General practice update

February 2021
Practice update

Welcome back
We hope you were all able to enjoy some down time after such a big 2020. FHT tech and clinical support teams are back from leave and here to support your participation in the program. Please do not hesitate to get in contact with them (email tech support / clinical support) if you would like assistance or have some feedback on the FHT platform.

In late December we received some great news with a paper on the co-design process of the FHT platform published in BMJ Open.

Reminders

Small Group Audit Activity
Practices are well underway with training to commence the CKD small group audit activity. With the activity due for completion by 31 May 2021, and if you haven’t already done so, now is a good time to set up your patient cohort, review and approve cohort patients for recall or deferral in consultation with the activity participants and to document planning and progress meetings in your QI webform. Activity requirements can be found here.

Patient referral for interview
As you start to recall patients for CKD testing, detection or CKD cardiovascular risk management, please consider asking these patients, where appropriate, if they would like to talk to the FHT research team about their experience of being recalled to your practice. At this time, all interviews would be conducted via phone.

The intention of these interviews is to understand the patient experience of chronic disease care in general practice, their preferences for care in the future including how practices communicate with patients, and how patients feel about the use of FHT and technology generally to inform the care that they receive.

Please note that it is not necessary for patients to be aware that FHT was utilised in relation to the visit at the time of the visit. Patients will be reimbursed with a $50 Coles gift voucher for their time.

If any of your patients are interested in participating in an interview, please email Natalie. A plain language statement can be found here.

Education and Awareness Events

Chronic disease prevention and management in general practice – case-based learning series
Our Project ECHO series is returning in March and will deliver topics and case discussion in sessions focused on cardiovascular disease and type 2 diabetes. GPs and practice nurses are invited to attend this series where participants will hear from, and join in conversation with, colleagues in general practice as they discuss approaches to prevention and management of these chronic diseases.

Presented by the Future Health Today team, the six sessions will take place via Zoom on Thursday evenings across March-June 2021 using the Project ECHO model. The series is open to staff of all Australian general practices so you’re welcome to share the invitation within your networks (places limited). View the FHT Project ECHO series flyer and FHT website for more information.

Software News

Expansion of disease focus
In the coming weeks, Point of Care recommendations will expand to include the first set of cardiovascular disease and diabetes recommendations. Resources such as practitioner guidelines and patient resources regarding these disease areas are currently on the FHT dashboard.

The above-mentioned Project ECHO series provides the perfect opportunity to expand your knowledge on the identification and management of these diseases in general practice.

Technical logs and usage reports
To help detect any software issues a nightly log of the number of recommendation algorithms generated by FHT will be collected by the FHT technical team. No identifying information is captured during this process. This information is for technical support purposes only and does not get shared beyond the FHT technical team.

In addition, the research team will soon be looking at the patterns of usage of FHT within each practice. This usage information is captured in FHT and identifies the various actions that have been taken within FHT e.g. number of recalls, deferrals, patient reviews, Point of Care actions etc. This helps us understand what FHT functionality is regularly used and what functionality may require review or improvement.

Usage information can be viewed by generating a report from the Reporting tab. The FHT Clinical Coordinator will be in contact to provide you with information about this.

If you have any questions in relation to either the nightly technical logs or the usage report please do not hesitate to contact us.

Advising your insurer

With the start of a new year now is a good time for practices to remind their insurance providers of participation in the FHT project if they have not already done so. Please provide the insurer with the ethics approvals (original and amendment) and project flyer if required.

Consider filing these documents for future practice accreditation as proof of participation in quality improvement work.

Clinical Tip – Access for GPs and Nurses to the full functionality of the FHT platform

A reminder that in order to access the full functionality of the FHT platform, including the ability to view and approve cohorts of patients awaiting approval for recall or deferral, FHT users need to be registered and have a role assigned to them.

How to register: Open FHT dashboard, select ‘register account’ on the sign in box and follow the prompts.
Time required: less than 1 min

How to assign roles: After sign up, go to User Management from the Account menu (selected below). Scroll to the end of the user list, find the new user from the dropdown menu, click the pencil icon to edit and assign role as general user. If the new user accesses the practice clinical system enter in the practice clinical system username in order for them to see the FHT approval webpage from the FHT Point of Care. Click on the tick to save.
Time required: less than 1 min

Benefit: Fully registered GPs will be able to review and approve their patients in a cohort for recall or deferral from the Point of Care by clicking the icon next to the patient name, clicking ‘Open Approvals webpage’. GPs will be taken directly to a list of their patients where they can review patient details related to the reason for recall/deferral and determine the most appropriate course of action.

