era for general practice electronic prescribing a new
TRANSCRIPT
June 2019 - In brief June 2019 - In Brief
Electronic Prescribing, or ePrescribing is the electronictransfer of a prescription for dispensing. This processreplaces the use of the paper prescription givingflexibility to the patient and prescriber. Just likea paper prescription, electronic scripts are a legalform of prescription. The introduction of electronic prescribing is greatnews for medicine, you and your patients. It improvespatient safety and provides a better experience foryou and your patients. As with any change to a largesystem it takes time to implement, however if ourCOVID-19 response has taught us anything we areable to change the way we work more quickly thanwe had previously imagined. We are confident thatall systems are in place. Here’s what you need toknow;
What is a TokenScript?Your patient receives their prescription as a token(QR code) via SMS, rather than a paper script. Yourpatient presents their token at their preferredpharmacy where the script is scanned and dispensedas normal. Repeats are returned to the patient viaSMS. How does TokenScript work?A script link is sent electronically to the patient orcarer. Your patient can choose to receive this link ontheir smartphone via SMS or email. Opening the linkwill reveal the QR code held in the ‘cloud’ byprescription exchange (PE) until it is dispensed by thepharmacy. QR codes are able to be viewed incompatible apps such as MedAdvisor®.
The pharmacy scans the QR code to download thescript information for dispensing. Repeats are returnedto the patient via SMS. Once the prescription has beendispensed, the QR code is inactivated. Token scriptsare not able to be converted to paper basedprescriptions and repeats.
Can I use this for all my patients?Your patient must have an IHI number registered inyour practice software. Phones need to be able toreceive an SMS, have internet access and a webbrowser. Each script will have a separate token, so thismay not be suitable for patients on multiple medicinesor blister packs. Paper tokens can be printed by thepractice or pharmacy if this is your patient’spreferred method of handling their QR codes. Some pharmacies are not yet equipped to dispenseelectronic prescriptions, so it may depend on yourpatient’s preferred pharmacy. What if my patient deletes the SMS?For original prescriptions, patients need to contacttheir practice to resend the prescription via SMS.For repeat prescriptions, patients need to contact theirdispensing pharmacy to resend the repeat via SMS.
11 March 2021
Electronic prescribing a newera for general practiceBy Mayli Foong BPharm, MPS, AACPA, MBAGP Pharmacist
For links to resources, clinical updates and more, visit news.wapha.org.au
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Patients must have a smart phone with internetaccess for this service GP and Pharmacies must both be usingcompliant softwareAlways confirm your patient’s mobile numberprior to sending the SMSAlways confirm the SMS is received beforecompleting the consult.
Can I cancel a prescription?TokenScripts can be cancelled by the prescriber ontheir practice software. This will remove thescript/repeats from the prescription exchange (PE) inreal time. Patients will receive a message when theyopen the link that their script has been cancelled. Are pharmacies in my area accepting TokenScripts?Most pharmacies have now updated their softwareto dispense token prescriptions. Check with your localpharmacies if their software is compliant. If yourpractice has a GP Pharmacist, they will be able toliaise with pharmacies in your local area and give youa list of pharmacies ready for token script dispensing. Is my software compatible?WA Health has a list of compatible softwareproducts available. Things to remember:
For more information, see the recently published‘Electronic Prescribing’ HealthPathway.
08 6272 4900 | [email protected] | www.wapha.org.au
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Royal Perth Hospital - Are youreceiving your GP Notifications ofpatient admission, discharge ordeath?
GP Hospital Liaison Updates
GP name(s) and provider numbers.Practice name and address, phone, fax and thegeneric email for your practice - The PatientAdministration System used across WA Health canonly register one email address for GP Notify perpractice. The email address for your practice istherefore preferred over individual email addresses. Whether you’d prefer to receive GP Notify by fax oremail (secure electronic messaging is not availablefor GP Notify, although it is used to send inpatientdischarge summaries – the GP Notify Coordinatorcan arrange this if you include your practice’s EDIcode).
