The Clinical Team
The College extends its thanks to the following group of clinicians and academics, who wrote and reviewed the educational material.
The writing team was comprised of three great rural GP leaders and educators;
By Ewen McPhee
Over 80% of Australians visit their GP every year, in rural areas that figure is somewhat less. Barriers such as affordability, access and availability of health professionals create challenges for rural people.
Underpinned by higher rates of obesity, smoking and reduced exercise, rural areas see a greater relative burden of chronic disease including ischaemic heart disease, chronic obstructive pulmonary disease and diabetes.
Aboriginal and Torres Strait Islander people live with even higher burdens of disease and reduced life expectancy compared with most rural Australians.
Mental illness - including depression and suicide - are tragically worse in rural areas for lack of clarity of access to care, let alone the stigma associated with seeing a health professional.
Connectedness - that seamless ability for rural people to transition the health system - is challenged by greater distances to be travelled, lack of local services, and lack of trained professionals.
The linchpin to improving services to rural people is quality information. For many people that information and the supporting work that has been undertaken exist within their local general practice. Good information begets informed planning, and supports the primacy of local general practice as a key to the health of local populations.
The patient journey from home to hospital and back is fraught for rural people. Timely clinical handover, relevant discharge summaries, improved medication management and effective team care reduce secondary impacts such as readmission rates and reduced quality of life, and improve outcomes.
Our youth and more commonly our elderly are turning to online media for information, for advice and for connection. The use of social media to share information and advertise ineffective and low quality health advice is unfortunately commonplace.
For these reasons amongst many there is a compelling case for the local general practice to be a leader in sharing clinical information, providing the backbone for effective clinical communication, and informing population health experts about the specific needs of every unique community.
The patient health summary can inform a local emergency department on key health concerns known by the GP. The eHealth backbone can deliver discharge summaries to the relevant GP more quickly than paper or fax. Secure messaging can connect clinicians safely and allow for real time case management of complex patients.
Setting up a "digitally connected" practice, and delivering the quality outcomes that can be achieved is a journey. The stepping stones to achieving this are described with clarity in this module.
The Clinical Lead: Dr Ewen McPhee [more]
Dr Ewen McPhee
General Practitioner - MB BS (Hons), FRACGP, DRACOG, FACRRM DPDermatology
Dr Ewen McPhee - member of the Primary Health Care Advisory Group and long term rural General Practitioner, GP Obstetrician and GP Supervisor in the town of Emerald.
Dr McPhee has recently joined the Board of the Australian College of Rural and Remote Medicine, and taken the role of President of the Rural Doctors Association of Australia.
Dr McPhee has held the position of deputy chair of the Queensland branch of the Royal Australian College of General Practitioners and State Director of the National Rural Faculty (RACGP) until recently.
Dr McPhee is Chair of the Telehealth Governance Committee for Queensland Health and eHealth Champion for the Rural Doctors Association of Australia. Dr McPhee is a Fellow of the Australian College of Rural and Remote Medicine (ACRRM) and consultant to the college on eHealth and Telemedicine.
A former deputy chair of the Central Queensland Medicare Local Dr McPhee has a strong interest in improving the health or rural and remote communities. Dr McPhee is a member of the International advisory committee to the World Organization of Family Doctors (Rural). He has recently completed an informal public speaking engagement in Japan addressing rural communities and health practitioners about primary care in Australia.
Cluster 1- Quality and Safety; Dr Tony Lembke [more]
Dr Tony Lembke
Dr Tony Lembke is a GP in Alstonville, NSW. He is chair of the North Coast Primary Health Network.
Tony is a Clinical Advisor and Chair of Faculty for the Improvement Foundation and Clinical Director of the Australian Primary Care Collaborative Program. This is a national program that has improved health outcomes by facilitating proactive and systematic care in general practice, and by increasing accessibility to primary care services. He is also Executive Director of the Australian Centre for the Medical Home and the Person Centred Care Collaboration. Tony has a strong interest in Health IMIT, having been Sydney University Medical School Donkey Kong Champion in 1983. He served as a NEHTA Clinical Lead and chaired the national eHealth collaborative - the 'eCollaborative'.
