GP Chronic Disease Management Plans (GPMP) are shown to improve Patient Health Outcomes if done appropriately and are patient oriented.
Dickson GP aims to provide not only medicare compliant but also best quality patient care possible.
This Policy is developed to assist Doctors and Nurses along with Admin staff to ensure Care Plans and Reviews are organised appropriately and with patient consent, involvement, input so as to maximise the health care benefits and outcomes.
Dickson GP encourages Doctors to perform Care Plans for eligible patients as they help early detection of and intervention for their chronic conditions, delay onset of complications related to the respective medical conditions and also help in improving the Quality of Life of patients.
As of 1st Of October, the following need to be ensured prior to doing a care plan.
A signed Patient consent stating they understand what a care plan is and how it can help them.
A signed Patient consent stating they understand what a TCA is and how it helps the patient and to improve their QOL.
A signed patient consent that they will attend for a review as planned and appropriate.
Patient written / addressed patient oriented Goals to be achieved other than Clinician oriented goals to be documented in the care plans.
A review date and appointment is organised prior to patient leaving the facility
A reminder for next review and care plan is entered in patient file on the PMS
With every care Plan and review a Shared Health Summary to be uploaded to eHealth record with patient consent.
With every Care Plan attendance and Review Patient BP, Height, Weight , Alcohol status, Smoking Status, Allergy status need to be reviewed and updated if necessary in appropriate places on the PMS.
Preventative Health Measures are documented for patients as appropriate for individual patients and reminders added for all of them on the PMS
As part of the service commitment to Doctors, to assist in providing high quality Health Care, Dickson GP provides the facility of a trained Practice Nurse.
Practice Nurse can assist in the documentation of the Care Plan and Organising TCA , answering patient queries etc under the guidance of the doctor responsible for preparation of the Care Plan.
The billing Doctor takes the ultimate responsibility for the Medicare Compliance of Care Plans and related flow of billings and Dickson GP administration does not take any liability on their behalf.
Therefore, Doctors are advised to review their billings at the end of the day and advise of any discrepancies to the Practice Manager as soon as possible.