Sunday, September 18, 2016

It Rather Looks Like The ePIP Incentive Is Blowing Up In The Department Of Health’s Hands.

This appeared last week:

Doctors forgo $23,000 and opt-out of uploading patient data to MyHealth record

September 14, 20167:13pm
Sue Dunlevy News Corp Australia Network
DOCTORS are so opposed to the troubled $1 billion taxpayer funded e-health record they are refusing a $23,000 incentive payment to upload patient information into the system.
From May doctors had to upload 0.5 per cent of their patients’ records to the new system to qualify for a $23,000 practice incentive payment as the government struggles to get doctors to use it.
The AMA has revealed 30 per cent of GPs will miss out on the payments because they have refused to do this.
Without these records outlining a patient’s health condition these records are virtually useless and it means even though taxpayers have spent $1 billion on the record doctors are not using it.
Four years after it was launched only one in five Australians has signed up for a MyHealth record and this includes one million Australians enrolled through an opt-out trial.
News Corp has revealed the government was issuing records to people who had been dead for decades.
The government has employed Tim Kelsey, a former journalist and head of the UK’s own failed e-health record system, to fix the mess. He’s being paid as much as the prime minister.
Doctors have little interest in using the record because it does not mesh with existing practice software, only one in five patients have one and it does not include necessary information such as scans and blood tests.
The AMA is now warning the government’s decision to link GP practice incentive payments to using the record could see doctors lose $23,000 a year in income — putting further pressure on their ability to provide billed visits.
AMA vice president Dr Tony Bartone said the Australian Medical Association has made repeated representations since June to Health Minister Sussan Ley about how harmful the PIP changes will be to GPs who are already burdened by the Medicare rebate freeze.
“The PIP Digital Health Incentive has now been in place for a full quarter and the AMA has been advised that 1500 general practices have failed to meet their SHS upload target, and a further 69 practices have formally withdrawn from participation in the incentive,” he said.
More here:
There is additional coverage here:

GPs failing to regularly upload e-health records

By Paris Cowan on Sep 14, 2016 5:00PM

AMA slams new ‘penalties’ for doctors.

As many as 1500 GP clinics have failed to meet the minimum benchmark for My Health Record participation in the past quarter and risk losing thousands of dollars in incentive payments as a result, the Australian Medical Association has claimed.
It said as many as 40 percent of GPs are still not equipped to regularly upload shared health summaries into the system, and one-third of the clinics previously receiving funds to help them with the e-health transition now risk a shortfall of more than $24,000 a year.
The AMA slammed the government’s move to toughen the eligibility criteria for incentive payments for MyHR participation, claiming it will “erode the goodwill of GPs” rather than prompt them to upload more patient data into the national health records system.
The federal government doles out the payments in exchange for medical practices adopting compliant software and processes that hook into its My Health Record e-health system.
But in May it stepped up its demands, asking GPs to upload shared health summaries for a minimum of 0.5 percent of the patients they see each quarter in order to keep receiving the funds.
Getting doctors adding to patient records has been one of the perennial headaches of the My Health Record implementation, with the Department of Health revealing in April that only 300 of the 8625 clinics in Australia are regularly using the system.
But the AMA has warned the government its eligibility reform risks getting doctors further offside.
More here:
These articles were driven by this AMA press release:

