eAssess: A reliable telehealth solution for regional psychiatric medicolegal assessments

eAssess: A reliable telehealth solution for regional psychiatric medicolegal assessments

In Australia, roughly one million people suffer depression and two million suffer anxiety and despite two decades of investment in improving mental health services, the mental health of Australians has not improved.

Unfortunately, people living in regional, rural and remote locations in Australia are at a significant disadvantage with access to mental health services substantially more limited than in major cities.

The introduction of reliable and robust telehealth networks across regional, rural and remote Australia has been one measure taken to improve how healthcare services are delivered to those living in regional locations, and MAG is pleased to play its part with the introduction of eAssess- our telehealth video conferencing service.

eAssess uses state of the art cloud-based technology to connect your claimants with Psychiatrists located anywhere across Australia. Unlike older video-conferencing technologies, MAG’s eAssess provides your claimant with a unique access code, making it easier to connect with assessing Psychiatrists from your rooms, the GP’s surgery, anywhere!  And the technology is more reliable too, meaning less drop-outs and a better-quality connection.

Strict protocols apply to ensure the integrity of the assessment is maintained, but now MAG helps you provide a better service for your clients by minimising unnecessary travel, distress, costs and inefficiencies. And when claimants are less anxious, they deliver a more reliable account!

Please see the FAQ on the attached for further information. For bookings or queries, please contact admin@medicolegalassessmentsgroup.com.au or dial 02 8090 7611.

New MAG Services: Book your IME’s, Clinical Notes, MRI’s and Factual Investigators all through MAG

New MAG Services: Book your IME’s, Clinical Notes, MRI’s and Factual Investigators all through MAG

MAG is pleased to announce a range of new services you can book directly with us:

  • MRI Services
  • Clinical Note retrieval
  • Factual investigators

Now there’s no need to contact multiple providers, to provide claimant details each time, or to track progress separately.

Simply contact MAG, provide your claimant’s details once, tell us which services you need, and we’ll do the rest. It’s that easy.

To make a booking or for more details please contact admin@medicolegalassessmentsgroup.com.au or call 02 8090 7611.

MAG eAssess

MAG eAssess

The MAG Team are delighted to release our online assessment tool, MAG eAssess which is now available for bookings.

Specially designed for regional clients, who find it difficult to travel, as well as those physically incapacitated in terms of travel, MAG eAssess brings the doctor to the client though online video conferencing, saving time and money for everyone.

MAG eAssess is a Web-based video application. No installation or account set up is required. It just uses your existing camera and microphone on via a PC or laptop. Participants will be invited through a secure invitation link, with a time and date, just like a regular appointment. At this point they will also sign a consent form for the session to be recorded.

Whether the client is in a regional location or in the city – this brings the doctor and the claimant together in a time and cost-effective manner.

For physical examinations this is organised at a local physiotherapy office with a registered physiotherapist who will supervise the entire physical assessment, liaising with the specialist via the web throughout.
For psychological assessments, all that is required is a quiet room with a computer, either in the claimant’s home or somewhere comfortable and private.
The complete audio and video files of the consultation are available upon request, these are securely stored on a cloud-based platform.

The benefit of an online system is that it allows multiple participants, such as an interpreter, to join in on the assessment without being in that physical location.
MAG eAssess also contains an on-line dictation feature which allows on the spot dictation of notes during or after the medical session. These notes are stored with the main files and allow for review before submitting the files to our team without using any extra tools.

As always, our report turnaround for these assessments is prompt and emailed within 5 working days, however should there be an urgent referral, we can work on a tighter timeframe.

With MAG eAssess you can access a full range of Specialists for Psychiatric, Psychological, Orthopaedic, Surgical, Neurosurgical or IMC reports for any claimant, anywhere.

Please contact us today to book your first MAG eAssess session.

