Powering Your Journey & Driving Change 16-19 October 2018 Canberra Convention Centre IN THIS ISSUE
10
Is it time to review your current payroll system?
12
Digital health for all
14
Why do healthcare services need a business plan?
2018 – Issue 1 | www.aapm.org.au
the practice manager
Avant Practice Medical Indemnity. By doctors, for doctors. Hills Family General Practice, Bella Vista
Your Practitioner Indemnity policy covers you as a doctor...
Dr Sofia Ambreen Avant member
...but you need a Practice Medical Indemnity policy like Avant’s to cover the actions of your staff. If you’re a practice owner, you can’t assume your individual Practitioner Indemnity will protect your practice. The actions of your staff and claims made against the practice could still put you at risk.
Is your practice at risk? £ Do you provide healthcare treatment, advice or services via a trust, partnership or practice company?
To ensure you have the extra cover you need as both a practice owner and employer, Avant have developed a Practice Medical Indemnity policy that seamlessly integrates with your practitioner professional indemnity.
£ Do you employ administrative staff to support the doctors and other professionals working in the business?
You may want to look at your existing business cover while you’re at it, as the Avant Practice Medical Indemnity policy is designed to seamlessly integrate with the new Avant Business Insurance, which means that nothing overlaps and nothing is over-looked. It’s complete peace of mind.
£ Own or lease machinery and/or medical equipment to provide the services (eg. diagnostic equipment)?
£ Do you engage locums and other temporary staff?
If you tick just one box, your practice could be at risk.
Talk to Avant today to ensure you have the cover you need. Not just as a doctor, but as a practice owner. 1800 128 268
avant.org.au/practices
Professional indemnity insurance products and the Practice Medical Indemnity Policy are issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. Avant arranges Avant Business Insurance as agent of the insurer Allianz Australia Insurance Limited ABN 15 000 122 850, AFSL 234 708 (Allianz) and may receive a commission on each policy arranged. The information provided here is general advice only. You should consider the appropriateness of the advice having regard to your own objectives, financial situation and needs before deciding to purchase or continuing to hold a policy with us. For full details including the terms, conditions, and exclusions that apply, please read and consider the policy wording and PDS, which is available at avant.org.au or by contacting us on 1800 128 268. 2135 (0909) 10/17
Contents
Your Association A message from the National President From the desk of the CEO News Bites AAPM 2017 National Salary Survey National Practice Manager of the Year 2017 Is it time to review your current payroll system? Digital health for all Why do health care services need a business plan? Top tips for developing a marketing plan for your medical practice AAPM National Education Framework 2018 Cloud computing: Part 1 First prosecution of a healthcare corporation for unlawful advertising Medical Assistants: the two for one deal! Four email tips you can’t live without Improving chronic care in our practice The importance of security and data backup in the healthcare industry Practice Profile: Lakes Radiology – Morisset
1 2 3 4 6 8 10 12 14 16 17 18 20 22 24 26 27 28
Your Association AAPM BOARD President Cathy Baynie
Treasurer Jackie Beer
Vice-President David Osman
Chief Executive Officer Gillian Leach
Secretary Fiona Wong
Non-Executive Directors Danny Haydon Cecily Igglesden Richard Evans James Downing
CONTACTS HEAD OFFICE Level 1, 60 Lothian Street, North Melbourne, VIC 3051 P 1800 196 000 F (03) 9329 2524 E headoffice@aapm.org.au VISIT THE WEBSITE www.aapm.org.au LIKE US ON FACEBOOK www.facebook.com/AAPMAustralia FOLLOW US ON TWITTER @AAPM_National
INTERNATIONAL
PUBLISHED BY:
IHM Institute of Healthcare Management 18-21 Morley Street, London SE1 7QZ P +44 20 7460 7623 | F +44 20 7460 7655 E enquiries@ihm.org.uk | W www.ihm.org.uk
ark:media PO Box 824 Surfers Paradise, QLD 4217 P +61 7 5629 5300 E marketing@arkmedia.net.au W www.arkmedia.net.au
PMAANZ Practice Managers and Administrators Association of New Zealand
Managing Editor: Sue Guilfoyle Design Team: Andrew Crabb, Arlen Chidzey
W www.pmaanz.org.nz
No part of this publication may be reproduced, copied or duplicated without the written consent of AAPM.
The content of articles and advertisements contained in the Practice Manager Journal solely reflect the personal opinions of the authors or contributors and does not necessarily represent the official position of AAPM.
THANK YOU TO OUR NATIONAL PARTNERS
www.aapm.org.au | 1
FOREWORD
A message from the President Cathy Baynie National President
WELCOME TO OUR FIRST EDITION FOR 2018!
communication and time management challenges –
Hopefully most of us have had quality time with family and the opportunity for some well-deserved rest, ready to tackle the year ahead.
day. If you were unable to attend, this will be available
2016/17 saw unprecedented change and reform within the Primary Health Care sector. Hopefully then 2018 will bring some breathing space in order to adapt and consolidate within our practices.
2017 closely followed by the second tranche on 1
handling the mass of emails that land in our inbox each for purchase along with all of the 2017 webinars. Health Care Home trials commenced on 2 October December 2017. We look forward to sharing with you the learning outcomes from our member pilot practices and offering any support we can to these practices
AAPM will be right there supporting our members along
during the two-year trial period. Perhaps as managers
the way. It is pleasing to note that in 2017 we had record
one of our greatest concerns has been around bundled
growth in membership of around eight percent.
funding models and the nature of the engagement
We are excited to announce the establishment of a new member category as AAPM welcomes Medical Practice Assistants to the fold. MPAs will have access to all member benefits and continuing professional development opportunities.
relationship with the practice and the provider. The
Certificate IV in Medical Practice Assisting is being offered by University of New England Partnerships nationally in QLD, Far North QLD, NSW (currently six cohorts) and TAS with demand for enrolment coming from all other states. UNEP have had 330 enrolments in the course since 2015 and are expecting three more groups in early 2018, in Brisbane, Tasmania and in Perth, which will take the number to approximately 380 by March 2018. Many more groups are anticipated for the full qualification, which involves compulsory face to face training in workshops, and a short course of five units is available online for enrolment anytime. The MPA role presents an excellent workforce solution for both general and specialist practice. Later in this edition Catherine Ryan (State Committee member NSW/ACT) presents an interesting case study on how this role functions in her practice in rural NSW. Alongside our member growth, AAPM experienced a 19 percent growth in education attendance at our 2017 program. This tells us that not only are our members requiring relevant education offered through varying modalities but also the development of our National Education Framework is delivering on these requirements.
ATO has released a statement and fact sheet available on its website with regards to the tax implications of bundled payments. The Digital Health arena also demands our attention with, among other things, the Australian Digital Health Agency moving to an “opt out” model planned for later this year. AAPM has produced a Position Paper, Digital health for better health: The role of Practice Managers, in response to the Australian Government’s National Digital Health Strategy. It can be downloaded from the advocacy page of our website. General, Specialist and Allied Health practices need to be supported in taking part in digital health initiatives such as the My Health Record if the full benefits for both consumers and practices are to be realised. We will ensure resources are made available to practice managers across all disciplines in order to assist our members navigate the digital arena. The AAPM Directors and CEO look forward to seeing all State Committee Presidents and AAPM staff at the National Strategic Planning Forum which will be held in Melbourne on 2 March this year. The day will be spent planning the strategic direction of your
The 2018 program commences on Thursday 8
association in order to continue being a relevant and
February. By the time we go to press many of you will have attended our first webinar, presented by Debbie Mayo-Smith, to learn how to address one of the biggest
viable organisation, ensuring we provide the tools, resources, education and networking opportunities the profession demands.
Cathy Baynie National President
2 | www.aapm.org.au
Foreword
From the CEO’s desk Gillian Leach CEO
WELCOME TO THE FIRST EDITION OF THE PRACTICE MANAGER FOR 2018. AAPM is really coming of age as the national peak organisation for the profession of Healthcare Practice Management. AAPM is recognised as the prime source of advice on the implementation of the Commonwealth Government’s health reform agenda. The Practice Management viewpoint is now provided by AAPM members on over 30 different committees. Both industry and the Government are aware that professional and wellinformed practice managers are well placed to support practice owners through this period of healthcare reform and help them develop and execute a strategy to navigate the change ahead. The National Education Framework was established in 2017 and has been further developed for the coming year. Each State will hold a Practice Management Education Day, and a Receptionist/Administration workshop in their capital city and in some major regional centres. For the first time, we will also hold a joint seminar with the Australian Primary Care Nurses Association to provide information so nurses and Practice Managers can work together to improve the effectiveness of their practice in providing excellent patient care. This year we have doubled the number of webinars we are producing to provide education for both practice managers and their teams. These webinars will be recorded so registrants can download them and watch them at their convenience. There are also a number of face-to-face seminars in every state. These are always popular and the interaction with other practice managers is invaluable. Our education and events calendar can be found on www.aapm.org.au. Registrations for events and webinars can be made directly from the website calendar. Members are eligible for discounts on all education. There is a 50 percent discount on all webinars and further discounts if members purchase a package of several webinars. Remember to login to the website to receive these discounts.
changes in the health sector. We are looking forward to visiting Australia’s national capital, Canberra, for the first time for 2018 AAPM National Conference on 16-18 October. Expect to be excited and inspired by the fantastic array of speakers we have assembled for you. The location will give members the opportunity to view national icons such as the National Gallery, National Museum, National War Museum and Parliament House where we are very excited to hold the Gala Dinner in the Grand Ballroom. Nominations for the AAPM Practice Manager of the Year, sponsored by AGPAL/QIP are now open. Nominations may be made by a colleague, practice principal or the practice manager themselves by completing a form on the AAPM website. An additional online application form must be completed by the nominee. It is important for practice managers to nominate for this prestigious award, not only for themselves but also to promote their practices and the profession of practice management. State winners will be judged for the National Practice Manager of the Year Award which will be presented at the 2018 AAPM Conference in Canberra. The AAPM Practice Manager networks are growing in strength throughout the country. Networking events offer members the opportunity to meet with colleagues to discuss common issues and provide support to each other. Dates for networking events can be found on the AAPM website events calendar. Call the AAPM head office if you are interested in joining or setting up a network in your locality. Best wishes for a successful 2018.
