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Monash Minute is a collection of short articles and headlines about Monash Health which may be useful for primary health providers. 
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December 2020 Update from Monash Health GP Liaison

Please forward this newsletter to GPs in your practice or email us at GPLiaison@monashhealth.org to subscribe to this newsletter.

COVID-19 Care Pathways at Monash Health 

The DHHS COVID-19 Care Pathways initiative is designed to provide timely and appropriate care for COVID-19 positive patients in our catchment. Patients are risk stratified based on symptoms and psychosocial screening questions into: 
  • low risk (primary care)
  • medium risk (Complex Care, Hospital in the Home (HITH) or Monash Children's at Home) or 
  • attend to symptoms whilst waiting and 
  • high risk (inpatient care)
We are using a web-based application, COVID Monitor, to collect intake information and patient symptoms, and to manage de-isolation/clearance.
GPs are encouraged to access COVID Monitor to:
  • enter patient symptoms
  • request de-isolation/clearance
Registered patients can also enter their symptoms directly into the database, via a daily SMS reminder. For patients unable to enter their symptoms, our triage partners at Central Bayside Community Health will assist with symptom entry.

Households with COVID-19 cases will be managed together, either by Central Bayside Community Health or by Monash Health Complex Care, depending on the complexity of cases. This is intended to reduce duplicate phone calls and ensure consistent advice.
 
For more information - Please see the SEMPHN Health Pathways page.

For any queries (including access to COVID Monitor) please contact :
F: 0404 084 273 
E: covidcare@monashhealth.org
GP eReferrals to Monash Health now available
Specialist Consulting Services

 
Monash Health has successfully piloted an electronic referral system through HealthLink, which has enabled GPs to refer their patients to Monash Health Specialist Consulting Services directly through their clinical software. 

After receiving a lot of positive feedback and increasing interest from GPs, the platform is now available for the local practices.

How do I access Monash Health eReferrals?
If your practice uses one of the following clinical software packages, and is HealthLink enabled, you can start using it now.
  • Medical Director - v.3.16 and above
  • Best Practice - v.9x and above (Indigo)
  • Genie - v.8.8 and above
  • Medtech - v.10.4
What does it cost?
It is completely free for GPs to make eReferrals via HealthLink

For Pregnancy referrals please include expected Date of Delivery (EDD) 

How do I make a eReferral?
Refer to the GP eReferral website here for further information on how to make a referral.
 
To register for HealthLink please contact HealthLink Technical Support:
E:  helpdesk@healthlink.net
P: 1800 125 036
 
The Aboriginal Health Service at Monash Health 

Monash Health Community works closely with our Aboriginal and Torres Strait Islander communities to improve the health outcomes and wellbeing of community members.

Primary care practitioners  benefit from our programs as they provide a range services designed to link primary care and General Practices to Aboriginal and Torres Strait Islander communities.

Services we offer include: 

Access and Support Workers
The Access and Support workers offer support to Aboriginal and Torres Strait Islander people accessing care to maintain their health, wellbeing and independence. This includes navigating My Aged Care and NDIS systems, as well as transportation to appointments and accessing General Practice Services.

Healthy Koori Kids Program
Healthy Koori Kids service is for Aboriginal children aged 0-18 years who are at risk of entering, or are in, out-of-home care. The service offers a multidisciplinary team of skilled professionals comprising a paediatrician, paediatric psychologist, speech therapist, oral hygienist and Aboriginal Health Workers, providing a fortnightly clinic to address children’s health needs. body text. 

Aboriginal Hospital Liaison Officers
The role of an Aboriginal Hospital Liaison Officer is to provide cultural support and assistance to all Aboriginal and Torres Strait Islander patients and their families during their inpatient stay in Monash Health. They can also assist in connecting patients to community services during discharge planning, including linking to General Practice.

Aboriginal Midwife Coordinator
Monash Women’s has an Aboriginal Midwife Coordinator who can either care for or provide assistance to pregnant Aboriginal and Torres Strait Islander women. We now have a dedicated Bupup Clinic for women based at Pakenham on a Tuesday. At the moment this is for lower risk women however, acuity does not preclude any woman from accessing our Aboriginal Midwife Coordinator.
One of our forward bookings in the clinic is for a women who have been assisted by our Aboriginal Midwife Coordinator in a previous pregnancy. We believe this will make a positive impact on pregnancy outcomes.

Eligibility criteria 
•  Clients with an Aboriginal and/or Torres Strait Islander background
•  There are no catchment or boundary restrictions

Cost
•  No cost
 
All enquiries
P: 9792 7948
E:  ahs@monashhealth.org
Monash Imaging
Changes to Myocardial perfusion studies: Medicare item numbers and bulk billing restrictions
 
Monash Health Imaging - PET and Nuclear Medicine Services welcome imaging requests for your patients. 

Myocardial perfusion studies (MPS) have been reviewed by Medicare. These cardiac studies have been reclassified with new item numbers and restrictions on how often MPS can be bulk billed per patient.

