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EPC Referral letter rant

Discussion in 'Australia' started by surfboy, Feb 18, 2015.

  1. surfboy

    surfboy Active Member


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    I don't know about everyone else, but I for one am becoming very tired of having to write a letter to the referring GP after the first and last visit with these EPC plans.

    Don't get me wrong, I am grateful for the opportunity to utilise the EPC program,
    But I do not feel that we as Podiatrists are adequately remunerated for the onerous task of writing and also keeping track of these letters.

    It is also very annoying when the GP issues an EPC Podiatry referral for only two visits, as there is the requirement to then write the letter after the first and also last (second) visits. - In my opinion this is ridiculous and needs to be addressed.

    Does anyone know of a letter template? How detailed are these letters supposed to be anyway? There is minimal guidance from Medicare.

    End rant.
     
  2. JAYNES

    JAYNES Active Member

    Yes i feel the same i spend hours doing these letters
     
  3. Tim Foran

    Tim Foran Active Member

    surfboy

    Do you use Frontdesk? If so why not do a number of standard letter templates for the 1st visit and one standard letter for the last visit saying something along the lines that this now completes the final EPC visit for such and such. Another detailed letter will be sent at the commencement of the plan next year. Or something along those lines. Frontdesk should be able to insert all the patients details etc. I have maybe 30 or so that I did up covering things like ingrown nails to different results with Dopplers.
     
  4. Bug

    Bug Well-Known Member

    They are no longer EPC - they are CDM - Chronic Disease Management plans and we do similar to Tim.

    We have a diabetes proforma, biomech proforma etc. It is then the most common findings and our letters take under 5 min each to personalise it and generally can do most at the end of the consult prior to the next patient.

    There is pretty clear guidelines about what is needed though:

    - any investigators, tests and/or assessments
    - any treatment
    - future management of the patients condition/problem
     
  5. Mediclinic Software

    Mediclinic Software Active Member

    Hello Everyone. Our Mediclinic Software PMS does all this automatically for you and populates your session notes into the letter and EMAILS the letter to the GP through our system automatically alleviating the necessity for letter writing. YES we also do the letters first and last even if you get 1 or 2 referred sessions.

    We also have automated Medicare and DVA online claiming
     
  6. Bug

    Bug Well-Known Member

    Mediclinic,

    Is your email function encrypted and if so how is this handled by the receiver if they aren't running the same software?
     
  7. Mediclinic Software

    Mediclinic Software Active Member

    Hello "BUG". thank you for asking. the answer is YES and NO. Our software is fully encrypted and we send all EMAILS to fax or EMAIL addresses and along the route is not Encrypted.

    HOWEVER that being the case, under CURRENT AUSTRALIAN law there is no requirement to encrypt emails of this kind.

    To have ENCRYPTION all the way the client as you correctly state, also has to run an encryption service at their end and as a provider we would have to host ZILLIONS of client encrypted keys.
    We use ENCRYPTED CLOUD DATA and here is an extract from Cloud Security info on the web
    The data in the cloud is either tokenized or encrypted so it is meaningless when viewed in the cloud, and organizations can be confident that their sensitive data is within their full control at all times.
    What we do CURRENTLY is VALIDATE an email address, so if you have an email address and You do not validate our email then "BLOCKED" you are until validation is performed.

    Sending reports VIA email is tricky. We are in the process of writing up code to ENCRYPT all emails and the other side will have a pass code to de-encrypt but do this will be an OPTION for you as the user to turn on or off. Do you know how many GO clinics will scream at you : "why are you sending me so many passwords"????

    What we use which is FAIRLY SAFE and recognized and USED BY 95% of all medical practices at present - is to send an email from OUR SYSTEM to the GP / Medico FAX number. Fax is thus far encrypted enough to satisfy most demands and many clinics still rely on the old fax machine.

    But what we are doing which will be completed within a few weeks is doing the attachments as a SECURED DOCUMENT requiring a decoding key code and the email would have already been VERIFIED as the user or party legally accepting the email we send.

    As I said not easy but we comply with all the legislation thus far and a bit more :)

    I hope this helps.

    Please feel free o ask more detailed information at any time.
     
  8. Bug

    Bug Well-Known Member

    Thanks for the response. I'm still not sure why you would go down this path rather than integrated with Argus or similar as that is what the RACGP recommends all the GPs do and they are who we would primarily communicate with over email about medical records.

    However, I do understand it currently isn't an absolute requirement.


    I hope it's not stating the obvious to all those out there using unencrypted email to communicate with GP's/specialists etc, that your patient is informed that you will be communicating in that way as per the amendment to the privacy law that came in last year.
     
  9. Mediclinic Software

    Mediclinic Software Active Member

    I can see your concern and that is why we are going down the track we are. NOT EVERYONE uses Argus and Argus requires a system to run on a SERVER WITHIN YOUR OFFICE or via VPN and this can be expensive. Also with our services you end up saving a lot because you do not need ARGUS subscriptions, servers or server programs, no more VPN and associated IT costs and NO MORE IT REPAIR FIX IT MAN.
    ARGUS does not work not CLOUD based systems as of now and nor so any of the other systems like it so it does not cover all situations. Our system does and complies with the Health regs and laws and interpretations and rules and so forth Bureaucrats bring in to keep us on our toes.

    The new laws states that it is ADVISABLE to CONFIRM an email address BEFORE sending any information of a PERSONAL NATURE so that is what we do.