Gillian Leach CEO
AAPM’s education program and regular communications enable Practice Managers and owners throughout Australia to keep up with the continuing
www.aapm.org.au | 3
NEWSBITES
Powering Your Journey and Driving Change: AAPM CONFERENCE 16 – 19 OCTOBER 2018 MAKE SURE YOU SAVE THE DATE FOR THE 2018 AAPM NATIONAL CONFERENCE IN CANBERRA FROM 16-19 OCTOBER.
story told in the film ‘Lion’, adventurer - Huw Kingston and Dr Jordan Nguyen, a driving force behind positive human and technological evolution into the future.
Taking advantage of the location, we will be getting the Government’s view of healthcare, valuable information on health policies and give us the opportunity to showcase Practice Managers to the nation’s leaders in health.
The annual AAPM Conference is highly acclaimed for providing top level, practical education for anyone involved in practice management across all areas of healthcare. You will be inspired and motivated to lead your practice forward and be given the opportunity to network with people in similar roles all over Australia.
The theme is ‘Powering Your Journey and Driving Change’, focussing on Discovery, Development, and Refinement so expect to be excited and inspired by a fantastic array of speakers. They include international speakers - Dike Drummond and Debbie Mayo-Smith, Saroo Brierly with his amazing
Notifiable Data Breaches scheme in force since 22 February 2018
T
he Notifiable Data Breaches (NDB) scheme under Part IIIC of the Privacy Act 1988 (Privacy Act) establishes requirements for entities in responding to data breaches. Entities have data breach notification obligations when a data breach is likely to result in serious harm to any individuals whose personal information is involved in the breach. The NDB scheme will apply to agencies and organisations that the Privacy Act requires to take steps to secure certain categories of personal information. This includes Australian Government agencies, businesses and not-for-profit organisations with an annual turnover of $3M or more, credit reporting bodies, health service providers, and TFN recipients, among others.
The extensive and busy trade exhibition allows you access to a range of services and products which will enable your practice to become more effective and efficient.
Mental Health Pilot for Veterans T
he 2017-18 Budget included $3.6M of funding for a Coordinated Veterans’ Care (CVC) Mental Health Pilot, which will be an additional service to the existing CVC Program. The Pilot will target veterans with mild to moderate anxiety or depression and health problems, in particular musculoskeletal conditions with pain. A digital coaching app will guide them through a tailored program consisting of educational information, goal setting and monitoring.
www.oaic.gov.au/privacy-law/privacy-act/notifiable-data-breaches-scheme
Further details about the Pilot will be made available later in 2018. More information on the CVC Program, including details on eligibility, how to enrol patients and GP payments is available at
www.oaic.gov.au/resources/privacy-law/privacy-act/notifiable-databreaches-scheme/flowchart.pdf
www.dva.gov.au/providers/provider-programs/coordinated-veteranscare#guide-general-practice
See links to OAIC for further information:
Thinking of investing in cryptocurrency? Hmmm… Japan raps Coincheck, orders broader checks after $655M cryptocurrency theft www.abc.net.au/news/2018-01-28/coincheck-worlds-biggest-cryptocurrency-hack/9368056 News outlets worldwide including ABC News online report on the largest cryptocurrency theft on record. Apparently trading in cryptocurrencies is risky for more than one reason… Hackers have stolen $655M in NEM ‘coins’ from Japan’s Coincheck exchange. Crypto-currencies which are based on blockchain technology are touted as being secure but the crypto-currency exchanges are not. Buyer beware…
4 | www.aapm.org.au
Australian Association of Practice Management
Practice Manager of the Year Awards 2018
l e v a r t 0 0 0 5 $ s u o l u b a f a d l u o ? Where c u o y e k a t r e h c u vo
Be recognised and rewarded for your special contributions to medical, specialist, dental or allied health practice management.
Applications for the State Practice Manager of the Year Awards open 1st March
Each State Practice Manager of the Year will receive flights, accommodation and registration for the 2018 AAPM National Conference in Canberra. They will also be Finalists for the National Practice Manager of the Year Award. The 2018 National Practice Manager of the Year will be the recipient of a $5,000 travel voucher, with thanks to our National Partner, AGPAL/QIP.
AAPM 2017 National Salary Survey:
Qualifications, practice type, size and salaries I
n the first article on the AAPM 2017 National Salary Survey, we discussed the scope of the survey and commented on the fact that many factors would influence the salary levels of practice managers – it may be location or it could be membership of professional bodies, educational standards achieved, or perhaps associated with age or practice size. This article looks at a number of these factors to add more detail to practice manager salary analysis. The article begins by looking at formal education and links that to professional association membership, and then there are three analyses looking at practice size measuring in terms of number of fee earners or annual gross fees or number of patients per day – and the impact of practice size on salaries reported. Again, the approach to be taken by practice managers who are reading these articles is to identify where they fit into the classification of age or education or practice size and make some comparisons between their own salary levels and those reported on average by respondents to the AAPM National Survey of Practice Managers. The full survey gives a complete breakdown of the data for all of these important areas that influence salaries.
number of practice managers are lifting their formal education awards. PROFESSIONAL MEMBERSHIP AND AVERAGE SALARY RANGE The vast majority of those responding to the survey are members of AAPM; however, there are many participants who are members of RACGP, the AMA, APNA or AIM and Colleges, such as RANZCO. The survey results indicate that the 2017 median salary range for members of AAPM is higher than those who have never been a member or those who previously were a member. SALARY BY AAPM MEMBERSHIP AAPM Membership
2017 Median Salary Range
2017 n
Yes, I am a member
$75,001 - $80,000
175
No, I have never been a member
$70,001 - $75,000
28
No, but I have been previously
$65,001 - $70,000
16
HIGHEST FORMAL EDUCATION AND AVERAGE SALARY RANGE The outcomes are reported in terms of four levels of formal education. Many practice managers have only had an opportunity of completing secondary school whereas others have had opportunities of proceeding to a Certificate or Diploma and a smaller group has been able to undertake some university undergraduate or postgraduate study. The question is to what extent these formal education opportunities and qualifications have an impact on salary levels? From the start of the AAPM salary surveys, those who have secondary school award only have a lower salary range. As would be expected, practice managers who reported a Certificate or Diploma and a Bachelor degree have a range of $75,000 to $80,000, while those with a postgraduate qualification or higher degree reported higher salary ranges – $80,000 and above. In line with international studies, all of this proves that qualifications do make a difference and that an increasing
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The final areas looked at in this report all relate to the practice itself- the type of practice and the practice size – measured in terms of number of fee earners within the practice as well as annual gross fees and finally number of patients per day. PRACTICE SIZE AND AVERAGE SALARY RANGES When we look at the size of the practice we can consider the gross fees and the number of patients seen per day and then see how the salary ranges relate to these figures. Those practices with less than $500,000 in gross fees reported average practice management salaries of between $55,001 and $60,000 whereas if we go to the other extreme of practices reporting $3 - $5 million in fees per annum, salaries were reported as between $80,000 and $85000. At the top end of the gross fees i.e. more than $6,000,000 the 2017 median salary range is $95,001-$100,000.
SALARY BY PRACTICE ANNUAL GROSS FEES Practice Annual Gross Fees
2017 Median Salary Range
2017 n
Under $500,000
$55,001 - $60,000
18
$501,000 - $1,000,000
$65,001 - $70,000
50
The type of practices which responded to the survey included general practice (city, rural, travel, Aboriginal and women’s health), specialist and allied health. We also had a small number of respondents from dental practices, public and private hospitals, community health and primary health networks. It is a great opportunity to get more participants from all areas of healthcare and the collection of the data and our longitudinal studies will become even more important.
