Plibersek gives way on pay for PCEHR

The federal government has acceded to the demands of doctors' groups to be adequately remunerated for work on the PCEHR, announcing at a function in Canberra this evening that doctors can count time spent on a patient's PCEHR towards the total time of the consultation.

The government had previously stated that doctors could only claim longer MBS item numbers if the clinical complexity and duration of the consultation warranted this, without any consideration for the amount of time spent on the PCEHR.

Some doctors groups such as the Australian Medical Association (AMA) and the former Australian General Practice Network (AGPN), now known as the Australian Medical Local Alliance (AML Alliance), had called on the government to create new MBS item numbers specifically for PCEHR work.

While the government has not done this, Health Minister Tanya Plibersek told the AMA's annual parliamentary dinner in Canberra this evening that doctors could use the time spent on a consultation that included the curation of a PCEHR as the sole determinant of whether a Level B or Level C item number would be applicable.

Explanatory notes now accompanying the MBS state:

Creating and Updating a Personally Controlled Electronic Health Record (PCEHR)

The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:

  • Reviewing a patient's clinical history, in the patient's file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient's care by other providers; or
  • Preparing an Event Summary for the episode of care.

Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities. When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.

MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service."

Ms Plibersek also announced that changes to the eHealth Practice Incentive Payment (ePIP), due to come into effect in February, will be pushed back until May.

The new rules for the ePIP will require practices to participate in the PCEHR program or become ineligible for the incentive. The payments will also require practices to have secure messaging capability, electronic transfer of prescriptions (ETP) capability and NASH certificates and to provide GPs with access to a range of electronic clinical resources.

Industry sources have told Pulse+IT that the ePIP rules will be much more demanding than in the past, with previous ePIP and IT/IM benchmarks having only minimal effect on general practices. GP desktop software is being prepared to interface with the PCEHR and will start to be rolled out next month.

It also appears that an agreement has been made between the Department of Health and Ageing (DoHA) and the AMA, the RACGP and doctors' indemnity insurers over the participation of healthcare providers in the PCEHR.

The doctors' groups and insurers had strongly rejected the original terms and conditions of participation, saying the conditions were too onerous and laid too much liability for potential privacy and security breaches on practices.

A range of participation agreements have now been posted on the www.ehealth.gov.au website, and Pulse+IT understands that doctors' groups are in general agreement with the terms, but have reserved the right to revisit this stance at a later date.

AMA president Steve Hambleton said in a statement that the government had “provided important policy clarity and greater incentives for GPs to become fully engaged more quickly” with the PCEHR system.

“The government has clarified that additional time spent by a GP on a shared health summary or an event summary during a consultation will count towards the total consultation time, and that the relevant time-based GP item can be billed accordingly,” Dr Hambleton said.

“The Minister has tonight fully explained how doctors can now safely and confidently provide new PCEHR clinical services such as a shared health summary under current MBS items.”

Dr Hambleton said the changes would allow doctors more time to make the transition to the new eHealth environment in their practices.

“The activity that is required to create and maintain a shared health summary is a new clinical service for doctors that will need to be factored into current clinical practice,” he said. “The work involved in creating an event summary will also have to be factored into clinical practice.

“These activities are clinically relevant services that will require extra work for the doctors who choose to provide them.

“Tonight’s announcements are significant incentives for doctors to take part. The government has delivered a catalyst to accelerate the implementation of the PCEHR.”

Posted in Australian eHealth

Comments   

# Anthony 2012-08-24 05:21
It seems that finally things are moving in the right direction, it's all slowly coming into place, incentives for uptakes, abilities to bill apropriately, and indemnity insurers getting on board. The ePIP will be a substantial sell point for the uptake of the system, because lets face it, who doesn't want to receive up to $50,000 for doing, not that much! Most GP's have a majority of the requirements already implemented, and others will be built into software by prominant vendor software packages, so GPs let's get to it! As a consumer i'm looking forward to having my health information securely managed and accessible for the right person, at the right place at the right time!
# Linda Tippiing 2012-08-26 06:53
Our local Division of General practice has been helping us all set up for this to happen, but unfortunately the program for safe electronic email that was recommended and installed has a conflict with ordinary email and has to be fixed in the software's next release. It all sounds good in theory, but I feel we have a very long way before it is off the ground.

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