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16 August 2018
In this issue
Winter tips: Angina, myocardial infarction and burns
Tender open: statewide eReferral system
Update: National Diabetes Services Scheme
My Health Record opt-out period extended
Pen CS turning off access to older CAT4 versions
EOIs: ATSI preventive health national guide
Govt warning about illicit opium and lead poisoning
Update: Meningococcal ACWY response
In the north west
In the south
Useful resources
Educational opportunities
Upcoming events
The Check Up with Dr Okafor Stephen Omenka
Winter tips: Angina, myocardial infarction and burn injuries 
By Dr Graeme Bleach, GP Clinical Leader with Tasmanian HealthPathways

With spring on the horizon, the days getting longer and warmer, and the worst of winter hopefully past us, our latest article about winter illnesses is a reminder that both angina and myocardial infarction are more common in colder months.

We have a large suite of recently reviewed cardiology pathways, all developed with the active involvement of Dr Nathan Dwyer and Dr Paul MacIntyre. The Medical Journal of Australia has also recently published its new guidelines for atrial fibrillation and we are changing our relevant pathway to ensure it is consistent with these new guidelines. So, check out the chest pain, post-op care of cardiac patients, and percutaneous coronary intervention follow up pathways and make sure you are up to speed!

With the cold weather and more heaters and fires in use, burn injuries also become more common. If you’re not quite sure how to assess burn depth and the best management of each type, or how to check surface area affected and which burns need specialist care - or if you’ve forgotten correct first aid (got your ADT booster and cling wrap ready?) - just open the burn injuries pathway. You can scan it while your nurse is running the burn under cold water – and maybe see if your practice nurse is interested in the pathway too?

And finally, all that cold, dry air and artificial heating plays havoc with skin, causing dryness and eczema to flare. Simple interventions can make a huge difference to the patient's quality of life. There are pathways to help you manage eczema, pruritis, and use emollients more effectively.
Go to Tasmanian HealthPathways
Tender open for statewide eReferral system software vendor
Primary Health Tasmania recently launched a tender to select a software vendor to build an eReferral system for Tasmania.

The project's ultimate aim is to develop a powerful, holistic tool that can help all healthcare providers deliver digital referrals in an efficient and streamlined way. 

The tender will close at 2pm on 31 August 2018. Interested applicants can register through our eTender portal, which is accessible via the button below.

A limited trial of the system is expected to be held between January and June 2019.
Go the eTender Portal
Updates available: National Diabetes Services Scheme
Diabetes Tasmania is now offering updates to all general practices given changes to the way the National Diabetes Services Scheme (NDSS) provides services and products in recent years.

The NDSS has a range of resources and education programs for people living with diabetes, provided by Diabetes Tasmania, including a comprehensive self-management program (DESMOND) and a range of topic-specific SMART programs. Diabetes Tasmania also provides a telephone-based coaching program for those with type 2 diabetes or at high risk, called The COACH Program.

Please contact Melanie Frodsham at Diabetes Tasmania via the button below if you would like to arrange a time for Diabetes Tasmania to visit your practice.
Get in touch
My Health Record opt-out period extended until 15 November
The Australian Government has extended the opt-out period for My Health Record by an extra month to 15 November 2018.

The Government has also announced it will amend 2012 legislation to ensure if someone wishes to cancel their record they will be able to do so permanently, with their record deleted from the system forever.

This means any Australian will be able to opt out of the system permanently, at any time in the future, with their record deleted for good.
More information
Pen turning off CAT versions 4.8 and 4.9
Primary Health Tasmania has been advised by Pen CS they are turning off access to CAT4 versions 4.8 and 4.9.

The current CAT4 version is When a user tries to log in to a version of CAT pre-dating 4.10, they will now receive an error message with advice to contact the Pen CS support team. More information on CAT4 releases can be found on their CAT4 resources webpage, which is accessible via the button below.
Practices affected by the closure of CAT4.8 and CAT4.9 can book an appointment here to have the latest version of CAT4 installed. Those using a current version of CAT4 with a version number below are encouraged to check for updates by clicking on 'tools', then ‘check for updates’ and follow the prompts as appropriate.
More information
EOIs sought for RACGP and NACCHO collaboration on ATSI health
The RACGP and the National Aboriginal Community Controlled Health Organisation (NACCHO) are seeking expressions of interest from practices interested in being part of a national network to explore the awareness and uptake of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.

