Filex 2012 building referral networks presentation

WORKING FOR A FITTER, HEALTHIER AUSTRALIA

Building successful Referral Networks


Introduction – recent history

Why a focus on referral networks

Fitness a valuable player in Health landscape

Current state of referral opportunities for Fitness

Submission for Evidence based strategies

Feedback from Health sector and practical

application

Agenda


Recent history of Fitness on Health map

2010 – Government funding for Healthy

Communities initiatives.

Saw roll out of funding for the Lift for Life program

2011 – Introduction to the Adult Pre-exercise

Screening System (APSS)

2012 – Further opportunities for integration into

Health Networks


Recent history of Fitness on Health map

Fitness industry has not traditionally engaged effectively with health and medical services.

No uniform method for engagement.

Beginning with standardised screening process is a positive step.

Clear absence of a systematic, effective approach to referral.


Locally, Active Script and Lifescript programs - government funded initiatives

Focused on capacity building and awareness-raising amidst GPs

The Green Prescription program in New Zealand

Focused upon GP engagement and referral to activity providers

The General Practice Exercise Referral Scheme undertaken by the Sutherland Division of General Practice and the Sutherland Shire Council (NSW)

Focused on referring individuals to facility based programs and activities

Recent history…


Recent history…

Government funded initiatives and research have collectively led to improved knowledge and understanding of what can work and why.

For example, we now know: 85% of the pop visits a GP at least once per year

the average person makes 5.4 visits per year (2008/09)

60% of patients were 45+ years, 80% of them with a chronic condition

GPs believed to have the most significant influence on lifestyle decisions

behaviour can be significantly affected through brief consultations with GPs

GPs are first point of contact for a referral, with 13% of all visits including a referral – 28% of these to allied health (Physio, Psych, Pods, Diet, etc.)


Research has also helped to identify the features of a successful referral model.

These include: Strong relations between providers and GPs

GP knowledge around physical activity and exercise

Having a central point for referral, having an enabler/ coordinator role

Electronic and hard copy support resources

A clear definition of duty of care for GPs and exercise providers

Provision for specific populations

Training and quality assurance of providers

Good access to affordable local programs and providers

Recent history…


A number of detailed resources that contribute to an informed

understanding of Exercise Referral have been developed

for GPs in Australia:

The RACGP’s red book and green book provide an outline of

evidence and process for GP referral to preventative

activities such as physical activity.

The RACGP SNAP population health guide to behavioural risk

factors in General Practice is another resource that

provides guidance.

Recent history…


It is evident that considerable investment and effort has been made to better understand and progress the development of exercise referral in the past,

HAVE YOU EXPERIENCED THE BENEFIT OF THIS??

A clear need for a sustainable broad-based method for referral between health and exercise services still remains.

Recent history…


Fitness Industry Association Initiative

Recent funding submission to the Department of Health and Ageing:

Develop and test a multi-disciplinary exercise referral system within the new Medicare Locals (primary care health network setting).

Several other stakeholder organisations have supported the submission.

1. Evidence collection of existing schemes2. Consultation process with relevant associations

RACGP SMA APA DA ESSA

3. Pilot – focus on Medicare locals


Changing face of population health – are we adapting?

Desire from medical and allied health sectors – but also barriers.

Why focus on referral networks


Fitness in Health landscapeChanging face of population health – are we adapting?






Current state of referral opportunities for

Fitness Industry

Barriers?

Awareness of service providers

Awareness of quality

Fears over liability

Lack organised referral system


Current state of referral opportunities for

Fitness Industry

the positive, negative, positive sandwich…

Positive: You are passionate and enthusiastic about health and fitness

Negative: Your approach and business process is not structured and measurable

Positive: You are an inspirational person who can motivate people to change


Barriers to referrals

Fears over liability

Recent ‘Australian Doctor’ Journal article:

Mounting requests for 'fit to exercise' certificates have led to accusations gyms are shifting liability onto doctors for training-related mishaps.

"The problem is you don't know what the exercise program is, you don't know how experienced the person writing the program is, and you don't know if the patient has some underlying problem”

“the lack of consistency between fit-to-exercise forms was a concern, with certificates often vague or open-ended.”


Practical application and tips

Standardised screening and referral tool

Clearance vs guidance language

Re-assessment tool of modifiable risk factors (Stages 2 and 3)

Focus on follow through on information collected

Webinar 17th May 11am-12pm



Positive and professional first impression for client and medical or allied health professional

Demonstrates commitment to evidence-based industry standards, nationally recognised procedures and legal obligations – as per other professionals in health sector

Helps to build client and professional trust, rapport and communication

Guide to defining scope of practice - operating outside of scope is a common reason for conflict with other professions

Demonstrates commitment to a client-centred approach



Medicare Locals

Replacement for Divisions of General Practice

Primary health care organisations

Established to tackle local health care needs and service gaps

Opportunities for education and networking

www.yourhealth.gov.au



Allied Health Professional (AHPs – Physio, Pod, Chiro, Diet, Psych, etc.)

They WANT to hear from you

They look for further support for their patients

If in private business they NEED referrals from you!!



Allied Health Professional (AHPs – Physio, Pod, Chiro, Diet, etc.)

Have a working relationship established (ideally prior to the initial referral being made).

Sound working knowledge of how the professional works, from the basic practicalities such as:

Costs

Opening hours

Locations

Individual knowledge base (particular strengths and weakness)

What particular client groups they enjoy working with.

Ensure client is well prepared for referral experience!



Allied Health Professional

Ideally involves meeting face to face to establish these things

Observe each other in practice

“I encourage the fitness professional to visit our clinic to see first hand the way we manage clients from the initial phone call to the assessment and ongoing treatment process. A complete understanding of these things enables the referral to be set up for success from the outset and trust in the person being referred to.”



Allied Health Professional (AHPs – Physio, Pod, Chiro, Diet, etc.)

Gain written, informed consent to communicate from the client

When referring, communicate (via phone, email, letter or fax prior to the client arriving for their assessment) about:

The reason for the referral

and what they and the client want to get from AHP.

Expectation for regular progress reports, specifically about identified goals (Short and objective)

Prompt reply to communication when appropriate (within 24 hours/business day)



Allied Health Professional

Client must have a good understanding of why the referral process is necessary

Client should be informed of practical things like the location, costs, appointment times, waiting times;

what to expect within the assessment and treatment process

and why the referrer specifically wants the client to see that practitioner or practitioners within that business prior to them making a booking

This helps to establish the client's expectations and ultimately trust in the process


Practical application and tips - lettersFour short, punchy, and purposeful paragraphs! (start with existing clients!)

Subjective – what did the client tell you they want? Their

goals.

Objective – what did you measure? Waist, mass, fitness

measures, pre-ex screen, etc.

Assessment – typically a diagnosis – what is your

summary?

Plan – what will you do? And when will you report back?



And always remember:

People first – professionals second – business last



Thank You!

Filex 2012 building referral networks presentation

Health & Medicine

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healthier australia

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successful referral

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