$1,000,001 $2,000,000
$70,001 - $75,000
112
SALARY BY PRACTICE TYPE
$2,000,001 $3,000,000
$75,001 - $80,000
80
$3,000,001 $4,000,000
$80,001 - $85,000
42
$4,000,001 $5,000,000
$80,001 - $85,000
28
$5,000,001 $6,000,000
$85,001 - $90,000
More Than $6,000,000 More than $7,000,000
Practice Type
2017 Median Salary Range
2017 n
General Practice
$70,001 - $75,000
250
Specialist
$75,001 - $80,000
129
Allied Health
$65,001 - $70,000
14
Dental
*
<10
20
Hospital (Private)
*
<10
$95,001 - $100,000
12
Hospital (Public)
*
<10
$95,001 - $100,000
23
whereas at the other extreme, those practices reporting more than 300
At this stage with the reports from the AAPM national survey discussed in this article, a picture begins to develop of factors that influence practice managersâ&#x20AC;&#x2122; salaries and the potential range of those salaries. It is clear that salary ranges in the high $70,000 range and even to six figures are feasible where you have a combination of large practice size and practice manager qualifications and experience. Forthcoming reports will look at allowances and benefits for practice managers other than salary and factors concerning practice fees and billing and finally core responsibilities of practice managers. It is also important to remember the key influences on salaries:
patients per day indicated salary ranges for practice managers of between
KEY INFLUENCES:
Finally, practice size in this report is also measured in terms of number of patients per day and again there are obvious links between number of patients per day and number of fee earners per practice. We therefore would expect to find a similar pattern as reported earlier. And this is actually what has happened with practices reporting up to 100 patients per day indicating average salary ranges of from $75,001- $80,000
$95,001 - $100,000 per annum. SALARY BY PATIENTS PER DAY Number of Patients per Day
2017 Median Salary Range
2017 n
1-25
$70,001 - $75,000
58
26-50
$80,001 - $85,000
67
51-100
$75,001 - $80,000
85
101-150
$70,001 - $75,000
56
151-200
$75,001 - $80,000
68
201-300
$80,001 - $85,000
50
More than 300
$95,001 - $100,000
29
Size of practice
Responsibilities of the position
Type of practice
Professional development
Location
Qualifications
The full report of the 2017 AAPM National Salary Survey includes all of the results from surveys conducted since 2009 and provides an important picture of healthcare practices in Australia. We now include salaries for enrolled and registered nurses, clinical assistants, receptionists and administrative assistants, bookkeepers. There is a great interest in this wider range of positions and our next longitudinal study will be important. We have expanded the information gathered to include the major financial components of a practice as well as the responsibilities involved in maintaining the practice. The National Salary Survey can be purchased from the AAPM Shop.
PRACTICE TYPE AND AVERAGE SALARY RANGES One of the interesting sections of the survey relates to the type of practice and the salary range. In the 2017 survey, the salary ranges for both General Practice and Allied Health has not increased. In General Practice it has gone from $75,001-$80,000 in 2015 to $70,001 - $75,000 in 2017. In Allied Health, it has gone from $75,001 - $80,000 in 2015 to $65,000 - $70,000.
Colleen Sullivan
The median Salary range of $75,001 - $80,000 has remained the same in
OAM, BA AAPM Life Member
2015 and 2017.
www.aapm.org.au | 7
L-R: Danny Haydon (Immediate Past President), Gillian Leach (CEO), Brett Miller, Cathy Baynie (National President), Dr Richard Choong (AGPAL Chair)
National Practice Manager of the Year 2017:
Passionate about People and Community L
ike many practice managers, my professional journey has not been confined to healthcare and indeed I have only been working in the
our local community. During this journey we have made the transition from being a small business of 10 employees to a medium-sized business
field for the past five or so years. The prior 10 years included working
comprising a team of 100 and realised sustained growth to our bottom
as a Biodiversity and Land Management Project Officer across country
line whilst consolidating our operations through the effective implementation
South Australia for three years before relocating to Cambridge, UK to
of new, more efficient governance arrangements, management systems,
work as a Sustainability Consultant with companies including the National
processes and structures. Though challenging at times, sharing this journey
Health Service. I returned to Adelaide to continue my career as a Principal
with colleagues, rolling out innovative services and programs that make a
Consultant, then Commercial Manager, during which time I completed
real difference to people, and recently having eight practices QIP accredited,
further studies in business, project management and training/education.
rate as achievements I’m most proud of.
Though I enjoyed aspects of the commercial consulting ‘game’ - I found
Working in healthcare is an environment in which I find myself surrounded
that my job was becoming more corporate in nature, very much bottom line focused and less about helping people and the community which was, and still is, my passion. My wife and I also had our first child, Isabelle, which gave me time to think about what I really wanted regarding employment and my lifestyle at large.
with passionate people who genuinely want to make other’s lives better and this is a huge motivating factor for me. Supporting the local community is something that both my family and I have always been very passionate about. As our business realised successful growth, it made sense to help find ways to reinvest back into the community and establish programs
When an opportunity came up in 2012 to trade in my corporate role in
which support the delivery of local care to those communities that need
favour of carving a new role in the Healthcare sector I decided to take a
it the most. Away from my ‘day job’ I am proud to be a founding Board
leap of faith and the rest, as they say, is history…
member of the Australian Dental Outreach Foundation, a charity which
With much hard work our business has since expanded from one clinic to
delivers outreach dental services to the neediest South Australians who are
a multiple practice group that invests a considerable amount back into
access-constrained and lack local service providers.
8 | www.aapm.org.au
Animal Health Centre at Zoos SA: Tiger receiving dental treatment
Our group proudly supports charities including the Little Heroes Foundation, Foster & Kinship Carers SA and The Smith Family, and sponsors the Animal Health Centre at Zoos SA and the Adelaide Bite baseball team. Away from work I also love to travel, so winning the travel voucher as part of the PMOY is a great opportunity to take my daughter to Disneyland in mid2018 - San Diego here we come! It’s very humbling to be nominated for an award – to be recognised by your peers and colleagues as the PMOY is something that is very special to me. Everyone has also been so kind to me since winning the award, particularly my AAPM colleagues. Certainly, I’m an advocate for any medium that can be used to help recognise a co-worker or associate who you feel is doing a great job. The process to nominate is really simple and it’s a great chance for those nominated to spend some time reflecting on what they accomplished over the past year and to remember all the successes and achievements. As Australians, many of us don’t do this as we’re often too busy focusing on what needs to be done next! I look forward to further supporting AAPM’s growth in 2018 both through advocacy as PMOY and in my role as the SA/NT Branch President. I’d like to thank AGPAL/QIP for sponsoring the Award, Sue McPherson, who nominated me, together with my SA/NT colleagues and would also like to recognise and congratulate everyone who was nominated for PMOY in 2017, and wish you all a great 2018.
Take your practice to the next level!
Government funded training and incentives may be available Call us today!
1800 066 128 www.practicemanagement.edu.au
Brett Miller AAPM National Practice Manager of the Year 2017
The Education & Training Company of the University of New England • RTO 6754
www.aapm.org.au | 9
Cutcher & Neale
Is it time to review your current payroll system? S
ingle Touch Payroll (STP) is on its way, we ask you as a healthcare management professional - have you started to prepare your practice for success?
• Secure
Tax File Declarations, Payment Summaries and Employer Reconciliation Summaries (EMPDUPE) will be a thing of the past with the commencement of STP.
• Scalable
STP will commence from 1 July 2018 for practices with 20 or more employees, completely changing the way practices report payroll information to the ATO. SO, WHAT IS SINGLE TOUCH PAYROLL? STP will make it mandatory for practices to report payments such as salaries and wages, PAYG withholding and superannuation contributions directly to the Australian Taxation Office from their payroll software at the same time they pay employees. IS IT TIME TO REVIEW YOUR CURRENT PAYROLL SYSTEM?
• Multi layers security with users connected to pre-defined roles or able to create a customized role for a specific user • Whether its 20 employees or 1,000 the process should be just as simple • Ability to add additional functionality like Employee Self Service portals, Human Resource and Work Health and Safety • Simple Pay run • Wizard based • Date driven with no month end roll • User friendly • Report • Combination of paper based, spreadsheet, pivot and data sheet style reports • Build custom reports • Intuitive • Alert you when exceptions occur • Remind you when skills expire • Auto e-mail actions
Having the right software system in place is integral to the overall working of your practice, therefore it is important to ensure your current solution meets the needs of your practice.
WHO WILL BE IMPACTED?
All software vendors have indicated they will be releasing STP compliant products in the first half of 2018, with many already making changes to their products.
• Full-time employees
If you think your current payroll system isn’t right for your practice, your software should address the following key points:
• Employees based overseas
• Compliant • Is your payroll vendor committed to keeping up to date with the ATO’s changes each year
• Seasonal employees (staff who are engaged
10 | www.aapm.org.au
STP will impact all practices that have a head count of 20 or more employees as of 1 April 2018. This includes accounting for all:
If you are part of a company group, the total number of employees employed by all member companies of the wholly-owned group must be included. Do not include: • Casual employees who didn’t work in March 2018 • Independent contractors • Staff provided by third party labour hire organisation • Company directors • Office holders WHAT DO I NEED TO DO TO PREPARE? • Conduct a head count on 1 April 2018 (this is not FTE) • Update your payroll solution - all Vendors will be providing updates early in 2018 • Start reporting from the first pay run commencing 1 July 2018 It is often overlooked how important your payroll function can be, so it’s crucial to ensure your system suits your needs and creates efficiencies within your workplace. If you believe your system is not up to scratch or would like to consider an alternative, we can help! Talk to one of our software specialists today on 1800 988 522, or read more about STP on our website cutcher.com.au.
• Part-time employees • Casual employees who are on your payroll on 1 April and worked any time during March • Any employee absent or on leave (paid or unpaid) short term to meet a regular peak workload, for example, harvest workers)
Michael Graham Director, Business Systems
As a Practice Manager you have 107 pieces of legislation to work within on a daily basis. That’s a lot to think about! Ease your workload and have peace of mind knowing that your finances are cared for by a trusted professional.
There is only one firm that covers all of your accounting, financial needs and more under the one roof
Benchmarking Practice ownership options Building your own personal wealth Joining or buying a practice/ opening a new branch
Salary packaging Equipment finance Budgeting and bookkeeping Attracting new doctors’ to your practice
Have a technical question you just can’t figure out? Call us for a no-obligation consultation today and speak to one of our medical accounting specialists. An exclusive offer to you as part of our Duty Accountant service for AAPM members.
