Upgraded eHealth PIP under consideration: DoHA

The Department of Health and Ageing (DoHA) is currently consulting with stakeholders to consider an upgrade to the Practice Incentives Program (PIP) eHealth payments.

While there is no detail as yet and a decision has not been made, a DoHA spokeswoman said “consultation is currently under way to upgrade the current Practice Incentive Program payments to encourage the adoption of upgraded software that will contain PCEHR capability”.

According to Health Minister Tanya Plibersek, the government invested around $85 million in the PIP eHealth incentive in 2010-11, with around 4200 general practices receiving up to $50,000 each.

“These practice incentive payments have ensured that over 95 per cent of GP are using computers and the Internet,” she said.”

GP groups have been pushing for additional incentives through the PIP as well as an expansion of MBS claiming to cover the extra workload entailed in managing and uploading to a patient's PCEHR from July 1.

Ms Plibersek announced yesterday that GPs will be able to claim the longer consultation items such as the $69 or C level benefit for consultations that involve taking a detailed medical history for more than 20 minutes, and the $101.55 D consultation item for consultations of more than 40 minutes.

She said Medicare would look at the use of longer consultation items as appropriate “in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history”.

The DoHA spokeswoman confirmed that general practices currently involved in the wave 1 and 2 eHealth sites for the implementation of the PCEHR do not receive any additional payments for creating shared health summaries for the PCEHR system.

“GPs are able to claim for these services as part of taking clinical notes using the appropriate existing MBS consultation items,” she said.

While GP groups welcomed the expanded MBS capability, they are still calling for additional funding to support the establishment of the necessary PCEHR infrastructure in general practices.

The Australian General Practice Network reiterated its position that an eHealth practice incentive payment was necessary to support the establishment of the foundational PCEHR infrastructure.

The AGPN suggests payments could be linked to the incremental milestones associated with such infrastructure implementation such as secure messaging, Public Key Infrastructure (PKI), Healthcare Identifiers and clinical coding.

“PIP payments would also be linked to the development of quality improvement processes within practices to ensure that patient health summaries are fit for sharing on the PCEHR system, using standards-compliant software.”

AGPN chairman Emil Djakic welcomed yesterday's announcement but repeated his call for an eHealth practice incentive payment.

"At a macro level though, AGPN is still urging the federal government to realise the need for two other elements that will be critical in changing business processes required to have general practices successfully adopt the PCEHR ...” Dr Djakic said.

“[These are] general practices must also be provided with an eHealth Practice Incentive Payment to support the establishment of the necessary PCEHR infrastructure; and adequate resourcing of Medicare Locals to support general practices to build up the foundations and infrastructure needed to get the PCEHR up and running from July 2012.”

Mike Civil, the eHealth spokesman for the Royal Australian College of General Practitioners (RACGP), said he believed it would probably be necessary to have an additional payment to GPs along with the extended MBS claiming rights to ensure widespread uptake of the PCEHR.

A strong believer in the value of the PCEHR, Dr Civil said that before yesterday's announcement he had expected the government to release an incentive package to encourage uptake.

“I thought they might have chosen some sort of incentive package through the PIP, that you would receive if the patient indicates that they have chosen you as a nominated provider, but thinking about it [MBS claiming] is more simple,” Dr Civil said.

However, he said he still thought an incentive payment would be necessary as many practices, including his own, will not be capable of managing or accessing the PCEHR from July 1.

“I think the groups that [the National eHealth Transition Authority (NEHTA)] has been working with in phase 1 will be able to start but … even my practice, which is very well-computerised, will need an upgrade,” he said.

“This is a good start and good recognition, and we all want it to be successful, but they are going to need something more. This is just the first step and it will take a long time – it is not a sprint, it is a marathon.”

Posted in Australian eHealth

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