Designated
Aviation Medicine Examiner/Designated Aviation Ophthalmologist
DAME
Newsletter
August 2002
- Medical forms
- Filling out medical forms
- Vision testing
- Change of date for seminar at Marriot Hotel, Sydney
- Elenore Karpfen - MRS Online
- Response to "Call up for Australian DAME's/DAO's whom perform Overseas Medicals"
- Attendance at DAME/DAO seminars by staff
Acknowledgment
DAMEs/DAOs should confirm receipt of this Newsletter, noting their DAME stamp number, per return email to powell_t@casa.gov.au. Alternatively, please fax confirmation of its receipt to CASA AvMed at (02) 6217 1640
Distribution
DAMEs/DAOs should read and digest the contents of this Newsletter, retain it for future reference, and make relevant sections of it available to other staff members who have dealings with CASA on behalf of practice principals.
The PMO's Column
Ophthalmic examinations of applicants
ICAO and CASA prescribe ophthalmic standards for all categories of medical certificates. Australia’s creation of positions for Designated Aviation Ophthalmologists (DAOs) was consistent with best practice in that it ensured excellence in refraction for initial class 1 and class 3 applicants, facilitated early detection of conditions which might later limit an applicant’s career longevity, and promoted ready access by applicants to treatment of amenable ophthalmic conditions of aeromedical concern. The 2001 update of ICAO ophthalmic standards (which will be incorporated in CASA’s revised medical standards), for the first time, mandated pre-certification ophthalmic review of all applicants with high refractive errors or who have undergone refractive surgery.
In a number of remote areas of Australia, the paucity of specialist ophthalmologists has led to a de facto acceptance that required original and review CASA ophthalmic assessments may be undertaken by optometrists. Additionally, CASA has recognised the particular expertise of a small number of academic or specially qualified optometrists it has approved to undertake these examinations and whom it consults for advice on some specialised refractive or other issues from time to time. Effective immediately, all DAMEs need to be aware that applicants for class 1 or class 3 certification whose uncorrected distant visual acuity in either eye is worse than 6/60 must be assessed by a DAO or a CASA-approved optometrist prior to original / next medical certification, and periodically thereafter as directed by CASA. Also, applicants for class 1 or class 3 certification who have undergone refractive surgery must be assessed by a DAO or a CASA-approved optometrist an ophthalmologist prior to original / next medical certification.
Changed administrative requirements
Yes, the on-line medical has been a long time coming. Unfortunately, it has not been possible / cost-effective to produce updated versions of the existing hard copy examination forms to reflect changes introduced over the last two years, although these changes will be incorporated in the MRS Online medical forms. Meanwhile, DAMEs are reminded that:
- the maximum permissible diastolic BP is 90 mm Hg; and
- fasting blood glucose estimation is required whenever serum lipids are required.
Continuing professional education for DAMEs
There has been no dissent notified to the relevant proposal advanced in the last DAME Newsletter. Initially, CASA will require all DAMEs to attend an approved training course at least once every two years. Generally-approved courses will be listed on the CASA website. DAMEs may apply to have other appropriate courses recognised on a case-by-case basis. Further requirements may be determined in future, following full consultation with AMSANZ and other interested groups.
Note that the International Congress of Aviation & Space Medicine 2002, because of its duration and high level of academic content, has been approved as meeting DAMEs’ continuing education requirements for 4 years.
Feedback welcome
DAMEs’ suggestions have led to a number of recent improvements in CASA’s practices and procedures, including the revised Coronary Artery Risk Factor Prediction Chart released in August 2002, together with several new chapters for The DAME Handbook. CASA values constructive suggestions and implements them whenever appropriate.
Administrative Matters
Medical Forms
You may have noticed it can be difficult to tear off the top of the medical forms.CASA is liaising with J S McMillan Ltd (the manufacturer) about this problem and will give an update in the next Newsletter.
Filling out Medical Forms
A few medical forms have come in recently that have been hard to scan because answers have been crossed out if not applicable. Please do not cross out answers as this increases the time required to scan and assess a medical report, also may lead to errors of interpretation.
Also, please remember to complete details of blood pressure reading and blood glucose level when required. The blood glucose requirement is fairly new and will be included specifically in the forthcoming MRS Online.
Vision testing
Please remember to ask all applicants if they are wearing contact lenses. If they are and they require an Original Medical, you must complete testing with and without correction. For a Renewal Medical, testing with correction will suffice.
Change of date for seminar at Marriott Hotel, Sydney
The NSW Branch AMSANZ seminar at the Marriott Hotel in Sydney has been changed to Saturday October 26 and Sunday October 27 due to accommodation there being booked out for another event.
DAME Handbook
There are three new chapters in the DAME/DAO Handbook, 2.6 Psychiatry, 2.13 Medication – Drugs and Flying/Controlling and 2.14 Malignancy. Psychiatry has been updated, as has the 2.13 Medication. Malignancy is a new chapter, whose interpolation has caused Differences between Australian Medical Certification and ICAO Medical Certification for International Operations to be renumbered to 2.15.
The Coronary Heart Disease Risk Factor Prediction Chart has also been updated.
The revised DAME Handbook can be viewed at http://www.casa.gov.au/manuals/regulate/dame/index.htm.
Please ensure that you and your staff read it, and keep a copy on hand for future reference to ensure we are all ‘singing from the same hymn sheet’.