NATIONAL SPONSOR
T 1800 988 522
E medical@cutcher.com.au
A CUTCHER & NEALE INITIATIVE
Digital health for all MARINA FULCHER HAS OVER 25 YEARS’ EXPERIENCE IN HEALTHCARE PRACTICE MANAGEMENT AND IS A CLINICAL REFERENCE LEAD WORKING WITH THE AUSTRALIAN DIGITAL HEALTH AGENCY ON THE MY HEALTH RECORD
A
re well-connected systems that communicate with each other so that
question. Perhaps it is due to fragmentation of healthcare in Australia. Perhaps it is because
information flows seamlessly and is available
of the wide range of software being used by
to healthcare providers with a single keystroke
healthcare providers, or because of the highly
a practice manager’s dream or can it be a
sensitive information that is often involved.
reality? These systems hold the promise of no longer needing to fax or frantically call around
BENEFITS OF DIGITAL HEALTH
to find out results for a patient who is in the
From the perspective of any patient but most
consulting room.
particularly from that of someone with chronic
In our 2018 daily lives, we are immersed in an
and complex care needs, the benefits of not
ever-evolving digital world, and it is fair to say
having to repeat their story or remember
that digital health is here to stay. This series of
their medications every time they see a new
articles over the next few editions of The Practice
healthcare provider are self-evident.
Manager will consider what digital health means for Australia, from a healthcare provider and a healthcare consumer (patient) perspective.
These benefits also extend to any healthcare provider, providing them with access to accurate and up-to-date information about the patient,
AUSTRALIANS ARE ALREADY DIGITALLY
who may be someone they have never met
CONNECTED
before and know nothing about.
So why is it that the benefits of a digitally
Regardless of the type of practice you manage
enhanced healthcare environment is lagging so
or work in – large or small, GP, allied health,
far behind other industries we interact with in
specialist or hospital – it is critical for us to
our daily lives? There is no simple answer to this
support safe and secure digital enablement
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in our practices and to ensure that the people working in our practices are aware of this and are appropriately trained. The My Health Record system supports access to up-to-date information, with benefits as shown below. MY HEALTH RECORD SYSTEM BENEFITS Avoid adverse drug events: A recent key enhancement to the My Health Record is the Medicines View. A collection of medicines and allergy information from a number of places displayed on a single page. Enhanced patient self-management: By encouraging patients to have a My Health Record and to refer to it, they will become more informed about their health and can be active partners in their care. Improvements in patient outcomes: With access to up-to-date information, healthcare providers are assisted to make more informed decisions leading to improved patient outcomes. Reduced time gathering information: Less time spent looking for information that has not been sent directly to the provider or has not yet arrived.
other doctors, including changes to dosage and ceased medicines as well as allergies from all sources, including any entered by the patient or a discharge summary if the patient has been in hospital.
Avoid duplication of services: With the staged introduction of pathology and diagnostic imaging results to the My Health Record, the need for patients to have tests repeated will be reduced. FOUNDATIONS As with any robust strategy, sound foundations need to be in place. Digital health is no different. The Healthcare Identifiers Service that came into operation in July 2012 is a key enabler and one of the foundations for Australian digital health. It requires healthcare providers to be registered and have an individual Healthcare Provider Identifier (HPI-I) and the practice to register for an organisational Healthcare Provider Identifier (HPI-O). Whilst AHPRA registered professions are issued with a HPI-I, other professions will need to apply to the Department of Human Services. Applications may be made through the Healthcare Identifiers Service for health professionals page on: www.humanservices.gov.au. WORKFLOW A major key to any change in work practises is to build the desired behaviour into the workflow. This will vary from one practice to another. Having well-connected systems will support ease of workflow and is a key to driving uptake of change, with the aim of reducing the burden of work, rather than increasing it. It is important to ensure that any systems that are used in practices are the latest available version to ensure that all users have access to any enhancements. Running out-of-date versions of clinical information systems, for example, will mean that, although they still access the Healthcare Identifiers Service and the My Health Record, the system has not been modified to provide access to any available new features. The benefits of uploading Shared Health Summaries (SHS) is much more than meeting your practice’s 0.5% SWPE to qualify for the ePIP! By educating doctors to upload a Shared Health Summary (SHS) to a patient’s My Health Record as part of their usual consultation process, perhaps beginning with a focus on patients who have complex and chronic health care needs, is an excellent starting point.
“In our practice we use My Health Record widely. We are always trying to upload more, and as many patients’ information as we can. We have an active program to ensure practitioners are aware and conscious of that. Coming up in our inhouse education series is a series on My Health Record and how to upload records, how to read records, and how and when to access records, so that all the doctors are aware and are able to use the My Health Record.” Townsville-based GP Dr Ron Malpas Thereafter, an updated SHS would be uploaded for patients when there is a change to their diagnoses, medications, immunisations, allergies or adverse reactions. This SHS document is likely to be relied on by other healthcare providers your patients may see, particularly if they are travelling away from home. Encouraging healthcare providers in your practice to review information in their patients’ My Health Record may also save time searching for information that may not have arrived at the practice, reducing the administrative burden that can often ensue as a result. SO WHAT’S NEW? Medicines View: The middle of 2017 saw the introduction of a key enhancement – the combined Medicines View. This brings together medicines information from many different sources including patient-entered information and discharge summaries displayed in a single view in the patient’s My Health Record. With this view it is possible to see what has been dispensed and what has been prescribed by
Pathology and Diagnostic Imaging results: Pathology and diagnostic imaging results are starting to be uploaded to My Health Record. Australia’s largest pathology laboratories and 95% of diagnostic imaging practices have agreed to start to connect to My Health Record and upload patient results. With patient’s having access to their results, they will be empowered to take increased control of their own health. From a practice perspective, results will continue to be received in the same way they are today and patients will have access to their results after seven days, allowing time for their doctor to contact them to discuss anything they need to with the patient. GET ON BOARD I have been saying for many years that ehealth or digital health works best if we all do our bit, practice managers included. As more information gets added to the My Health Record the benefits to healthcare providers such as those working in private practice, primary care, emergency departments, specialists – either in hospital or in private rooms, pharmacists, and allied health are getting greater! There are many advantages to incorporating digital technology and My Health Record into the daily workflow of all practices. I encourage you to embrace this change and to embed digital health systems into your practices.
MORE INFORMATION On demand training: www.digitalhealth.gov.au/home/using-the-myhealth-record-system/training-resources/ondemand-training Read the blog from Dr Ron Malpas in full: www.digitalhealth.gov.au/about-the-agency/ digital-health-space/my-health-record-get-onboard
Marina Fulcher Life Member FAAPM CPM
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AGPAL and QIP
Why do health care services need a business plan? A
health care service is a business like any other, and every business needs a plan.
Could you imagine building a house without a blueprint? A business plan is the blueprint for your business. Yet unlike the blueprint of a house, a business plan is necessary throughout your health service’s life time – not only at the time of building or setting up your facility. A business plan will support the future direction, sustainability and growth of your service and is the key to a more efficient and productive health care facility. As part of Criterion C3.1- Business operation systems, in the Royal Australian College of General Practitioners (RACGP) Standards for general practices 5th edition, business planning is a new Standards requirement and falls under the following Indicators: C3.1> A Our practice plans and sets goals aimed at improving our services. C3.1> B Our practice evaluates its progress towards achieving its goals. Creation of a business plan can also support health services to prepare for accreditation against Standard 1: Governance for Safety and Quality in Health Service Organisations as part of the National Safety and Quality Health Services (NSQHS) Standards. The process of developing a business plan allows your team to identify and set goals, consider strategic and big picture approaches to your day-to-day operations, monitor and review progress against your objectives, ascertain opportunities and potential risks, while working together as a team to succeed. The business planning process provides an opportunity for your team to take a step back to consider what is currently working within your practice and what needs improving. DURING THE BUSINESS PLANNING PROCESS CONSIDER QUESTIONS SUCH AS: • Where is your health service now? • Where would we like it to be this time next year? • Is your mission statement current?
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• What’s important to your service and do you deliver care, interact with patients, team members and suppliers in ways that are consistent with those values? • What are your strengths, weaknesses, opportunities and threats? • Are there any services that you currently provide which could be promoted more effectively? (Skin Checks? Travel Immunisations? Dental checks? ) • Are there any new services you would like to provide? (Vasectomies? Mental Health Wellbeing sessions? Child-friendly sessions?) • Are there any particular types of patients you would like to treat? (e.g. people with diabetes?, the aged?, time poor professionals?) • What strategies and actions are needed to achieve what you want to achieve? For example, if your health service has the goal of improving the provision of care to patients with Diabetes, for example, your strategies may include: • Contract a diabetes educator • Deliver diabetes education sessions, and • Promote these sessions via your newsletter, Facebook page and website • Obtain feedback from Diabetes patients as to their experience of your service and use the constructive feedback obtained to improve your service.
