GPs get the pip with QI
It has been years in the making and has suffered several unexpected delays, but the Department of Health's bright and shiny new general practice quality improvement incentive (PIP QI) arrived this week, and was promptly met with a chorus of disapproval from GPs.
The PIP, which replaces a handful of others and requires general practices to send quarterly reports to their primary health network (PHN) on the proportion of patients with 10 different clinical indicators, is worth the not insubstantial sum of up to $50,000 a year to practices.
PHNs are funding the use of two tools – Outcome Health's POLAR tool and PenCS's CAT4 – to extract de-identified data from clinical information systems, and practices are also required to take part in quality improvement activities in partnership with the PHN to receive the PIP payments.
All well and good but once a group of GPs began looking closely at how the program will work, they began to get a little nervous. Nervous about the security of the data being sent to 31 different organisations with uncertain data storage capabilities, nervous about the contracts they were being asked to sign and nervous about exactly what data is being extracted and how it is going to be used.
A group of high-profile GPs issued a letter this week under the auspices of the Australian General Practice Alliance calling for a rethink of the whole structure of the program. They have since been supported by some pretty big hitters in Ganesh Naidoo, national medical director of Healius, and its CEO of medical centres Tim Haggett, and Newcastle GP Craig Barnett, who gave this interview to local ABC radio (forward to 1:38:35).
Doctors Naidoo and Haggett sent us a statement in support of the open letter released by AGPA earlier this week. “We are supportive of the appropriate use of de-identified general practice data in quality improvement to improve health outcomes for patients,” they said.
“We share concerns outlined by the group, particularly the inability for clinic management to review data extracts prior to transmission.”
Another concern raised is that patients don't have the ability to opt out of their data being used and that general practices are responsible for getting the appropriate consent from patients. Some are questioning why the My Health Record isn't being used for this, as it has the required consent model included.
The government has defended the program, saying it was developed in consultation with the PIP advisory group (PIPAG), which is comprised of representatives from all of the primary care groups. The department also points out that 55 per cent of practices are already taking part in quality improvement activities with their PHNs, including the extraction of de-identified data.
Nonetheless, the issue is still going to bubble away. Mukesh Haikerwal told us this week that it all reminded him of that other PIP – the eHealth one – which also caused a minor revolt when changes to it were introduced as a carrot to encourage practices to use the My Health Record.
One of the problems then and now is that members of the PIPAG are sworn to secrecy so the thinking behind any changes is kept behind closed doors. Perhaps if there was a little more transparency in early discussions these regular eruptions of anger would not take place.
We'll have more on the PIP saga next week, along with some news on the Australian Digital Health Agency's program for medical specialist participation in the MyHR, and some interesting news coming out of eHealth Queensland, where the ieMR is under renewed scrutiny.
Last week, our poll question concerned Amazon's Alexa and whether you would trust her with your personal health enquiries. Nope, most people said. 88.5 per cent said no while 11.5 per cent okayed Alexa.
This week, our question is: Are you confident that PIP QI data will be secure if held by the PHNs?