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POAC funding of X-ray

An internal review of radiology cases claimed under POAC has highlighted many X-ray requests that do not align with the plain X-Ray HealthPathway  POAC funded X-ray should be reserved for same day imaging where results will inform immediate management and/or determine requirement for acute hospital admission.  To support claims, clinical notes submitted to POAC must include documentation of same—day review  of the X-ray result and the subsequent plan for patient care. &...

November 12, 2019

POAC funding awaiting ambulance transfer

Historically it has not been part of POAC’s remit to fund unavoidable admission i.e. admissions where, from the initial community assessment, it is clear that hospital evaluation is required.   In the current environment, delays in ambulance services continue to increase. This is particularly concerning with winter pressures and places additional resource issues on primary care facilities.   ...

August 31, 2019

Acute Pelvic Pain in Young Women

This pathway assists GPs with navigating through the causes of pelvic pain in young women to decide a provisional diagnosis and thereby refer to the correct service, or appropriately investigate and follow-up in the community. Please note there are limited indications for POAC-funded acute pelvic ultrasound –see (POAC pelvic policy); for publicly funded USS use access to diagnostics or DHB e-Referral if outside POAC criteria.View the full pathway for acute pelvic pain in women here...

May 28, 2019

Management of cellulitis accompanying an abscess

In January 2019 new pathways were published for Skin and Soft Tissue Abscess in Adults, Mastitis and Breast Abscess and Bartholin’s Cyst or Abscess. Communications were sent via Medinz and the POAC blog – click here to sign up Following review by the regional Antimicrobial Stewardship group please be reminded that any cellulitis surrounding an abscess should be managed in line with the cellulitis pathway (adults or children’s).  IV antibiotics are not funded by POAC for abscess m...

April 12, 2019

Changes to Hepatitis C Treatment

The Chronic Hepatitis C pathway has been updated for the newly funded direct acting antiviral (DAA) medication, Maviret™. Maviret™ is the recommended treatment in primary care for a majority of patients with Hepatitis C who do not have cirrhosis: Cure rate of 99% in primary care use.Only eight weeks of tablets once a day.Much simpler treatment to prescribe than previous funded medications.Very few drug interactions.Side effects usually minor and transient.Requires no on-treatment blo...

February 1, 2019

New Abscess Management Pathways

Auckland Regional HealthPathways has developed three new pathways for abscess management: Skin and soft tissue abscess in adultsBartholin's cyst or abscess Mastitis and breast abscess These best practice regionally agreed pathways have been developed with both primary and secondary clinicians and signed off through the regional Clinical Pathways Operational Group.  Please note the following main points: SKIN OR SOFT TISSUE ABSCESS Management of a skin or soft tissue  abscess is ...

January 31, 2019

Hospital Referral to Urgent Care/GP Clinic

When a patient attends Urgent Care with a hospital discharge summary stating for further POAC funded treatment, this includes the following principles: The Urgent Care clinic generates the POAC referral/case number when the patient attendsThe initial consult and all treatment for this episode of care should be invoiced to POACACC surcharges are funded by POAC, where relevantHyperemesis includes all presentations for duration of the pregnancyThere should be no cost to the patientAny queries pleas...

January 15, 2019

Christmas and New Year Holiday Period

Thank you for your support over the year, we look forward to an exciting 2019.   From our team to yours, Merry Christmas and a safe and happy holiday season! POAC HOURS OVER THE HOLIDAY: The POAC coordinators are taking a well deserved break over the Christmas and New Year period.  The office will close midday 21st December and re-open on Thursday 3rd January. Limited services will be available and someone from the team will be available for urgent phone calls.  Refer below f...

December 20, 2018

Pelvic Ultrasound Funding

Suspected retained products of conception beyond Section 88 funded scan time period. Persistent, heavy PV bleeding lasting more than 2 weeks following miscarriage or termination of pregnancy, or more than 6 weeks post-delivery, to rule out retained products of conception. For persistent but lighter bleeding a scan should be requested under Access to Diagnostics or via e-referral to radiology. Note that women within 2 weeks of miscarriage or termination of pregnancy, or within 6 weeks of delivery...

November 7, 2018

Rivaroxaban funding

In line with the Auckland Regional HealthPathway, when there is a delay in obtaining community ultrasound for DVT, Enoxaparin continues to be the medication to be administered and funded through POAC. The issue of using rivaroxaban instead of enoxaparin for anticoagulation coverage whist awaiting ultrasound for DVT was considered when the pathways were updated upon the PHARMAC funding of rivaroxaban. However, rivaroxaban use for this indication would be off licence and is not recommended by the ...

September 17, 2018

DVT Risk Stratification

A reminder that the first action for suspected DVT is completion of Wells Score. ONLY if <2 is a d-dimer required.  If score is 2 or more then proceed directly to request for ultrasound. Awaiting d-dimer delays the ultrasound request and this may not be necessary For full details, see the DVT pathway NB: If you are unable to login to Auckland HealthPathways site, please contact POAC 09 535 7218...

June 27, 2018

Antibiotics in sore throat and tonsilitis

Background In patients at low risk of rheumatic fever, antibiotics should only be prescribed if the patient is severely unwell. ≥ 70% of sore throats will be viral and do not need antibiotic treatment. For risk stratification and management of sore throat see sore throat and tonsilitis Where antibiotics are required they should be administered in accordance with the Heart Foundation guideline. Consideration should be given to the use of antibiotic syrup and an antiemetic if the patient is...

