Person Centred Medical Neighbourhood Readiness Program

Misbah Faiz – After Hours Program Officer – m.faiz@cesphn.com.au Liam Shanahan – Health Informatics and Strategy Program Lead – l.shanahan@cesphn.com.au Misbah Faiz – After Hours Program Officer – m.faiz@cesphn.com.au Lucy Armstrong – Aged Care Project Officer – l.armstrong@cesphn.com.au

Rationale for Change Electronic communications are not standard practice between GPs, specialists, allied health providers and hospitals Even when electronic communication is used, there is doubt as to whether the communication has been received or acted upon Questions around the impact on clinician’s workflow Timely receipt of electronic communications may improve patient satisfaction with the health system and may facilitate more timely review and follow-up

Overarching Aims and Objectives To move practices along the continuum to a higher performing primary care practice Practices will be supported to deliver a stronger, more systematic yet flexible approach to the management, referral and review of patients with chronic and complex health needs Electronic communications are seen as business as usual for all providers in the health care neighbourhood, and their use is expected by patients and carers

Enhanced and timely electronic communications Diagnosis Results Enhanced and timely electronic communications Health Pathways Change management process to develop high performing primary care practices - Training - Shared Care Planning Tools - Data Quality - Digital Health

Analysis and Design Results Need Inputs Output Outcomes Short Term Long Term Optimised patient care through enhanced and timely communication Secure messaging vendors LHD staff PHN staff General Practice Staff Specialists AHPs Clinical Leadership Training sessions for practices on embedding electronic communication into workflow Commitment from LHDs and GPs to utilise electronic communications Translating evidence from case studies into practice eReferrals being made Discharge summaries received correctly Accurate GP records Assuring users of the integrity of the system Meaningful use of My Health Record Accurate records of GP details in LHD systems Enhanced integration and coordination of clinical services to optimise patient care Assumptions Patient care is negatively impacted by lack of electronic communication Implementing electronic communication will improve patient care Adequate uptake and embedding into work flow External Factors LHDs/NSW Health may implement state-wide electronic communication standards Capacity and drive of partner organisations Commonwealth funding models for use of electronic communication and My Health Record

Mission Statement We will undertake a proof of concept activity that focuses on developing a high performing general practice through seamless electronic communication as part of a medical neighbourhood that provides ongoing, comprehensive, whole-person care.

Action Plan with timescale Re-assessing our Needs Assessment to really narrow down on key gaps and issues Scaling back and starting small Targeting one chronic condition Working with a small number of practices (connecting to one LHD based) Stronger engagement with the LHD Look to trial over 12 months