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30 August 2018
In this issue
Have your say on psychosocial support services
Pulmonary embolism and Tasmanian HealthPathways
Tender open for rural primary health services (south)
Immunisation: software updates
Primary Health Tasmania seeking Board director applications
My Health Record: New registration process
Feedback sought on Tasmanian HealthPathways
Useful resources
Educational opportunities
Upcoming events
The Check Up with Professor Richard Hays
Have your say in online survey for psychosocial support services
Tasmanian GPs will have the chance to shape new, statewide support services designed to help people with severe, episodic mental illness meet the demands of daily life. 

Primary Health Tasmania has received new Australian Government funding for psychosocial support services to improve the health of Tasmanians with mental illnesses that are serious, but don’t permanently reduce their day-to-day functioning. 

We want to hear from psychosocial support stakeholders, including via four online surveys specifically for GPs, service providers, consumers and carers. The surveys are open until 14 September. 

Consultation will take place across the state in September, with commissioned services expected to be up and running in early 2019.
Go to the GP survey
Pulmonary embolism and Tasmanian HealthPathways
By Dr Vivien Wright, GP Clinical Editor with Tasmanian HealthPathways

Quick question: Sudden onset of dyspnoea, pleuritic chest pain, cough and haemoptysis, distress. Answer: Pulmonary embolism! 

But what about this? A winter’s day in the middle of the ACWY meningococcal immunisation effort. Regular reports of the emergency department stretched to capacity. Your 55-year-old patient presents for a routine consultation for his usual medications three weeks after a successful laparoscopic cholecystectomy. He has been back at work for two weeks. He mentions he has had pain in his back for the past few days, which is worse when he takes a deep breath. He has had no fever, cough, or shortness of breath. He had no shoulder tip pain post-surgery. He used Clexane post-operatively but forgot the injections on the last three days.

He has a temperature of 37.6, a regular pulse of 85, is normotensive, respiratory rate is 14. His pain is over the right lower ribs posteriorly. He winces when you persuade him to take a deep breath. There is no pleural rub or obvious muscular tenderness. There is no obvious DVT. His BMI is 40.

You ask yourself: What is this likely to be and what mustn’t I miss? How do I sort this out and quickly (please!)

I suggest that you do what I did: consult Tasmanian HealthPathways. I quickly discovered that my patient had a Wells score of 4.5 which meant that he had a moderate risk (21% prevalence) of pulmonary embolism. In his situation, a D Dimer wasn’t indicated and urgent imaging in the emergency department was.

I was able to confidently tell my patient that we needed to make sure that there wasn’t a clot on his lung and to protect him against more if there was. He went without protest to the emergency department with a letter covering all the details needed to sort him out as quickly as possible.

Check out Tasmanian HealthPathways: more than 650 pathways provide real help for real situations.
Go to Tasmanian HealthPathways
Tender open for rural primary health services in the south
Primary Health Tasmania has opened a tender for the delivery of rural primary health services in the Tasman, Huon Valley and Bruny Island areas.

This tender process follows consultation with stakeholders in these communities. More than 100 consumer representatives, service users, carers, local council representatives, GPs and other health and community service providers provided feedback.

The tender closes on Wednesday 12 September. To find out more or submit a tender, register on our eTender portal (accessible via the button below).

More information about our rural primary health program is available here.
Go to the eTender Portal
Immunisation: software updates after schedule changes
Following recent changes to the immunisation schedule, the Primary Health Network Immunisation Support Program recommends practices update their clinical software as soon as possible to ensure all immunisations are recorded accurately and transmitted promptly to the Australian Immunisation Register (AIR).

Practices using MedicalDirector version 3.17.3a are advised:
  • a software update is expected in the upcoming release this summer
  • vaccinations that do not appear on the National Immunisation Program schedule pop-up box can be recorded using the ‘Enter another type of vaccination’. For instructions, click here
  • For further information, click here or call 1300 300 161.
Practices using BP Premier Indigo version are advised:
  • BP released Indigo Revision 1 on 17 August which now supports the changes to the National Immunisation Program
  • practices not yet ready to install Revision 1 are advised to use the 'other vaccination given' to record any vaccinations that are not visible in the standard immunisation tab
  • further information, click here or call 1300 401 111.
More information
Primary Health Tasmania seeking Board director applications
Primary Health Tasmania is seeking to fill a number of elected director positions on its Board.

Applications are sought from people with a range of industry skills across the primary health care profession as well as various commercial skills.

Applications close Monday 10 September.
More information
My Health Record: New registration process for healthcare providers
There is a new registration process for healthcare providers who wish to register and connect to the My Health Record system.
It is a more streamlined process, available through the Health Professionals Online Service (HPOS), improving registration time from weeks to hours. Before using this new registration process, you will need to have a PRODA account, which can be created here.
Primary Health Tasmania is also offering face-to-face training and support to assist practices in their use of the My Health Record system. To arrange a practice visit from a Primary Health Consultant, please phone 1300 653 169 or send us an email.
More information
Reminder: Feedback wanted about Tasmanian HealthPathways 
Researchers from Curtin University are seeking feedback on HealthPathways sites across Australia and New Zealand via a quick survey.

If you use the Tasmanian HealthPathways, they are interested in hearing your opinions and experience of the resource to help identify any areas of improvement for future use.

Click the button below to take the survey. Please note: by clicking on the button you are consenting to taking the survey and providing responses.