Specialist | Dr Glen Smith

Specialist | Dr Glen Smith

BSc (Hons), MBBS, FRANZCP, Cert. Addiction Psych.,GradCert Forensic Mental Health (UNSW) | WIA MAA

  • Consultation Waiting Time: Appointments available 7-14 days in advance
  • Report Turn Around Time: Less than 7 days, urgent reports available on request.
  • Sample Report: Contact us today for a for sample report.
  • Locations Available: Brisbane and Sydney
  • Video assessments: Any regional area in NSW and Queensland.
  • Call 02 8090 7611 to book Dr Smith today

 

  • Visiting Medical Officer, Northside Clinic, Greenwich – Drug and Alcohol Program
    (2009 – Present)
  • Visiting Medical Officer, Northside West Clinic, Wentworthville – Drug and Alcohol Program (2009 – Present)
  • Medical Council of NSW, Council Appointed Practitioner
  • Approved NSW Health Opioid Pharmacotherapy Prescriber
  • WorkCover NSW Trained Assessor of Permanent Impairment
  • Member of Faculty of Addiction Psychiatry, The Royal Australian & New Zealand College of Psychiatrists (RANZCP).
  • Member, Australian & New Zealand Association of Psychiatry, Psychology and Law (ANZAPPL)
  • Member of the Australian Medical Association (AMA)

Dr Smith specialises in treatment of drug and alcohol problems and admits inpatients for detoxification and rehabilitation to the Northside Clinic, Greenwich and the Northside West Clinic, Wentworthville. He is an appointed practitioner to the Impaired Registrant’s Program of the Medical Council of NSW. He has expertise and experience in medicolegal psychiatry having prepared reports for criminal and civil matters and the NSW Coroner. He has over 20 publications in peer reviewed medical journals in the areas of mental illness, substance abuse and homicide.

Available in Sydney, Brisbane, Canberra, Coffs Harbour, Newcastle, Wagga Wagga and Albury and for Video Assessments for Regional areas of NSW and Queensland.

Call 02 8090 7611 to book Dr Smith today for your trusted and reliable, court ready Medico-Legal report delivered time efficiently.

Specialist | Dr Neil Cochrane

Specialist | Dr Neil Cochrane

Dr Neil Cochrane

MBChB FRACS |WIA GEPI | Neurosurgeon & Spinal Surgeon

  • Consultation Waiting Time: Appointments available 7-14 days in advance.
  • Report Turn Around Time: Less than 7 days, urgent reports available on request.
  • Sample Report: Contact us today for a for sample report.
  • Locations Available: Gold Coast, Brisbane and Sydney.
  • Video assessments: Any regional area in NSW and Queensland.
  • Call 02 8090 7611 to book Dr Cochrane today.

Dr Neil Cochrane is a Neurosurgeon specialising in the diagnosis and treatment of the nervous system. This includes treating brain injury, brain tumours, spine tumours, spinal injury and degeneration of the entire spine.

Dr Cochrane is a Consultant Neurosurgeon consulting in Southport, Gold Coast and operating at Sunnybank Private Hospital in Sunnybank, Brisbane in Queensland. He is Fellow of the Royal Australian College of Surgeons and he is committed to providing his patients the very best health care and spinal surgery.  Dr Cochrane has a particular interest in comprehensive spine surgery at all levels of the spine.  He specialises in minimally invasive spinal surgery, lateral and posterior lumbar fusion, cervical fusion and artificial disc replacement. While fully qualified in neurosurgery, Dr Cochrane has focused his practice on spinal surgery.

  • AMA (Australian Medical Association) Queensland – current member
  • Neurosurgical Society of Queensland – current full member
  • Neurosurgical Society of Australasia (NSA) – current full member

Dr Cochrane’s undergraduate education was at the University of Canterbury in New Zealand.  He completed his medical degree in 1996 with the University of Otago, New Zealand. On entering Neurosurgical training he worked in New Zealand, South Australia and Queensland.  He gained his Fellowship with the Royal Australasian College of Surgeons (FRACS) in Neurosurgery in 2007, and has based himself on the Gold Coast.   As a family man who believes in healthy living and life balance, he understands all the demands of life, work and family and therefore the need to manage a medical condition taking into consideration of all aspects of your physical health and your life.  Dr Cochrane has a philosophy of ensuring patients are educated regarding their condition. He will explore all options available to you and strongly believes in patient education so you can make an informed choice.  Dr Cochrane will present the information you will need providing non surgical and surgical options.

Available in Gold Coast, Brisbane and Sydney and for Video Assessments for any Regional area NSW and Queensland

Call 02 8090 7611 to book Dr Cochrane today for your trusted and reliable, court ready Medico-Legal report delivered time efficiently.