Identifying your overall high-level objectives will help you to ascertain where you may need to invest additional resources, such as finances and/or staff. It is also important to review the external environment; awareness of potential factors which could impact upon the future of your business such as government health policy, will help you to be prepared and navigate changes within your practice with minimal disruption. Undertaking a 360 review of your health service provides you with an understanding as to your business’ current state, utilising this information to plan where you would like to be in the future and the steps you are going to take to get there. It is important to remember that a business plan is not a static document. Your team should be constantly working toward the objectives of your business plan in one way or another, each and every day. A key component of the business planning process involves reviewing, monitoring, reporting and improving to ensure you are continuously achieving and striving toward your goals. Establishing key performance indicators (KPIs) will allow you to keep track of your progress. Once a business plan has been developed, your team can use it as a benchmark against which to measure progress in achieving goals. WHAT ARE SOME INITIAL STEPS MY TEAM CAN TAKE TO START THE BUSINESS PLANNING PROCESS? There are multiple ways to approach the task of business planning. The Australian Government of Business (www.business.gov.au) has a whole section online dedicated to useful tips, templates and resources to support your team in better understanding this process and ideas on how to formulate your business plan. • Try to include all members of staff in the planning process. Key staff may be required to input more into the planning however involving everyone in some way will ensure greater commitment and dedication to the overall objectives identified.
• Identify the key areas your business plan will address – vision, mission, values, objectives, strategy, governance structure, roles and responsibilities, reporting and monitoring systems, processes and timelines, financial status and budgets. Many organisations find working with a facilitator helpful when they are developing or reviewing a business plan. A professional can lead you through a simple step-by-step process to help maximise your practice’s revenue and profit by testing your strategies.
Keen to learn more? At the AGPAL and QIP 2018 Conference, taking place at the Grand Hyatt Melbourne from 17 to 19 May, AGPAL Surveyor and Medical Practice and Business Advisor Riwka Hagen will be delivering a two hour practical workshop, guiding participants through the process of developing a business plan. This will assist health care teams with better preparing and understanding the requirements of business planning and the new RACGP Indicator requirements, as well as becoming a more efficient and productive practice. Register your attendance at www.agpalqipconference.com.au.
Emily Geering General Manager Marketing and Communications
Top tips for developing a marketing plan for your medical practice DO YOU HAVE A MARKETING PLAN FOR 2018? Are you regularly reviewing your marketing plan? Are you measuring marketing activity for return on investment (ROI)? If you answered no to any of the above questions, then you most certainly are not alone. In fact, despite the critical importance of having and following a marketing plan, many medical practices still do not have one. WHY IS A MARKETING PLAN IMPORTANT? Planning is crucial in every aspect of your business, marketing planning included. A marketing plan enables you to understand who your target market is, how you communicate with them, which channels to use per your audience and your budget, and how to measure the return on investment of your marketing activity. Planning makes your marketing activity more efficient, more consistent and in the end, helps attract and retain patients for your practice. A marketing plan clarifies the key marketing elements of your business and maps out the direction, objectives and activities for you and your team. Your plan does not have to be lengthy and can be a work in progress, it should however specifically define key information including your target market and value proposition, as well as tactical ideas and actions you wish to take to attract, acquire and retain patients resulting in increased sales and increased profit for your medical practice. Here are some top tips to consider when creating your marketing plan. TOP TIPS FOR DEVELOPING YOUR MARKETING PLAN: Know who you are and what you do: Define your service offering and who you are. Describe your service in simple and easy-to-understand terms. You should also include your practices mission and vision, point of difference and outline the intrinsic value your patients will receive. Identify your target audience: In conjunction with your practices service offering and culture essence elements, take the time to clearly describe your target audience. Be specific as to the demographics and
pricing, process etc. Gain insight into your competitors and understand the competitive landscape, this will enable you to better position, differentiate and target your audience refine your messaging. Allocate a marketing budget: Marketing expenses can add up quickly, so set aside a specific dollar amount per month or per quarter. Evaluate your marketing decisions such as advertising based on the amount of business that an initiative generates. Track each initiative and continue with what works. Create an action plan: Each tactical idea comes with its own set of action steps/road map. For example, if you want to create a practice brochure, you need to write (or outsource) the copy, design then print the brochure. Take the time to list the details that will get you to your desired end goal. Set timing: Listing action steps is not enough -- you must establish a timetable for each step. Be realistic so that you do not set unreasonable expectations, thereby creating frustration for yourself and your team. At the same time, be careful not to set goals so far out in the future that there is no sense of urgency for you to act. Be accountable and review: The best laid marketing plans fail when they are not reviewed regularly and followed. Stay on top of it and set aside time to refer to and monitor your plan. Seek help from a specialist: Marketing Plans can be a bit tricky and time consuming and you want to have a good plan to be able to follow, and monitor to ensure your practice achieves its targets. It may make more sense to outsource to a qualified and experienced marketing specialist to assist you in this process. Creating and sticking to a marketing plan is the best way to keep you and your practice focused, and on track for success. Writing the plan is the easy part; following and monitoring it tends to be more difficult for most people. Get planning and best of luck! MORE INFORMATION: www.realitymarketing.com.au
psychographics of your ideal patient. You can then focus your resources and marketing tactics on these groups. Set goals and objectives: Set the bar as to what you want to achieve. Establish both short-term and long-term objectives for your practice. Make sure your goals are specific, measurable, attainable, realistic and timely (SMART). Tangible goals such as revenue and new patient acquisition will help you keep you on track and enable you to accurately measure return on investment (ROI). Your marketing goals should be in alignment with your overall business goals.
Leonie Arnebark
Assess your competition: Who is your competition? What do and donâ&#x20AC;&#x2122;t
Chief Executive Officer Reality Marketing
they do well, what market share do they hold, what is their service offering,
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AAPM National Education Framework 2018 Over the past two years, AAPM has developed a National Education Framework to ensure that members all over Australia have equitable access to a uniform education program. The National Education Framework consists of a number of face-to-face events complimented by an extensive webinar program.
National Education Events AAPM will annually facilitate a series of education programs which will be run uniformly in all states in all capital cities and in some major regional centres. The content and structure of these events will be consistent between states.
Practice Manager Education Days • Full Day Seminar • Targeted at Practice Managers from General Practice, Specialist, Dental, and Allied Health practices. In the larger states there will be Foundation and Advanced streams
AAPM/APNA Workhop • Targeted at Practice Managers and Practice Nurses • This seminar will help you to build a complementary team for a sustainable practice. The seminar will include scope of practice, maximising use of nurses to improve sustainability, innovations (Health Care Homes, Chronic Disease Management), working together to develop successful tenders and team building.
Receptionist/Admin Workshop • Targeted at Receptionists, Admin Staff, Nurses from General Practice, Specialist, Dental, and Allied Health practices. • Three-hour interactive workshop including building credibility, effective scheduling and privacy and confidentiality.
National Webinar Program These will include webinars on selected Core Principles of Practice Management based on the results of the Member Survey. Webinars will be held fortnightly from February to November. The webinars will alternate between focussing on Practice Managers and Practice Staff. They will be held at 1pm2pm (AEST) on the second and fourth Thursday of each month from February to November. We know Practice Managers and their teams are very busy and interruptions are common. So a few days after each webinar, a link will be sent to all people who registered so they can download it and watch it at their leisure. The webinars can be purchased in advance in packages of five, 10 and 20 at significant discounts.
State/Regional Events Regional Events • Small Education events of one to two hours will be held in some regional centres. Check the calendar on the AAPM website for events in your area.
Networking Events • Network Meetings are held in both suburban and regional locations. These may have a speaker for a short period of time (20 mins maximum), followed by discussion and networking; or may be informal (i.e. discussion over coffee). These can be held at a time most suited to local members i.e. breakfast networking, lunch sessions or network dinners. Networking meetings will attract two CPD points for members registering online.
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Cloud Computing Part 1 P
ractice managers and owners increasingly ask me the question, “should we go with cloud computing?” usually at the point when that practice is considering significant capital investments in IT such as file server end of life (EOL) replacements or upgrades.
a data centre, accessed by practice users via tele-communication networks or internet. IT support could still be internal resource or external provider.
My answer to the question, “should we go with cloud computing? “comes at the end of a process of weighing the pros and cons of this particular form of IT called ‘cloud computing’ and whether this is the best option for this practice at this time. Assuming that practice IT is now an essential part of how a practice provides healthcare, and can be costly, any technology that is offered by various vendors as reducing upfront costs, is more reliable, more secure, more ‘available’, more ‘accessible’, is less worrisome, etc., needs to be considered carefully.
A point to note is that the operating systems and application (i.e. clinical/ practice management) software required for both on premise and co-located IT is traditionally sold as a perpetual license to the primary healthcare practice with an up-front or annual cost, together with either an optional or mandatory ongoing maintenance/support fees. The up-front costs for software licenses can be significant.
Before we can de-construct this so called ‘cloud computing’ and see if a framework can be established to assist practice managers asking the same question, we need to first understand some definitions: Google Dictionary defines cloud computing as; “[...]the practice of using a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a personal computer.” ON-PREMISE IT: Hardware and software assets are purchased, situated (or hosted) on premises and operated by the practice with some mix of internal resource or external IT provider. Users access the programs and data via a local area network (LAN). Practices with multiple clinics locations can also typically host at, say, head office and branch clinics connect via telecommunication networks or internet based wide area network (WAN). Still considered ‘on premise IT’ as hardware and software is owned and operated by practice even though this scenario could be defined as a ‘private cloud’. CO-LOCATION: Hardware and software assets purchased and owned by the practice are ‘co-located’ at another party’s premises, either an IT provider location or at
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SOFTWARE LICENSING:
CLOUD COMPUTING: Cloud computing is a collection of IT resources owned and operated by an external party to be consumed, is categorised as being private, public or hybrid and as being single or multi-tenanted, and provided ‘as-a-service’ model depending on what is being consumed, nowadays usually via the internet. PRIVATE CLOUD: “Private cloud is cloud infrastructure operated solely for a single organization, whether managed internally or by a third-party, and hosted either internally or externally”. PUBLIC CLOUD: “A cloud is called a ‘public cloud’ when the services are rendered over a network that is open for public use”. HYBRID CLOUD: “Hybrid cloud is a composition of two or more clouds (private, community or public) that remain distinct entities but are bound together, offering the benefits of multiple deployment models. Hybrid cloud can also mean the ability to connect collocation, managed and/or dedicated services with cloud resources”.