A YouTube video on user registration can be viewed via the link. You can also access this video on the How to use FHT page located under the Education menu on the FHT dashboard.

Clinical Tip- Recommendation query support

The new look Point of Care has a nifty feature that allows you to send a query to FHT about any recommendation that you feel is not appropriately applied to a patient. Lodge a query by clicking on the icon next to a recommendation and selecting ‘Lodge a recommendation query’.

We highly encourage you to submit a query if you have any questions or concerns about the recommendation after accessing and reviewing the factors (accessed by hovering over the recommendation text) and the practitioner guidelines (accessed by clicking on the icon next to the recommendation).

You can also learn about this feature and others in the FHT Point of Care by viewing the youtube video. You can also access this video on the How to use FHT page located under the Education menu on the FHT dashboard.

Support

For any technical support regarding FHT please email: FHT-support@unimelb.edu.au

For all other enquires please contact your FHT Coordinator, Natalie Lumsden via email natalie.lumsden@unimellb.edu.au or phone 0466 418 183


December 2020
Holiday period

Please be advised that the FHT Research Office will be closed between 21 December 2020 and 10 January 2021 for a bit of a break.

FHT Technical Support will be available throughout this holiday period via email.

If you need software training or have any queries around our quality improvement activities please contact Natalie outside of this holiday period via email or calling 0466 418 183.

Reminders

For those who haven’t yet invoiced for Payment 1 or returned the extended service agreement please do so by COB 15 December 2020. Thank you to everyone who has already done this.

We also remind practices as they start to recall patients for CKD testing, detection or CKD cardiovascular risk management, to please consider asking these patients, where appropriate, if they would like to talk to the FHT research team about their experience in being recalled to your practice.  At this time, all interviews would be conducted via phone.

The intention of these interviews is to understand the patient experience of chronic disease care in general practice, their preferences for care in the future including how practices communicate with patients, and how patients feel about the use of Future Health Today and technology generally to inform the care that they receive.

Please note that it is not necessary for patients to be aware that FHT was utilised in relation to the visit at the time of the visit. Patients will be reimbursed with a $50 Coles gift voucher for their time.

If any of your patients are interested in participating in an interview, please email Natalie.

A plain language statement for patients is also available.

Education and Awareness Events

FHT ECHO Series 2021

Our ECHO series will be returning in March and will deliver topics and case discussion on cardiovascular disease and type 2 diabetes. More details including links to registration to follow early next year. Thank you to those who have attended and contributed to our 2020 ECHO series, and in doing so, helping to build our ECHO community of practice.

Software update

New prostate and platelet-related cancer algorithms will be visible on the dashboard and the point of care as recommendations for follow up or referral activity. Practices will be able to create cohorts of patients who meet the algorithm criteria and manage actions, along the same lines as the CKD recommendations.  Users will be prompted to review a patient at the point of care if a patient has been identified by the algorithms.

Additional minor updates have been made, including: the ability to filter cohorts using the new MBS items opportunities category; updated education and resources pages include new How to Use FHT videos (approx. 2mins each); updated create cohort page which improves clarity of information provided; the introduction of a download usage statistics functionality to enable users and the researchers to explore how FHT is being used at each practice (the researchers may ask you to provide them with a copy of the CSV file from time to time); and, bug fixes. 

A new look point of care will also be released soon.

You can read more details about these updates in the FHT Release Note December 2020.

Clinical Tip – Kidney Health Check recommendation

The FHT Point of Care (POC) prompt for a kidney health check follows the 4th edition of the Chronic Kidney Disease (CKD) Management in Primary Care, Kidney Health Australia, 2020.  The kidney health check is comprised of a blood test, urine test and BP check as described in this diagram.

The FHT POC will prompt for the kidney health check if one of these tests hasn’t been completed at the recommended frequency (every two years for patients with any of the kidney disease risk factors, except diabetes and hypertension when testing is required every year).  Further detail can be found on pages 19 and 21 of the Kidney Health Australia guidelines.

If the POC is prompting for a kidney health check when all tests have been completed at the recommended frequency please contact FHT-support@unimelb.edu.au with a screenshot (de-identified) displaying the prompt and any supporting pathology and blood pressure monitoring data. This will help us to investigate the prompt. 

Clinical Tip- Patients awaiting approval

Did you know that a GP can approve or defer patients for recall by clicking on a link on the FHT Point of Care (POC)? 

On the bottom left-hand side of the POC box there is a statement: # Patients awaiting approval. When clicked, this statement will take you directly to the approval page on the FHT Dashboard, where you can simply select those patients to be recalled for an appointment, or defer the recommendation for selected patients for a period of time. Click the arrow next to each patient name in the cohort list to access FHT clinical and billing data summaries.