The changes came into effect on 1 August 2020. Referring practitioners, including GPs, consultant physicians or specialists, now have different Medicare numbers for the same test.
The procedures are now classified in 5 separate groups have have different bulk billing restrictions:
  • Combined Stress & Rest MPS for assessment of Ischemia (once in 2 years)
  • Single Stress MPS for assessment of Ischemia (once in 2 years)
  • Single Rest MPS for assessment of known disease using Technetium (once in 2 years)
  • Single rest MPS for assessment of known disease using Thallium - this can be repeated for 24hr image (one combined in 2 years)
  • Assessment of viable & non-viable myocardium on a patient with probable or confirmed CAD (once in 2 years)
  • Repeat combined Stress & Rest MPS for patients who have undergone revascularisation (once in 1 year)
  • All of the studies include the cost of the ECG.
Refer to MBS Online for further information on these changes.

Please contact one of our Nuclear Medicine specialists or technologists to discuss patient referrals.

P:  03 9594 2691.
New Community Hospitals Update
Cranbourne and Pakenham have been selected as sites for the State Government's $675 million commitment to developing community hospitals in high growth areas. These community hospitals will add real value to the way healthcare is delivered in suburban and regional Victoria, providing more access to in-demand services, closer to home.

The range of services offered at each hospital will be tailored for each community, with a strong focus on ensuring better integration of health and human services under one roof.

Cranbourne
The Cranbourne Community Hospital service plan is now complete, and will provide a framework for how services will be delivered.

The Victorian Health and Human Services Building Authority is currently working to identify a preferred site for the Cranbourne Community Hospital. Once a site is identified, we will continue working with Monash Health to further develop design options. The Cranbourne CCC will have the opportunity to review and provide feedback on the initial design work. 

For more information about the Cranbourne Community Hospital, please visit the project website.

Pakenham
The Pakenham Community Hospital service plan will soon be finalised with Monash Health. Based on local population characteristics and insights from our Community Consultative Committee (CCC), this plan will provide a framework for how services will be delivered.

The Victorian Health and Human Services Building Authority is continuing work to identify a preferred site for the Pakenham Community Hospital. Further site testing and due diligence is being completed on a number of shortlisted sites to ensure a suitable and viable site is selected for the community hospital. The Pakenham CCC will have the opportunity to further comment on the services being delivered and priorities for the function and design of the hospital at the next CCC meeting.

For more information about the Pakenham Community Hospital, please visit the project website.
Specialist Consulting Referral Cancellations

Has your patient already been seen elsewhere during COVID? 

Due to COVID-19 reductions in clinic services, some patients have accessed private care. If you have patients who fall into this category, please cancel their referral to Monash Health as soon as possible so we can reduce duplication and free up appointments for other patients.

For example:
A patient was referred to Monash Health Gynaecology for the Dysplasia Clinic. Whilst on waitlist, the colposcopy was performed privately. In this case, the specialist referral to Monash Health should be cancelled.

How do I cancel my referral?
Please call the Referral Management team, or email them with the referral details.

For further information -
Monash Health Referral Management
P:  1300 342 273                                                                                      
E:   outpatient_enquiries@monashhealth.org
W : https://monashhealth.org/health-professionals/referrals/
 
Refugee Health Fellow supporting primary health carers

Introducing our inaugural Refugee Health Fellow, Dr. Mark Timlin, GP. The RHF role is to build primary healthcare capacity to effectively care for people of refugee backgrounds. The initiative is funded through the Department of Health and Human Services (DHHS).
 
Refugee Health Fellowship Services offered:
•    Actively supporting general practice clinics to increase confidence working with patients of refugee background
•    Delivering training on the refugee experience, refugee health conditions, and other health and wellbeing information
•    Providing useful clinical and non-clinical refugee health resources, and;
•    Consulting and providing information and education on specialist refugee health services, referral processes and guidelines.

Primary Care Services - Monash Health Refugee Health and Wellbeing:
•    Refugee health assessments and medical interventions
•    Refugee health nurse care management
•    Complex health case management
•    Allied health
•    Immunisation
•    Collaborative maternity care management.

Speciality Services -  Monash Health Refugee Health and Wellbeing:
•    Adult Infectious Diseases and medical interventions
•    Development and General Paediatrics
•    Adult Psychiatry

Who to refer:
•    Patients with complex medical needs who would benefit from multi-disciplinary care
•    Patients at high risk of multiple hospital presentations/admissions
•    Patients with significant mental health issues
•    Patients without Medicare access
•    Vulnerable families, particularly those with children under 5 years.
 
For more information click here

How to refer to us:
Refugee Health Nurse on Triage 
(For advice on clinical issues and how, when and where to refer)
E:  refugeehealthnurseontriage@monashhealth.org
P:9792 8100
F: 9792 7765
Advance Care Planning (ACP)

GPs play an important role assisting people plan for future medical care.  ACP provides patients with the opportunity to make their care preferences known in the event they are unable to make decisions for themselves.
ACPs ensure those close to the person, and those caring for them, know:
  • what is important to them
  • what preferences they have regarding medical care and 
  • who is appointed to make decisions for them if they are unable to do this for themselves
Documents available for advanced care planning:
  • appoint a Medical Treatment Decision Maker (MTDM) (previously called a Medical Power of Attorney)
  • document preferences, values, consent or refuse treatment
  • prepare an Advance Care Directive (ACD)
  • appoint a Support Person
ACP documents need to be discussed with, and witnessed by, the person’s  medical practitioner (GP). 

