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Better, sooner, more convenient health care in Midlands

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7 Deliver<strong>in</strong>g on <strong>health</strong> targetsOld WayNew WayHayden has to get a medical <strong>in</strong> order toqualify for his life <strong>in</strong>surance to be renewed.He has not been to the doctor <strong>in</strong> over fiveyears. At the medical Hayden discovers thathe must complete different parts of the checkat different locations and that none of theirschedules are shared. Hayden leaves feel<strong>in</strong>g<strong>in</strong>tensely frustrated with the process and tellshis workmates of his awful experience.As part of his birthday communication Hayden receives a basic <strong>health</strong> screen.The communication also <strong>in</strong>cludes a summary of screens he had last year and theones he will require over the com<strong>in</strong>g twelve months. He completes the screenonl<strong>in</strong>e and uses the secure email to book an appo<strong>in</strong>tment for his medical.The Flow Team knows what the medical will require and make sure that Haydenreceives a coord<strong>in</strong>ated check (bloods are taken at work and available at thecheck). The Medical PA emails Hayden to let him know that he will require anECG and that she has contacted the service to organise an appo<strong>in</strong>tment on hisbehalf. The medical is completed and highlights no areas for concern. Haydenis thoroughly impressed with the service and tells others about his experience.A blood test confirms Maree has highcholesterol. Maree googles her cholesterollevel and discovers that it is only marg<strong>in</strong>also she eats the piece of bacon and egg pieshe brought for lunch and throws away thepamphlets her General Practitioner gave her.Maree’s bloods were taken at work by the peripatetic phlebotomist. While sheis wait<strong>in</strong>g for her check - a Flow Team member gives her a web<strong>health</strong> touchscreen with an <strong>in</strong>teractive Heart Forecast. Dur<strong>in</strong>g the consult Maree’s GeneralPractitioner confirms that she has high cholesterol and works with her to createa self-management plan. Her General Practitioner’s Medical PA organises anappo<strong>in</strong>tment with Green Prx before she leaves and books another appo<strong>in</strong>tmentfor her <strong>in</strong> three months to review her progress. Maree’s appo<strong>in</strong>tment, contactdetails for Green Prx and self-management plan are available for her toview onl<strong>in</strong>e.Vicki is 27 and flatt<strong>in</strong>g with two other youngwomen. Vicki has had three letters regard<strong>in</strong>gher cervical smear but all have gone to herlast flat and she is unaware she has fallenoff the recall list. She th<strong>in</strong>ks smears are ickyanyway, its w<strong>in</strong>ter and she will have to shaveher legs, the last time she had to go on herown and she felt like a real idiot.Vicki hasn’t cleared the letterbox <strong>in</strong> years and when her Integrated FamilyHealth Centre asked her if she wanted to receive her communication onl<strong>in</strong>eshe jumped at the chance. Vicki received a rem<strong>in</strong>der <strong>in</strong> her onl<strong>in</strong>e birthdaycommunication that she would require a smear this year. She goes onl<strong>in</strong>e andbooks an appo<strong>in</strong>tment that suits her. She also f<strong>in</strong>ds a l<strong>in</strong>k to a great website thatanswers some of her <strong>more</strong> gross questions without her hav<strong>in</strong>g to ask them tosomeone’s face. The Flow Team r<strong>in</strong>gs to confirm her appo<strong>in</strong>tment and asks herif there is anyone she would like to br<strong>in</strong>g with her. Vicki says she will br<strong>in</strong>g one ofher flatmates and the Flow Team takes the opportunity to book an appo<strong>in</strong>tmentfor her flatmate’s smear while they are both there.Marama is a lifelong smoker who has had arecent <strong>health</strong> s<strong>care</strong>. She is currently <strong>in</strong>hospital and, as she can’t smoke <strong>in</strong> thereanyway, has taken the opportunity to getpassionate about quitt<strong>in</strong>g. She has hadnicot<strong>in</strong>e patches while she has been <strong>in</strong>hospital. She asks one of the nurses abouthow to give up and the very friendly nursegives her lots of helpful pamphlets and asksher to talk to her Pharmacist about nicot<strong>in</strong>ereplacement. Marama goes home and isunable to get to the pharmacy for the nextthree weeks. She recommences smok<strong>in</strong>g andthe moment is lost.Marama is visited <strong>in</strong> hospital by a member of the Integrated Family Health Centrecommunity team. The Team member talks to Marama and discovers her desireto quit smok<strong>in</strong>g. This is <strong>in</strong>cluded on her discharge <strong>in</strong>formation and dischargeprescription. The Regional Referral Centre notes Marama’s <strong>in</strong>tentions and flagsthese with the Integrated Family Health Centre for follow up. The IntegratedFamily Health Centre Community Team coord<strong>in</strong>ate nicot<strong>in</strong>e replacement therapyand smok<strong>in</strong>g cessation support so that Marama’s good <strong>in</strong>tentions do not becomea wasted effort.How we will implement that changeBasic (onl<strong>in</strong>e or manual) <strong>health</strong> screen<strong>in</strong>g for every enrolled patientEvery patient to receive a basic <strong>health</strong> screen that is Integrated Family Health Centre <strong>in</strong>itiated. Thescreen is updated annually and the def<strong>in</strong>ition of an unengaged patient will be determ<strong>in</strong>ed by thenumber of patients that have not completed this screen <strong>in</strong> the last 12 months.85

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