Mapping activities
Reviewing you practice’s existing activities and initiatives can help you determine where you may already be using mHealth. Each general practice is unique in its structure and patient cohort, and this section is designed to get your practice looking at what activities are being undertaken and what supporting structures may already be in place to enable a more focused mHealth strategy.
Use the table below to map out what activities and initiatives your practice is already using in each of these areas. Mapping out your current activities will help your practice choose the most relevant sections and topics within this toolkit.
| Computer and information standards |
Your practice’s activities and initiatives in this area |
Our practice has:
- documented policies and procedures for managing computer and information security, including monitoring access to health information and the use of mobile electronic devices
- a documented ‘bring your own device’ policy/strategy.
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| Training and professional development |
Our practice:
- provides training opportunities to staff to increase their understanding of the benefits of technology in a healthcare setting.
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| mHealth activities |
Our practice currently uses:
- online appointments
- SMS alerts, including appointment reminders for patients
- mobile medical devices for remote monitoring
- reporting tools to recruit patients for research and clinical trials
- store and forward technologies to electronically send patient data (eg reports or images)
- mobile devices to access evidence-based information, tools and practice systems
- health and fitness tracking software and apps that we recommend to our patients.
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| Telework |
Our practice provides:
- opportunities for staff to perform work functions from locations other than the general practice
- engagement in telework by using email, instant messaging, Voice over Internet Protocol (VoIP) and/or videoconferecing for team meetings, broadcast emails, web cams or web-conferencing.
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| Telehealth |
Our practice uses:
- video consultations as an alternative to physical consultations.
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| Remote monitoring devices |
Our practice uses:
- data collected by patients using a mobile device to regularly monitor medical conditions.
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Practice insight
Healthcare delivery in rural and remote communities
General practice is the frontline of healthcare in rural and remote Australia. GPs have a broad scope of practice outside of the country’s main centres – they cover emergencies, deliver babies, and visit people in hospitals, aged care facilities and in their homes.
The advent of tablet devices and mobile broadband technology, coupled with improved connectivity, is transforming the way GPs in rural and remote communities deliver quality care. These GPs can save time and improve quality and safety with access to patient records (including medications, allergies and history), email and other practice resources on the go.
By using their tablets for a visit to an aged care facility, for example, rural GPs can record consultation details and immediately upload them into a patient’s file, eliminating the potential for human error inherent with written notes or recall.
Increased access to numerous medical database applications, including Merck Index, MIMs and UpToDate, also facilitates safe and high-quality practice and provides professional development opportunities.
Case study
Delivery model for chronic disease management
Alicia is practice manager in a small rural general practice located three hours from the nearest regional town and base hospital. All of the general practices in the region have arranged to share health resources and facilities, and are interested in using mHealth to improve access and delivery of care to their patients.
GPs in Alicia’s practice manage a number of patients with chronic conditions. They feel mHealth could improve care, as so many of their patients across different socioeconomic backgrounds and age groups use devices such as smartphones.
Alicia decided to run an eight-week pilot program in order to test the benefits of automated SMS self-management reminders to patients with type 2 diabetes. Medication reminders were sent up to twice a day based on when patients said they took their medications and how often they wanted reminders.
The messages consisted largely of reminders (‘Time to take your diabetes medication’), tips (‘Keep your medications next to the sink so they become part of your morning routine’), assessments (‘On how many of the last seven days did you take all of your diabetes medications?’) and feedback (‘Great job!’)
Patients eligible to be part of the pilot were aged 18 and older and referred to the pilot by their GP. Practice nurses were responsible for registration and training patients on how to utilise the mobile health software program used for automated SMS reminders.
Initial concerns from GPs and practice nurses included:
- pilot roll-out after a difficult electronic health record implementation
- lack of time to enrol and monitor patients in the SMS system
- responding to incoming patient messages.
With clinician input, Alicia developed protocols to increase care in response to incoming patient messages. She also designed the pilot so GPs and nurses would only be required to respond to emails from the practice administrators regarding clinical issues, as emails are already part of the workflow. Messages were written with no protected health information and without naming diabetes or specific medications that could link the patient to the condition.
The pilot showed a number of benefits to the patients and the practice:
- High levels of patient engagement and satisfaction, with improvement in self-management.
- The mobile technology leverages existing health resources in the clinic– as the system is largely automated and designed for self- management support, dedicated staff members are not required.
- Cost savings – the model piloted requires one full-time equivalent (FTE) care manager per 300 enrolees, while other face-to-face care
- management programs reported in the literature typically serve 30–100 patients per FTE staff member.