Filex 2012 building referral networks presentation

Building successful
Referral Networks

WORKING FOR A FITTER, HEALTHIER AUSTRALIA

Agenda
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

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.


Recent history…

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…
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.)


Recent history…
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.


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 schemes
2. Consultation process with relevant associations
 RACGP
 SMA
 APA
 DA
 ESSA
3. Pilot – focus on Medicare locals


Why focus on referral networks

Changing face of population health – are we adapting?

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


Fitness in Health landscape
Changing 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 - letters
Four 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

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Filex 2012 building referral networks presentation