Totalcare + SOGIE, SFCU and Personal Pronouns

Equipoise International is proud to announce that Totalcare 8.2 includes significant enhancements to support SOGIE, SFCU and personal pronouns.  These enhancements have been included not just to satisfy emerging legislative or regulatory requirements, but to provide the capability to capture and present sex, gender identity and gender expression in an inclusive, useful and efficient manner.

What do the acronyms SOGIE and SFCU mean? 

SOGIE is an acronym for Sexual Orientation, Gender Identity and Expression whilst SFCU is an acronym for Sex for Clinical Use.   

Why are SOGIE and SFCU important?

Inclusive patient care and communication is an important principle that is gaining increasing awareness in Australian healthcare settings.  State Health Authorities have either already instituted the capture and reporting of patient gender as distinct from patient sex or have plans to do so over the coming 12 to 18 months.  Professional organizations such as the RACGP have published fact sheets on the collection and recording of information about patient sex, gender, variations of sex characteristics and sexual orientation, and the AMA has published position statements on gender affirming care.  

What is changing in Totalcare to support SOGIE, SFCU and inclusive care?

Totalcare 8.2 includes new patient attributes that support the capture of Gender Identity, Gender Expression, Preferred pronouns, Sex for Clinical use, Sex at Birth and Sexual Orientation.  These new fields supplement the pre-existing patient sex attribute which is treated now explicitly as the administrative sex.

Screens from Appointments and Admissions to Registration, Tracking and Tasks have been enhanced to display available gender information and, if chosen and applicable, preferred pronouns.

The choices available in the new fields are drawn from a rich data set compiled from International and Australian sources.  The choices can be modified or extended by each Totalcare client to meet their needs.  

To support standardized interchange of the new patient attributes, Equipoise has mapped selections to Australian Bureau of Statistics (ABS) references sets and/or SNOMED CT Concepts Identifiers.

The Totalcare Document merge engine has been enhanced to support use of the new attributes, including the ability to choose the correct grammatical form of a patient’s preferred pronouns based on context.

What screen changes can I expect when registering a new Patient?

The screenshots below display how the new fields are presented in the Patient Registration screen.

The “Sex (Clinical)” field is used to define the patient’s sex for clinical use.  Totalcare Clinicals “Mozart” now displays this information prominently in the patient banner.

The “Identity” and “Expression” fields are used to capture respectively the patient’s gender identity and gender expression.

The “Pronouns” field is used to capture the patient’s preferred pronouns.  The selector also includes an option “Name only” to support people whose preferred pronoun is their name.


The “Orientation” field is used record the Sexual Orientation of a patient. This value defaults to ‘Not recorded’.

The “Birth Sex” fields is used record the sex at birth documented for a patient. 

Tooltips have been added to selectors to provide information on their intended use.

There are a lot of new fields, how can I efficiently capture this extra data?

Totalcare 8.2 supports initialisation of the new fields based on preference rules.  These rules include, for example, initialisation based on Australian cisgender norms.  When enabled, these rules make data entry very quick and efficient for the majority of patients, whilst still enabling variation when applicable.

What if SOGIE, SFCU or Pronouns are not of interest to my practice?

Equipoise recognises that the new Gender and Pronouns fields may not be of interest for some medical practices so whilst they are enabled by default, they can be disabled or hidden by preference.

More information

The Australian Government Guidelines on the Recognition of Sex and Gender can be viewed at https://www.ag.gov.au/rights-and-protections/publications/australian-government-guidelines-recognition-sex-and-gender

The AMA’s (Australian Medical Association’s) Health position statement can be viewed at https://www.ama.com.au/articles/lgbtqiasb-health-position-statement

The RACGP’s (Royal Australian College of General Practitioner’s) fact sheet on collecting and recording information about patient sex, gender, etc can be viewed at https://www.racgp.org.au/FSDEDEV/media/documents/Running%20a%20practice/Practice%20standards/5th%20edition/Collecting-and-recording-information-about-patient-sex-gender.pdf

To find out more about Totalcare 8.2 please contact the Totalcare helpdesk via email at This email address is being protected from spambots. You need JavaScript enabled to view it., call on 1300 239 477, or log in to the Totalcare support portal.

Totalcare + Real Time Prescription Monitoring

Equipoise International is proud to announce that Totalcare has successfully passed all conformance testing to support Real Time Prescription Monitoring (RTPM) for all Australian States and Territories.

RTPM integration is one of the new features in Totalcare 8.2 and continues to build on the prescribing enhancements introduced in Totalcare 8.1.

What is RTPM?

ADHA describes real-time prescription monitoring as “a nationally implemented system, designed to monitor the prescribing and dispensing of controlled medicines with the aim of reducing their misuse in Australia. The RTPM provides information to doctors (prescribers) and pharmacists (dispensers) about a patient’s history and use of controlled medicines when they are considering prescribing or dispensing these medicines.”

Each State and Territory manages their own uniquely named RTPM system. Totalcare Clinicals “Mozart” seamlessly directs queries to the appropriate RTPM system based on the prescribing practitioner’s location.

