This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Thursday, October 20, 2011
Common Sense Descends on the Royal Australian College of GPs. Seems There Has Been A Real Change in Views Internally!
RACGP identifies critical success factors for Australia’s PCEHR
19 October 2011
The Royal Australian College of General Practitioners (RACGP) is encouraged by the progress made towards providing access to personally controlled electronic health records (PCEHR) for people in Australia, especially with the release of the Department of Health and Ageing’s PCEHR System: Legislation Issues Paper for comment.
However, there are four areas that are of particular concern to the RACGP, and the College would seek to further contribute to the refinement of the PCEHR program. The recent termination of England’s existing National Health Service (NHS) Connecting for Health program has further highlighted the College’s concerns.
1. Need for greater definition of general practice role in PCEHR
A major criticism of England’s NHS Connecting for Health program was a lack of sustained and high level clinical input into the design and implementation processes. The RACGP is concerned that as we move closer to implementation of the PCEHR that there should be greater agreement between the Department of Health and Ageing, the National E-Health Transition Authority (NEHTA) and the RACGP across a broad range of areas, including consideration of data quality and ownership within the PCEHR, the PCEHR’s links with clinical software, and possible impact on clinical and practice workflows which will be a disincentive to widespread adoption.
2. Recognition of GPs’ additional workload
The RACGP is concerned that the current plan does not offer any incentives for general practice to create documents for indexing in the PCEHR such as shared health summaries, and urges the Government to consider how this additional effort will be acknowledged. This applies to obtaining informed consent from a patient (or their carer) to have a PCEHR created for them, as well.
Professor Claire Jackson, RACGP President, said: “We would like to see amendments to the Medicare Benefits Schedule to recognise the additional workload GPs will undertake in consultations initiating and maintaining the patient’s shared health summary and other elements of the PCEHR. To make this program a success, it is crucial that all general practitioners get on board.”
I have to say the tone of this release is much less co-operative than others emerging from lower down the hierarchy of the RACGP. I would not know anything but it just might be that those in the College who have been taking NEHTA’s money to do its bidding have been told by the President the membership at large is not happy and that change is needed!
There is press coverage with additional context here:
GPs should be compensated for e-health, says Royal Australian College of General Practitioners
October 20, 20115:00AM
THE Royal Australian College of General Practitioners wants GPs to be reimbursed for the work of creating and maintaining personal e-health records.
RACGP chair Claire Jackson has called for new payments under the Medical Benefits Schedule in recognition of the extra workload GPs "will undertake in consultations (including updating) the patient’s shared health summary" and other elements of the Gillard government’s $500 million personally controlled e-health record system.
"We are concerned that the current plan does not offer any incentives for general practice to create and maintain documents for indexing in the PCEHR, such as shared health summaries," Professor Jackson said in a statement on Wednesday.
"We urge the government to consider how this additional effort will be acknowledged.
"This applies to obtaining informed consent from a patient, or carer, for the creation of a PCEHR as well."
She didn't provide an estimate of a minimum level of compensation.
The RACGP has expressed concern over a range of matters which are yet to be considered, just seven months before the PCEHR program is due to start on July 1 next year.
These include questions of data quality and ownership within the PCEHR, system links with doctors’ own clinical and medical practice software, and possible impacts on workflow.
So we now have both the AMA and the RACGP singing from the same song sheet. Guess what all this still does not cover all the other staff and specialists who may be involved in supporting this folly.
It seems that the situation now is that we have NEHTA beating up on staff to get the PCEHR done (see just below) and the clinicians moving to open rebellion if they are not paid for the time and effort.
The National E-Health Transition Authority (NEHTA) has been investigated by WorkCover over bullying within the organisation, while reporting an annual staff turnover rate of 30 per cent, a senate estimates hearing has heard.
The company is charged with managing and supporting the delivery of personally controlled e-health records (PCEHR) as part of the Federal Government's $466.7 million investment in e-health. Speaking at an estimates hearing last night, NEHTA CEO Peter Fleming confirmed that WorkCover had been brought into the NEHTA offices in Sydney to investigate a staff complaint over bullying.
"There was, just recently, a very brief investigation. I believe a WorkCover officer came and had a talk to our head of personnel, and I believe that issue was dealt with to their satisfaction," he told the committee.
Australian e-health IT blogger Dr David More had last month posted information that he had obtained from former employees of NEHTA who had claimed there was bullying within NEHTA and WorkCover had been brought in to investigate.