ARE WE THERE YET?
The cloud “as-a-service” models are: “IaaS”
“PaaS”
“SaaS”
Infrastructure–as-a-Service
Platform-as-a-Service
Software-as-a-Service
HOST
BUILD
CONSUME
“[…]a software licensing and delivery model in which software is licensed on a subscription basis and is centrally hosted. …It is sometimes referred to as ‘on-demand software’ […]” Unlike traditional software, which is conventionally sold as a perpetual license with an up-front cost (and an optional ongoing support fee), SaaS providers generally price applications using a subscription fee, most commonly a monthly fee or an annual fee.”
“[…] is a category of cloud computing services that provides a platform allowing customers to develop, run, and manage applications without the complexity of building and maintaining the infrastructure typically associated with developing and launching an app.”
“[…] provision [of] processing, storage, networks, and other fundamental computing resources where the consumer is able to deploy and run arbitrary software, which can include operating systems and applications. The consumer does not manage or control the underlying cloud infrastructure but has control over operating systems, storage, and deployed applications; and possibly limited control of select networking components (e.g., host firewalls).”
e.g.:
e.g.:
e.g.:
Amazon Web Services IBM EMC Google Microsoft Telstra
Microsoft Azure Rackspace force.com Google App Engine VMWare Cloud Foundry
Microsoft Office 365 Tyro Argus Xero Medical Director Helix clinictocloud
Malcolm Gladwell in his now classic book, The Tipping Point, explored how ideas, social movements, fashions, epidemics and new technologies spread to the point of ubiquity. Gladwell describes this idea of ‘The Tipping Point’ as being “[…] the moment of critical mass, the threshold, the boiling point. There was a Tipping Point for violent crime in New York in the early 1990’s, and a Tipping Point for the re-emergence of Hush Puppies, just as there is a Tipping Point for the introduction of any new technology.” Gladwell then gives as new technology examples the introduction and uptake of fax machines and mobile phones in the 1980s and 1990s to illustrate his point. Gladwell goes on to define the three rules of the Tipping Point; “the Law of the Few, the Stickiness Factor, the Power of Context,” which work together to determine whether epidemics, social trends or new technologies spread and become the new reality. Does Cloud Computing have the three factors required to reach a Tipping Point? Are the promises of no-upfront costs, worry free computing, super reliability, high data security and accessibility by any device from anywhere (i.e. mobile and multi-location access) being realised in 2018? Is cloud computing the way that your practice computing will be ‘consumed’ any time soon? That of course depends as much on the particular SaaS software product as it does depend on the circumstances and IT requirements of your particular practice as well as obvious critical factors in the IT ecosystem such as internet connectivity availability, reliability and performance. In Cloud Computing: Part 2 we shall review currently available clinical and practice management SaaS cloud software offerings and provide a summary of any prerequisites, features, as well as costs, to assist practice managers in evaluating the viability of cloud.
Miroslav Doncevic Managing Director Digital Medical Systems
For most practice managers, the only cloud computing model that will be relevant here is public ‘Software-as-a-Service’ so this is where we shall focus.
References: www.google.com.au/search?rlz=1C1EODB_enAU553AU553&q=Dictionary#dobs=cloud%20 computing, accessed January 2018 en.wikipedia.org/wiki/Cloud_computing#Private_cloud, accessed January 2018 en.wikipedia.org/wiki/Cloud_computing#Public_cloud, accessed January 2018 en.wikipedia.org/wiki/Cloud_computing#Hybrid_cloud, accessed January 2018 en.wikipedia.org/wiki/Infrastructure_as_a_service, accessed January 2018
en.wikipedia.org/wiki/Platform_as_a_service, accessed January 2018 en.wikipedia.org/wiki/Software_as_a_service, accessed January 2018 The Tipping Point, Malcolm Gladwell, Little Brown, 2000 Ibid, page 12 Ibid, page 29
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First prosecution of a healthcare corporation for unlawful advertising I
n April last year, AHPRA revised its approach to advertising compliance and enforcement. Under this new strategy a press release from AHPRA reported an Australian-first, as Wellness Enterprises Pty Limited, which traded as Australian Male Hormone Clinic, was fined $127,500 plus costs after being found guilty and convicted of 17 charges related to unlawful advertising of regulated health services. Charges brought by AHPRA followed advertisements the business published in newspapers around Australia between February and August 2017 for treatment of testosterone deficiency. The full page ‘advertorial’ style advertisements made a number of claims about the benefits of treatment, including increased energy, focus, masculinity and strength, and ability to satisfy sexual partners. AHPRA challenged the validity of the claims citing best available evidence. In the Downing Centre Local Court in Sydney on 3 October, the corporation was found guilty and convicted on 17 charges. The magistrate cited the seriousness of the offences in fining the corporation $7,500 on each charge, totalling $127,500. The corporation was also ordered to pay court costs of $3,000 and professional costs up to $3,000. This is the first time that a corporation, not an individual health practitioner, has been convicted following advertising charges brought by AHPRA under section 133 of the National Law. AHPRA’S APPROACH AHPRA acknowledges that most practitioners want to comply with their professional obligations. The main focus of the strategy is to make compliance easier for practitioners wanting to change their advertising.
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For low risk breaches against individual practitioners, AHPRA will take an approach that supports voluntary compliance. When a complaint is received AHPRA will assess it and, if it is low risk and non-compliant by reference to AHPRA’s advertising guidelines, it will write to the practitioner and give them the opportunity to rectify within 60 days. The letter will have general information about the breach as well as resources to assist the practitioner to comply. After 60 days they will randomly audit practitioners who have received a letter and if not compliant they will issue a show cause notice which will have specific information about the breach by reference to the advertising guidelines. If the practitioner does not rectify after this, then the Board can impose advertising restrictions. For practitioners with moderate risk breaches and those with previous advertising complaints, the same process will be followed but there will be targeted audits after the 60 days. In other words, practitioners will get two opportunities to fix their advertising before escalation and increased enforcement action. High risk breaches or breaches by corporations will be referred to the statutory offences team at AHPRA. In NSW, AHPRA will follow a similar process but if the practitioner does not rectify, AHPRA will refer to the NSW Medical Council as a notification. In Queensland, AHPRA has agreed with the Office of the Health Ombudsman (OHO) that advertising breaches will be dealt with by AHPRA and not the OHO. For practitioners who are contracted or employed by corporations and have
Designer Uniforms www.kitamiclothingco.com/uniforms limited control over the advertising, if they can demonstrate this to AHPRA, AHPRA will refer to the statutory offence team rather than proceeding against the practitioner. PROTECTING MEMBERS Avant has seen a few of the initial warning letters come through. If doctors and practices receive a letter from AHPRA notifying them of a possible issue with their advertising, doctors and practices need to address the issues raised by AHPRA to avoid further action being taken. This is an opportunity to seek advice from Avant to assist with compliance. We can find out more about the specifics of the alleged non-compliance to get to the heart of the issue. Read Avant’s article for more information: avant.org. au/news/advertising-your-practice-while-staying-within-the-law/ Many practices unintentionally breach advertising laws through the use of testimonials and social media. Avant’s Practice Medical Indemnity Insurance Policy* includes access to medico-legal advice and legal costs to defend the practice. Avant’s Practitioner Indemnity Insurance Policy* provides cover for breaches of consumer protection legislation which includes those related to advertising.
Caroline Tuohey Senior Solicitor
Further information AHPRA has updated its advertising webpage (ahpra.gov.au/ Publications/Advertising-resources/Legislation-guidelines.aspx) which includes case studies and examples designed to assist health practitioners check whether their advertising complies with the National Law. AHPRA also publishes examples of non-compliant advertising common to all regulated professions and this is a practical way to understand what their expectations are. If you require advice on your obligations around advertising in your practice, visit the Avant website at: avant.org.au/or for immediate advice, call Avant’s Medico-legal Advisory Service (MLAS) on 1800 128 268. *Cover is subject to the terms, conditions and exclusions of the policy. Please read and consider the Product Disclosure Statement available at avant.org.au or contact us on 1800 128 268. Disclaimer: This article is not comprehensive and does not constitute legal advice. You should seek legal or other professional advice before relying on any content, and practice proper clinical decision-making with regard to the individual circumstances. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is current only at the date initially published.