State

RTPM system

ACT
CanberraScript
NSW
SafeScript NSW
NT
NTScript
QLD
QScript
SA
ScriptCheckWA
TAS
TasScript
VIC
SafeScript
WA
SafeScriptWA

What is a monitored medicine?

The term 'monitored medicine' is used to describe all medicines within RTPM that are classified as 'high-risk' due to their potential for harm or unsafe use. The specific list of monitored medicines varies by state and territory. 

How does RTPM work in Mozart?

After the prescriber has chosen a controlled/monitored drug in the prescribing screen, a check is initiated for the appropriate RTPM system. This check includes,
• Patient demographics
• Prescriber details
• Practice location details
• Medicine information

The RTPM system responds with a 'traffic light' indicator and context data:

A ‘green’ notification indicates no known issues. This notification will be displayed for 5 seconds before automatically disappearing.

An ‘amber’ or ‘red’ notification requires the prescriber to access the RTPM System (via a web browser) to display details about the alert. This level of notification requires action before it can be dismissed.

When the prescriber clicks on the notification box, a web browser will open with the direct link to the patient in the relevant RTPM system.

More information

To find out more, visit the Department of Health and Aged Care website, which includes links to more information on the RTPM system used in each State and Territory.

To find out more about Totalcare 8.2 please contact the Totalcare helpdesk via email at This email address is being protected from spambots. You need JavaScript enabled to view it., call on 1300 239 477, or login to the Totalcare support portal.

Totalcare + Electronic Prescriptions

Equipoise International is proud to announce that Totalcare has successfully completed all the requirements and testing to support Electronic Transfer of Prescriptions (ETP).

Following several months of comprehensive formal testing with eRx and the Australian Digital Health Agency (ADHA), Totalcare 8.1 has been recognized as meeting the stringent requirements set out in the ADHA 3.0.1 conformance profile for electronic prescribing.

Totalcare is one of only a handful of Clinical systems that have successfully completed the rigorous 3.0.1 conformance requirements stipulated by the Australian Government for electronic prescribing.

Electronic Transfer of Prescriptions with Totalcare is included in Totalcare 8.1 and builds on the support for healthcare identifiers released in Totalcare 7, and the My Health Record in Totalcare 8. Totalcare 8.1 is available for use now.

What are some of the features of Totalcare’s Electronic Transfer of Prescriptions?

Underpinning the support for Electronic Transfer of Prescriptions has been a rewrite of all the prescription and medication screens in Totalcare Clinicals Mozart to support new prescribing capability.

  • Paperless prescriptions can be sent via SMS or Email to patients or their nominated carer.
  • Paperless prescriptions can be emailed or faxed to a pharmacy where applicable.
  • Medications included on a paperless prescription can be automatically added to a patient’s Active Script List Registry.
  • New capability to electronically cancel a prescription that hasn’t been dispensed, or cease any further repeats for a prescription that has been dispensed.
  • New capability to reissue an electronic prescription to a different SMS or Email contact, or resend it to an earlier contact.
  • New capability to identify a prescription as a “Script owing” or having an “Unusual dose”.
  • New capability on paperless prescriptions to include pharmacy instructions in free text, or with indicators such as “Retain repeats”, “Stage supply” or “Send to Dosing point”.
  • New capability to optionally record a reason for prescribing either as free text or as a SNOMED-CT coded reason.
  • New capability to specify where applicable an alternative route of administration for a drug.
  • New audit actions for prescriptions record when a prescription was created, uploaded to the My Health Record and/or eRx, sent to a patient, printed, amended, cancelled or ceased.
  • Support for State based Approval/Authority/Warrant numbers (collectively ARN – Approval Reference Number) when prescribing restricted substances in different Australian states.
  • Automatic inclusion of jurisdiction-appropriate annotations for prescriptions such as “for optometry use only”, “for dental use only” etc. based on the type of prescriber and the Australian State or Territory in which the prescription is written.
  • A new Prescriptions view has been added to the Clinical Workbench. The new view displays all prescriptions written for any patient and includes status icons displaying whether a prescription has been successfully sent electronically or whether there are warnings associated with it.
  • Transition support to enable progressive use of electronic prescribing capability in environments that include prescribers who are not registered with eRx, the Healthcare Identifier Service, or without multi-factor authentication support.

What are some of the features of the security enhancements in Totalcare 8.1?

A key component of satisfying the 3.0.1 conformance requirements for electronic prescribing is enhanced security functionality to better protect Totalcare clinical systems from unauthorized access.

  • Support for two factor authentication (2FA) using one time passwords and apps such as Google Authenticator, Microsoft Authenticator, Duo, etc.
  • Support for password policies including password reuse, password expiry, password complexity and minimum length.
  • Support for defining an inactivity timeout in Mozart before reauthentication is required.
  • Enhanced support for storing passwords using Australian Signals Directorate (ASD) approved algorithms.
  • Transitional support for the new security enhancements including user profile based requirements for 2FA, login grace periods and password policies.