If not, please re-register for GP Notify by advising, orasking your practice manager to phone or fax the RPHGP Notify Coordinator on the new contact numbers.
Phone 9224 3673 or fax 9224 2348 or [email protected], including:
1.2.
3.
What is GP Notify?GP Notify is an automated notification system thatinforms the patient’s nominated GP (where registered)about patient admission, discharge and death at RPHby email or fax.
I used to get GP Notify from RPH–why did they stop?GP Notify needed to be reset in 2018 due to technicalissues, and GP registrations were lost. A number of GPsand practices responded to notices that they needed tore-register, but it appears a large number missed thecommunication. I asked to get GP Notify by email, but they are beingfaxed. Why and can I change this?A technical issue led to all new GP Notify registrationsover an extended period being defaulted to fax insteadof email. If you would like GP Notifications to be sent toyour practice by email, please advise the GP NotifyCoordinator as above (noting that only one emailaddress per practice can be used).
Dr Jacquie Garton-SmithHospital Liaison GP, Royal Perth [email protected] available: Monday and Thursday
Electronic prsecribing (cont'd)
Active Script List (ASL)Coming soon
Active Script List, next generation of electronic
prescriptions, is expected to be rolled out in
2021. Patients will ‘opt in’ to the ASL model at
a pharmacy before a doctor can send a script
via ASL. It is proposed that patients will be
able to access e-prescriptions without a token.
This will be useful for patients on multiple
medicines or blister packs. It is expected that
the patient will be able to control access to
who can view the list.
08 6272 4900 | [email protected] | www.wapha.org.au
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Let's not forget the Metro SyphilisOutbreakRockingham and Peel are considered metropolitansyphilis hotspots and as you may be aware, asyphilis outbreak has been declared in metropolitanPerth. More information is available here. Please also be aware of the risk of congenital syphilisand the guidelines for antenatal screening (see theSilver Book and the KEMH Guidelines).
The Metropolitan Communicable Disease Control(MCDC) can provide support and advice, includingcontact tracing. Phone 08 9222 8588. MCDC can also provide education for yourpractice. Email [email protected] you are interested in having a publichealth physician or nurse visit your practice.
The South Terrace Sexual Health Clinic can alsoprovide clinical advice on case management on 9431 2149.
All cases of syphilis should be notified to theDepartment of Health.
See also the “Syphilis” HealthPathway
Dr Simone StubbsHospital Liaison GP, Rockingham Peel Group [email protected]
More than 90 percent of patients with a penicillinallergy label do not have a true penicillin allergy.Unnecessary avoidance of penicillins leads topoorer clinical outcomes.Patients with a low-risk (e.g. benign, distant rash)reaction to penicillin are best assessed with anoral amoxicillin challenge, without skin testing. Oral challenge in low-risk patients has beenshown to be safe. The risks are comparable toiron transfusion, immunotherapy, andvaccinations. The oral challenge process takes two - threehours.
A pilot project with Fiona Stanley HospitalImmunology
Did you know?
The Immunology Department at Fiona StanleyHospital (FSH) is looking to work with a smallnumber of practices within the Perth metropolitanarea who will be interested in performing direct oralamoxicillin challenges within their practices fromFebruary 2021. The FSH Immunology Departmentwill provide the necessary training and support forparticipation in the pilot project. To register your interest or to find out more, pleaseemail Xiang on [email protected]
Low-risk penicillin allergy delabellingwithin a GP setting
Some departments have recently made changes totheir preferred contact details for GPs seeking clinicaladvice and/or arranging early outpatient review aswell as routine departmental enquiries. Downloadthe contact list on the Fiona Stanley HospitalWebsite A reminder that NaCS discharge summaries, mostOutpatient letters, pathology and radiology resultsmay now be accessed via My Health Record for mostpatients and there may not be the need to formallyrequest such information from the hospital.
Dr Monica LaceyHospital Liaison GP, FS & [email protected]: Monday and Thursday
FSH GP contact list
Did you know ?