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Medical Assistants: the two for one deal! L
akeside Medical Centre is a rural, solo private General Practice in Finley, a farming community located in Southern New South Wales. Some patients have to travel over 300 kilometres round trip to the practice. Our closest base hospital and specialists services are over 100 kilometres away. Our two practice nurses work a maximum combined total of five sessions per week. Most afternoons we do not have a practice nurse on site. We identified a need for those services to be delivered; however being a solo practice, it is not feasible to have a full-time practice nurse. This created a window for me to become a Medical Assistant (MA). I’d seen Medical Assistants working in General Practice in the United States. The position was appealing, due to the dual clinical and front desk administration roles. The Medical Assistant has the ability to ‘float’ between these two roles pending/anticipating the needs of the practice on a day-to-day basis. After discussion with our practice principal, we knew this would be a complementary role to our current clinical team and a financially viable model. As a full time Practice Manager, I am already on-site all week, allowing me to step into the MA role as necessary. I work both autonomously and cohesively as part of the Practice team under direct or indirect supervision of our GP and Practice Nurses. Rather than allocating session times for MA tasks, I can step out of my role as Practice Manager and can be a second set of hands assisting clinicians or perform an unscheduled ECG on a patient when the nurse is not available. If requested, I can help the patient complete consent forms prior to minor surgery, Implanon insertion or before a vaccination. I perform a range of clinical tasks on a day-to-day basis. Our practice does in house pathology (and has a courier attend twice daily) which means that I’m frequently handling pathology specimens and spinning blood in the centrifuge. Our practice runs multiple rooms for our GP, I room the patients,
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which includes recording their blood pressure, updating height, weight and waist measurements. This has been advantageous as our practice is a demonstration site for several Primary Healthcare Network projects. One project involves increasing the recording of Body Mass Index and waist measurements across the whole practice by 10 percent, which is successful due to the data collection I am performing daily. Another project aims to increase preventative cancer screening rates of our patients. As a MA this means that once the patient has completed their consult with the GP, I may need to instruct how to undertake a take home faecal occult blood kit. I also maintain our cervical screening reminder register, mailing out monthly reminders and phoning overdue patients to encourage them to have screening. Another aspect of my MA role is clinical administrative tasks, record keeping and inventory. For example, cold chain monitoring of the vaccination fridge, downloading the data logger, stock rotation, ordering of medical supplies and vaccinations. Maintaining the practice reminder system including booking appointments for chronic disease management: annual cycle of care, care planning sessions and health assessments with the Practice Nurse and GP. Recalling patients to discuss urgent or abnormal results. This enables our registered nurses to spend more time with the patients delivering direct care. Being a Medical Assistant has significantly helped our workflow. For example the ability for me to be able to step in and help out with unforeseen time consuming consultations such as a surgical review that requires removal of sutures and a dressing change. The GP can call for me to come in, I can take down the dressing and clean the wound. I’ll call for the GP to check the wound, take a swab if needed then, and discuss how to redress the wound or decide if the sutures are ready to come out or should we
take alternates, then redress the wound. The GP can continue seeing other patients in another room, during the time I take to compete those tasks. Once completed I’ll handover to the GP again, clean down the treatment room, then go back to my desk and continue in my administrative role. In my role as both Practice Manager and Medical Assistant I have further job satisfaction due to greater diversity of my role within the practice team. I really enjoy having clinical contact and hands-on patient interaction. As a Practice Manager, being a MA has deepened my knowledge and empathy to the needs of my clinical team, which has given me a more rounded view of how to manage all elements of the practice. Having a Medical Assistant is a cost effective way to provide flexibility to deal with the unpredictable day-to-day needs of the practice reactively. MA’s can also be utilised to cover potential staff shortages because they can offer assistance to clinical nurses in the treatment room and/or work in the reception team. If you have a receptionist that has a flare for the clinical, and would like to take on more responsibility within your practice; this may be the course for them.
Being a Medical Assistant has significantly helped our workflow. For example the ability for me to be able to step in and help out with unforeseen time consuming consultations such as a surgical review that requires removal of sutures and a dressing change.
Catherine Ryan Practice Manager / Medical Assistant
Hassle-free patient feedback for your accreditation Practice accreditation is stressful and occupies the valuable time of busy practice staff. Let us lighten the load and help you improve the service you provide your patients. We can co-ordinate and help you complete the patient feedback component of your practice accreditation. Insync’s survey tool and method are approved by RACGP. Insync is a leader in healthcare patient experience and engagement research. We’ve been delivering patient satisfaction surveys for over 20 years.
To find out more, contact our team on: 1800 143 733 vop@insyncsurveys.com.au www.insyncsurveys.com.au/vop
Four Email Tips You Can’t Live Without I
f you use even two or three of the tips and tricks as described below, you could save at
your email preferences (and other variations) in the body of incoming emails and have these
least 20 minutes a day managing email. When
promotional emails moved directly into a folder
you quantify that over a 45-week work year –
for you to look at later.
that’s 74 hours. A huge saving of time, stress
Where: Outlook: Home Ribbon > Rules.
and overheads.
Lotus Notes: Tools > Rules.
How to use: Set once, then forget. Add your normal salutation. Where: Outlook: In an email’s Insert ribbon > Quick Parts. Lotus: no. Gmail: no. TASKS - NEVER FORGET AGAIN
Gmail: Settings > Filters.
What: Your automatic memory prompt, persistency builder and project manager
level of self-taught learning. Most of us learn only
DRAG & DROP - NEVER TYPE OUT AGAIN
to the point of getting a job done which might
What: Used creatively drag and dropping
not be the smartest, quickest or most efficient
can replace cut and paste and typing out
manner. Many would spend 45 minutes working
from scratch.
How to use: Tasks should be one of your favourite functions. Build in business development tenacity by reminding yourself to follow up on outstanding patient payments, overdue immunisations, items due. Build relationships by reminding yourself to call business contacts regularly. Assign meeting action points to practice nurses and Doctors to prompt them.
Managing email is a huge problem in business today. Work is completed at each individual’s
with email when five minutes would have got the job done well if they had a little knowledge of the program features, shortcuts and clever thinking.
How to use: take incoming emails and drag, then drop into your contact icon to create a new contact. Drop to your calendar icon to create
Here are four great tips to remember when
a new appointment or meeting. To windows
managing and using email:
explorer to save the email (and attachments).
RULES - YOUR PERSONAL INBOX SECRETARY. THIS TIP ALONE CAN BE LIFE CHANGING You probably have heard of rules/filters, but dollars to doughnuts you’re not using them to their phenomenal potential
Even better, you can highlight text within an email and drag and drop that instead of the entire email. Where: Primarily an Outlook function. Lotus Notes: You can drag and drop into the To Do list only. Gmail: not available.
What: This function automatically reads your
QUICK PARTS – NEVER RETYPE
incoming or outgoing emails and performs
PARAGRAPHS, BANK NUMBERS,
the tasks you set - such as filing in folders;
REPETITIVE PHRASES AGAIN
forwarding to someone else; responding to the email; deleting.
Debbie Mayo-Smith aka Ms Effective is a motivational speaker and trainer. Debbie will be presenting at the AAPM National Conference in Canberra 2018. www.debbiespeaks.com to see Debbie’s great tips newsletter.
What: Set up your own templates from a simple bank account number; through to detailed
How to use: automatically sort incoming /
paragraphs or descriptions including images.
outgoing event emails; answer web enquires
Type them out and then highlight and save
quickly; perform routine tasks, sort through
as a Quick Part. You’ll never have to retype it
irrelevant emails.
yet again or dig through sent items or drafts.
Advanced thinking: You can set a Rule that
Create a quick part and then click your mouse
looks for the word unsubscribe or manage
to insert it.
24 | www.aapm.org.au
Where: Icon under Sent. Lotus Notes: To Do. Gmail: Tasks.
Debbie Mayo-Smith Motivational Speaker & Trainer
Improving chronic care in our practice A
n ageing population and increase in chronic conditions are some of the biggest health challenges for Australia’s healthcare system. Over half of all Australians have a chronic health condition (Australian Institute of Health and Welfare, 2014)—and GPs are increasingly managing these patients. CareFirst is part of the CareComplete suite of programs, one of the largest chronic disease management programs in Australia. CareFirst is a six month support program for people diagnosed with type 2 diabetes, cardiovascular disease, osteoarthritis, chronic heart failure or chronic obstructive pulmonary disease, helping them to develop skills to improve and manage their health. Janelle Jones is a Practice Nurse at Sunbury Medical Centre, one of 250+ clinics across Australia independently delivering CareFirst within their own practice. She shares her experience helping to implement CareFirst and what it’s been like for her team and their patients. TELL US A LITTLE ABOUT YOUR PRACTICE. After completing my Bachelor of Nursing in 2008, I worked in the Royal Children’s Hospital and then in the Emergency Department of a remote regional hospital in Western Australia. We moved back to Melbourne in 2011 and I have been a Practice Nurse at Sunbury Medical Centre for five years. It’s a large practice with a staff of 10 General Practitioners, seven Practice Nurses and seven Reception staff. In May 2016 we partnered with CareComplete to deliver CareFirst, a six month support program for eligible patients who had been diagnosed with type 2 diabetes, cardiovascular disease,
26 | www.aapm.org.au
osteoarthritis, chronic heart failure or chronic obstructive pulmonary disease.
that patients had previously not brought up with their GP.
To date we’ve enrolled 142 patients in the CareFirst program.
As a result of this we have had some fantastic health outcomes for our patients.
WHAT’S IT BEEN LIKE FOR YOUR PRACTICE TEAM IMPLEMENTING THIS PROGRAM?
DOES A PARTICULAR CASE COME TO MIND?
