RACGP rejects moves to link MBS items to PCEHR uploads

The Royal Australian College of General Practitioners (RACGP) has urged the government to strengthen governance arrangements for the PCEHR and to expedite the establishment of the proposed Australian Commission for eHealth (ACeH), but has rejected suggestions that uploading documents be mandatory in order to claim certain MBS item numbers.

In a submission to the Department of Health on the PCEHR and Healthcare Identifiers (HI) Service legislation discussion paper, the RACGP says it strongly supports the establishment of the ACeH but would like more clarity around the transition arrangements and would also like the whole process to be expedited.

“Governance of the PCEHR should be streamlined and transparent and overseen by ACeH, which should be responsible and accountable for the whole PCEHR system including any product design and release,” the college says.

It wants more clarity on the appointment of an independent chair for ACeH and how its board will be selected, emphasising that it is important to choose people “who are seen by the health professions as credible and authoritative”.

The RACGP has also called on the government to focus the eHealth work program on improving the core PCEHR clinical documents relevant to general practice – the shared health summary and event summary – as well as medicines reconciliation and point-to-point, interoperable secure messaging.

“These are the core clinical value propositions for GPs and other clinicians and provide the platform for continuing engagement with the clinical community,” the college says.

However, it has come out strongly against mooted moves to mandate that GPs upload documents to the system in order to be able to claim certain MBS item numbers.

In its recent consultations with the sector on the potential legislative changes, the department raised the possibility that some payments, such as those for creating care plans, could be linked to uploading those care plans to the PCEHR.

“The RACGP supports voluntary participation by healthcare providers and will not support any mandatory requirement for uploading of any documents by clinicians to the PCEHR…” the college says.

“Any requirement to mandate the uploading of certain or specific document types to the PCEHR via changes to the relevant acts and MBS requirements will almost certainly be significantly counterproductive and have a negative impact and will inevitably result in many Healthcare Provider Identifier – Organisations (HPI-O) and clinicians opting out of the process.”

Instead, it supports new incentives such as an additional MBS item number for uploading a shared health summary, particularly for patients with multi-morbidities who are most likely to benefit.

On moving to an opt-out system, the college wants the ability to opt out to be available on multiple platforms – online, by phone or in person – and it also wants more education on the use of the existing access controls.

On a potential model, the RACGP says it supports the creation of a generic blank record and a trigger mechanism that patients would positively have to activate to allow health and Medicare information to populate the record. This might be initiated via a web-based portal, at a general practice or via a Medicare office.

However, it warns that a proper privacy impact assessment should be conducted and that patients need to understand that by not opting out, they are providing standing consent for providers to upload information to the PCEHR.

Posted in Australian eHealth


0 # Terry Hannan 2015-07-02 08:29
The statement "However, it has come out strongly against mooted moves to mandate that GPs upload documents to the system in order to be able to claim certain MBS item numbers" is but one of the many aspects of the PCEHR project that show its functionality is NOT linked to direct patient care but reimbursements. It reminds me of the wonderful statement by my colleague Prof Warner Slack of Harvard University. "Medicine is not a business. Our business is CLINICAL CARE".

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