In 2007 he was awarded the John Aloizos Medal for Outstanding Service to the Australian Divisions of General Practice, and in 2013 won the National Medicare Local Individual Distinction Award. He is the 2012 RACGP 'General Practitioner of the Year'. He is also an ever optimistic coach of the Lismore U16 Rugby team.
Cluster 2- Systematic Management of Chronic disease and Multimorbidity: Dr Dale Ford [more]
Dr Dale Ford
Dr Dale Ford has been a GP with Hamilton Medical Group since the mid-1980s following his graduation from University of Melbourne in 1978, and training at St Vincent’s Hospital Melbourne, PANCH and Hamilton Base Hospital. He has developed interests in Diabetes Management and Prevention, Cardiovascular Disease Management and Prevention, as well as skin problems.
Dr Ford has had many other roles which has led to him to be able to influence policy and advocate for the needs of rural patients and doctors. Currently these include - Being a Principal Clinical Advisor for the Improvement Foundation Australia which runs the largest Practice Improvement Program within Australia. This has been called the Australian Primary Care Collaboratives (APCC). Previously Chair of Southern GP Training (regional GP training provider). On the Board of Great South Coast Medicare Local. He has many other roles in Health Quality Improvement and has a number of peer reviewed journal articles published, and has presented on Quality Improvement in Health throughout Australia and overseas as Designated Aviation Medical Examiner.
Cluster 3 - eHealth: Dr Ewen McPhee
Case Study Authors
- Professor Dennis Pashen [more]
Professor Dennis Pashen
General Practitioner - VMO MBBS Qld, MPHTM, FACRRM, FRACGP
Professor Dennis Pashen has joined the Queenstown General Practice in 2015 with 40 years' experience working within rural and remote practice. This has included procedural practice in Ingham, the North Queensland Clinical School of the University of Queensland, Foundation Director of the Mt Isa Centre for Rural and Remote Health, Director of Medical Services in South Burnett and Rural Darling Downs Health and Hospital Services with responsibility for 18 rural hospitals.
In 2014 Prof Pashen moved to Southern Tasmania and spent the year providing Locum services throughout Australia in emergency medicine, obstetrics and general practice.
Prof Pashen is a former President of the ACRRM and currently the National President of the Rural Doctors Association of Australia and President of the Tasmanian RDA. He sits on the Assessment Committee and Board of Examiners and was the Chair of the Post Fellowship Committee of ACRRM.
In the past he has been the College Censor of ACRRM, and an Examiner on a number of their Assessment Panels. He has been an active member of the PESCI Panel of ACRRM.
He has been a Medical Educator and Supervisor since 1979 and worked with the RACGP Family Medicine Program in North Queensland in the late 1990s.
In his role as Director of the Mt Isa Centre for Rural and Remote Health from 1997 to 2010 he was responsible for oversight and teaching of medical students and GP Registrars in the NW of Qld. He set up a Skills Training laboratory for the training of staff in Emergency Medicine. This service allowed local health practitioners across the NW to participate in scenario-based training and improved the safety and quality of emergency care. He also currently supervises and teaches GP Registrars in the Remote Vocational Training Program and was a founding Board Member of that organisation.
Prof Pashen is passionate about rural and remove health services across Australia and has been active in working towards improving access to health care for rural communities.
Specialty interest areas: medical education and training, rural health care, use of social media to promote rural health care.
- Mr. Chris Walpole [more]
Chris is a Rural / Remote Area Clinical Pharmacist from Queenstown on the West Coast of Tasmania. He has been a practicing Pharmacist for 24 years since graduating from the University of Tasmania in 1992. In 2012 he completed his accreditation through the Australian Association of Consultant Pharmacy (AACP) to provide both Home Medicine Reviews (HMR’s) and Residential Medication Management Reviews (RMMR’s) to the community of the West Coast of Tasmania.
In 1993, Chris completed his pharmacy graduate year at the Canberra Hospital and spent two years in various specialties including gastroenterology, oncology, respiratory, paediatrics and ICU.
In 2007, Chris was recruited by the Queenstown Medical Union to bring new leadership to the pharmacy business. Chris is the sole pharmacist in Queenstown and is the only practitioner providing HMR and RMMR Service’s across Tasmania’s West Coast an area covering around 9,500 square kilometres.
