Last updated: 13 March 2020
As part of a response to the COVID-19 outbreak, your practice may initiate or escalate telehealth appointments for patients who are eligible for temporary MBS telehealth services. Your practice may also introduce a dedicated workflow for an influx of COVID-19 patients for testing, for example, for a separate practice area or a popup clinic dedicated to COVID-19 patients.
This article provides some suggestions for practices on how best to adapt Bp Premier to both of these scenarios.
Before you do anything else, download the March Revision 1 Data Update from the Resources Downloads page and install the update on your Bp Premier.
The Department of Health has released guidance on the new MBS telehealth item codes for COVID-19, available here. The Department of Health has also released a Fact Sheet advising of which patient groups will be eligible for the temporary MBS telehealth items.
For further information on telehealth consultations:
- MBS Online has an information page on specialist video consultations under Medicare.
- The RACGP also has resources on telehealth video consultations.
COVID-19 diagnoses and reasons for visit
The following Diagnoses and Reasons for visit were made available in the March 2020 Data Update:
- COVID-19 exposure
- COVID-19 infection
If your practice has not engaged any third-party vendor for online telehealth appointment booking, and does not wish to, your practice may run telehealth appointments using consumer-grade video conferencing or telecommunications applications.
Consent and security
Your practice should consider any implications of using 'consumer' telecommunications applications over standards-based telehealth platforms, including but not limited to:
- the potential for unsecure communications
- any need to record patient consent to participate before the consult
- whether and for how long patient telecommunications IDs are stored in the patient record or appointment book.
Telehealth consult overview
If your practice intends on using a telecommunications application for telehealth appointments, your practice will have to:
- Select an appointment type of 'Telehealth Consult' when booking.
- Arrange provision of the software to both providers and patients, or communicate with each patient which software they would prefer to use.
- Record the patient's ID for the telecommunications software (the identifier that allows one party to find and connect to the other party).
- At the start of a telehealth consult, the provider must manually start the software and establish the connection to the patient using the patient's ID for that software.
- When finalising the visit, the provider will select one of the MBS Telehealth items recently issued for the COVID-19 virus outbreak.
What will the process look like?
Your practice will decide how best to incorporate telecommunications software into your consultation workflow. However, the flow below summarises the actions required to ensure that appointments are marked with the correct type, and that the provider has the right details at hand to start the telehealth consult.
- Book the appointment with an Appointment Type of 'Telehealth Consult' or 'Telephone Consult' as appropriate.
- At the time of booking, confirm the preferred software to use and obtain the patient's ID for that software. Best Practice Software suggest two ways of recording this information:
- In Today's notes, the provider will select a Visit type of 'Telehealth' for the consult.
- When the provider finalises the visit, any new MBS Telehealth items will be available from the Finalise Visit screen (if the practice has installed the March Revision 1 Data Update).
- Practice staff can process the account as per your practice guidelines for telehealth consult payments.
In the Details text box when booking the appointment, which makes the patient's ID available from the text in the appointment slot (right-click > View text).
In the Appointment notes text box in Patient Details (right-click > View details), which makes the patient's ID available to the provider when the visit is started.
Important: Depending on Department of Health stipulations, practices or providers that bill privately may need to change the Account type for finalisation to 'Direct Bill', if temporary Telehealth MBS item numbers are to be bulk-billed only. This is indicated in the example below.
If your practice is required to manage a significant number of patients related to COVID-19, you may wish to differentiate these patients in the appointment book as a group so they can be managed separately to your regular patients. Best Practice Software suggest two possible ways to do this: creating a 'resource' user and book all patients against that user, or creating a dedicated 'COVID-19' location and booking all patients into that location.
Which appointment types are available?
The Appointment types Telehealth Consult and Telephone Consult are available when booking telehealth or telephone consultations.
Create a user to book patients against
This is the simplest method.
- Create a user with an indicative Name, Category 'Resource', and the Has appointments options ticked, so that appointments can be booked against that user. The 'Resource' category has access to only a bare minimum of Bp Premier functionality; selecting this category will help prevent the user being used for anything else.
- Book all COVID-19 patients against that user. All appointments will appear in that user's column in the appointment book.
- Any doctor can start a consult with the patients in the 'COVID' column of the appointment book. The doctor performs the local or Telehealth consult as normal. However, at finalisation, the doctor must remember to click Yes when prompted to move the appointment.
- This will set the correct doctor to bill against in the Account details. Process the account and payment as normal.
Create a location to book patients against
This method gives a practice more options for reporting by location. However, it requires more initial setup, as providers need to be assigned to the new location with a provider number.
Important: For practices with multiple locations and Minor IDs, staff who create the invoice for the consultations using this method MUST remember to reset the location in the Account Details screen from the 'COVID19' location to the actual location the provider was in. This will prevent items being rejected by Medicare.
- In Setup > Configuration > Appointments, ensure the Allow patients to be added directly to Waiting Room and Allow patients to be added to Waiting Room for 'Any doctor' options are ticked.
- Create a new practice location called 'COVID19' or similar. You do not need to provide any details apart from an address.
- For each provider who may treat patients in this group, add the location in the User Details. Click Set to add the provider number for this location. The provider number you enter here is the number associated with the physical location the consult was performed at.
- From the Waiting Room, click Add to waiting room. In the 'Any doctor' top row, set the Location to the COVID19 location just created.
- Search for or create the patient you want to add to the waiting room and click Book appointment. The patient will be added to the waiting room.
- From the Waiting room, the doctor should set the Provider filter to 'Any doctor' to see waiting patients. Select a patient and start the visit.
- The doctor should finalise the visit as normal, using the new Telehealth MBS items if appropriate.
- From the Waiting room, staff who manage accounts and payment should set the Provider filter to the provider in question, and tick the Include 'With doctor' and 'At billing' option to show patients just seen by a doctor. Patients just seen will be shown in green.
- Create the account for the visit from the Appointment book as normal. (You can also create the account from the waiting room if your practice does this.)
Set up locations and Waiting room
Add patients to COVID19 location in waiting room
Doctor performs the consult
Note: To see their regular patients, doctors just need to switch the Provider dropdown in their waiting room back to their own name.
Create the invoice
Important: For practices with multiple locations and Minor IDs, you must set the Location in the Account details screen to the location of the doctor for the visit BEFORE you save the account details.
Reporting by location
If your practice wishes to group invoice and payment totals for the Coronavirus location, you could keep the Location in the Account details screen unchanged. However, this may make paying your doctors more difficult, depending on the provider disbursement reports you use to pay your doctors.