SWSPHN and SWSLHD have work closely with the Diabetes Obesity and Metabolism and Translational Research Unit (DOMTRU) regarding a range of initiatives to support diabetes management in primary care, including the case conferencing program.
Case conferencing involves a local diabetes specialist visiting a GP practice to discuss patients who meet the criteria. Practice time is paid for under Medicare.
There is also the added benefit of providing patients with timely access to specialist services at no cost.
The criteria for referral include:
Patients with type 1 or type 2 diabetes with:
- HbA1c ≥ 9% (8 to 8.9% included once those ≥ 9% have been discussed)
- Significant and frequent hypoglycaemia
- Recent hospitalisation, CVD or foot event in past 12 months
- Nephropathy / raised ACR
- Blood pressure over 160/100 mmHg
- Triglycerides 10 + mmol/L
- Women planning/at risk of pregnancy
- Other (other patients with diabetes requiring discussion)
Here is the steps in organising a diabetes case conference:
- Download template for medical director (go to sws.healthpathways.org.au). Follow steps to incorporate template to your software.
- Open up patient file and pre-populate demographic boxes. You need to spend about 10 mins doing the rest. (I get my nurse to do that for me). She also rings patient to get verbal consent to “seek discussion” with specialist. I also get her to double check on current insulin doses if on insulin.
- Practice bills for “organising” of case conference (done and claim online)
- Fax to 4634 3215 or email to email@example.com. I normally have 8-10 and set aside 1-1.5 hours over lunch for the discussions.
- If you have an email contact with Susan (firstname.lastname@example.org) at DOMTRU, she will email you a list of days/time suitable for the endocrinologist to visit.
After receipt of a referral a case conference is arranged for a mutually agreed time between the general practitioner, endocrinologist, and a third health professional (e.g. practice nurse, CDE, etc.) without patients present. For practices without a third health professional available an allied health professional may be sourced from the specialist team.
Items to use when organising:
- Item 735 -15-19 mins – $53
- Item 739 – 20-39 mins – $90
- Item 743 >40 mins $151
Items to use when discussing with endocrinologist at your practice
- Item 747 – 15-19 mins $38
- Item 750 – 20-39 mins – $66
- Item 753 – >40 mins – $111
Even if you claim the minimum for organising and the minimum for discussing, it will bring you $91 per case prepared and organised.