Clinician Connect

Integrated healthcare in the COVID-19 era

By Dr Walid Jammal, General Practitioner, Western Sydney

22 Feb 2022 Reading time approximately

Like the rest of the health system, primary care (and specifically general practice) has had to adapt and find new ways to deliver healthcare to patients throughout the pandemic. Dr Walid Jammal reveals the impact of COVID-19 on general practitioners (GPs), and how greater collaboration across the health system is contributing to positive outcomes.

COVID-19 has disrupted all our lives. We have had to find new ways to connect, work, play, function and seek healthcare.

The heath system has, and will continue to, face many challenges. The first point of contact for a person’s healthcare needs is often primary care, and our sector has faced its own specific challenges.

As a GP, everything we would ‘normally do’ had to be reconsidered and changed. From the need to screen patients and wear personal protective equipment; manage exposures and contact trace COVID-19 cases; protect our vulnerable patients; deliver care virtually and embed electronic prescriptions and referrals into our systems.

Using these new systems and workflows in our practices, we now virtually manage as many of our patients as we possibly can. We constantly monitor changing public health and policy advice and support our staff to keep pace with current guidelines.

All of this had to be implemented while trying to vaccinate as many people as possible and dealing with the usual care needs of patients; in particular, managing their chronic diseases and helping them deal with more hidden aspects of the pandemic – like mental health.

With COVID-19 becoming so prevalent during the Omicron wave, primary care health providers needed to learn how to manage, guide, educate, monitor, treat and reassure our patients about an illness that had, for the better part of two years, created fear and concern.

A shared purpose for our patients

The need and urgency to integrate care across the health system has never been greater. To me, integrated care has always been about encompassing four key elements:

  • integrating systems
  • integrating information and data
  • integrating funding
  • integrating people.

Our practice has been lucky to have had the opportunity to demonstrate new shared care models with adults and children. These trials highlighted the foundational aspect of ‘integrating people’ – through trust and relationships.

From the primary care perspective, providing care is always about maintaining relationships with our patients as well as other healthcare providers across the entire health sector. To truly bridge the primary–tertiary care gap, we must all be able to learn from one another, adapt, communicate, share information, handover care and, most importantly, work towards a shared purpose – looking after our patients.

I purposely say “our patients” because every patient of the tertiary healthcare sector also has a primary care provider, which is most often their GP.

As stated by Dr Levesque in his editorial, patients don’t see a primary care or tertiary care system – they see one health system.

A collaborative approach to drive us forward

The Agency for Clinical Innovation (ACI) continues to provide leadership and guidance on the principles of healthcare co-design and ways of working together.

Throughout the past year, my GP colleagues on the ACI’s GP Advisory Group (and many others involved in various communities of practice) have had the pleasure of providing input and advice, designing protocols, workflows, patient information, clinical guidance, exposure management advice and GP education webinars.

This collaboration has involved all levels and pillars of NSW Health. I have never seen such wonderful, respectful, fruitful and rewarding collaboration between primary and tertiary care as I have in the last few months of the Omicron wave. We must strive to maintain this level of collaboration in the long term.

With the central role that primary care plays in coordinating care in the community, collaborating with GPs and primary care will always bring an important perspective and bolster the effectiveness of the entire health system.

If there is just one legacy of the COVID-19 pandemic, I believe this level of trust and collaboration across the NSW health system must continue. This gives us hope that we can achieve truly individualised patient-centred care (and care for the entire population), working as one system with one purpose – looking after our patients.

About Dr Jammal

Dr Walid Jammal is a GP in Western Sydney. He has been involved with testing and developing integrated care models for many years, both with NSW Health and the Commonwealth. He is Co-Chair of the ACI’s GP Advisory Group, Co-Chair of the Commonwealth’s Primary Care Reform Steering Group, and a Board Member of WentWest (Western Sydney Primary Health Network) and Western Sydney Local Health District.

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