Tuesday, October 20, 2015

I Wonder What The AMA And The RACGP Are Going To Do To Have The Government Actually Deliver A Working, Useful PCEHR.

We have had two lead organisations working with GPs come out and express considerable concern regarding the future of the PCEHR.
First from the AMA we have had this:

AMA blasts “half-baked” MyHealth medical records plan

Friday, October 16, 2015 - 10:21
Claiming that “forcing GPs to adopt half-baked e-health record [is] a dud idea,” the Australian Medical Association (AMA), has opposed government plans to link GP incentive payments to the adoption of the scheme.
The Government has proposed that Practice Incentive Program e-health payments be tied to doctor use of the MyHealth Record (MyHR) system being developed to replace the $A1 billion Personally Controlled Electronic Health Record scheme. The PCEHR has been dumped amid dismal take-up rates among patients, doctors and medical practices.
But AMA President Professor Brian Owler said the MyHR system was far from fully developed, so using PIP incentives to get doctors to sign up was ill-considered and premature.
“The MyHealth Record is not at a stage where it can be adopted by practices, so it should not be linked to the PIP scheme,” Professor Owler said. “There are fundamental issues with the design of the MyHR that are yet to be fully addressed.”
The AMA has detailed a long list of problems with the current version of the system in a submission to the Health Department, including:
  • the ability of patients to remove information from view, making the record potentially incomplete and of no clinical value;
  • no flags to indicate if information has been removed from view;
  • radiology or pathology results are not yet included;
  • the shared health summaries are not automatically updated, rendering them quickly out-of-date; and
  • inaccuracies occur in the upload of data.
In addition MyHR, in its current iteration, remains an ‘opt-in’ system.
Lots more here:
From the RACGP we also have:

RACGP urges Federal Government to dump proposed changes to PIP e-Health

14 October 2015
The Royal Australian College of General Practitioners (RACGP) strongly opposes proposed reforms to the PIP e-Health that would see payments linked to meeting targets for uploading shared health summaries (SHS).
This week the RACGP has responded to the Department of Health (DoH) Practice Incentives Program (PIP) e-Health Incentive discussion paper, which was released as part of the consultation process to revise the current PIP e-Health Incentive eligibility criteria to encourage ‘active and meaningful use’ of the My Health Record (formally PCEHR).
Increased uptake of My Health Record will be achieved by addressing the fundamental usability issues as raised by the profession, rather than implementing misaligned financial incentives.
RACGP President Dr Frank R Jones said proposed changes to the PIP aimed at encouraging practitioners’ participation were futile.
“The proposed changes to the PIP e-Health Incentive are misaligned, ill-timed, superficial, will not support meaningful use, and – as a result – will not improve patient care and safety”.
“When usability issues for the My Health Record have been addressed, additional MBS rebates or a Service Incentive Payment (SIP) would be a better approach to support practitioner uptake”, Dr Jones said.
The RACGP submission was based on member feedback, with many GPs expressing concern regarding the DoH’s proposals for the PIP e-Health requiring the uploading of shared health summaries (SHS) as the sole measure of ‘active and meaningful use’ of My Health Record.
More here:
The AMA is also unhappy re the ePIP plans:
Here is a good summary of their points:

8 reasons to avoid the latest e-health record system

15 October, 2015
The AMA says the model has eight flaws that must be fixed. These are:
·         Patients can remove information from view, making the clinical record potentially incomplete and of no clinical value;
·         Clinicians are unaware if information has been removed from view;
·         Radiology or pathology results are yet to be made available to the MyHR;
·         Shared health summaries are static documents and quickly go out of date;
·         Inaccurate data uploads present clinical risks;
·         Most patients don’t have a MyHR, and are unlikely to get one under opt-in arrangements;
·         Opt-out trials are yet to be conducted; and
·         Other medical specialists are not being supported to engage with the MyHR
Full article is found here:
The question is what all those who realise the PCEHR is a pile of crock is actually going to do to have DoH and NEHTA face up to the fact they have goofed and stop good money being thrown after bad.
A new realistic e-Health Strategy is needed - and not something just emitting from the DoH in Canberra. The sooner the AMA and the RACGP (among others) start to wind up the heat the better!


Anonymous said...

The AMA and RACGP in this particular instance have made their position quite clear.

The problem with all this is they are INCONSISTENT. They put out MIXED MESSAGES on the subject. They change with the wind. This confuses the Minister and gives department bureaucrats the arguments they need to continue promoting this lost cause.

One minute they favour the PCEHR and ex-Presidents and others run around telling doctors that it's terrific and if they use it all will be well. In the next breath they denigrate it by pointing out some of its major deficiencies and why no doctor should be expected to use it.

CONFLICTING messages emanating from these peak bodies mirrors the conflicts of interest at play within them - objectivity and consistency is buried as the rent seekers chase positions of influence for themselves and the peak body.

The victims are their members and the members' patients and the nation as a whole. Egos rule the roost.

Anonymous said...

ROFL with the poor reporting in the first article. Specifically "The PCEHR has been dumped" and "MyHealth Record (MyHR) system being developed".