The following appeared today.
GP standards to include e-health
by Jared Reed
New accreditation standard will mean that GPs may be required to show they are working towards the government's e-health agenda that kicks off later this year with the launch of unique health identifiers (UHI).
A likely addition to the upcoming fourth edition of the RACGP Standards for General Practices will ask GPs to ensure their practice and patient data is coded and de-identified.
But Dr Lynton Hudson, Chair of the college’s National Expert Committee on Standards for General Practices, tells 6minutes that coding itself will be done by software programs and is likely already happening in most practices.
Practices will also need to ask patients for three forms of identification to be checked against the patient’s file, such as proof of name and date of birth, and possibly the patient’s UHI should forthcoming legislation pass through Parliament, Dr Hudson says.
“The three identifiers are important because it’s been shown that that decreases error,” said Dr Hudson.
Lots more here:
http://www.6minutes.com.au/articles/z1/view.asp?id=511635
And can you see every General Practice in the country consuming secretarial and GP time doing all this for the sake of patient identification for no payment or incentive?
As a tired old blogger all I can say is that these people are totally out of touch with what is practical and affordable in GP. As far as specialists and others I suspect they will break down in tears of laughter!
Who on earth thinks this is a good idea? If this is an accurate report the RACGP has really lost it!
David.
19 comments:
It is fair to say the RACGP is responding to the prevailing political climate and in the process endeavouring to be seen to be relevant on matters of ehealth about which it has little experience and insight. Unfortunately, whilst as a body politic it represents the majority of primary care practitioners in one way or another, it has failed to provide much needed leadership in this area. So much so, that whilst it should have utilised the opportunities presented by ehealth to ensure that its members are seen to be (and are) the most important pivot point in the provision and coordination of primary care it has failed them badly. In doing so it has surrendered or exposed its members to the vagaries of the market and the aspirations of rival forces eager to assume more relevance in the eyes of the 'patient' at the expense of the primary care medical practitioner. It is not yet too late to recover lost ground but it will not be easy and it certainly won't be able to do that unless its members get behind it to do just that.
Yeah, instead of providing education about e-health (isn't it a college?), the RACGP hired help have got side tracked picking winners and show boating around, most recently with NEHTA who have paid them off with conference sponsorships and other "e-health" related goodies.
If the college wants to do anything useful, it should start by getting its president on NEHTA's board. NEHTA mouth pieces like Murkesh are no longer acting in the best interests of clinicians if recent statements - add odds with his former comrades at the AMA - are any indication. The clinical leads team are being used as outward facing evangelists, not inward focused change agents which is what the BCG recommended was needed.
It’s all about process, box ticking in response to bureaucratic legislative initiatives driven by policy changes which ‘they’ (whoever ‘they’ are) think are good (whatever ‘good’ is) and in the public interest. Do you get my drift? Who is actually using the laughing gas is a moot point but it certainly seems as though someone in Canberra must be.
It’s all a bit bizarre but in that context it’s difficult to criticise the Chair of the college’s National Expert Committee on Standards for General Practices when he says:
“If you use the standards then you’ll feel very comfortable in the new decade, really, and in your general practice and you will have ticked the boxes that need to be ticked.”
It is important to note that he does point out that it’s not the college that is pushing this, they are just responding to a set of circumstances which are being forced upon medical practitioners everywhere. Look at what he said:
“Many of these requirements are not college requirements, these requirements occur because of governments and other agencies. What we’re doing is going out there, finding them and putting them all in one document and making sure that general practice, if they follow the standards, will be quite comfortable and they can go home and sleep well at night because their systems are going to work in this coming decade.”.
........ "because their systems are going to work in this coming decade". hhaaaahha hhheee hhhaaa did he say that? Have another puff on that gas man and leave some for me.
It’s difficult to imagine doctors ever being able to influence directions and outcomes because the system is set up to prevent that from happening and while we have a voice through the college and the AMA it’s more noise and posturing than anything else.
