Mental Health & Better Access Quality Improvement - Activity 5

August 7, 2026

The purpose of this activity is to ensure patients with a mental health diagnosis (particularly high-risk mental health patients, e.g. bipolar disorder and a Mental Health Treatment Plan) that require phone (level C or D) and/or videoconference longer appointments (level C, D or E) are identified and proactively offered MyMedicare registration supporting continuity of care and improved outcomes.

Note:

  • For Better Access telehealth services (including MHTPs), eligible patients must have had at least one face-to-face appointment in the previous 12 months with a GP or PMP.  
  • Phone level C and D appointments are only available to MyMedicare registered patients at their MyMedicare practice.
  • Phone and video level C, D or E appointment attract ‘triple’ bulk billing incentives for MyMedicare registered patients at their MyMedicare practice.

Preparation

  • Assemble your QI/data team: Include clinical, admin, and IT staff.
  • Back up your database: Always back up before making bulk changes.
  • Ensure access to POLAR or equivalent audit tool: For reporting and cross-checks.
  • Review relevant guides:
  • Best Practice Knowledge Base
  • Medical Director: Medical Director Help

Step-by-step guide

Step 1: Identify High-Risk Mental Health Patients with Current Diagnosis and MHTP

Best Practice Premier

  • Search for patients with a current mental health diagnosis and a MHTP in place:
  • Go to Utilities > Search > Patients.
  • Set criteria for mental health diagnoses (e.g., bipolar, schizophrenia, severe depression) and filter for those with a Mental Health Treatment Plan (MHTP).
  • Export or print the list for review.
  • Best Practice Knowledge Base

Medical Director

  • Search for patients with a current mental health diagnosis and a MHTP in place:
  • Go to Search > Patients.
  • Filter by diagnosis (e.g., bipolar, schizophrenia, severe depression) and by those with an active MHTP.
  • Export or print the list for review.
  • Medical Director Help

Step 2: Identify Patients Who Require/Prefer Telehealth

  • Review the list with clinicians to determine which patients are high-risk, have barriers to in-person care, or have previously indicated a preference for telehealth.
  • Identify which of those patients are currently registered or not registered for MyMedicare with the general practice.
  • Engage patients not registered for MyMedicare to voluntarily register as appropriate.
  • Add a flag or note in the patient record for those who should be prioritized for phone/video appointments.

Step 3: Schedule and Offer Telehealth Appointments

  • Contact eligible patients (via phone, SMS, or email) to offer a telehealth appointment.
  • Use recall or appointment systems to schedule and document telehealth appointments.
  • Provide instructions to patients on how to access phone or video consultations.

Step 4: Documentation and Follow-Up

  • Record all contact attempts, patient preferences, and appointment outcomes in the patient record.
  • Update the register to reflect telehealth appointments and any changes to the care plan.
  • Track the number of patients identified, contacted, and who attended telehealth appointments.
  • Reflect as a team: What worked? What could be improved for next cycle?

Key Tips and Resources

Summary Table

Step Best Practice Premier Medical Director
1. Identify MH patients with MHTP that require telehealth Utilities > Search > Patients Search > Patients
2. Flag for telehealth Add note/flag in record Add note/flag in record
3. Schedule telehealth Recall/appointment system Recall/appointment system
4. Document & follow-up Update patient record & register Update patient record & register
Download worksheet

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