Specialist | Dr Michael Shatwell

Specialist | Dr Michael Shatwell

MB ChB Dip.Occ.Med. MCh(Orth) FRCS(Eng) FRACS FA(Orth)A | WIA MAA| Orthopaedic Surgeon

  • Consultation Waiting Time: Appointments available 7-14 days in advance
  • Report Turn Around Time: Less than 7 days, urgent reports available on request.
  • Sample Report: Contact us today for a for sample report.
  • Location Available: Sydney
  • Video assessments: Any regional area in NSW and Queensland.
  • Call 02 8090 7611 or to book Dr Shatwell today

Dr Shatwell gained Fellowship of the Royal College of Surgeons of England in General Surgery in 1979 following graduation from Liverpool Medical School in 1974. He then gained Fellowship of the Royal College of Surgeons of England in General Surgery in 1979 following graduation from Liverpool Medical School in 1974.  Specialising in Orthopaedic Surgery and gaining a Mastership in Orthopaedic Surgery in 1981.  Further orthopaedic experience included 5 years as a Lecturer in Orthopaedics at Liverpool University with clinical duties at the Royal Liverpool Hospital, Alder Hey Children’s Hospital and Halton General Hospital.

He was the Head of Department of Orthopaedic Surgery at Wanganui Hospital, New Zealand for 15 years, and was also the Branch Medical Advisor to the Wanganui Branch of the Accident Compensation Corporation of New Zealand from 1987 to 2001.  During this time he gained a Diploma of Occupational medicine from Auckland University in 2001.

Dr Shatwell has worked in Orthopaedic and Accident Surgery in Port Macquarie Public and Private Hospitals since 2002 and was appointed Associate Professor of Anatomy at the University of New England, Armidale in 2013.

Available in Sydney and for Video Assessments in Regional areas of NSW.

Call 02 8090 7611 to book Dr Shatwell today for your trusted and reliable, court ready Medico-Legal report delivered time efficiently.

Specialist | Dr Ian Dickinson

Specialist | Dr Ian Dickinson

MBBS FRACS FA Orth A | WIA MAA | Orthopaedic Surgeon

  • Consultation Waiting Time: Appointments available 7-14 days in advance
  • Report Turn Around Time: Less than 7 days, urgent reports available on request.
  • Sample Report: Contact us today for a for sample report.
  • Locations Available: Brisbane and Sydney
  • Video assessments: Any regional area in NSW and Queensland.
  • Call 02 8090 7611 to book Dr Dickinson today

Specialities, Expertise and Experience:  

  • Bachelor of Medicine, Bachelor of Surgery (M.B., B.S.) University of Queensland
  • Fellow of the Royal Australasian College of Surgeons (F.R.A.C.S.)
  • Fellow of the Australian Orthopaedic Association (F.A.Orth. A.)

Current Positions and Affiliations:

  • Senior visiting consultant orthopaedic surgeon, Princess Alexandra Hospital.
  • Visiting orthopaedic surgeon, The Wesley Hospital.
  • Visiting Professor, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • Board member Asia Pacific Musculoskeletal Tumour Society.
  • Committee Member Medico-Legal Society of Queensland.
  • Editorial Board, Journal of Orthopaedic Surgery.
  • Reviewer, Clinical Orthopaedics and Related Research.
  • Reviewer, Australian & New Zealand Journal of Surgery.
  • Board Member, Wesley, St Andrews Research Committee.
  • External Examiner, Indonesian Orthopaedic Association.
  • Deputy Chairman, WorkCover Regulator Tribunals.

Dr Dickinson has been an orthopaedic surgeon at Princess Alexandra Hospital in Brisbane for 25 years and established the Queensland Bone Tumour Registry, which he continues to chair. He is a councillor of the Royal Australasian College of Surgeons where he chairs the Professional Development and Standards Board. Dr Dickinson has been chair of the Princess Alexandra Hospital Orthopaedic Department and the Queensland branch of the Australian Orthopaedic Association and sits on the Queensland Orthopaedic Research Trust. He has sat on the Board of the Australian Orthopaedic Association and continues to visit Princess Alexandra Hospital and Wesley Hospital in Brisbane.

Available in Sydney, Albury, Brisbane and Melbourne and for Video Assessments for any Regional area of  NSW, Victoria and Queensland

Call 02 8090 7611 to book Dr Dickinson today for your trusted and reliable, court ready Medico-Legal report delivered time efficiently.

