COVID +ve pathways

COVID +ve pathways

20 October, 2020

DHHS and Safer Care Victoria (SCV) have worked with the health sector and clinical leaders to develop comprehensive and consistent COVID-19 +ve care pathways for all Victorians who receive a COVID-19 +ve diagnosis.

In particular the pathways will provide additional support to low risk COVID-19 +ve patients and their treating GP. It's expected that 80% of COVID positive cases will be cared for by GPs, which highlights the significant and important role GPs will have in the delivery of these pathways.

Latest update - 20 October

DHHS is providing daily notifications of COVID-19 positive patients to the Major Hospitals across Melbourne and Country Victoria.

Local Covid positive pathways for Austin, Eastern, Monash and Northern Health catchments are now operating.

Low risk clients will be referred to General Practice for clinical management (if required, social supports will be provided by the local community health service), medium and high risk clients will be managed by the Hospitals.

Hospitals each have a single contact number for GPs to seek advice on care and/or escalate care.

HealthPathways Melbourne has Local Health Network (LHN) specific pathways for Eastern, Austin and Monash which provides LHN and community health contact numbers and other details such as risk stratification criteria, escalation alerts and process for clearance from isolation.

Clearance from isolation

In most situations clearance from isolation is still being managed by DHHS. For low risk patients being managed in the Covid positive pathways the process for notifying DHHS that the patient meets the clearance criteria differs slightly across LHNs.

Austin are using a web-based symptom monitoring tool called COVIDCare. The data from CovidCare is collated into a database called COVIDMonitor, which gives visibility to all the treating teams of patient status and symptoms. Once a patient meets clearance criteria the GP can notify the LHN of this via CovidMonitor. Austin has been authorised to provide the clearance letter directly to the patient

Monash is also using CovidMonitor and GPs will ust the app to notify Monash when a patient meets the clearance criteria. Monash provides this information back to DHHS and they contact the patient (within 24hrs) to provide them with clearance from isolation.

Eastern Health are using an online tool called REDCaps to collect the relevant symptom data it also allows the GP to signal to the LHN when the patient is ready for clearance. Eastern Health then provides this information back to DHHS and they contact the patient (within 24hrs) to assess them for clearance from isolation.

Both processes are reliant on frequent GP review and data recording as LHNs must provide details of symptom history to DHHS.

Further details on GP use of these monitoring tools can be found on HealthPathways on the links to the right.

Northern Health - is providing ongoing monitoring of symptoms for low risk patients in their Covid19 positive pathways. Northern Health notify DHHS that the person is ready for clearance and provide the symptom history information and then DHHS contacts the patient to provide them with clearance.

Key Features of the local pathways

The hospitals in partnership with a community health service will be contacting patients, enrolling them into the pathway and performing a primary assessment.

The assessment process will allocate people into a low, medium or high risk category.

  • Low risk patients are defined in the model as those who have no or mild symptoms and no risk factors.
  • Medium risk patients and high risk patients are cared for by Austin or Eastern Health.

What can GPs expect

General practitioners will receive communication from a local community health service to ask to be involved in managing their own low risk COVID-19 +ve patients.

GPs will be asked to perform telehealth check-ins with all low risk COVID-19 +ve patients. All telehealth consultations will be bulk billed and funded through MBS, as per the MBS guidelines.

The monitoring period for COVID-19 +ve patients is 14 days. Detailed guidelines regarding frequency of monitoring, signs and symptoms that would require escalation of care are provided on HealthPathways Melbourne. Specific pathways for Austin and Eastern Health will be available with Northern Health and Monash Health coming online shortly.

Health services will each have a single contact number for GPs to seek advice on care and/or escalate care.

Community health services will provide social and welfare support to enable patients’ access to essential services and assist them in maintaining self-isolation.

EMPHN Sector Capacity and Workforce team will be reaching out to GPs who have a patient enrolled in the model to provide support and access to useful resources and tools.

Recorded webinar on 14 September with Eastern Health:

(Please note the recording takes place a several minutes into the video)

Calling for GP expression of interest

Are you a GP and are interested in caring for low risk COVID-19 +ve patients who do not have a regular GP and are being cared for within the community?

To find out more or to express interest, please email Alisha.Jackson@emphn.org.au