June 8, 2018

ECG funding under POAC

The following principles apply when considering ECG funding under POAC CHEST PAIN Patients who present with current pain and high suspicion of ACS - admit as per regional acute chest pain pathway. Any management awaiting ambulance transfer is standard care and POAC funding does not apply. Patients who present with current pain and low suspicion of ACS work up with POAC funding as per acute chest pain pathway. ECG must be accompanied by troponin testing, and with evidence of rapid (same...

April 16, 2018

NEW POAC Nurse Advisor

We welcome back to the POAC team Sarah Hyder in the role of POAC Regional Nurse Advisor. Sarah qualified as a registered nurse in 1993 and has held senior nursing positions in Auckland since 2004. These include Clinical Nurse Specialist in Haematology, where Sarah presented research at ISTH, Amsterdam in 2013 and POAC Nurse Leader from 2009-2013.Sarah has been with Auckland Regional HealthPathways since its inception in 2013, working as the Development Lead. During this time she has led the deve...

February 9, 2018

POAC Cellulitis Management Funding Policy

POAC aligns its funding with the best practice recommendations contained within the Auckland Regional HealthPathways. These recommendations have been agreed by primary care clinicians and hospital specialists across the metro Auckland region. This includes Infectious Diseases, Medical Specialists and the regional Antimicrobial Stewardship Group....

January 31, 2018

IV ferric carboxymaltose - funding update

Intravenous ferric carboxymaltose (ferinject) is now available fully subsidised for treatment of iron deficiency anaemia in the community, with Special Authority approval. POAC funding is available for administering the infusion for those residing in the Counties Manukau catchment where all criteria is met.   You can view the full clinical pathway, revised criteria and apply online for funding here View POAC information View regional clinical pathway View BPAC article...

November 30, 2017

IV antibiotics for paediatric Cellulitis

The IV antibiotics for Paediatric Cellulitis guidelines are now up on the live HealthPathways site here.Intravenous antibioticsFor cellulitis, consider intravenous antibiotics administered in the community for children aged ≥ 10 years who are stable but not responding to oral antibiotics (review full pathway for details). This is funded by POAC.  Review exclusion criteria and if uncertain, seek paediatric advice.Treatment:IV ceftriaxone 50 mg/kg/dos...

November 22, 2017

POAC funded ECGs - The ins and the outs

1.       Investigation of current/recent chest pain with possibility of acute coronary syndrome (ACS) – low risk of ACS but diagnosis still under consideration.  See Acute Chest Pain HealthPathway. https://aucklandregion.healthpathways.org.nz/27916.htm.  ECG must be accompanied by troponin testing, and with evidence of rapid follow up of ECG and blood results (re safe management).  POAC does not cover if admission inevitable (ie clear ACS needing ad...

August 17, 2017

Hepatitis C Treatment Primary Care Reimbursement

Funding has been allocated for the provision of integrated Hepatitis C Services.  The Primary Options for Acute Care (POAC) service will be the mechanism for distributing the funding to GPs across Auckland Metro who provide Hepatitis C treatment in a primary care setting. GP Reimbursement A single extended consult per patient can be claimed up to the total amount of $115.00 (including GST).  There is to be no patient co-payment charged.  Payment for treatment of Hepatitis C by a...

July 10, 2017

Opioid Substitution Therapy Funding

From 1 May 2017 authorised GPs who provide Opioid Substitution Treatment (OST) to patients can claim a reimbursement for a fixed number of patient/GP visits per year. This service is only for patients who are identified as stable and suitable to receive this care from an authorised GP by the Community Alcohol and Drug Service (CADS)/Auckland Opioid Treatment Service (AOTS).The Auckland metro DHBs have agreed to fund :4.5 (four and one half) visits per patient/service user, per year, for those on...

May 31, 2017

Frequently Asked Questions

Who is eligible? When to initiate POAC? When should the patient be discharged? What services can and cannot be claimed? How much to claim? The answers to many of your questions regarding the POAC service can be found in our recently updated FAQs. Please download the FAQs document and have a read. Ensure the rest of the practice team are familiar with the funding criteria too to avoid delayed or declined claims. If you have any further questions or would like to schedule practice tr...

November 3, 2015

Latest POAC News

Click on image below to view latest POAC news online ...

October 22, 2015

New POAC Claiming Schedule

In response to your feedback, the POAC claiming schedule has been reviewed and updated. The aim has been to further standardised fees and make the claiming process more streamlined. The revision has a strong focus on supporting and aligning with regional clinical pathways and POAC guidelines and policies. As always, we value your opinion and welcome any feedback - please email poac@easthealth.co.nz ...

October 1, 2015

Antibiotics in Community Acquired Pneumonia

POAC supports the Auckland Regional Clinical Pathway (ARCP) for Community Acquired Pneumonia (CAP) which can be found on our website, www.poac.co.nz under clinical guidance, or at http://aucklandregion.healthpathways.org.nz (contact POAC or your PHO for user name and password). The pathway recommends oral antibiotic therapy rather than IV therapy for the management of CAP in the community. The rationale for this is given on the pathway as follows: Cure of bacterial infections as the result...

September 23, 2015

New Pyelonephritis Guideline

A new guideline has been developed to support community management of Pyelonephritis. Funding will be available through POAC to administer intravenous Gentamicin for patients who meet the criteria outlined in the guideline (see link below). Feedback or questions can be emailed to the POAC Clinical Director helenl@easthealth.co.nz ...

September 10, 2015 Posts 1-25 of 28 | Page next
 

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