Did you know? There is a contact list of the Rockingham Peel
Group clinics and specialists available on the
website to enable GPs to easily find a direct
clinical contact.
08 6272 4900 | [email protected] | www.wapha.org.au
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The South Metropolitan Health Service will soonlaunch an audit for referrals of patients who werelast seen in a specialist outpatient clinic more thantwo years ago and have not required furtherappointments. It is likely that their care was completed and thatthe referral remained open due to an administrativeerror. The purpose of the audit is to allow safe dischargeof referrals where a patient does not requirefollow up. As part of this process GPs mayreceive a letter notifying the referral is to bedischarged.
Dr Monica LaceyHospital Liaison GP, FS & [email protected]: Monday and Thursday
South Metropolitan Health Service -Outpatient Referral Audit
Clincal Updates
From 1 February 2021, the National CervicalScreening Program’s (NCSP) Clinical Guidelines forthe Management of Oncogenic HPV (not 16/18) fromclinician-collected samples have changed. There are no changes to the management of resultsfrom self-collected samples. See the “CervicalScreening” HealthPathway.
Change to Cervical ScreeningGuidelines on HealthPathways
The National Asthma Council of Australia hasreleased an update to the My Asthma Guide.Health professionals will know of this resource as theNational Asthma Council of Australia’s popularpatient handbook designed to help peopleunderstand and manage their asthma. It includesinformation and advice based on the bestevidence and provides practical strategies to helppeople with asthma and their families.
My Asthma guide update
COVID-19 Vaccination InformationPathway
Links to education and trainingVaccine specific informationGuidance on vaccination in specific populationsConsent formsAccessing AIR, practice and patient preparationinformationComprehensive list of patient resourcesLinks to Practice Assist rollout information andFAQs
HealthPathways WA has published the new “COVID-19 Vaccination Information” Pathway. This pathwaycompiles all of the relevant clinical information fromboth the State and Federal Governments that iscurrently available for GPs regarding the vaccinationrollout, including:
GPs are strongly encouraged to familiarise themselveswith the content of this HealthPathway and to refer toit in the first instance for any queries they have aboutCOVID-19 vaccination. There is also a comprehensivelist of resources that GPs can provide for patients whomay have questions about COVID-19 vaccination.
This pathway is subject to continuing review byWAPHA’s GP Clinical Editors, and GPs should beassured that the information contained is ascomprehensive, accurate and up-to-date as possible.
Stay up to date with COVID-19 Updates
To support WA GPs, general practice staff and
other primary health care providers to
respond to the COVID-19 pandemic, the
Practice Assist COVID-19 information page
provides access to the latest information and
resources, including updates relating to the
national vaccine rollout strategy.
WA GPs can also stay informed by subscribing
to WA Primary Health Alliance COVID-19 GP
Update and COVID-19 Immunisation Updates.
08 6272 4900 | [email protected] | www.wapha.org.au
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The State-wide Obstetric Support Unit in partnershipwith WA Primary Health Alliance (WAPHA)and the King Edward Memorial Hospital Liaison GPhave developed new WA State-wide MaternityShared Care Guidelines. This project followedrequests from clinicians across the state andworkshops held in 2018. We are now pleased to announce that following atwo year gestation, the Guidelines have arrived. TheGuidelines will provide direction for GPs, midwivesand other maternity health care providers workingwithin the Western Australian public health systemwhen caring for women who make the informedchoice to have their antenatal care provided within ashared care arrangement. Shared care represents an opportunity to practicecollaborative holistic maternity care by combining thevaried skills of Midwife, General Practitioner andObstetrician and Health Service Providers to thebenefit of the community and promotes mutualunderstanding between colleagues. The Guidelines were developed using evidence-based, contemporary professional practicestandards and outline the minimum clinical carerequired by maternity shared care providers. TheseGuidelines are underpinned by the NationalClinical Practice Guidelines for Pregnancy Care(2018) and should be used in conjunction withexisting Health Service Provider Guidelines.They are the default guideline in the absence ofexisting current guidelines.
