Wednesday, April 13, 2016

Now This Is A Remarkably Good Question I Believe. Relying On Flawed Infrastructure Might Very Well Ruin The Trial.

This appeared last week:
April 4, 2016

Will Health Care Home fail on the back of MyHealthRecord’s fail?

Posted by Jeremy Knibbs
MyHealthRecord appears to be key to engaging with the ‘revolutionary’ Health Care Home Medicare reform, despite being plagued with problems and low GP uptake.
“One is tied to the other,” according to Dr Steve Hambleton, chair of the advisory group that helped shape the pilot and current NEHTA chair.
“I would think that a high-performing Health Care Home would want to opt in,” Dr Hambleton said. “And if you don’t want to be a Health Care Home then you won’t have access to the new funding model.”
While Dr Hambleton said creating the records was “dead easy” and took less than 90 seconds per patient, February saw fewer than 400 GPs updating a shared health summary with the program. 
The 65,000-person trial of the medical home model for chronic and complex conditions would shed light on doctors and patients opting out of the MHR and guide the national implementation of the reforms.
Between July 2017 and June 2019, up to 200 metro and rural general practices will be asked to sign up to the pilot, designed to inform the Health Care Home infrastructure rollout.
The federal government has promised to revolutionise healthcare for patients with chronic and complex conditions, and called it “one of the biggest health system reforms since the introduction of Medicare 30 years ago”. 
Health and consumer groups have come out in support of the move towards a medical home model of funding, with the RACGP calling it a “life-saver”.
However, Dr Bastian Seidel, current chair of RACGP Tasmania, cautioned against overstating the influence of the mere $21.2 million earmarked for the four-year project.
“It’s very easy to do something that underfunded and set it up to fail,” he said. “So you just over-promise and under-deliver, and if we have a look at the funding now we are talking about $100,000 per practice roughly.
“Now you could argue that’s a lot of money, but realistically it’s not that much.”
He pointed out this didn’t come near the $60 million given to hospitals to fix the elective surgery lists, or the $600 million extra money given as part of the Community Pharmacy Agreement to expand into “GP-lite” services.
Nevertheless, Dr Seidel was enthusiastic about the trial, and said that it was reasonable to hope the reform could reduce unnecessary hospital admissions and emergency hospital presentations. 
Lots more here:
With what we have learnt this week regarding the attitude of DoH to the current state of the myHR it is hard to know just why you would attempt to conduct such an important trial (and the trials are really important) using such inferior Health IT support and infrastructure.
It is made even more absurd when you realise there are already much better tools for managing co-ordinated care available in the Australian market place.
Pretty silly I reckon. Looks much like a solution in search of a problem and finding the wrong one to me!

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