch Dr, Winthrop 6155
Thursday, 13 September 2018 (Registration closes 6 Sept 2018)	12.00pm – 2.30pm	Secret Harbour Surf Lifesaving Club, Secret Harbour Blvd, Secret Harbour 6173
Tuesday, 18 September 2018 (Registration closes 11 Sept 2018)	12.00pm – 2.30pm	St John of God Midland Public Hospital Retreat Room, 1 Clayton St, Midland 6056

Please note that these sessions do not replace the yearly immunisation update, you can complete this here.

Cost: Free. Certificate of attendance will be provided.
Register: To register please visit here. Sign-in takes place 15 minutes prior to the start time of the presentations listed above.

Strength Your Legs Forum - 5 September

The Stay On Your Feet Strengthen Your Legs Forum will provide attendees with current evidence of the benefits of strength training for older adults, barriers and enablers to older adults to engaging in strength training, identifying older adults at risk of falls in everyday practice, evidence-based strength and balance exercise programs, and practical application for the delivery of strength and balance exercise programs for older adults including referral pathways, implementation, challenges and key learnings. Presented by guest speaker Dr Elissa Burton.

Date:                Wednesday, 5 September 2018
Time: 5.30pm – 7.30pm (5.30pm – Registration)
Venue:             Western Australian Centre for Rural Health, 167 Fitzgerald St, Geraldton
Cost:                  $25
Register:         To register, please visit here.

Clinical Deterioration: Identify, Assess, Prevent Seminar - 13 to 14 September

There is a significant potential for patients across any clinical setting to rapidly become unwell. Recent system changes have been rolled out to encourage better management of clinical deterioration. However, your ability to recognise and respond to changes in a patient’s condition early is a high priority if acute illness is to be averted. Attend this two-day seminar to gain knowledge that will help you to feel more confident that your essential assessment skills and early nursing management can detect early cues and prevent poor patient outcome. Learn about the power of assessment when your patient is deteriorating, how to recognise sepsis early, warning signs of acute kidney injury and many more.

Date:                    Thursday, 13 September – Friday, 14 September 2018
Time:                    9.00am – 4.00pm (8.30am – Registration)
Venue:                 Holiday Inn Perth City Centre, 778-788 Hay Street
Cost:                      $398 for one day, $520 for both days
Register:             To register, please visit here.

Mandurah and surrounding areas networking - 18 September

The WA Rural Networking Group is a group designed to provide an opportunity to connect like-minded Practice managers from all disciplines to learn from each other by sharing ideas, sharing experiences, giving perspectives and brainstorming any current issues. Our meetings are casual and held in a relaxed atmosphere where you can purchase refreshments and/or meal and network with other practice managers.

Date:                Tuesday, 18 September 2018
Time: 6.30pm – 8.30pm
Venue: Sandy Cove Tavern, 146 S Yunderup Rd, South Yunderup WA 6208
Cost:                  Free (food and beverage at own cost)
Register:         To register, please visit here.

HIV PrEP update for GPs and Practice Nurses - 10 October

This training will provide GPs, nurses and health professionals working in primary care an update on strategies available for the prevention of HIV transmission, focusing on prevention particularly pre-exposure prophylaxis (PrEP). This program will also include an STI update and WA AIDS Council session covering a health consumers perspective around PrEP.

Date:                Wednesday, 10 October 2018
Time: 6.15pm – 9.30pm (6.15pm – Registration)
Venue: Fraser Suites Perth, 10 Adelaide Terrace, East Perth WA 6004
Cost:                  Free
Register:         To register, please visit here.

Alcohol Screening and Brief Interventions Project Findings - 24 October

If you are a GP interested in expanding your professional knowledge on alcohol screening and brief interventions, please consider attending the Fiona Stanley Hospital (FSH) Grand Round to hear presentations on the Alcohol Screening and Brief Intervention Project, which was carried out with the WAPHA funding in 2017-208 at Fiona Stanley and Rockingham General Hospitals. The presentation will cover burden of alcohol in Australia and project overview, patient and staff attitudes, research evaluation results, clinical impact and operational feasibility and future directions.

Date:                Wednesday, 24 October 2018
Time: 12.00pm – 1.00pm (11.50am – Registration)
Venue:             Fiona Stanley Hospital, Education, Lecture Theatre G.1
Cost:                  Free
Register:         To register, please visit https://bit.ly/WAPHA_ASBI. Registration close Friday, 28 September 2018

The Ehlers-Danlos Society Learning Conference Australia - 10 to 11 December

After years of demand and need The Ehlers-Danlos Society is very excited to bring together in Australia leading world experts to discuss the Ehlers-Danlos syndromes and related disorders, including the recently-described hypermobility spectrum disorders.

Date:                Monday, 10 December – Tuesday, 11 December 2018
Time: 8.00am – 6.00pm (Day 1), 7.30am – 6.00pm (Day 2)
Venue:            Curtin University Building 410, Kent Street, Bentley Perth WA 6102
Cost:                 $150 (Day 1), $350 (Day 2)
Register:         To register, please visit here.

Health promotion events in August

Is your practice looking for a health promotion activity for your practice? Each edition we provide a list of upcoming health promotion activities for the coming months along with resources and contact details.

You can also view all health promotion activities for the year by visiting Practice Assist’s health calendar: https://bit.ly/2HWZX3B

Be Medicinewise Week - 20 to 26 August

For eight years, Be Medicinewise Week has been encouraging Australians to make good decisions about medicines, medical tests and other health choices.

Medicinewise families

This year our focus is on medicine wise families. Medicines are part of most people's lives, so it's critical to have access to all the information we need about the medicines we, and our family members, are taking.

Important information that medicinewise families need to know includes:

Taking medicines during pregnancy
Taking medicines while breastfeeding
How to give medicine to a child in your care
How to remember what medicines you're taking
How much medicine to take and when to take it
How to store medicines correctly

Find out more about how to be medicinewise:

Find out 5 questions to ask your doctor about medicines and more about Be Medicinewise Week at nps.org.au/bemedicinewise
Find out 5 questions to ask your doctor from Choosing Wisely Australia
Call our Medicines Line on 1300 MEDICINE (1300 633 424)
Download our free Medicinewise app
Follow us on Facebook and Twitter

To get involved download the campaign toolkit, display posters, host an event or share the message on social media.

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