Shared maternity care providers can access upto date information and resources usingthe embedded links within the Guidelines. Thelayout of the Guidelines provides a systematicprocess for shared maternity care providers todeliver quality care through assessment,screening, education and referral. Included arespecific information regarding Family andDomestic Violence, Syphilis and FirstTrimester Screening. A Quick Reference Guide provides a summary ofcare for each trimester and the postnatalperiod. A standardised referral form is alsoincluded and where practicable sharedmaternity care providers are encouraged to usethis.
Any queries regarding the Guidelines should bedirected [email protected]
Launch of new WA State-wideMaternity Shared Care Guidelines
National CancerScreening Register (NCSR)The National Cancer Screening Register (NCSR)supports Australia’s National Bowel Cancer ScreeningProgram and National Cervical Screening Program byinviting, reminding and following up participants forscreening. It also helps healthcare providers makedecisions about their patients’ health care.
The NCSR has introduced an online HealthcareProvider Portal providing a new way to interact withthe National Register. It will also soon be releasing anIntegration with Clinical Software. The newfunctionality will support better patient care byallowing healthcare providers and pathologists toaccess and submit patient’s bowel and cervicalscreening program-related data at anytime of the day. For more information visithttps://ncsr.gov.au/content/ncsr/en/healthcare-providers.html or call the Contact Centre on 1800 627 701
Statewide Telehealth Service Deskarrangements and contact detailshave changed.
In response to growth in telehealth services and toensure continued quality of support, the StatewideTelehealth Service Desk has merged with WA CountryHealth Service ICT Help Desk. The new number tocall is 1800 794 748.
Urgent incidents and requests will also have theoption of being transferred to a ‘PRIORITY’ line. Callsthat are not urgent will be returned to the main queueand serviced by the next available operator. Telehealth Service Desk email address remains thesame at [email protected] You can also access the HealthPoint Self-servicePortal
Work-related mental health conditions are thesecond most common cause of workers’compensation. However, these conditions aretypically challenging to diagnose and treat. 5-10percent of people will suffer from posttraumaticstress disorder (PTSD) at some point in their lives. Most injured workers will seek care from their GP andthere are two resources that can help GPs diagnose,manage and treat a patient who is suffering from awork-related mental health condition: Clinical guideline for the diagnosis and managementof work-related mental health conditions in generalpractice - Provides GPs with the best availableevidence to guide their diagnosis and managementof patients with work-related mental healthconditions.
The guideline was approved by the National Healthand Medical Research Council (NHMRC) in late 2018.It is endorsed by the Royal Australian College ofGeneral Practitioners (RACGP) and the AustralianCollege of Rural and Remote Medicine (ACRRM).
Australian Guidelines for the Treatment of AcuteStress Disorder, Posttraumatic Stress Disorder andComplex PTSD - The Guidelines aim to support highquality treatment of people with PTSD by providing aframework of best practice around which to structuretreatment. Approved by the National Health andMedical Research Council (NHMRC), the Guidelineswere developed by Phoenix Australia (formerlyAustralian Centre for Posttraumatic Mental Health)and a team of Australia’s leading trauma experts, incollaboration with psychiatrists, psychologists,general practitioners and other health professionals.
To request logon details for HealthPathways visit:
https://waproject.healthpathways.org.au/Home.aspx
and complete the ‘Request a login’ form. To provide
feedback on the criteria, email
[email protected] or press the send
feedback button within the site.
Mobile-Friendly HealthPathwaysLogin Update
Accepting the “Remember me” selection within thelogin screenSaving your password when prompted by yourinternet browser.
From Wednesday 24 February, some users of mobile-friendly HealthPathways will be prompted to log inmore often. This change is part of a project to improvethe accuracy of the metrics we use to help monitor theeffectiveness of HealthPathways. This should onlyaffect a small number of HealthPathways usersoverall and won’t affect you at all if you’ve previouslysaved your password at the login point. Theusername and password have not changed. To avoid being regularly prompted to log in again, youcan save the username and password by:
Note: If you regularly clear your browsing history, you’llthen be prompted each time to log in again with yourusername and password.