Participating practices will have to commit to some minimum requirements, including one GP and one staff member to actively participate in workshops, webinars and activity periods for a six-month timeframe.

Click on the button below to find out more. EOIs close 14 September.
More information
Imported illicit opium lead poisoning cases detected interstate
The Tasmanian Government advises local health practitioners that a handful of severe lead poisoning cases from using illicit opium contaminated with lead have been reported interstate.

The use of imported opium in Tasmania is extremely low and while there are no reported cases in Tasmania, it may pose a potential health issue to be aware of. The illicit opium products were in a dark paste or resin. They were bought locally but probably originated in Iran where an outbreak of lead poisoning from opium began in 2016.

The health effects of lead exposure vary depending on the individual’s age, comorbidities and the time and amount of lead to which they are exposed. Acute lead poisoning may present with non-specific symptoms including:
  • abdominal pain
  • constipation
  • myalgia
  • fatigue, irritability and confusion.
Anaemia, renal impairment, encephalopathy and death may result from lead poisoning. Blood lead testing is recommended for patients with clinical presentations consistent with lead poisoning that are otherwise unexplained, and any individuals who may have used imported opium.

A blood lead level greater than five mcg/dL is notifiable to the Department of Health under the Public Health Act 1997.
More information
Tas Govt: Thank you for ongoing Meningococcal ACWY work
The Tasmanian Government wishes to send the following message to local general practices:

A sincere thank you for your ongoing hard work. Around 40,000 vaccine doses have been distributed to general practices statewide. Public Health Services would appreciate if you could advise the Public Health Hotline on 1800 671 738 of any adverse events during this vaccination response.
More information
In the north west
What can you get out of advanced suicide prevention training?

An advanced suicide prevention training workshop for GPs and GP registrars run by the Black Dog Institute will take place on 13 October in Ulverstone.

New Mornings Mental Health Support's Alison Whishaw took part in the workshop when it was initially run in May, and says she found strategies provided by the training to be very useful to her work as a GP counsellor and program manager:

"Having a practice where I see a large proportion of patients with mental health concerns, I have found the structured safety plan tool and other strategies provided at the training to be very useful. Using these with my patients has given them a greater awareness and confidence to implement other strategies at times of high emotional crisis. It has also helped them to know they have really been heard in their distress.

"(I) found the course to be of high quality and beneficial to my practice. I would encourage other GPs to attend the one-day training session in Ulverstone in October. It would be especially beneficial to GPs who see a lot of patients with mental health issues and for those GPs who lack confidence in managing suicidal patients."

Register for the training
In the south
New singing group for healthcare workers, family and friends

Musically-inclined healthcare workers in the Hobart region are advised a new singing group has been established with a view to promoting health and wellbeing.

The Tonic Singing Experience group aims to provide a safe and enjoyable environment for those who work in the health and wellbeing sector to develop and enhance their vocal skills through singing songs under the expert leadership of Helen Todd, Andrew Morrisby and Tom Misson.

The group meets on Thursday nights between 7-8:30pm at the Scots-Memorial Uniting Church and there is a $12 door fee. 

More information
Does your practice align with new guidelines for cervical screening? 
The National Cervical Screening Program reminds healthcare providers patient recall and reminder systems should be aligned with the new recommended commencement age for routine screening and screening intervals as outlined in the 2016 Guidelines.
Primary Health Tasmania has partnered with Train IT to develop a variety of training resources to assist Tasmanian practices in optimising their clinical software and practice systems, including recalls and reminders.

To access the resources, please send an email via the button below.
Get in touch
New poster: Multiple administrations sites for childhood vaccination

The Tasmanian Government has developed a new poster on multiple administration sites for childhood vaccination, in line with recent changes to the National Immunisation Schedule.

For further information, refer to the current online edition of the Australian Immunisation Handbook.

Download the fact sheet
Inappropriate use of antipsychotics infographic

As part of the Caring for Cognitive Impairment campaign, the Australian Commission on Safety and Quality in Health Care has produced this infographic targeted at reducing inappropriate use of antipsychotics.

It summarises the issue as it refers to people with behavioural and psychological symptoms of dementia (BPSD) across multiple healthcare settings and highlights strategies that can be put in place to reduce inappropriate antipsychotic use.