What is meant by Electronic Transfer of Prescriptions?

Electronic Transfer of Prescriptions or ETP is the transfer of a digital version of a paper prescription to a recipient (usually the patient) through an electronic channel such as SMS or email.  It replaces the requirement for a paper prescription.

A paperless prescription is technically referred to as a Prescription ‘token’. The token is deemed to be the ‘Evidence of Prescription’ (EoP). The recipient of a paperless prescription presents the Prescription token to a pharmacy, who then use the barcode included on the EoP to retrieve the prescription from the NPDS or National Prescription Delivery Service.

Paperless prescriptions are also referred to as ETP2 prescriptions. An ETP1 prescription is a prescription that is electronically uploaded to eRx, supplementing a paper prescription provided to a patient that includes eRx barcodes. A paper prescription is a prescription printed on preprinted prescription stationery that is not uploaded to eRx or sent electronically to a patient.


Electronic Transfer of Prescriptions Resources

The Australian Digital Health Agency provides online training, webinars and resources for healthcare providers to learn more about electronic prescribing.

My Health Record Integration in Totalcare 8

Equipoise International is proud to announce that Totalcare has been successfully integrated with My Health Record following a comprehensive formal assessment. 

Rather than the typical “bolt on” incongruous interface, Totalcare’s development team has worked to seamlessly integrate My Health Record content within Totalcare’s rich document repository, and upload letters and prescriptions created in Totalcare’s clinical module “Mozart” into My Health Record without any additional steps.

Clinicians may choose between simply viewing information shared in the My Health Record, or downloading a copy of My Health Record documents into their local Totalcare document repository.  When downloaded, Totalcare displays My Health Record content in document lists, cumulative, timeline and review views with the same power and flexibility as locally created documents.

Letters and prescriptions generated locally can be seamlessly uploaded to the My Health Record when they are printed or sent.  Any changes or deletions to previously uploaded content can automatically be superseded or withdrawn from the My Health Record.

My Health Record integration with Totalcare is included in Totalcare 8 and builds on the support for Healthcare Identifiers released alongside Medicare Webservices in Totalcare 7. Totalcare 8 will be available for use in April 2023.


Feature Highlights

Access to a patient’s My Health Record is available after a clinician has verified the patient’s details and gained access to their My Health Record.  

  • Patient’s My Health Record access is automatically requested on opening a patient record in Mozart.  If a patient has restricted access to their My Health Record, a clinician may request access by providing the patient’s access code or in the event of an emergency, emergency access.
  • The status of the patient’s My Health Record is displayed in the Patient banner in Mozart.
  • My Health Record documents can be downloaded into Totalcare or viewed without saving.  Downloaded documents are saved into the Totalcare document repository and are included in the List, Cumulative, Timeline and Review views.  Downloaded My Health Record documents support the same document attributes as locally created documents.
  • A per user indication of which documents have been viewed.
  • Correspondence may be uploaded to the My Health Record by simply checking the “Upload to My Health Record?” checkbox in the Document print screen or eSend wizard.  This checkbox is preference set with a default of on.
  • If a letter is changed after it has been uploaded to the My Health Record, Totalcare may be preference set to automatically supersede the copy previously uploaded, prompt for the My Health Record document to be superseded or undertake no additional actions.
  • If a letter is deleted after it has been uploaded to the My Health Record, Totalcare may be preference set to automatically supersede the copy previously uploaded, prompt for the My Health Record document to be superseded or undertake no additional actions.
  • Prescriptions may be uploaded to the My Health Record by simply checking the “Upload to My Health Record?” checkbox in the Prescription screen.  This checkbox is preference set with a default of on.
  • Diagnostic requests may be printed with a checkbox “Do not upload to the My Health Record?”
  • A My Health Record generated Medicare overview is accessible from the Financials Navilist in the Patient record.
  • New preferences to control interaction with the My Health Record, choose views of interest and filter content.
  • Per-Provider rules for uploading content to the My Health Record
  • Per-Patient rules for uploading content to the My Health Record
  • My Health Record tabs are included on the Documents, Scripts, Medications, Immunisation and Reports views in the Patient Record including the customized clinical desktop.

What is the My Health Record?

The My Health Record is a secure shared digital place for storing health information.  An initiative of the Australian government, it is accessible by consumers and healthcare providers.  

Consumers have control over what information is included in their My Health Record and who can access it.  A consumer has the ability to permanently delete their My Health Record at any time.  

In February 2023, there were more than 23.5 million My Health Records.


My Health Record resources

The Australian Digital Health Agency provides online training, webinars and other resources for healthcare providers to learn more about My Health Record.

Any Questions?

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News

Totalcare + SOGIE, SFCU and Personal Pronouns

Equipoise International is proud to announce that Totalcare 8.2 includes significant enhancements to support SOGIE, SFCU and personal pronouns.  These enhancements have been included not just to satisfy emerging legislative or regulatory requirements, but to provide the capability to capture and present sex, gender identity and gender expression in an inclusive, useful and efficient manner.

Read More