Specialist | Dr Hugh English

Specialist | Dr Hugh English

Dr Hugh English

MB ChB FRCS (Eng) FRACS (Orth) | AMS WIA GEPIOrthopaedic Surgeon

  • Consultation Waiting Time: Appointments available 7-14 days in advance.
  • Report Turn Around Time: Less than 7 days, urgent reports available on request.
  • Sample Report: Contact us today for a for sample report.
  • Locations Available: Brisbane and Sydney.
  • Video assessments: Any regional area in NSW and Queensland.
  • Call 02 8090 7611 to book Dr English today.

Current Positions and Affiliations:

  • Fellow of the Royal Society of Medicine
  • Fellow of the Australian Orthopaedic Association
  • Fellow of the British Orthopaedic Association
  • Member of the Australian Medical Association
  • Member of the Australian Arthroplasty Society
  • Member of the International Society of Hip Arthroscopy
  • Honorary Senior Lecturer, University of QLD
  • Certified Independent Medical Examiner
  • Approved Medical Specialist for WCC (NSW)

Dr Hugh English is our Hip, Knee, Foot, Ankle & Trauma surgeon.

Hugh is U.K. born and educated, and moved to Brisbane in 1990, completing his Orthopaedic training here.

He is the 6th generation Doctor in his family to have attended the same Scottish medical school (St. Andrews/Dundee) and a second generation Orthopaedic surgeon.

Dr English has undertaken extensive training both locally in Australia and overseas. His practice has a strong focus on patients with hip and knee concerns, in particular, reconstructive surgery of the hip and knee and arthritis.

Dr English runs a hip and knee clinic at the Brisbane Orthopaedic Specialist rooms in conjunction with an Orthopaedic Clinical Nurse to provide ongoing management of orthopaedic conditions; pre-theatre admission information sessions to ensure the best outcomes post surgery for all of his patients. Dr English has published and presented extensively and is involved in ongoing research of patients particularly with hip and knee orthopaedic conditions.

Available in Sydney and Brisbane and for Video Assessments for Regional areas of NSW and Queensland.

Call 02 8090 7611 to book Dr English today for your trusted and reliable, court ready Medico-Legal report delivered time efficiently.

 

Family and Criminal Reports

Family and Criminal Reports

SECTION 32 CRIMINAL LAW REPORTS

MAG provides Criminal Law reports in support of an application under Section 32 of the Mental Health (Forensic Provisions) Act. These reports are commonly used to divert those who suffer from mental conditions away from criminal penalisation and towards getting help and treatment they need.

A Section 32 can be granted in situations where someone was suffering from a mental condition at the time of the alleged offence, or can be shown to be suffering from an ongoing mental condition during the court proceedings.

If your client has been charged with an offence and the court makes an order pursuant to  a section 32, the effect of such an order is that your client will not be dealt with under the court system, but rather by a court-mandated mental health treatment plan and will not receive a criminal conviction for this offence.

FAMILY LAW PSYCHIATRIC REPORTS

MAG now have Psychiatrists who can provide dual reports for the Family Law Court in relation to parental access children to children.  Previously, this was largely provided by psychologists and social workers, however, we have recently seen a trend towards greater use of Psychiatrist reports.


For more information or call us today 02 8090 7611.

MedicoLegal Assessments Group and its affiliates do not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before engaging in any transaction.

Head Clash: concussion, mild, moderate or severe traumatic brain injury?

Head Clash: concussion, mild, moderate or severe traumatic brain injury?

If you pay any attention to the media, it would seem we have entered an age of prolific concussion and brain injury. The issue has been brought to the forefront, mainly through the coverage of concussions and their long term effects on sports people, with a focus on contact sports. But before we label the current incidences as a ‘concussion crisis’ with irrevocable consequences, it is important to know what a concussion actually is and how it differs from a mild traumatic brain injury (mTBI) or even a moderate to severe traumatic brain injury. Concussion and mTBI are often confused, even in medical literature, and the terms are often used interchangeably. However there are some important differences between the two.

According to the American Association of Neurological Surgeons, a concussion is defined as an injury to the brain that results in temporary loss of normal brain function. Concussions are usually caused by a blow to the head, acceleration or deceleration (whiplash), a projectile or an explosion. However this is not necessarily the criteria for a mTBI.

