Sunday, April 10, 2011

The Government is Still In Denial About Resourcing Clinicians for Involvement E-Health. They Had Better Re-think and Soon!

A few articles appeared in the last few days impinging on GP attitudes to the resourcing of E-Health.

First we had:

GPs under resourced for Govt e-health agenda

GP NSW CEO says much effort will be required to train and support GPs to deal with e-health changes

The chief executive of General Practice NSW has warned both State and Federal Governments that GPs are lacking the resources to deal with the country’s e-health agenda, including the $467 million personally controlled electronic health record (PCEHR) program.

Addressing attendees at the annual e-health forum for divisions of General Practice NSW, CEO Jan Newland, said extensive effort would be required to train and support GPs to deal with the expected e-health changes.

“Greater support is needed to provide infrastructure and support in primary care,” she said. “General practices are essentially small to medium businesses which are already under significant pressure to meet quality and regulatory requirements. Practices will not be able to meet the expected pace of change without assistance and possible additional support for security upgrades and infrastructure.”

According to Newland, GPs should look to sharing resources, learning and support in new e-health initiatives, and advised divisions transitioning to Medicare Locals that there would be an increased need for population health data management within the new organisations.

“Medicare Locals will also be required to engage in the e-health agenda by participating in early stage rollout of initiatives such as the Patient Held Electronic Health care Record (PHEHCR),” she said. “There will be a need to support practices in the implementation and use of the PHEHCR in a way which meets the expectations and pace of consumers.”

More here:

At the same time we had alignment between GP organisations happening to try and cope:

RACGP and AGPN get together on e-health

The Royal Australian College of GPs and the AGPN have announced they are “united” on e-health as they work together on the rollout of the IT reform.

The RACGP and AGPN say the collaboration will guarantee a “smooth transition” to e-health across primary care and help with the implementation of the personally controlled electronic health record (PCEHR).

“The RACGP and AGPN are in a position to strategically design the quality of work expected within the e-health agenda,” AGPN Chair Dr Emil Djakic says.

“And by collaborating on the design, implementation and management of e-health programs we can minimise duplication of resources and services.

More here:

In parallel we also had this:

PCEHR pledged for July 2012

Patients will be able to start building their own Personally-Controlled E-Health Record (PCEHR) from July 2012, the head of the Federal health department Jane Halton has announced.

Speaking at an AMA-hosted session on e-health in Sydney this week, Ms Halton said patients would have the chance to register and ‘opt-in’ to the system from the middle of next year, although it would be a work in progress with an “incremental rollout”.

She said the system would comprise of a GP-curated summary health record, an event record and a record on which information could be added and amended by the patient.

More here:

What we have is a perfect storm of additional work being imposed on the GP and not a single mention of just how they will be funded and supported to get all this done!

There seems to be only minimal recognition that the implementation of the PCEHR, if it ever actually happens, is not happening for altruistic reasons but because there are population benefits and cost benefits to the public purse if it can be achieved.

Sharing the cost between Government and the providers will be the only way it can come about I believe - being - I hope - a hard headed realist. Just think of the billions the US Government is throwing at a similar issue in the US.

If the Government thinks GPs are going to ‘curate summary records’ without an item number to cover the cost of their time - they are dreaming. Pharmacists are demanding $0.15 cents to accept electronic prescriptions - and this has been agreed - so there will need to be some similar accommodation with the docs and this additional work!



Anonymous said...

This is all just posturing by divisions...they are doing such a good job the RACGP has put aside its differences with its government funded competition in an effort to get in on the act.

No one seriously believes GPs will be in a position to do anything with the PCEHR in 15 months time. At best we can expect HIs to be implemented and in most practices in this time frame. This will happen with or without the RACGP and division hangers on as the rollout of HI functionality will simply involve a software update...3 clicks in many software packages these days. The delay in getting this out the door is more to do with developer contracts and developer funding arrangements...the technology is pretty straight forward in comparison with other Medicare related work software developers have had to go through over the years.

An entire tender process has been built around this practice support guff, and it closed a few weeks ago. Certainly practices will need some support if and when the PCEHR hits the streets, but I'd have throught the "change and adoption" should start after the thing was built? Just what exactly are the winners of this tender going to be doing in the mean time?

A properly constructed ePIP and some decent software documentation and training facilitated by those best able to provide it -- the practice software developers -- will get many practices over the technical and financial barriers.

Workforce issues (the fact that GPs are already too busy) is the nigger in the wood pile. Fortunately Nicola's super clinics, midwives, nurse practitioners and Medicare Locals will address this simple problem...don't get sick as they say.

Anonymous said...

We will be shocked if this Government delivers on the 1 July 2012 deadline they've set for themselves.

This article typifies the way that the GP sector has hijacked the funding for the EHR and so do the Wave 1 and Wave 2 Grants.

The big issues are the lack of funding for the other sectors that will need to participate in the PCEHR Scheme and the complete lack of effective engagement with the software vendors who will need to upgrade their software to cater for the NEHTA standards.

We have seen small Community projects FLOP for the very same reasons. This national industry-wide mega project is teetering at the moment and we are anticipating a very BIG FLOP.

The Rudd / Gillard Government has an appalling track record for epic failure to deliver which we have seen and are seeing in other programs that they've launched. Has there been one success to speak of? No - and that is their track record.

Anonymous said...

"This article typifies the way that the GP sector has hijacked the funding for the EHR and so do the Wave 1 and Wave 2 Grants."

Sadly it is not the GP world that will benefit with an effective EHR - and it also not the GP world that controls the majority of spending in the health sector.

An epic costly failure is the most likely outcome.