AGPN calls for PCEHR practice incentives

The Australian General Practice Network (AGPN) has urged the federal government to consider paying incentives to general practices to use the personally controlled electronic health record (PCEHR).

The AGPN's official position on the PCEHR states that general practices must be provided with an eHealth practice incentive payment to support the necessary infrastructure to establish the PCEHR.

It is also demanding that individual GPs receive a financial incentive to compensate them for the extra time taken to encourage patient confidence and to get their consent to participate in the system and to upload information into a shared portal.

AGPN chair Emil Djakic said in addition to the incentive payments, the Medicare Locals network must also be appropriately resourced to support GPs and practice managers to build the foundations and infrastructure needed to get the PCEHR up and running by and beyond July 2012.

"Medicare Locals are perfectly positioned to support the general practice sector to establish the PCEHR if funded to provide eHealth support officers, who can educate and support general practice to adopt and integrate the system," Dr Djakic said.

"These are the minimum requirements to support PCEHR uptake. With the right levels of flexible funding, Medicare Locals are also well placed to promote community awareness and build change-readiness among allied health, nursing and pharmacy professionals around the benefits of a PCEHR.”

When questioned about practice incentives at a Senate committee hearing into the PCEHR in Canberra on February 6, Rosemary Huxtable, deputy secretary of the Department of Health and Ageing (DoHA), said the system was being designed to be as easy to use as possible so that accessing the PCEHR was streamlined into normal clinical workflows.

Ms Huxtable said one of the objectives of setting up the eHealth lead sites was to better understand what the practical implications of the PCEHR would be for practitioner communities.

“One of the important things is what exactly is the requirement on providers in a practical sense,” she said.

“In terms of the design of the infrastructure, what we are seeking to achieve is ease of use as far as possible and having the software within practice management systems that enable a very easy upload and download of information so that it is not at all an onerous task and in fact is probably no different from what occurs now in the recording of notes etcetera.

“The second thing is that there is a range of investments that are already made into general practice. I think there is capacity to see them in the context of changing the healthcare delivery environment, including eHealth. Clearly, there has been a lot of investment already in computerisation, particularly of GPs.”

She said the department had established an eHealth payment within the practice incentive payments (PIP) system some time ago.

“If you exceed certain thresholds, you can access the eHealth PIP and the payments are up to $50,000 per year for a practice,” she said.

“We are in active discussion with the sector now about how those requirements may change in the future to take account of the PCEHR. The PIP becomes a potential financing flow-in for practices around eHealth.”

She said consultations under the the Medicare Benefits Schedule already include the taking of notes, the recording of notes and the creation of information about the patient, including some items that are specifically aimed at care coordination.

“We would see in a world where the PCEHR becomes part of the practice of medicine that the MBS would also cover the practice of recording notes and putting them into the practice management system, uploading documents etc,” she said.

“[W]here Medicare Locals fit and the sort of support that potentially can be provided to practices through Medicare Locals are important too. There are eHealth support officers that we have funded for some time within Medicare Locals that can support practices.”

However, Dr Djakic said the brunt of the work will fall to GPs and at this point, there is little incentive for the sector to adopt the PCEHR system.

“Most of the initial work involved in completing and uploading a shared health summary is up to the GP,” he said. “For every 15 minutes a GP is spending on the PCEHR, it's another patient the GP can't see.

"Magic 'wand waving' isn't going to make this happen; adequate funding and resourcing is what's needed to create the momentum to get this work done.

"The PCEHR will significantly progress the future of primary health care in this country. However, the Federal Government has to acknowledge that an improvement like the PCEHR needs some down payments.”

The Australian Medical Association (AMA) is also calling for incentives, telling the Senate committee hearing that it was concerned about the administrative burden on medical practices.

“Medical practitioners who decide to use this system will have to adapt their clinical workflows and train their staff to work within the requirements of the legislation,” AMA president Steve Hambleton told the hearing.

“Doctors will have to consider the impact of this additional workload and the changes to clinical workflow on the fees they charge their patients.

“The biggest impact will be on general practitioners. GPs will take on the role of the nominated healthcare providers and create and maintain the shared health summary … That will take time.

“It is only reasonable that patients should receive a Medicare rebate for this very important clinical service.”

Posted in Australian eHealth

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