Practice Update – Spring 2013

Published in Practice Update

Date published: About this date

Clinical content may change after this date. This information is not intended as a substitute for medical advice from a qualified health professional. Health professionals should rely on their own expertise and enquiries when providing medical advice or treatment.

From the MedicineInsight National ManagerMeet the MedicineInsight teamPractice improvement around the worldWhat MedicineInsight is telling usMedicineInsight practice profileFor more information

From the MedicineInsight National Manager

Nancy Huang, national manager of the MedicineInsight program

Nancy Huang, National Manager MedicineInsight

Welcome to our first MedicineInsight Practice Update. I want to begin by letting you know that as of late August around 70 general practices are participating in MedicineInsight. It’s great to see that we’re on the way to establishing one of the most comprehensive prescribing and clinical activity databases in Australia.

Our practice support visits to report on the information collected through MedicineInsight have now started. These visits will first focus on the quality of each practice’s data. We will then provide further support visits focused on specific clinical areas.

In this update you’ll meet one of our MedicineInsight team delivering practice visits in Victoria. We’ll also revisit MedicineInsight’s first practice in Shepparton and see what their practice support visit revealed to them. We’ll also look inside the workings of the Peninsula Family General Practice in Frankston.

Finally, I would like to take this opportunity to congratulate you on being one of the foundation members of MedicineInsight. This will be a groundbreaking service that will contribute to a better understanding of medicine use and improved healthcare across Australia. I hope you’re as excited as I am about the road ahead and I look forward to working with you on the MedicineInsight journey to better medicine use.

Nancy HuangDr Nancy Huang
National Manager, MedicineInsight

Meet the MedicineInsight team

Clare Delaney, MedicineInsight team member

Clare Delaney, MedicineInsight team member (Victoria)

Victorian MedicineInsight practices will soon become familiar with one of our MedicineInsight team members, Clare Delaney. Clare is a pharmacist with a background in rural health service delivery. Clare is very excited to be working one-on-one with general practices to look at their data quality and prescribing and to see where she might be able to help with improvements.

”I’ve worked with a number of other NPS MedicineWise programs for general practice and what I think is particularly unique about MedicineInsight is that we will have very specific data to feed back to individual practices”, Clare said.

”So hopefully the conversations we have, and the activities we run with MedicineInsight general practices will be quite specific, meaningful and actionable.”

”In my role, I will be doing a lot of listening to the needs of general practices and drawing on the resources within NPS MedicineWise to try to meet those needs.”

”I look forward to working with the many diverse practices we have on board in Victoria.”

Practice improvement around the world

A 2007 Danish study1 of 154 GPs' notes on patients with COPD before and after a 12-month educational program mainly involving face-to-face interventions with participating GPs and their staff, showed marked improvement in quality of care across many measures.

Recording of FEV1 improved from 53% of cases in the first survey to 71% in the second. There was a significant improvement in the recording of body mass index and provision of smoking cessation advice, recommendation of physical activity, checking of inhalation technique, dietary instruction, and referral to pulmonary rehabilitation. A decline in the use of inhaled corticosteroids in patients with mild COPD, from 60% in the first survey to 49% in the second was also observed.

1.  Lange P, Rasmussen FV, Borgeskov H, et al. The quality of COPD care in general practice in Denmark: the KVASIMODO study. Prim Care Respir J 2007:16(3):174–81.

What MedicineInsight is telling us

University of Melbourne Shepparton Medical Centre

University of Melbourne Shepparton Medical Centre, Victoria

The University of Melbourne Shepparton Medical Centre in northern Victoria, was the first practice in Australia to participate in MedicineInsight. Early in July we returned to Shepparton with the first report that analysed the data from the practice.

Data quality in the Shepparton practice was high for most indicators such as recording of patient characteristics and diagnosis.  Despite this being the first MedicineInsight report, practice principal, Dr Derek Wooff was impressed with the analysis of the data.

”It was good to see that we are rating really well in terms of our data quality. You can only get a good indication of your practice’s clinical activity if the data you enter is of a high quality”, Dr Wooff said. ”It was also interesting to get an overview of the range of patients we have coming through our door.”

”While the data for medicine use at a practice level was not that surprising, it was interesting to see the variance in the way individual GPs within the practice approach their prescribing. Obviously there are a number of factors that affect the way GPs prescribe, but it’s given us some things to reflect on as a team.”

Please note that the University of Melbourne Shepparton Medical Centre gave MedicineInsight permission to identify them for this newsletter.

MedicineInsight practice profile

MedicineInsight started its proof of concept phase in Victoria and we now have about 50 practices participating across the state. One of these is the Peninsula Family General Practice in Frankston. MedicineInsight asked the principal, Dr Jenny Downes-Brydon about the practice and its expectations of MedicineInsight.

Peninsula Family General Practice, Frankston (Victoria)

Peninsula Family General Practice in Frankston, Victoria

Peninsula Family General Practice - Frankston, Victoria

How many active patients does the practice have?

We have 2310 active patients.

What staff do you have at the practice?

We have 3 doctors and 2 registrars along with 1 prevocational doctor and medical students from the University of Melbourne for most of the year.

We also have division 1 and 2 nurses, 2 administrative staff along with a number of reception staff. There are several contractors focused on such areas as psychology, mental health and podiatry.

What are the practice’s specialty areas?

Aged care is certainly a focus for us. We manage over 350 patients at aged care facilities. We also provide the largest delivery of mental health items on the peninsula and we’re on the 99th percentile for mental health plans with Medicare.

We are a teaching clinic and I am a medicolegal and presiding member of the Medical Panel for Workcover and personal injury.

What would you say provides the greatest challenges for the practice?

Recruiting and retaining an excellent medical workforce is a significant challenge - though that is changing with our registrar training program. Staying afloat financially and dealing with red tape are also constants.

There is also a growing burden of complex presentations and people with multiple chronic diseases. We also experience a lack of access to specialist services in a timely fashion, including ED and acute mental health access.

What do you expect from MedicineInsight?

We would like assistance in maintaining and improving our quality and keeping an eye on medical trends, disease burden and planning for the future. We also see MedicineInsight as providing teaching and research stimulus and material.

It would also be good if there were some assistance in compliance, if the likelihood of capitation and target reaching for GP payment increases.

Please note that the Peninsula Family General Practice gave MedicineInsight permission to identify them for this newsletter.

Data quality tip

Coding diagnosis

Remember, it will be easier for MedicineInsight to provide a complete picture of the care provided to patients with a particular medical condition if you record their diagnosis in the coded field in your clinical system. ‘Coding’ will differ slightly depending on the clinical system used at your practice. In general, ‘coding’ means that practice staff use ‘drop down’ boxes to select from set options instead of entering information in the free-text or uncoded field.

For more information

If you would like any information on MedicineInsight, email us on or call 1300 721 726.