Health professionals are also reminded pages within Tasmanian HealthPathways that are not yet adapted for Tasmania are flagged with a witch's hat icon and yellow backdrop. 
Take the survey
Pain management resource from the Drug Education Network (DEN)
DEN has a new educational and engaging resource - More Options for Managing Pain - to explain to consumers how opioids work, overdose risks and other side effects.

The information is presented in a pack of easy-to-handle cards, and the colour-coded design allows people to focus on specific topics around this issue.

Click on the button below to view the resource online, or email DEN to order hard copies for your practice.
View the resource online
Travel scholarships available for Adelaide sexual health conference
The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine invites primary care nurses whose patients have, or are at risk of, blood-borne viruses and sexually transmissible infections to enrol in a free training day in Adelaide, which involves a combination of online and face-to-face education. 

Travel and accommodation scholarships are available for the Fundamentals of HIV, Viral Hepatitis and Sexual Health event, which takes place on Monday 17 September.

For more information or to apply for a scholarship, please contact Emma Williams on 02 8204 0740 or via the button below.
More information
ACRRM releases three new rural sexual health courses
The Australian College of Rural and Remote Medicine (ACRRM) in partnership with NSW Health have launched three new online training courses via ACRRM Online Learning, each regarding sexual health care.

The courses cover topics such as the GP's role in delivering sexual health care in rural areas and strategies to make sexual health care part of routine practice.

The training is free for ACRRM members and subscribers, and $70 per course for non-members.
More information
Event for GPs: Reviewing the Dark Heart of Diabetes report
Date: Monday 17 September
Time: 6:30pm
Location: Launceston
Host: Baker Heart and Diabetes Institute
This event will feature a discussion with Professor Jonathan Shaw, Deputy Director, Baker Heart and Diabetes Institute reviewing the Dark Heart of Diabetes report.

Click here for more information.
RACGP My Health Record in general practice - Launceston
Date: Thursday 18 October
Time: 7:00pm - 9:00pm
Location: Launceston
This workshop will address questions about the expansion of My Health Record, including how it may affect general practice and patients.
At the end of the workshop, attendees will be able to:
  • describe the role of My Health Record
  • articulate the drivers for the implementation of a national eHealth system
  • identify scenarios in which a general practice’s use of My Health Record might assist in improving patient care coordination
  • understand the impact of My Health Record expansion on general practice workflow
  • make an informed decision regarding participation in My Health Record.
Click here for more information.
The Check Up
We chat to Professor Richard Hays about the future of general practice

Professor Richard Hays began his career as a rural medical generalist in northern Queensland before turning his attention to academia, where he has recently explored issues surrounding Tasmania's medical workforce.

Now, he splits his time between the two states, having completed stints in Burnie, Triabunna, Somerset and Lindisfarne.

But a life in medicine wasn't his first choice.

"I wanted to be a doctor from the age of about five, before which I wanted to drive a fire truck," he says. "That would still be a great job, but somehow I decided to be a rural GP quite early and have always enjoyed the variety.

"I found early on that I enjoyed teaching and was fascinated by how to measure good practice, which led me to ask questions that could be answered only through research.

"Since then I have been heavily engaged in medical education and health services research, and have played interesting roles in leading new medical education initiatives or managing change in medical education both in Australia and internationally."

Recently, Professor Hays published an article in the Australian Journal of General Practice about developing a general practice workforce for the future, in which he concluded "rapid changes" would continue to influence how practitioners work.

In particular, he noted the need for general practice training to include "preparation for managing continuous change".

"In my career so far there have been many changes and the pace of change is likely to increase. Many of the medications I was taught to use are no longer available, and new drugs, minimally invasive procedures and immuno-genetic options are emerging constantly," Professor Hays explains.

"Many new specialties and careers have emerged, a few have faded, and more are likely to be created. Technology is advancing really fast, and while I do not think that artificial intelligence (AI) will replace much of what doctors currently do, there is potential for AI to be a powerful tool in medical care."

Here’s what else he told Primary Health Tasmania:

  • On the personal and professional pressure on the next generation of doctors: "People usually enter medical education with passion and enthusiasm, but medicine can be a demanding profession that can be difficult to balance with other things. Some observers talk of generational differences but that is unlikely to be the whole story. Perhaps the current emerging generation just respond differently to the pressures that have always been there, perhaps modern society places higher pressures. We certainly live and work in a much more regulated and scrutinised world."
  • On the similarities and differences between providing care in outback Queensland and Tasmania: "The problems are similar to those I see in Tasmania and much of what I do in a clinical session is not so different from in Tasmania. However, people in remote communities sometimes have more serious degrees of similar illnesses and diseases, often in tricky combinations and sometimes at a younger age. This means more complex consultations and greater use of care plans. On top of that, GPs and rural generalists really do provide most of the medical care, supported by generalist nurses and allied health practitioners, intermittently visiting specialist services, specialists in regional centres (often by telehealth) for more routine care, and effective retrieval services or emergencies."
  • On his plans for the future: "I am kind of trying (but largely failing) to semi-retire."

Do you know someone working in general practice who would be a good subject for The Check Up? Suggest them by clicking the button below and getting in touch!

Nominate someone for The Check Up
Contact us
1300 653 169
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Brought to you by Primary Health Tasmania (Tasmania PHN).
The information in this newsletter comes from a range of sources, and every reasonable effort is made to ensure it’s accurate.
While the Australian Government helped fund this document, it has not reviewed the content. The Australian Government and Primary Health Tasmania are not responsible for any injury, loss or damage however arising from the use of or reliance on the information provided herein.
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