Sunday, July 17, 2016

It Looks Like The Stick Is Working Well On The GPs As Far As The myHR Is Concerned. Not That The System Is Actually Being Used Much!

This appeared a few days ago.
8 July, 2016

GPs warming to e-health records

Posted by julie lambert
The financial pinch on GPs is clearly sharpening interest in electronic health records.
According to the latest figures, 1085 general practices uploaded health summaries to the My Health Record system in the week to 19 June, more than 2.5 times the weekly average of 400 a week during April.
In the same period, the number of health summaries uploaded has jumped from 2000-3000 per week to more than 8000, while the number of views by healthcare providers has shown a similar increase from around 400 per week to almost 1100.
The spurt in activity is clearly linked to the threatened loss of the eHealth Incentive PIP for practices that fail to upload a quota of shared health summaries under new rules adopted on 15 May.
“Following the implementation of these changes to the eHealth Incentive, use of the system by general practitioners has increased significantly,” a Health Department spokeswoman said.
Some doctors are unhappy about the use of financial incentives to promote the system, saying privately the rule could amount to coercion of GPs who are strapped financially by the four-year freeze on Medicare rebates.
But others see a lot more carrot than stick in adopting the new system, which is an “opt-out” model for patients which replaces the failed “opt-in” Personally Controlled Electronic Health Record.
“From my personal point of view I can only see the advantages,” says Dr Chris Goodall, a GP in Cairns, part of the north Queensland PHN area where one of the two MHR trials is getting under way.
In the tropical city, with a large itinerant population, the ability to share and view patients’ health records will save huge amounts of time and avoid duplication of tests, he says.
“At this time of year, 10 to 20% of our business is travellers and holidaymakers,” Dr Goodall told The Medical Republic.  “There are lots of grey nomads and people escaping the southern winter, and all of them are on a white tablet with a line down the middle and they can’t remember the name of it.
“It will be massive for us that we don’t have to send faxes down to their local GPs asking for a fax back with their medication summaries and that sort of thing.  It will save us a lot of time. That’s the principal reason why I am interested.”
Dr Goodall, an early user of the PCEHR, said colleagues who had had concerns about the system tended to be less well informed.
“A lot of my colleagues probably weren’t aware of what was going on and were quite worried. I think they’re now starting to see the advantages. Once you know what you are doing, uploading takes three clicks of a mouse.  You click on the health summary and upload what you want.”
Another Cairns GP, Dr Peter Vanrietvelde, says he is very positive about the concept but is concerned about the heavy cost of the e-health system development while rebates remain frozen and the advantages remain far in the future.
There is a lot more here:
What I found interesting here – other that just how effective the ePIP payments were being were the statistics on the myHR.
There is a useful, pretty current page on the statistics the Government is releasing on the myHR.
Here is the link:
So what we have, after one million people where opted in to the system, we have a total of 16% of the population registered. It has taken now over four years to get to this point.
However the total number of shared health summaries held is all of 166,000.This means that only 4.3% of enrolled people and less than 1% of the total population have a shared health summary.
Each shared summary seems to have cost $7,200 which really does make one wonder about the value for money we are receiving – especially given that the expenditure is still running at $100M p.a. ongoing.
Note also there is absolutely no information on how often anyone has actually looked up a Shared Record. I wonder just why that is?
So we seem to have a pile of hard to search documents masquerading as an usable electronic health record. What a money wasting joke!  I also feel sorry for the GPs forced to use this awful ill-conceived system for the ePIP payments.


Anonymous said...

The only figure that would demonstrate value for money is the number of document downloads.

Yet we still have no idea how often the system is actually queried, let alone how often a downloaded document actually led to any clinically meaningful outcome. To equate 'usage' with uploading information into the system is a slight of hand that only fools the uninformed.

The continuing refusal to publish download rates I think should give us all concern. Either they don't publish it because the purpose of the system is to suck information in, not spit it out - the data mining hypothesis!- or they would love people to be using it but are so deeply concerned that it will all blow up in their faces, that they dare not publish that no one much actually uses to system.

Anonymous said...

To equate 'usage' with uploading information is no slight of hand; far from it Surely you can see what's coming next. ePIP incentives will soon be measured the number of health summary downloads a practice makes. Let me expand - to be sure, to be sure said my Irish fried - every time you see the patient you will be required to download their health summary - to stay informed of course to be sure, to be sure.

Bernard Robertson-Dunn said...

"The only figure that would demonstrate value for money is the number of document downloads."

I don't think even that shows value for money. Downloads/access are a necessary but not sufficient indication.

IMHO, the only value comes from improved health care and/or reduced health care costs.

How this was/is to be measured should have been included in the business case. I bet it wasn't; it certainly has never been publicised.

The ADHA needs to explain exactly how it intends measuring it's own performance.

Bruce Farnell said...

My observation, from the relatively small number of GP clinics I am associated with, is that they are only being engaged with the PCEHR to retain the PIP. The general consensus is that it is of very limited benefit to a few and of no benefit at all to most of the population. This is reflected in the low level of engagement to date.

The use of health summaries as a proxy for health benefits from the system is a woefully inadequate metric. A vanity metric if ever there was one.

Take my record as an example. I must have something approaching 100 clinically worthless health summaries listed and subsequently removed. Why - you might ask? With systems of this nature there is a lot that can go wrong. In my GP clinic support role it has proven necessary to authorise the use of my record for qa/testing purposes. Hence the relatively large number of clinically worthless uploaded documents. Presumably, these will contribute to the vanity metric.

If each uploaded document has cost $7,200 each then my record has cost the taxpayer about $720,000. I'd rather have the money. :-)