Priority Health Systems integration and coordination (GEN – 6) opportunities, priorities and options cont…
2.
Possible Options Promotion and facilitation of the Patient Centred Medical Homes. ∙ Review and redesign of integrated health systems. ∙
Work with and drive inter-sectoral partners supported by research to develop a ‘primary health service delineation model’ for rural SA.
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Identifying and seeking to rectify inequalities in services delivered regionally.
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3.
Use existing resources, redirected, to engagement of ∙ care coordinators in various employment models.
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Implementation of a project which enables shared clinical reviews which are evidenced to be a useful tool in managing complex conditions, particularly for people who blur the eligibility lines across services and whose needs vary from time-to-time.
Expected Outcome Mapping, collaboration and education activities resulting in real restructuring of local activities to include models of coordinated care in service delivery.
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Potential Lead CSAPHN and other public and private providers
Commissioning activities reflect the placement of care coordination in local models of connected care.
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CSAPHN and other public and private providers
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Shared clinical reviews reported to be occurring in sentinel sites and expanding.
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CSAPHN facilitating and supporting GP led local initiatives
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Multi-party conferencing to enable activities such as ∙ case conferencing with health professionals within SA Health.
Shared clinical reviews reported to be occurring in sentinel sites and expanding.
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CSAPHN
6.
Implementation and promotion of My Health Record.
Better coordinated care through use of shared electronic records.
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CSAPHN facilitating and supporting GP led local initiatives.
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Investigate potential models for support to or ∙ coordination of activity to assist the management of high or frequent users of the health system, as an avenue for hospital avoidance and support for patients with complex needs.
Partnership with LHN and other ∙ providers achieved, focussing on better data intelligence of needs and sentinel activity achieved and implementing alternative service provision in out of hours.
8.
Stakeholder engagement program – Primary Health Care ∙ Nurse Networks & Clinical Council; Provide access to relevant resources, training and guidance on MBS item use including care plans and practice nurse support
Resources provided consistently across the region with evidence of uptake and use identified.
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PRIMARY HEALTH NETWORKS Needs Assessment 2018 Page 30
CSAPHN
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CSAPHN facilitating and supporting GP led local initiatives.
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CSAPHN initiative to be