The role of GPs in witnessing an Advance Care Directive (ACD) is to:
  • not make judgements about the reasonableness of a person’s decision
  • ensure the person understands the nature and effect of the statements in their ACD and the possible implications of including these statements in their ACD
  • help ensure that the ACD is consistent and practically applicable
Witnessing requirements:
An ACD must be witnessed in the presence of the person completing the document by two people, with one being a registered medical practitioner. Each witness* must certify that the person:
  • appeared to have decision-making capacity at time of signing
  • appeared to freely and voluntarily sign the document
*The witness is not an appointed Medical Treatment Decision Maker

Monash Advance Care Planning Program can:
  • assist with preparing documents 
  • lodge copies of documents on the patient’s Monash Health medical file

REFERRAL:
For further information or to refer a patient to Monash Health Advance Care Planning Program contact via:
E: acp@monashhealth.org 
P: 9594 3475
Web: https://monashhealth.org/services/advance-care-planning

Please note that due to COVID 19, no face to face discussions can be conducted with patients.  Appointments will be via telephone or video conferencing until further notice.
 
Disability Liaison Officer – New Service
Monash Health
 
To better support access to health care for people with a disability, a Disability Liaison Officer (DLO) position has been created. This new Monash Health service is based at the Centre for Developmental Disability Health, and is an initiative of the Department of Health and Human Services.

The DLO seeks to -
  • Provide people with disability inclusive access to assessment and treatment for COVID-19, and other health needs
  • Provide an outreach service to people with disability who may be less likely to access their local health services
  • Provide disability-specific advice and support to other healthcare providers to assist with the assessment and management of people with disabilities.
     
For further information contact the Centre for Developmental Disability Health 
W: https://cddh.monashhealth.org/
P: 9792 7888

 
 
New Check Program on Chronic Disease includes module on cerebral palsy
Chronic Conditions are the focus of the September 2020 edition of the RACGP Check program.

GPs from Monash Health’s Centre for Developmental Disability Health (CDDH), Dr Jane Tracy and Dr Paul Nguyen, were invited to work with internationally respected developmental paediatrician Prof Dinah Reddihough to write a module on cerebral palsy, one of the 4 modules in this edition.

The contribution the CDDH has made to this RACGP learning program for GPs reflects the Centre’s commitment to professional education in topics related to the health and healthcare of people with intellectual and associated developmental disabilities.

This edition has been well received and 253 GPs have already completed the Unit.

For further information please visit the website here.
 
Cognitive, Dementia and Memory Service (CDAMS)
 
Patients experiencing changes to their memory and thinking benefit from CDAMS specialist diagnostic service which provides information and advice on management, and referral to other services, as appropriate.
CDAMS does not provide ongoing treatment or case management.

Service Update
  • CDAMS continue to offer assessment via telehealth (video appointment)
  • CDAMS are resuming face-to-face appointments where clinically necessary for diagnosis. Face-to-face assessments depend on client risk and urgency.
  • Our team continue to support those on our waitlist, providing information and advice as needed.
  • There are currently lengthy waits times due to high demand (6+ months), so we thank you for your patience. 
  • Please contact us If you have any queries about the CDAMS service
Referrals:
  • Referral letter required
  • Past medical history
  • Current medications 
  • Contact details of client and/or family
Assessments/investigations recommended prior to referring:
  • Dementia
  • MSU
  • CT brain scan
Location:
Kingston Centre - Cnr of Warrigal and Heatherton Roads, Cheltenham VIC 3192
 
Please send referrals to:
E: mailto:icareaccess@monashhealth.org
T: 1300 3 iCare (1300 342 273) Option 5
F: 9554 9151
 
Casey/Cardinia Adult Mental Health 
Support for GPs through the Cranbourne & Pakenham Community Mental Health Service

To help GPs access appropriate mental health services for their patients, the GP Liaison service will: 
  • help build relationships that promote collaboration and partnership between services.
  • promote continuity of care across the mental health sectors.
  • improve communication to GP’s through our new GP introductory letter and up to date Consultant Psychiatrist reviews.
  • provide specialist support to GP’s via telephone or attendance to the GP practice by appointment.
  • facilitate the transition of care to GPs during discharge planning.
  • improve the quality of health care.
  • optimise resource use and the efficiency of care across multiple providers.
This service is supported by:
  • Dr Antony, Monash Health Consultant Psychiatrist and Unit Head at Casey Hospital, 
  • Kelly Isle, Continuing Care Team Manager Cranbourne and Pakenham and 
  • Shane Szwaja,GP Liaison/ Patient Transition Co-ordinator.
For further information 
GP Liaison / Patient Transition Co-ordinator:
M: 0427 542 419


 
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