Re-thinking general practice beyond the clinic walls
Dr Gaveen Jayarajan (MediRecords) shares how mobile, cloud-enabled practice models can expand access, improve efficiency, and support sustainable care for older Australians.
Can you please give a brief overview of your career to date, including qualifications and career pathway?
I graduated from The University of Melbourne in 2003 then worked in public and private hospitals as a resident and locum doctor for 4 years before starting my GP training, which I finished in 2010. I then worked full-time in several GP clinics till 2017, after which I moved to focus on full-time work in aged care, only visiting residential aged care facilities as part of a mobile GP practice. In 2022 I started my own solo mobile GP practice, Doctors in Aged Care, and continue this work today.
This year we became one of the first AGPAL-accredited mobile GP practices in Australia, accredited under the RACGP 5th Standards as a non-traditional practice without a physical premises/consulting rooms.
Doctors in Aged Care also has a dedicated Facebook Group with over 2700 doctor members where peer-to-peer learning and discussion occurs about all things related to aged care from administration, Medicare, clinical and organisational aspects.
What is the product/work you are using/leading?
I use MediRecords as my clinical and practice management software as it gives me much greater reliability and speed working in mobile settings and without relying on remote access connections to access server-based software. It also provides much greater security along with automatic backups and ensures my IT costs are kept to a minimum by avoiding the need to pay for expensive third party IT service providers and maintaining hardware such as servers.
I also use Snapforms for various online forms that integrate directly into MediRecords and can auto-populate fields — for example, using an online new patient registration form that automatically creates a new patient file in MediRecords with certain demographic fields populated and a copy of the form automatically uploaded to the Correspondence tab.
I don’t use any AI software at present, but I do use a text shortcut software called Phrase Express to speed up my note-taking significantly.
Image supplied by MediRecords
What do you see as some of the enablers and barriers to health innovation in primary care in Australia?
Enablers include the current economic climate with rising costs across the board meaning we need to find new ways of doing things in order to be leaner, more efficient and thus more financially sustainable. I think there is openness to such innovation amongst the GP community.
Barriers include current operating models where GPs are operating their own independent medical practices within a common physical premises with the Practice Owner providing administrative and support services. Owners somehow need to cater to the needs of these individual GPs running their own practices and be able to customise their offering to each GP without increasing their costs too much.
A significant change — like a change of practice software — is harder to achieve in this situation as buy-in from many independent doctors is needed, who won’t necessarily see any direct financial benefit if their services fees remain the same and may be resistant to alterations to their usual workflows.
What do you think the future of general practice looks like?
I think the future of general practice will need to move towards one that is underpinned by modern cloud-based software that is more secure, scalable and interoperable. One where face-to-face visits are complemented by phone and video consultations as well as asynchronous communications via cloud-based patient portals, where patients have more access and visibility over their own patient health records.
It will incorporate new operating models such as the use of more virtual or remote administrative and support staff to reduce operating costs and improve financial sustainability. GPs must expand their service offerings and become more accessible to counter the effects of the Telehealth/Online-only providers that are providing more convenience to patients, but without the continuity of care that patients should expect.
Image supplied by MediRecords
Why is it important GPs are involved in health innovation/new technology design?
GPs should be involved in the early stages so the products built are fit for purpose and designed with fewer iterations and ultimately lesser time and cost. Incorrectly designed software will get very little traction amongst GPs, who will not have the time to see patients and adjust to this with work-arounds.
What would you say to early career doctors about general practice/primary healthcare?
Early career doctors should ensure they get the broadest exposure to General Practice through the different medical centres they work in, and later on consider sub-specialisation into a niche area that suits their interests and abilities and meets their financial and lifestyle objectives and family needs.
Let the work fit into your life, not the other way round!
