1. MEDICARE 45- 49 YEAR OLD HEALTH CHECK
Train the Trainer

2. Introduction
The Australian Government has introduced a number of health check items to assist in the identification of common health problems and risk factors of disease and illness in specific target populations.
Specifically MBS item number 717 targets men and women aged years with at least one risk factor for chronic disease.
This item was introduced under the Australian Better Health Initiative (ABHI), a joint initiative of the Council of Australian Governments which aims to enhance the capacity of the health system to promote good health and reduce the burden of chronic disease.

3. What are we going to cover..
Overview of the year old Health Check
Overview of other Health Check and Health Assessment
Items
Outline training resources
Motivational Interviewing – links to health assessment
Overview of Wave 2 funding
Provide/demonstrate links to the MPFA PI
Launch/baseline uptake
Division showcase regarding links with CDM item numbers and health assessments through the ABHI

4. Aims of the 45-49 year old health check
Once only health check
Assist with the detection and prevention of chronic disease and enable early intervention strategies in this age group
Lifestyle factors (smoking, physical inactivity etc.)
Biomedical factors (blood pressure, cholesterol etc.)
Family History of chronic disease
Focus on preventative care for the first time

5. Who is eligible for the 45- 49 year old health check?
Patients aged years who are at risk of developing chronic disease
Patients who have at least 1 risk factor for chronic disease

6. Aim of the 15- 54 year old Adult Health Check for Aboriginal and Torres Strait Islanders
Aboriginal and Torres Strait Islander people aged years should access the specific Aboriginal and Torres Strait Islander Adult Health Check (Item 710)
Aboriginal and Torres Strait Islander people may also
access Item 717 if eligible
Patients aged years who are at risk of developing chronic disease
Patients who have at least 1 risk factor for chronic disease

7. What does the 45-49 year old health check involve?
The MBS requires:
Information Collection, including taking history and performing examination and investigations as required
Making an overall assessment of the patient
Interventions as indicated
Providing advice and information to the patient

8. Who can help with a health check? And How?
Practice Nurses
Aboriginal Health Workers
Other Health professionals
Identifying eligible patients
Through examination of patient
records
Collection information from
patients
Such as measuring height,
weight, blood pressure (at the
direction of the GP)
Providing patients with
information
About recommended
interventions (e.g. details of
local community resources,
support services and referral
options)

9. What happens if you identify a patient with a Chronic Disease?
Prepare a GP Management Plan (Item 721)
Team Care Arrangement (Item 723)

10. Other Health Checks and Health Assessments
Type
Item Number
45-49 Year Old
717
Aboriginal and Torres Strait Islander People
704, 706, 708, 710
Patients aged 75 years and over
700, 702
Humanitarian entrants to Australia
714, 716
People with an intellectual disability
718, 719
Permanent residents of residential aged
care facilities
712

11. Training Resources Division-Specific resources
Practice-level Resources
For Practice Managers
For Health Professionals

12. Division-Specific Resources
PowerPoint Presentation and Facilitators Guide (AGPN)
2 hour Presentation
Learning Objectives
Increase understanding of who is eligible for the year old health check, what assessment entails, and who can help with each step of the assessment
Increase awareness of the burden of care that this patient group places on the Australian healthcare system and highlight that this health check can be used to reduce this burden; and
Inform participants of the tools, interventions and approaches available to help them bring about behavioual change.

13. Division-Specific Resources
Practice Detailing Cards (AGPN)
6 Practice Detailing Cards
Used to raise awareness with GPs and practice staff about the health check item numbers during practice visits
What information do they provide?
The eligible population for each item number
Details of the MBS fee for each item
Where and when the health check should be conducted
Guide to the health Check Information Resources (AGPN)
Overview of Health Check Resources available through AGPN

14. Division-Specific Resources
Rural Health Education Foundation DVD (RHEF)
Satellite broadcast of an expert panel discussing the best practice use of the 45 year old health check.
Also contains electronic versions of all AGPN resources.
A Guide to facilitating Adult learning (RHEF)
Adult learning principles for facilitating group learners
Provides basic instructional information to facilitate face to face learning.
The Learning Guide (RHEF)
Provides a framework for facilitating discussion
Contains activities to facilitate group discussion and engage with the material covered in the DVD.