08 6272 4900 | [email protected] | www.wapha.org.au
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Guidelines for treating patients witha work-related mental healthcondition
08 6272 4900 | [email protected] | www.wapha.org.au
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Disasters can be very stressful for those directlyimpacted, as well as health professionals and thoseinvolved in disaster management efforts. Phoenix Australia in collaboration with PrimaryHealth Networks and other key partners, haslaunched the Disaster Mental Health Hub to help GPsand other health practitioners to support individuals,families and communities during the disasterresponse. It includes access to free disaster mental healthinformation, sheets and videos, online trainingprograms and health professional support resourcessuch as Tips for Supporting Medical Centre Staff.
Phoenix AustraliaDisaster Mental Health Hub
Referral criteria for public Adult Community MentalHealth Services in the Perth metropolitan region haverecently been published on HealthPathways WA.
The criteria detail referral and exclusion criteria forboth acute and non-acute referrals to these services.The criteria detail the scope and limitations ofpublic Adult Community Mental Health Services inthe Perth Metropolitan region and it is hoped that thiswill assist General Practitioners in understandingwhich referrals are appropriate for these services.
The criteria were developed by a HealthPathwaysworkign group in consultation with GPs as well asrepresentatives from Adult Community Mental HealthServices, North Metropolitan Health Service, EastMetropolitan Health Service, South MetropolitanHealth Service and the Mental Health Commission.
The working group brought together relevantstakeholders to seek feedback and allow fordiscussion and finalisation of the proposed criteria.Consensus was reached by the 26 attendees at theworking group and the criteria were then signed offby the relevant area health services.
Many thanks to all who provided feedback on thecriteria and to those who attended the workinggroup in September last year.
To access the criteria see the “AcuteMental Health Assessment” and “Non-AcuteMental Health Assessment” HealthPathways andselect one of the Perth Metro regions.
Referral criteria for Adult CommunityMental Health Services
As part of the hospital's 150th Anniversary, theRoyal Children’s Hospital (RCH) is proud to launchthe 10th edition of the RCH Paediatric Handbook.
The Handbook presents collective expertise of thehospital’s world leading clinical staff, includingpractical advice on the assessment and managementof common and serious child health conditions. An essential practical management guide to thehealth problems of newborn infants, children andadolescents, the Paediatric Handbook is a valuablereference for all medical students, hospital residentsand community practitioners. The Paediatric Handbook 10th edition can bepurchased from December 1, 2020 viawww.shop.rch.org.au and www.wiley.com
The Royal Children’s Hospitallaunches Paediatric Handbook
Emerging Minds have launched A GP Framework forChild Mental Health Assessment (5-12 years). Thisnew accredited course has been developed tosupport GPs in undertaking child mental healthassessments and the management of ongoing care. Download the framework
Emerging Minds - GP Framework forChild Mental Health Assessment
The provision of allied health services, includingmental health services to DVA clients residing inaged care facilities, has been increased until 30June-2022, in response to the Royal Commission intoAged Care’s recommendations on COVID-19. 23December 2020.
Aged care residents, including DVA clients, can nowaccess up to 20 mental health services per year fromGPs or allied mental health providers. Residents willalso be able to access up to 10 allied health servicesper calendar year under a chronic diseasemanagement plan. For high care residents, services in excess ofthese limits will be considered under DVA’s priorapproval arrangements, as is currently the case. Lowcare residents may continue to access allied healthservices as they currently do, under DVA cardarrangements.
When claiming the new items for DVA clients, theinvoice to Services Australia must be submittedthrough the DVA Medical Online channel usingpractice management software. Or, if you use DVAWebclaim, by selecting ‘General Medical Service’from the Service Type menu on the ‘Fill In ClaimsDetails’ screen.