Draconian PIP requirements another hit to General Practice

14 Sep 2016
AMA Vice President, Dr Tony Bartone, said today that tough new changes to the Practice Incentive Program (PIP) Digital Health Incentive requirements could leave many individual general practices more than $20,000 worse off.
In May this year, the Government introduced a PIP eligibility requirement that practices must upload Shared Health Summaries (SHS) for at least 0.5 per cent of their patients each quarter.
Dr Bartone, a Melbourne GP, said the AMA has made repeated representations since June to Health Minister Sussan Ley about how harmful the PIP changes will be to GPs who are already burdened by the Medicare rebate freeze.
“An AMA survey indicated that up to 40 per cent of eligible general practices would be unable to meet the new requirements,” Dr Bartone said.
“The PIP Digital Health Incentive has now been in place for a full quarter and the AMA has been advised that 1500 general practices have failed to meet their SHS upload target, and a further 69 practices have formally withdrawn from participation in the Incentive.
“This means that close to one-third of previously eligible general practices now face losing significant financial support in an already testing environment of the Medicare rebate freeze and other funding cuts.
“Based on the results of our survey, practices that do not comply now face the very real threat of losing around $23,400 a year in PIP payments.
“The AMA is urging the Minister to do the right thing by hardworking GPs and introduce a moratorium on the SHS upload target,” Dr Bartone said.
The AMA Council of General Practice (AMACGP) referred its concerns about the PIP changes to the AMA Federal Council, which adopted the following policy resolutions at its August meeting:
• That Federal Council calls on the Commonwealth Government to agree to a moratorium on the loss of PIP incentives for those practices that fail to meet the new Digital Health Incentive requirements, and to ask the Practice Incentive Program Advisory Group to undertake a review of the reasons why practices were unable to comply and to make recommendations on how these might be addressed.
• That Federal Council calls on the Commonwealth Government to ensure that any future changes to the PIP Digital Health Incentive are based on the advice of the Practice Incentive Program Advisory Group.
Dr Bartone said that the Government decided to implement the new SHS requirement despite the contrary advice of all GP groups on the Department of Health’s Practice Incentive Program Advisory Group.
“It is now time to recognise the concerns that have been consistently raised by the profession and get a better understanding of why so many practices have failed to meet the Government’s SHS benchmarks,” Dr Bartone said.
“With adequate time, education, and support, many of the affected 1500 general practices may well begin to genuinely engage with the MyHealth Record, and eventually champion it. 
“But penalising them with draconian eligibility requirements at this critical point will have the opposite effect.
“It will undermine support for e-health initiatives within general practice.
“And it will further erode the goodwill of GPs who have been disadvantaged by Government health policies such as the Medicare freeze, and unfairly targeted and demonised in recent leaks from the Medicare Benefits Schedule (MBS) Review.” 
More here:
Following this I note there is now to be an enquiry as to what went wrong:

Government to investigate e-health PIP failure

Antony Scholefield | 15 September, 2016 | 
The Federal Health Department will investigate the e-health Practice Incentives Program after more than one thousand practices failed to hit targets for uploading shared health summaries.
Due to a controversial revamp of the e-health PIP in May, practices are now required to upload shared health summaries to the MyHealth Record system for at least 0.5% of their patients.
However, it emerged on Wednesday, that out of more than 5000 practices registered for the e-health PIP, 1500 had not met the new requirements for their quarterly payments.
A further 222 practices had simply withdrawn from the program, according to the AMA.
The department said it planned to review both the PIP and MyHealth Record data to find out what was happening.
It said some practices had experienced a combination of issues, including problems with software, which prevented them meeting their e-health PIP targets.
It was considering ways to ensure practices that had made “genuine efforts to comply" but were "prevented from doing so by circumstances beyond their control" were not penalised.
More here:
To me the core issue here is that the Government is bribing GPs to upload clinical information to a system that is hardly used and that can’t be much good if the Government feels bribery in needed to have it used.
Spending this much money, and now undertaking an enquiry and to what has gone wrong, just smacks of pure desperation to me!
I wonder has anyone assessed the clinical and financial value to the country is paying $23,000 to thousands of GPs to upload an occasional Shared Health Summary of unknown utility and quality? (5000 practices times $20K is a lot of money on the face of it! ($125M)).
David.

2 comments:

Anonymous said...

However much the "idea" of free healthcare for all is, this is part of the problem with the concept. The government feels it can force the profession to use something not fit for purpose by strong arming them over using the system. It has failed and so it should. It is a huge threat the the idea of affordable healthcare to all because doctors will start the think that they can't trust these dickheads and they are much safer setting their fees at a level that makes them independent of these idiots. When you combine it with a 5 year medicare freeze it does make you realize that its just not safe to continue bulk billing. Its not safe for patients either when you think that Canberra thinks they can make doctors use a system that takes time away from patient care for no benefit to the patient or doctor.

Its time to tell them to stop trying to manage things that are well out of their league, even if their pay grade is ridiculously high.

Perhaps this will make doctors think that its not safe to trust these people, and that would be a good thing, because they can't.

Anonymous said...

After over 6 years of bumbling around in the dark, knowing not what they do, spending (wasting) billions of dollars on a huge white elephant, I relish the day when someone has the guts to pull the plug and euthanise the whole thing and put us all out of our misery. MyHr and all its previous guises have been pointless, useless exercises in IT - pure and simple (and not a very good one at that). That's why it doesn't work and no-one will use it. Morrison should have a close look at where he could fix the budget by redirecting funding from here.