    When doing BULK reports, say all the CDM treatment letters and reports in a large volume, sending to FAX is about as SAFE AS IT GETS. Emails we verify and these will have the password protected and each will be encrypted using 256 SSL EVA encryption .

    The GP clinics you send to will be able to advise you as the user YES I WANT IT SENT THIS WAY or NO STOP STOP!!! and you can Turn on or OFF the encryption.
     
  10. Bug

    Bug Well-Known Member

    Yes I get what you are saying and it all sounds very fancy however, there is still some key missing parts. Firstly, yes, argus has cloud issues, Healthlink doesn't and the others are quickly catching up.

    It is an interesting paradigm in your system where the user (or podiatrist) is partially protected under your system, as they have sent an encrypted message from their secure email to your secure server, your server will push it out to the GP, via whatever world wide path it may take. Then the GP will receive privacy controlled information in clear text without any level of encryption. It will be interesting to see how many accredited GP practices will send back the NO STOP STOP! message as I suspect it will be high and get higher as email encryption becomes more an more integrated when medical director software goes cloud based.

    It is also the law from a health care providers perspective that we inform our patients if we are going to share their information in this (partially) unencrypted way, regardless of the GP clinic preference, the patient actually has the final say. No one else.

    I say this not to say what you are doing is right or wrong, but to ensure that people who are less tech savy are aware of the different aspects of legislation that aren't just about how you send an email.
     
  11. gbc

    gbc Member

    hi guys

    some time ago i went to see some doctors in my local area to see what if any requirements they seek in the way of EPC letters.

    of the 5 doctors i spoke too, 4 said they did not read the letters their staff simply file them or bin them

    1 doctor who did read them said they were of little help too her and most of the time the information held in the EPC letters didn't relate to the way she saw the patient

    and of course their is always the odd doctor who will disagree on whatever you write

    as such the doctors recommendation is standard letters on first and last visit and not much detail on our interruption of their medical conditions
     
  12. LCG

    LCG Active Member

    Simple. Incorporate the time you spend writing letters into the fee structure and charge a MBS10962 fee different to that of a F012. You are then remunerated for the extra time you spend writing the letters. The patient will either find a different provider and you are left with fewer CDM plans to reply to or they pay the fee, get rebated the MBS amount and your happy
     
  13. Mediclinic Software

    Mediclinic Software Active Member

    Bug, we get lots or calls regarding SAFE SENDING OF EPC letters and so forth. The truth is, if you want SECURE EMAIL DON'T USE EMAIL. Take the letters BY HAND. The people who write the privacy rules are actually quite ridiculous.

    If we do send an email to VERIFY and we get a reply that email is VALID, how do we know it is not a fake email of a spammer anyway? WE DO NOT.

    Privacy Act says
    Do you validate the email address with the recipient before sending the unencrypted email to reduce the chance of unauthorised disclosure to a party who is not the intended recipient?
    Do you ensure that accurate records are kept regarding when external emails are sent and received?
    Do you only send sensitive information or large amounts of non-sensitive personal information by email as an encrypted or password protected attachment? Is it possible that 2 emails are sent?
    Now password protection is also a furphy as you send the password to the same email address and again how do you verify it is not unauthorised. YOU DO NOT.

    Using the internet is a risk. People want fast efficient expedient means of gathering information.

    We do the best we can. We implement the best security we can as do other vendors but really, if you are so afraid of the information you are sending O NOT SEND IT.

    As GBC states, most Doctors do not care for the letters at all. It realy is a waste of an email, a stamp and your time
     
  14. Mediclinic Software

    Mediclinic Software Active Member

    The other thing I really would like to point out is that so many people are going absolutely crazy about security. If you really want to know about SAFETY encryption and so forth and cost yourself money, ASK EDWARD SNOWDON - he can verify what a waste of time it all is.

    I am sure other software vendors get hair loss over this very issue too.
     
  15. Bug

    Bug Well-Known Member

    Yes, my bald husband is one of them. As someone who also works in a hospital, private clinic and research, I'm surrounded by privacy so don't need the act quoted to me, but thanks anyway.

    GP's are like pods, good ones and bad one, ones that read everything and ones that don't, ones that continue to call things EPC's and ones that realise things have changed and they are no more, replaced with CDM's. Regardless of what the GP's say, all chronic disease management plans have rules. If you are audited, your communication will be reviewed by your peers, not GP's.

    Don't like CDM's, don't accept them. Don't like privacy laws, whatever.

    We all do what is important to us, but more importantly, what is important to our clients and patients. That should actually be the priority rather than defending the position of your company or business has chosen to take based on an interpretation of the law. Our children are being taught more and more about privacy and the internet, I've observed people being more and more wary and interested in keeping their information safe, I guess we all just need to keep up and do what we can.
     
  16. trevor

    trevor Active Member

    Local podiatrists are charging the new patient fee when a patient presents with a new CDM/EPC referral. This is to cover letter writing as one of our local GP clinics is only giving out 1 or 2 visits per referral.
     
  17. Mediclinic Software

    Mediclinic Software Active Member

    AND YES we do automated letters for you saving you postage time money stamps blah blah blah AND
    Hello everyone and it is with great pleasure we have now got TYRO Payments as a partner to our platform making your allied health and credit and debit card payments more easily integrated to your practice software - Mediclinic Software of course.

    Seamless less key strokes and yes it works . No more telephone line drop outs.
    INSTANT confirmation
    LESS hassle


    ITS FINALLY HERE - a solution man of you have cried for help so we listened
     
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