Chris has a special interest in working collaboratively with GPs and other member of the healthcare team conducting medication reviews to improve patient outcomes.
Chris looks forward to making a positive contribution towards ACRRM’s eHealth project given his mix of skills and experience in the practice of rural/remote pharmacy. After 9 years working in rural/remote pharmacy, Chris is uniquely positioned to be able to provide useful insights on HMR's and RMMR's and their integration into an eHealth platform as a Quality Use of Medicines initiative in a remote community to ultimately improve patient outcomes, improve cost efficiency, reduce duplication and reduce the risk of medication misadventures as part of an overall community-wide eHealth strategy.
- Dr Konrad Kangru [more]
Dr Konrad Kangru
General Practitioner - MBBS, FRACGP, B.App, Sci.
Dr Konrad Kangru gained his MBBS from University of Queensland in 2000, has been in private Rural General Practice in the Whitsundays region of Queensland since 2005, where he has been a GP Supervisor and Medical Educator since 2009. He has remained a very active advocate for improving the support of rural doctors, especially through the Rural Doctors Association of Queensland, having convened their 2011 and 2015 conferences, and as their President-Elect for 2017. Dr Kangru has also undertaken and presented his research on the Self-Care of rural doctors, and has special interests in Medical Education and Diabetes management, particularly in up-skilling colleagues about this important condition.
- Karin Barron (NQPHN) [more]
Regional Manager - Northern Queensland Primary Health Network (NQPHN)
Karin has worked in the Primary Health Care Sector for 12 years transitioning from Divisions of General Practice to Medicare Locals and now with NPQHN as the Regional Manager - Mackay and Portfolio Manager for Provider and Practice Engagement and Support, Workforce Development and Integrated and Connected Care Programs.
With tertiary qualification including a Masters of Health Service Management and a Bachelor of Health - Health Education / Health Promotion. Karin is driving capacity building activities for primary care providers in Northern Queensland through innovation, utilising population health data, research findings, health promotion, prevention & education methodologies. Karin is deeply committed to the advancement of primary care data collection, collation and meaningful to inform and facilitate improved service provision and funding allocation. Her career in primary health care has had a focus on management, education, chronic disease, quality improvements, clinical data and implementing new modules of care into primary health care that support providers and improve individual and community health outcomes.
- Dr Carole Reeve [more]
Dr Carole Reeve
Associate Professor - MBChB, Dip Obs, DCH, MPH&TM, FRACGP, FACRRM, FAFPHM, PhD
Dr Carol Reeve has spent the last 15 years working her way across northern Australia. She works both as a general practitioner and as a public health physician. Dr Reeve undertook her medical training at Otago University in Dunedin. After completing her diplomas in paediatrics and obstetrics she spent 2 years in Tanzania as the Director of Maternal and Child Health at a Government District Hospital. She undertook a Masters in public health and tropical medicine in Townsville, completed her ACRRM and GP training in Mt Isa working at MICRRH and the Aboriginal Medical Service, and has also worked in the Kimberley where she finished her public health physician training and was the regional public health physician for five years. She has spent the past year in Alice Springs as a senior lecturer at the Centre for Remote Health. Dr Reeves is the author of ACRRM Population Health Approach to Management of Chronic Conditions Module.
- Dr Ewen McPhee
- Dr Tony Lembke
- Dr Dale Ford
- Dr Myrle Gray [more]
Dr Myrle Gray
Dr Myrle Gray is a GP in Oatlands, Tasmania, a small historic town in the Midlands approximately 80 kms north of Hobart and 115 kms south of Launceston.
Dr Gray's practice serves Oatlands and the surrounding agricultural region where sheep, beef and dryland grain farming is the major industry.
Many people prefer to be treated locally rather than travel to Hobart or Launceston for specialist or allied health treatment.
