The AMA supports the proposed new standard but says GPs need more autonomy and communication.
The Australian Medical Association has made its submission regarding the Australian Commission on Safety and Quality in Healthcare’s new colonoscopy clinical care standard.
While the AMA is “generally supportive” of the changes to the standard, it indicated there were several areas where specific clinical guidance is not provided, and called for GPs to have “greater focus and autonomy” in this space.
“For patient who have a low surgical/anaesthetic risk and return a positive faecal occult blood test (FOBT), GPs… should be supported to directly book [a] colonoscopy for their patients,” the submission read.
The AMA pointed to New South Wales’ Direct Access Colonoscopy service as an example of how making it easier for patients to get a colonoscopy is beneficial for both the individual and the broader health system – provided the clinical governance of these models are made clear.
The submission also called for better linkage between primary care and the National Bowel Cancer Screening Program, with the AMA saying the national screening register should interface with all common GP software so treating practitioners can more easily access their patients’ results.
“In addition, when a patient returns a positive FOBT in the National Bowel Cancer Screening Program, the standards must guide the clinician/GP as to when the patient should be booked in for a colonoscopy based on the level of risk of bowel cancer. For example, whether the colonoscopy should be conducted 30 or 60 days post positive result,” the AMA said in its submission.
The use of artificial intelligence during colonoscopies also featured in the AMA’s submission, with the Association stating that the Commission’s documents “exhibit a notable lack of focus on the impact and potential applications of AI during colonoscopy procedures”.
The AMA acknowledged the incredible potential of integrating AI into healthcare, “provided it is used safely and effectively”, but felt the standards could address its use in greater detail.
“The new guidelines should specifically advise on how to safely integrate AI into clinical care or acknowledge another resource to do this, noting the rapid evolution in this field and the time required to refine AI processes in medical imaging,” the AMA wrote.
The care standard consists of nine quality statement and a collection of indicators to help ensure patients, clinicians and health service organisations can access, provide and implement safe and appropriate care.
The nine statements cover the entire colonoscopy journey, from the initial assessment and referral, ensuring informed decision-making and consent processes are used, how the procedure should be performed and how the results are reported as part of the follow-up process.
The revised standard is expected to be released in the middle of next year.