15. Practice-level Resources For Practice Managers and Health Professionals
Rural Health Education Foundation DVD (RHEF)
Satellite broadcast of an expert panel discussing the best
practice use of the 45 year old health check.
Included on the DVD:
4 Filmed case studies
Quick Reference Guides
Business Case
Guide to Health Checks Information Resource
Practice poster
Wall chart (no hard copy available)

16. Practice-level Resources For Practice Managers
Patient Practice prevention survey (RACGP)
Taken from “Putting Prevention into Practice” (the Green Book).
Used to identify eligible patients through identification of risk factors
Practice Support Templates (RACGP)
2 template letters
Used to contact patients who:
have a risk factor OR may have a risk factor
Medical Director Templates (AGPN)
A template for the year old health check can be uploaded into Medical Director
Available:

17. Practice-level Resources For Practice Managers
Business case for Item 717 (AGPN)
Discusses financial and non-financial benefits of conducting the year old health check to eligible patients.
Practice Poster and Wall Chart (AGPN)
PowerPoint presentation (RACGP)
Outlines the 45 year health check and the role of GPs and their teams.
Available:

18. Practice-level Resources For Health Professionals
Quick reference Guides (AGPN)
Companion resources to the practice detailing cards
To assist GPs in conducting health checks
What information do they provide?
How to conduct a health check
Information on eligibility of patients for each item number
What is involved with each health check

19. Practice-level Resources For Health Professionals
Checklist (RACGP)
“Guidelines for Preventive Activities in General Practice” (the Red Book).
Provides a checklist on key factors to address during a health check
Lifescripts (DoHA)
Lifescripts guidelines and evidence cards, assessment tools and
prescription pads help GPs and their practice manage lifestyle risk factors.
These resources can also assist GPs and practice nurses in conducting the year old health check.
Another Useful resources (RACGP)
“SNAP – a population health guide to behavioural risk factors in general practice”.

20. Practice-level Resources For Health Professionals
Motivational Interviewing Techniques
Helping patients change behaviour
Used to explore patients attitudes to their lifestyle and health risks
Assess patients’ willingness to change
Help patients identify and overcome barriers to adopting a healthier lifestyle
2nd Session: Stan Steindl – from Psychology consultants
Further information on Motivational Interviewing is
available from

21. Case Study 2 – Video Case Study 2 Time: 4 minutes 50 seconds.
The role of the practice nurse and other health professional in assisting GP’s in performing the year old health
Check.
Use of Lifescripts
Use of motivational interviewing techniques.
Time: 4 minutes 50 seconds.

22. How to order resources? AGPN and RHEF Health Check Kits
Send Order Form to
for downloads
Rural Health Education Foundation Resources
45-49 health check
Indigenous Health Checks
Lifescripts Resources
DoHA
AGPN
Order form: Fax (02) or Call (02)
RACGP Resources
Available from:

23. Wave 2 Funding for Divisions
The Department of Health and Ageing has requested a proposal from General Practice Queensland to act in a fund-holding capacity and conduct a Request for Proposal (RFP) process for Divisions of General Practice
$79, 200 (GST inclusive) will be available for disbursement to Divisions in each financial year to the period ending
Funding will be awarded on an application basis, outlining educational strategies focussing on health checks

24. Wave 2 cont.
Division funding proposals will be invited under 2 streams:
Generic use of the MBS health checks (including one new planned health check item)
Specific population cohorts identified with a greater burden of chronic disease and lifestyle risks, such as Aboriginal and Torres Strait Islander people, refugees and people with intellectual disabilities

25. Evaluation
Evaluation will be undertaken at a Division and SBO level to measure the extent and effectiveness of the various approaches to up-skilling general practices in best practice use of health check items for eligible patients.
This will be achieved through:
Monitoring uptake of Group A14 MBS items 700 – 719
Evaluation of health check resources including the practice detailing cards, satellite broadcast program etc (survey)
Identification of additional resource and materials developed by Divisions or practices to support implementation of the items at the practice level

26. Evaluation cont.
Assessing the extent to which the MBS health check items have been integrated with other Division initiatives/ programs
Evaluation results of Division educational strategies/
activities to:
assess changes in behaviour, attitude, skills and knowledge
determine barriers and enablers to general practice health professionals undertaking health checks in the practice setting
Identification of successful models for implementing health checks in target populations

27. Multi Program Funding Agreement 2008-12
National Performance Indicator
DGPP Access 2
The number of health checks and health assessments provided to patients of Aboriginal and/or Torres Strait Islander origin by GPs within the Division (compared to the estimated population in the area who could benefit from the health check)
Includes items 704, 706, 708 and 710
Data sources – Medicare Australia and ABS

28. MPFA 2008-12 cont. National Performance Indicator DGPP Prevention 1
The number of year old health checks provided to at-risk patients by GPs within the Division (compared to the estimated population who could benefit from the health check)
Includes item 717
Data sources – Medicare Australia and ABS

29. Support in ACTION!!
Redcliffe Bribie Caboolture Division of General Practice
Project Coordinator: Barbara O’Toole
Links with Chronic Disease Management item numbers and health assessments
through the Australia Better Health Initiative funding.

30. Motivational Interviewing Techniques
Coming Up…..
Session 2:
Motivational Interviewing Techniques
- Stan Steindl

31. Thank you