Only patients who are part of the cohort list of patients set up by your in-house FHT Quality Improvement delegate are listed on this approvals page.  This list can be printed or downloaded as an excel spreadsheet.

You can learn about this, and other, time saving features  available in the FHT Point of Care by viewing this video. This link is also listed on the FHT Dashboard under the Education tab How to Use FHT.

Support

For any technical support regarding FHT software please email FHT-support@unimelb.edu.au

For all other enquires please contact your FHT coordinator, Natalie Lumsden, via email or phone 0466 418 183.


November 2020
Seeking patients for interview

It is great to see so many practices using FHT.   As you start to recall patients for CKD testing, detection or CKD cardiovascular risk management, please consider asking these patients, where appropriate, if they would like to talk to the FHT research team about their experience in being recalled to your practice.  At this time, all interviews would be conducted via phone.

The intention of these interviews is to understand the patient experience of chronic disease care in general practice, their preferences for care in the future including how practices communicate with patients, and how patients feel about the use of Future Health Today and technology generally to inform the care that they receive.

Please note that it is not necessary for patients to be aware that FHT was utilised in relation to the visit at the time of the visit. Patients will be reimbursed with a $50 Coles gift voucher for their time.  A copy of the Plain Language Statement can be found here.

If any of your patients are interested in participating in an interview, please email Natalie: natalie.lumsden@unimelb.edu.au


Program extension

As a result of the impacts of the COVID-19 pandemic, we have extended the optimisation project timelines until May 31 2021. This will give practices more time to use FHT as a part of normal activities, contribute to the qualitative feedback and, if you would like, complete a small audit activity using FHT. It will also provide the opportunity for practices to access the new disease modules soon to be added to the FHT platform, and to attend ECHO sessions on cancer, type 2 diabetes and cardiovascular disease which will be released in the coming months.

Each participating practice will have received an email from Natalie Lumsden with details regarding this extension of the project. If your practice would like to continue to assist in the optimisation of FHT into 2021, please update the service agreement Natalie has provided with the new end date (31 May 2021) and return via email: natalie.lumsden@unimelb.edu.au. Please contact Natalie directly if you have not received an email with these details.


FHT ECHO session – Matters of the heart: identifying and managing cardiovascular disease risk 

University of Melbourne: Project ECHO
7-8pm, 19 November – last session for 2020

This event, delivered in partnership with the Heart Foundation, is for GPs and practice nurses interested in identifying people at high CVD risk and implementing systems to reduce that risk. Join with us to learn about the new Heart Foundation Tool Kit, the Life! Program and what our colleagues in general practice are doing to tackle the leading cause of death in Australia: coronary heart disease.


Software update

Upcoming update: Point of Care
Due to overwhelming feedback we have made some changes to the point of care so that clickable items are easier to identify. A query function will also be added to enable streamlined submission of queries about recommendations to the FHT tech team. These changes are due for release late November.

New content: Education tab
The Education tab on the FHT Dashboard has recently been updated. If you hover over the tab it will provide two options: Education and How to use FHT.

Under Education you will find an educational module about CKD, APNA resources for improving data in your EMR, and a FHT Quality Improvement Activity guide.

Under How to Use FHT you can now find a series of short training videos on You-Tube for those who would like a refresher (or introduction) on how to use the various components of FHT. Each video runs for between two and four minutes. User guides can also be found on this tab.

New content: Resources tab
The latest disease management guidelines are available under this tab, and will continue to be updated as new guidelines become available. Remember, you can also link directly to the relevant section of a guideline from the recommendation in the FHT Point of Care tool.

Filter by MBS items
The cohort tool (available on the dashboard) has now been updated to enable filtering by MBS items.


Clinical tip

A reminder that clicking on the X on the FHT Point of Care tool will close it until you actively reopen it. If you would like to close the FHT Point of Care for one patient, but have it alert you for subsequent patients, consider minimising the tool by clicking the minimise icon (-) rather than clicking the close icon (X).

If the FHT Point of Care has disappeared from your screen, first check the system tray to reopen the FHT Point of Care. To do this:
1) click on the system tray icon to open the system tray
2) click on the FHT icon (see gold circles bottom right).

If the FHT icon is not visible in the system tray please contact FHT-support@unimelb.edu.au.


Support

For any technical support regarding the FHT software please email: FHT-support@unimelb.edu.au

For all other enquires please contact your FHT coordinator, Natalie Lumsden – email: natalie.lumsden@unimelb.edu.au or call: 0466 418 183.