The resource was developed as a result of work undertaken in response to the Commission’s first Atlas of Healthcare Variation that found high and variable use in people aged 65 and over.

More information
My Health Record practice managers' webinar playback
The Australian Digital Health Agency recently held a webinar for practice managers, with copies of the presentation now available online.

You can now access:
Watch the webinar recording
Head and neck education day
Date: Saturday 8 September
Time: 8:45am to 3.30pm 
Location: Hobart
Cost: $35 for members, $50 for non-members
Host: Otorhinolaryngology Head and Neck Nurses Group
A full-day program focusing on head and neck cancer, this education day provides comprehensive content from a multidisciplinary perspective.

Click here for more information.
A comprehensive guide to prescribing HIV Pre-Exposure Prophylaxis
Date: Tuesday 11 September
Time: 6:30-9:15pm (meal provided)
Location: Hobart
Host: Primary Health Tasmania
RSVP: Wednesday 5 September

Date: Wednesday 12 September
Time: 6:30-9:15pm (meal provided)
Location: Launceston
Host: Primary Health Tasmania
RSVP: Wednesday 5 September
An educational event for GPs providing evidence-based information on prescribing HIV Pre-Exposure Prophylaxis in the community. The program will cover:
  • evidence on effectiveness of PrEP
  • potential problems with PrEP
  • how to guide delivering PrEP in clinical practice
  • starting in setting of recent HIV exposure
  • indeterminate HIV tests during PrEP use
  • HIV seroconversion during PrEP use
  • declining eGFR or urine protein during PrEP use
  • PrEP for adolescents.
Click here for more information.
Evidence-based management of diabetes and its complications
Date: Saturday 15 September
Time: 1:00pm - 6:00pm
Location: Hobart
Cost: $50 for members, $25 for students, free for members
Host: Indian Medical Association of Tasmania
All GPs are welcome to attend this scientific session, which will hear from speakers including Professor Ben Canny and Professor Sankar Sinha.
Click here for more information.
Launceston Nurses Conference
Date: Thursday 20 September, Friday 21 September
Time: 8:30am to 4:45pm 
Location: Launceston
Cost: $590 for both days
Host: AusMed Education
Every year Ausmed Education holds a local conference designed to help get nurses up to date on current nursing topics. Find out:
  • What are some of the health priorities that you need to know about?
  • What nursing interventions make a difference, especially to those with chronic conditions?
  • Why is evidence so important to the way you practise?
  • What is the latest information about a range of current treatments?
Click here for more information.
The Check Up

Dr Okafor Omenka arrived in Bicheno on Tasmania's east coast in July 2014 after relocating from Barbados.

While the two locations seemingly couldn't be more different, Okafor (who some may know by his middle name Stephen) says both are picturesque places to call home.

"I got few offers to work as a GP in Australia (and) after weighing the various offers carefully with emphasis on a place where a couple with young kids can easily settle, we chose Bicheno, given we were relocating from another paradise in the Caribbean," Okafor, who is originally from Nigeria, says.

"Bicheno and the locals are amazing."

The father of three says he finds his work as GP at the Bicheno General Practice very fulfilling, and that being part of a smaller practice has both benefits and challenges.

"Running the show on your own makes your impact very palpable in small community," he explains.

"However, the workload can be quite intense, demanding and challenging."

"It’s all enjoyable nevertheless, and the most important thing is being of help to those who need it."

Here’s what else he told Primary Health Tasmania:

  • On the biggest challenge of the job: "The biggest work challenge is time constraints, especially in dealing with patients presenting with mental health conditions. Such patients usually require a great deal of time, empathy and opportunity to let out bottled-up emotional stress and distress. In a busy day with so many others waiting and interruption by emergencies this is often difficult." 
  • What he likes to do when he's not working: "I am a family man. I spend quality time with them when I am free. We love nature. We love to explore new places. We enjoy scenic views, bush walks, beach activities (in summer, as being originally from a tropical country, we find the beach too cold in winter). I love sports, especially watching soccer and playing with my kids. I engage actively in Bicheno community church. I read a lot of non-medical literature and enjoy acquiring new knowledge in other fields. When I can, I like to relax with soothing music and meditation."
  • On his favourite parts of Tassie: "The east coast is my all-time favourite in Tassie but the north west region is next with so many sights, scenes and adventures to explore with my family."

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.
Copyright © 2018 Primary Health Tasmania, all rights reserved.

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