1. Why do a case conference?
2. Requirements of a case conference?
3. How to initiate a case conference
4. Preparation
5. The case conference
6. Documentation
7. Contributing to a case conference

If you are a GP, why do a case conference?

• It enables you to match patient needs to services simultaneously during a discussion
• It is a formal link to other care providers and provides for interaction and input from team members at the same time
• It may be useful when there is a change in the patient's condition and simultaneous input is required from other health providers
• The summary from the case conference is a reference point for the health providers and the patient
• Contributions and responsibilities of the other team members is identified
• Case conferences may be applicable to hospital admission and discharge
• If there is an existing care plan, it is able to contribute to longitudinal care
• Five case conferences are able to be held in a 12 month period
• The case conference is not restricted by a patient's age

What are the requirements of a case conference?

• Refer to Medicare Benefits Schedule Book 1 Nov 1999 and supplement 1 May 2000. Additional information is available in the RACGP guidelines.
• A case conference is a discussion between the GP and 2 other health providers (who provide different services) at the same time
• The care providers are able to communicate face-to-face, by teleconference, video link or a combination
• The patient must have a chronic condition, require multidisciplinary care or have a terminal illness
• A case conference is NOT dependent on the age of the patient;
• The team will need to:
  
  
  • Discuss the patient's history
  • Assess previously identified outcomes
  • Identify the needs of the patient
  • Identify tasks and outcomes to be achieved
  • Allocate tasks to team members

• As a GP you may initiate a case conference or contribute to one initiated by another care provider
• The other health providers may be, for example:

Medical specialist	Social worker	Dietitian
Dentist	Optometrist	Occupational Community nurses
Home help	organisation	therapist
Aboriginal health worker	Audiologist	Physiotherapist
Community support groups	Continence Adviser	Podiatrist
Education provider	Respite care	Psychologist
Pharmacist	Meals on Wheels	Speech
Specific patient programs	Parole officer	pathologist
Patient support groups	Counsellor	Gymnasium
	Massage therapist

If you are a GP and wish to initiate a case conference

• A case conference is a discussion process where all the parties involved must be present at the same time
• The statutory requirements are found in the Medicare Benefits Schedule.
• Additional information is available in the 'Enhanced Primary Care Kit' sent to you by the Commonwealth Department of Health and Aged Care.
• 'At a Glance' contained in the Kit, summarises the case conference process.
• A case conference must include a GP and at least 2 other contributing members who provide a different service. The team members must be present for the whole of the case conference which can be face-to-face, video linked, by telephone or a combination of these.
• The patient must have a medical condition that has been or is likely to be present for at lease 6 months or that is terminal.

Preparation

• Discuss with the patient the benefits of a case conference
• Disclose to the patient any fees that will be incurred
• Obtain patient's consent
• Inform the patient of the need to share information with the other providers and ask the patient if there is any information they do not want shared
• Identify other participants for the case conference, a list of diagnoses/problems and the patient's health needs
• The patient and/or the carer can attend the case conference.

The case conference

• Discuss the patient's history
• Identify outcomes to be achieved by members of the case conference team giving care to the patient
• Identify tasks that need to be undertaken
• Allocate tasks to team members

Documentation

• The day, times and names of participants needs to be recorded
• A summary needs to be signed by the patient and a copy provided
• A summary needs to be given to team members
• A record needs to be kept with the patient's record
• You may claim Medicare Item Numbers
• 756, 749, 757 prior to hospital discharge
• 740,742, 744 for a non hospital case conference

If you are a GP and contributing to a case conference

• Ensure the patient has consented to the care plan
• Make sure the patient is aware of any costs involved
• Communicate with the team members for at least 10 minutes
• The GP should inform the patient that their medical history, diagnosis and care preferences will be discussed with the other providers and the patient may want to specify that some information be withheld
• The GP needs to obtain a copy of the case conference and keep it with the patient's record
• As a GP you may claim Medicare Item Numbers
  
  
  • 768,771,773 prior to a hospital discharge
  • 759,762,765 for a non hospital case conference