Dr Arthur Shores, a Clinical Neuropsychologist, points out the differences between the two medical conditions: ‘Concussion is the historical term representing low-velocity injuries that cause brain “shaking” resulting in clinical symptoms and which are not necessarily related to a pathological injury. In contrast, mTBI is part of a spectrum of injury severity that reflects a pathological injury. This is typically assessed by the Glasgow Coma Scale (GCS) and the Westmead PTA Scales (WPTAS and AWPTAS) that are widely used in emergency departments and brain injury units in Australia. The assessment of traumatic brain injury and classification of the severity of an injury is reflected both by the depth of disturbance in consciousness (coma), as well as the duration of post-traumatic amnesia (PTA).’

Mild TBI

The operational definition of mild TBI (Carroll et al, 2004) is defined by the World Health Organisation (WHO) Collaborating Centre for Neurotrauma Task Force on mTBI as follows:

‘mTBI is an acute brain injury resulting from mechanical energy to the head from external physical forces. Operational criteria for clinical identification include:

  1. One or more of the following: confusion or disorientation, loss of consciousness for 30 minutes or less, post-traumatic amnesia for less than 24 hours, and/or other transient neurological abnormalities such as focal signs, seizure, and intracranial lesion not requiring surgery;
  2. Glasgow Coma Scale score of 13–15 after 30 minutes post-injury or later upon presentation for healthcare.’[1]

Moderate to extremely severe TBI

Moderate TBI is defined by a disturbance in consciousness producing a GCS score of 9–12, and a period of persistent deficits in retaining new information and processing new memories (PTA) of 1–24 hours. Severe TBI is defined by a GCS of 3–8, and a period of PTA of 1–7 days. Very severe TBI is characterised by a period of PTA of 1–4 weeks. Extremely severe TBI is defined by a period of PTA of greater than four weeks. (Figure 1).[2]

Figure 1. Classification of traumatic brain injury severity.

Mild Moderate Severe Very Severe Extremely Severe
GCS

13-15

GCS

9-12

GCS

3-8

GCS

3-8

GCS

3-8

PTA

<1-24 hours

PTA

<1-24 hours

PTA

1-7 days

PTA

1-4 weeks

PTA

>4weeks

Concussion may be seen as a ‘minimal’ injury subset that falls below the threshold of mTBI (ie, GCS) score 13-15. This represents the majority of concussive injuries seen in sports (Figure 2).[3]

Figure 2. Sports concussion as minimal injury subset of mild traumatic brain injury.

McCrory-(2013)-Fig-jpg

 

 

 

 

 

 

Assessment of outcome

Recovery from a mTBI can vary, however generally speaking, the severity of the mTBI will have a direct impact on the likelihood of a positive recovery. Dr Shores states, ‘Concussion and uncomplicated mTBI generally lead to full recovery, however repeat concussions and complicated or more severe injuries can lead to long term functional impairment.’ Dr Shores advises caution and care when evaluating an injury, as there are dangers in both over-estimating and under-estimating brain injury severity, particularly based on duration of PTA. ‘Duration of PTA provides a guideline to the severity of brain impairment and has been shown to be a useful outcome predictor of cognitive-behavioural-social dysfunction, with longer duration of PTA predicting a worse outcome. A careful scrutiny of the results of existing measures is necessary in determining severity of the injury. In contrast to mTBI, Moderate to Very Severe traumatic brain injuries are expected to have more permanent neurocognitive disorder than would be expected in claimants with mTBI. Neuropsychological assessments are useful in determining the severity of the injury and evaluating the outcome,’ Dr Shores states.

If you need a neuropsychological assessment regarding a concussion or mTBI, please contact our experienced team at MedicoLegal Assessments Group.

[1] Carroll, L.J., Cassidy, J.D., Holm, L., Kraus, J., & Coronado, V.G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: The WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, S43, 113-125.

[2] Neuropsychological Assessment of Children and Adults with Traumatic Brain Injury: Guidelines for the NSW Compulsory Third Party Scheme and Lifetime Care and Support Scheme, 2013, MAA, Editor. 2013, Sydney.

[3] McCrory, P., Meeuwisse, W.H., Echemendia, R.J., et al. What is the lowest threshold to make a diagnosis of concussion? British Journal of Sports Medicine, 47, 268–271.