- Australian Digital Health Agency staff
- Heather McDonald
- Dane Morling
- Vanessa Halter
- Karin Barron NQPHN
- Jane Connolly
- Assoc Prof Sophie Couzos [more]
Dr Sophia Couzos
Associate Professor General Practice and Rural Medicine - BAppSc, MBBS, Dip RACOG, MPH&TM, FRACGP, FACRRM, FAFPHM
Dr Couzos is an Associate Professor working for the College of Medicine and Dentistry, James Cook University. Trained as a Public Health Physician and General Practitioner, with 20 years' experience working within both Aboriginal community-controlled health services (ACCHS's) in remote Australia and the National Aboriginal Community Controlled Health Organisation (NACCHO) based in Canberra.
Dr Couzos has occupied the position of Public Health Medical Officer from 1998-2012 for NACCHO. Fourteen years in remote Australia, with seven years as a GP in the Kimberley region of Western Australia with one year in north-eastern Victoria. Residency training was completed at Royal Melbourne Hospital, Fairfield Infectious Diseases Hospital, Royal Children’s Hospital, and Wangaratta Base Hospital.
Dr Couzos has instigated and influenced a wide range of national policies, programs and research towards achieving health equity for the Aboriginal population within the Australian health system, by working with the Australian Government Department of Health and Ageing, Non-Government Organisations, research bodies, and private industry. Dr Couzos is the Coordinator Ecology of Health MBBS1 (College of Medicine and Dentistry), General Practice Tutor MBBS5 (College of Medicine and Dentistry) and Coordinator Aboriginal and Torres Strait Islander Health Assignment MBBS6 (College of Medicine and Dentistry).
Dr Couzos was the instigator and developer of the National Guide to Preventive Health Assessment for Aboriginal and Torres Strait Islander People (now in second edition) - a national clinical practice guideline for preventive interventions. Has undertaken award winning research (multi-centre randomised controlled trial- 'NACCHO Ear Trial'), developed systematic reviews, and has edited and authored the textbook: 'Aboriginal Primary Health Care: An evidence-based Approach' (now in 3rd edition, published by Oxford University Press) which was shortlisted and 'highly commended' in the Australian Awards for Excellence in Educational Publishing in 2008.
- Anthony Elliot
- Dr Steve Hambleton [more]
Dr Steve Hambleton
General Practitioner - MBBS FAMA FRACGP (hon) FAICD
Dr Steve Hambleton is General Practitioner working in Brisbane and a former State and later Federal President of the Australian Medical Association. He served on the AMA Council of General Practice for more than 15 years. He has been the AMA representative on various national committees and taskforces including Chair of the AMA Taskforce on Indigenous Health.
Dr Hambleton chaired the Independent Expert Panel that reviewed the application of the Modified Monash Model to the General Practice Rural Incentives Programme in early 2015. Later he chaired the Primary Health Care Advisory Group to investigate options to provide better care for people with complex and chronic illness; innovative care and funding models; better recognition and treatment of mental health conditions; and greater connection between primary health care and hospital care.
Dr Hambleton was Chairman of the National eHealth Transition Authority and assisted with its handover to the Australian Digital Health Agency and is now a Senior Responsible Officer within the new organisation. Dr Hambleton is a member of the board of Avant Mutual Group Limited and the Australasian Medical Publishing Company. He is also a member of the Atlas Advisory Group of the Australian Commission on Safety and Quality in Health Care.
- Mrs. Wendy McPhee [more]
Mrs. Wendy McPhee
Wendy is the Practice Manager of Emerald Medical Group, Managing Director of McPhee Medical Pty Ltd and Director of Central Highlands Healthcare Ltd. The wife a very busy rural GP Wendy has 27 years' experience living and working in rural QLD. Wendy set up McPhee Medical private practice with Ewen in Emerald in 1992. She continued to manage the practice through the growth from a single doctor practice to an 11 group practice of doctors trading as Emerald Medical Group. In October 2015 Emerald Medical Group was sold to a social enterprise community owned company Central Highlands Healthcare Ltd. Since then Wendy has continued to act as a Practice Management Consultant to the practice. She was appointed as a Director of Central Highlands Healthcare in December 2015.
- Prof Dennis Pashen
- Rachel Petro
- Assoc Prof Carole Reeve
- Vicki Sheedy
- Alan Taylor
Publishing and design
- ACRRM Online services team