These items cannot be claimed through DVA AlliedHealth Online, nor using the ‘Allied Health Service’type through DVA Webclaim.
You can familiarise yourself with the newarrangements by downloading the DVA FeeSchedules and Notes for allied health providers thathave been updated to include the claimingrequirements.
For more information visit the MBS Online website oremail [email protected]
08 6272 4900 | [email protected] | www.wapha.org.au
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Many people have been affected by disasters acrossparts of the country, ranging from those directlyaffected, to those with contact only through whatthey have seen in the media. The AustralianPsychological Society has published this informationsheet providing summary guidelines on the threelevels of psychological support that can be offered topeople affected by disasters. Access the summaryguidelines here.
Guidelines for provision ofpsychological support to peopleaffected by disasters
Increases to allied health services for DVA clients in RACFs
A new 90 second, animated heart check video A refreshed heart attack action plan
The Heart Foundation has recently developed somenew resources for Aboriginal and Torres StraitIslander people in the Pilbara:
The video is also available in a video brochure for useby WA health professionals with Aboriginal andTorres Strait Islander clients in primary care settings(such as remote clinics where internet access is anissue). To order a FREE video brochure [email protected]
New Heart Foundation resources forAboriginal and Torres Strait Islanderpeople
Active Ingredient Prescribing Iminent
From 1 February 2021 most prescriptions for supplyunder the PBS and the RPBS must describe themedicine by active ingredient name to be eligible forsubsidy. While current processes largely won't change, GPsshould continue talking with patients about theirmedicine’s active ingredient names where possible.
Visit the Australian Commission on Safety andQuality in Health Care website
For upcoming GP educationevents, visit
wapha.org.au/event
The Australian Government has advised that theTake Home Naloxone Pilot will run for an additionalfour months to 30 June 2021. Naloxone will continue to be available forfree and without a prescription to people who mayexperience, or witness an opioid overdose in NSW,SA and WA.
Providers currently participating in the pilot programinclude community pharmacies, medicalpractitioners, alcohol and other drug treatmentservices, and homelessness/outreach services. A listof participating WA providers is available from theWA Mental Health Commission. Resources and materials can be found at:Department of Health take-home-naloxone-pilot. Information regarding registering and participatingas a provider in the pilot can be foundat: naloxone-pilot registration and participation. The WA Mental Health Commission provides trainingon recognising and responding to opioid overdose.Contact [email protected] or phone (08) 6553 0560 during business hours.
Place an order through the ‘ADOLESCENT ANDADULT’ tab on the WA Health vaccine orderingsystem and select vaccine product ‘Engerix B –1.0mL – Hep B (Aboriginal) – State’.Initial approval is for Dose 1, then providersshould place orders for subsequent doses.Refer to the Australian Immunisation Handbook -Hepatitis B section for adult Engerix-B dosingguidance.
Aboriginal people have a higher risk of acquiring newhepatitis B virus infection than non-Aboriginalpeople. Although hepatitis B vaccination isrecommended for all non-immune Aboriginal adults,it is not funded through the National ImmunisationProgram (NIP). WA Health has commenced a program to providethis vaccine for free in WA for people aged ≥ 20years of age. Hepatitis B vaccines are alreadyprovided free through the NIP for people aged < 20years of age. All non-immune Aboriginal adultsshould receive a three-dose schedule of hepatitis Bvaccine. Prior to administering the hepatitis Bvaccine, providers should order a blood test todetermine the hepatitis B status of an individual (therequest on the pathology form should be for "chronichepatitis B"). Ordering the vaccine:
The WA Immunisation Schedule (effective01/12/2020) has been updated to reflect this changeand clarifications regarding the pneumococcalvaccinations. It is available to download. See also the “Immunisation – Adult” HealthPathway
08 6272 4900 | [email protected] | www.wapha.org.au
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Free Hepatitis B vaccination for non-immune Aboriginal adults
Take Home NaloxonePilot Extended to 30 June 2021