The whole practice supports the program which has been key to our success with CareFirst. Our GPs can see how the program complements existing patients care such as General Practice Management Plans and Team Care Arrangements. Two other nurses and I received free training in HealthChange® Australia behaviour change methodology. Using this methodology is great and I now apply it in all aspects of my nursing duties as well as in my personal life! Our practice has always had a very patient centred approach and communication between GPs and Practice Nurses has always been good, but working together to deliver this program has continued to strengthen those assets. HAVE YOU SEEN IMPROVEMENT IN PATIENT AND CLINICAL OUTCOMES? Yes many more than I ever expected. Due to the fact that patients choose their own goals, they are more motivated from the start to achieve these goals. Also because we are not telling them what to do but rather coaching patients to identify themselves what they need to do with our help, patients feel more in control of their health and subsequently the health outcomes. GPs only get limited time with patients, and the program – especially the use of Health Change Methodology - has helped us identify issues
We have a male patient in his 70’s who is legally blind and has osteoarthritis, rheumatoid arthritis, diabetes and bad shoulder pain. His diabetes was not well controlled. As a result of enrolling him in CareFirst, we were able to improve shoulder rotation and hand movement, and considerably reduce arthritic pain through a referral to a physiotherapist and chiropractor. The patient was given a blood sugar monitor which he can use via a computer to identify when his blood sugar levels rise. The patient has now adapted his diet, lost some weight and thinks the CareFirst program is amazing.
FURTHER INFORMATION For more information on CareFirst, visit our website, email us at care.programs@carecomplete.com.au or call 1300 650 742.
Janelle Jones Practice Nurse, Sunbury Medical Centre
The Importance of Security and Data Backup in the Healthcare Industry O
ne of the greatest fears of Australian practice managers is arriving to work in
estimated 19,494 appointments affected, with 6,912 appointments - including operations
the morning to find the IT system is down for
- cancelled. Of these cases at least 139
the foreseeable future. For situations like this,
people, some with severe illnesses, had urgent
it is vital to have a data-recovery plan that will
referrals cancelled.
eliminate the downtime created by unexpected IT outages, and to mitigate against data loss. But, data recovery and backup plans are rarely considered when most practices allocate their annual budget. The business consequences for not having a data recovery plan in place are severe. Patient service is delayed as health professionals have little or no access to patient information, which creates an environment where both the patients and healthcare professionals feel frustrated and confused. Due to the inherent reliance on technology in the modern practice, it is very difficult to plan for situations where that technology will not be available. That is why disaster recovery plans and data backups are vital, they give everyone a very clear plan of action to avert a system shutdown. Another area of concern for Australian practice managers that is becoming more and more prevalent, is cyber security, specifically regarding
The identifiable cost to the NHS from the attack on 12 May 2017 reached $314,000. The NHS still doesnâ&#x20AC;&#x2122;t know the total cost of the disruption to services. Costs include: cancelled appointments; additional IT support provided by local NHS bodies, or IT consultants; or the cost of restoring data and systems affected by the attack. Furthermore, national and local NHS staff worked overtime including over the weekend of 13-14 May to resolve problems and to prevent a fresh wave of organisations being affected by WannaCry on Monday 15 May. The 2017 WannaCry attack on the NHS is
importantly they can leak very sensitive patient data that can have severe legal consequences. Without a strong security and data backup protocol, healthcare professionals can affect patient outcomes, lose revenue, and lose the trust of the patients. New technology continues to enhance the patient experience and level of care that can be provided, but it also creates vulnerabilities that can allow for cyber-attacks and the potential for lost or stolen data. Practices can have peace of mind knowing their practice and patients are protected against the disasters that could occur and potentially shut down their business. It is strongly recommended that practices check with their IT provider regarding providing assistance when considering implementing a business continuity plan and disaster recovery plan.
believed to have been avoidable. According to the NHS, the security breach was a result of a failure to upgrade old computer systems at a
FURTHER INFORMATION
local level. Many offices were running unpatched
For more information on the backup and security services CT can provide to your practice, please phone us on 1300 888 918 or email sales@ ct.com.au
and or unsupported software on their systems, and could have prevented the attack simply by following basic IT security best practices.
ransomware attacks. In May 2017, Englandâ&#x20AC;&#x2122;s
Closer to home, there are constant phishing
National Health Service (NHS) was the victim of
attacks designed to replicate some of the
the WannaCry mass ransomware attack. The
most well-known Australian companiesâ&#x20AC;&#x2122; email
security breach infected the system through
correspondence, such Telstra, Australia Post,
malware that spread throughout the NHS
Xero, and the ATO. The risk of an IT disaster
network before encrypting system files and
in the healthcare industry goes far beyond
Jason Amato
withholding them from the user until a ransom
just the financial. Professionals and practices
was paid. The result of this breach was an
stand to take a hit to their reputation, but more
Marketing Manager Centorrino
www.aapm.org.au | 27
Practice Profile
Lakes Radiology, Morisset L
akes Radiology is in the small NSW town of Morisset, situated on the SE side of Lake
environment. Even though life at Lakes Radiology is definitely in the fast lane, the
Macquarie between Toronto and the Central
practice staff are amazingly resilient and go
Coast. The town has one main street, a couple of
above and beyond every day to provide their
supermarkets and banks and a super centre for
best. Our practice believes that people make
general practice across from the railway station.
the difference and our commitment to customer
Our practice, located within the super centre,
focus for all stakeholders has been the catalyst
began six years ago when our Radiologist
for our continued growth in this area.
decided he wanted to provide services to what
From an IT perspective our practice strives to
many people considered a ‘backwater’. Prior to this, the local community had to travel to the Central Coast, Toronto or indeed Sydney or Newcastle depending on the radiology services they required.
stay on top of new technology and embrace it. We have cloud management instead of physical servers, VPN telephones, business grade NBN and we have created a website, eNewsletter and Facebook page, which comes in very handy to
The practice commenced with six staff providing
notify patients. We recently advised patients by
only CT and general X-ray. It has grown
SMS and Facebook that we were experiencing a
substantially with current services providing CT,
rare power outage and remarkably each patient
General X-ray, OPG, Mammography, Nuclear
who was booked in had ‘liked’ our Facebook
Medicine and Ultrasound. Our practice now
page and so was alerted – it’s definitely the way
boasts 32 staff, many locums and two full-time
of the future!
plus three part-time Radiologists, including the
We are currently integrating our software with
one who fulfilled his dream to provide services in this region!
the Australian Digital Health to be able to upload our radiology reports into MyHealthRecord so
Due to some very fast growing nearby residential
that referring doctors and hospital emergency
housing estates, our practice demographic
departments are able to access the patient’s
now has many GP practices, physiotherapists
radiology report, thus negating the need for
and chiropractors who are our main feeder
the doctors to contact our practice for these.
referring practices. However, we are surprised
We have also implemented training for our staff
and excited to see so many patients now
to understand and comply with the New Data
travelling to us from the Central Coast, North
Breach Laws, having provided them with a Data
Sydney and Newcastle, so we must be doing
Response Plan and policy and procedure on
something right.
this subject.
When I became practice manager, eighteen
As a bulk billing practice, one of our biggest
months ago, I was in awe of the way the staff
challenges was introducing a gap payment on
provides such a caring, customer-focused
some services. The Medicare freeze had been
28 | www.aapm.org.au
in place since the practice opened with no rise in the rebate for diagnostic imaging, so we found bulk billing unsustainable. It was a difficult decision but one we ensured would not impact on disadvantaged customers with a strategy in place to continue bulk billing all services for pensioners, health care card holders and students. The practice decided to only charge a gap on 10 percent of ultrasound services, so the impact on the community was minimal and has been accepted widely, something the practice is very grateful for. Each day presents many challenges, with equipment needing servicing, power outages or unexpected staff absences but the practice manages to continually rise to the occasion. I try to make the staff’s time at work worthwhile and fun - we celebrate birthdays with cakes, provide delicious morning teas, have soup bubbling away in winter and provide ‘Thank You Thursday’ lunches to ensure they feel valued and respected. Our business is proof that if you care and look after people, they will in turn care and look after the business. As practice manager and leader of our fantastic radiology company, I am extremely proud of where we came from and where we are heading. It has been an amazing journey and one I will stay on for the long road ahead.
Elizabeth Jones Practice Manager
1300 865 977 WWW.DMS-IT.COM.AU DIGITAL MEDICAL SYSTEMS CONFIDENT IT
“DMS have provided IT systems and technical support to Berwick Medical Centre for 20 years. As a hands on GP principal and Manager with experience in using computers innovatively in every day clinical and management applications since 1987, including 5 different clinical IT applications, I am confident in our business continuity because of the DMS real time monitoring and proactive management of our IT systems. I can sleep at night not worrying about IT disasters and can take leave confident that our IT is in the best hands. That’s why I choose DMS.” Dr Wes Jame Berwick Medical Centre
DMS is the IT partner of choice for Berwick Medical Centre 20 years of IT support,
MANAGED IT SERVICES
24 x 7 MANAGED IT SERVICES
that’s DMS confidence!
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sometimes you just want more Based on a starting income of $50,000 and a starting account balance of $50,000 HESTA has delivered $17,837 more to members than the average retail super fund over the past 10 years*. This was because of both lower fees and higher investment earnings.
hesta.com.au/betteroff *Comparisons modelled by SuperRatings, commissioned by HESTA. Modelled outcome shows 10 year average difference in net benefit of the main balanced options of HESTA and 77 retail funds tracked by SuperRatings, with a 10 year performance history, taking into account historical earnings and fees â&#x20AC;&#x201C; excluding contribution, entry, exit and additional adviser fees â&#x20AC;&#x201C; of main balanced options. Outcomes vary between individual funds. Modelling as at 30 June 2017. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au for a copy), and consider any relevant risks (hesta.com.au/understandingrisk). Past performance is not a reliable indicator of future performance and should never be the sole factor considered when selecting a fund. See hesta.com.au/superraterassumptions for more details about modelling calculations and assumptions.