Medical Records Systems (MRS)
Elenore Karpfen - MRS Online - Project Manager's Update
Status and Schedule
As you may have noticed after my last update, we did not meet our target for DAME testing of the system in late June/early July. After almost getting into internal testing of the new system, we hit a technical issue that was harder to solve than we anticipated, and this has put us back several months. In brief, the problem arises from the need to be able to allow you to access the applicant's previous medical records, and also to send CASA attachments, while at the same time protecting the CASA network from unauthorised access. If we gave you access the easy way, it opens CASA up to outside attack. So our developers have had to be more devious in meeting this requirement and it has proven to be a tough nut to crack.
However, we believe we have now solved it, and we are now back on track. We are expecting to have the system available for external testing in September and for use in real life situations in October / November. Full implementation, when all medicals will be done using the new system, will be in the first half of 2003.
Implementation - managing the changeover
We are planning to pilot the new system, making it available to a limited number of DAMEs initially, prior to a full implementation.
This pilot will run for at least 3 months, and we will gradually increase the number of DAMEs able to use the system over this period. This will allow us to monitor the new system in a more controlled environment. During this time, it will also be possible to continue using the current forms and process.
However, you will have seen that in some cases the questions on the online form are very different to the paper form. This has meant that we have had to make a lot of changes to the CASA systems that store and process those forms. There will be two different databases during the pilot, one for the old system and one for the new. At the start of the pilot both databases will contain the same records, but during the pilot new medicals will be added to one or the other, depending on whether the medical was done using the paper-based form or the online system. At the end of the pilot it will be necessary to merge the two databases again, so that there is one complete record of all aviation medical examinations. After this it will not be possible to process a paper-based form.
Therefore, please be aware that from the date of full implementation you will only be able to perform aviation medical examinations using the new online system.
Using the new system
We will provide documentation to help you use the new system, but there will be some operational differences that I would like to draw your attention to now:
- applicants must have an ARN before they attend for their first medical. We will be advertising this fact with the Flying Schools, but we also recommend that you instruct your support staff to request the ARN at the time the appointment is made. Doing this will also allow you to download the tailored form before the time of the medical
- it will still be necessary to get a signed declaration from the applicant, along the lines of the declaration on the paper-based form. The new applicant declaration also takes in the requirements of the Privacy legislation and runs to over one page. You will be able to print a tailored declaration form after you have requested the medical. You will need to obtain the applicant signature and then post or send the form to CASA electronically. The tailored form will contain sufficient information to enable CASA to match it to the medical. No certificate will be issued until the signed declaration has been received.
- we will provide feedback on whether the medical has passed and any documents you request to your email address, not through the application. This has been necessary to deliver the appropriate level of privacy and security, however it also means that we need to have your current email address whenever a medical is processed. We will be providing a facility through the application to allow you to advise any change in your email address.
Demonstrations of the new system
I will be at the following DAME Information sessions, where I will be demonstrating the new system. I will be happy to answer any queries and concerns at these meetings, or if you contact me at karpfen_e@casa.gov.au
- DAME Aviation Medicine Seminar: Adelaide - 17 August 2002
- DAME Aviation Medicine Seminar: Perth - 19 October 2002
Continuing reminder to apply for your i-Key
Once again I encourage everyone who has not yet done so to apply to the Health e-Signature Authority for an individual healthcare certificate. This will be absolutely vital to enable you to use the new system.
To apply for a certificate you will need to send HeSA:
- a signed copy of the Gatekeeper Individual Healthcare Agreement
- a completed Identification Reference form, including details of the Acceptable Referee (who can be another medical practitioner)
- copies of identification documents adding up to at least 100 points (so that would be one from the primary identification documents group plus one from Group 1 or Group 2 of the secondary identification documents group OR 2 from Group 3 of the secondary identification documents group listed on the Identification Reference form)
These will be processed, and you will receive an I-key and a PIN separately.
You can download the forms from the HeSA web site, or I can email them to you if you prefer. And if you have a Medicare Provider Number there will be no charge associated with applying for the i-Key.
Greetings from Tara
Welcome to the August 2002 DAME Newsletter. CASA anticipates that future newsletters will be coming to you more frequently.
My name is Tara Powell and I am the new DAME Liaison Officer working with Netty Coan to provide support and service for all of you.
I have worked in administration, public relations and journalism previously exposing me to many interesting situations. These experiences will help me to understand your position, so please don’t hesitate to contact me with any suggestions on powell_t@casa.gov.au.
As Elenore Karpfen mentions above, MRS On-line is progressing, with testing coming soon. DAMEs are again invited to have input into the new system, which will make life easier for you and for CASA.
Netty and I are available to help you learn about and adjust to using the new system so feel free to contact us.
Also please advise us in writing of any change to your email or postal address at powell_t@casa.gov.au.
Response to "Call up for Australian DAME's/DAO's whom perform Overseas Medicals"
Dr Ian Marshall responded to our call, he performs medicals for Transport Canada and Department of Transport and Civil Aviation Papua New Guinea.
These details will be published on the CASA Web page.
Feedback
Attendance at DAME/DAO seminars by staff
CASA recently received a suggestion following a seminar about the possibility of bringing surgery staff along to future seminars.
Following up on this, CASA has arranged for staff to attend seminars and meetings with DAMEs and DAOs “at cost”. This will vary with the venue, but is intended only to cover the cost of catering for more people.
More information will be provided when the costs have been worked out for future seminars.