Do you think the college (or the AMA) will have more or less ability to influence ehealth and related events when the AGPN gets the $31 million it has asked for to implement its ehealth strategy for primary health care?
I think Saturday, February 20, 2010 2:06:00 AM is being naïve if he reckons having the college president on NEHTA’s board will make much difference. No disrespect intended but he would be one lone voice, not expert in ehealth (but neither is the rest of the Board - they see that as being NEHTA’s role). Also he would have no real influence because the parties with the sway are the ones who cough up the lolly required to fund NEHTA! A classic catch 22 situation.
Even having him joined by the AMA president would not change the situation. And anyway what you are advocating is a top-down approach; one which history has repeatedly shown does not work and will not change the status quo. Some might say that what is need is grass roots pressure from the bottom up (Les Miserable, but in this instance that too will not work because the grass roots are fragmented and poorly organised. So that leaves you with only two other options that I can see. The first is the Mukesh option, whom you have pointed out is no longer acting in the best interests of clinicians. And the other is to consider a totally new approach.
Oh, and by the way a totally new approach does not necessarily mean replacing NEHTA, which so many seem to want to do. It simply means thinking about how to solve what has become an inordinately difficult 'political' problem differently - that means employing more smarts, more nous, new blood and an ability to perform complex mental gymnastics.
And if you did that all that would be left essentially unchanged is the name!
David.
"And if you did that all that would be left essentially unchanged is the name!"
It's not clear what you mean here.
"that means employing more smarts, more nous, new blood and an ability to perform complex mental gymnastics."
If that was done it would not be the NEHTA we know and love anymore was what I meant.
David.
Agreed - so the name should be changed as well.
I agree with the earlier comment that it sure is a classic catch 2 situation. The college has been seduced into a false sense of security thinking it has a voice in ehealth somewhere at the NEHTA table through the clinical leads referred to above - how naïve. It's a conflict of interest situation paid for by NEHTA. Pontificating from above in fits and starts in reaction to isolated events is of no value to anyone. As members we deserve more but probably don’t expect it, although we should. A few days ago our software rep asked us what strategic direction we planned for our group. We had to confess we hadn’t given much thought to it which led us to discussing what vision the college had for ehealth and what strategies it had for achieving the vision or if we all just had to wait and see what NEHTA had in store for us. The thought was too scary to contemplate without help, so we adjourned to the pub.
You know, it's all well and good to criticise NEHTA but I was trying to think back to the days before NEHTA to try and determine what the RACGPs General Practice Computing Group actually achieved. Does anyone now if there were any big achievements of substance. I thought it had been taken away by the Department and given to the AMA to manage and then eventually disbanded. If that is right aren't we just witnessing a today the same old start, stop, change, reorganise, start again sequences of yesterday all over again. It's all so weird but I doubt AMA or RACGP could exert much useful influence if their GPCG track record of yesteryear is anything to go by.
“And can you see every General Practice in the country consuming secretarial and GP time doing all this for the sake of patient identification for no payment or incentive?”
No I can’t. But let me ask you why should it be necessary to have to consume secretarial and GP time? Surely to goodness a well designed, flexible, functional system that is part of the routine business processes of a busy medical practice would do all that ‘time consuming’ work pretty much automatically. Wouldn’t it, or rather shouldn’t it?
Saturday, February 20, 2010 8:07:00 AM quoted the college thus: “Many of these requirements are not college requirements, these requirements occur because of governments and other agencies.”
This is a copout. It’s not our fault, we are the victim of circumstances, we have no option but to accept and follow. Well, that is just not good enough. If we have a college which is responsible for professional practice standards then it should be taking the lead and not sitting on its thumbs waiting for others to tell it and us what needs to be done.
"No I can’t. But let me ask you why should it be necessary to have to consume secretarial and GP time? Surely to goodness a well designed, flexible, functional system that is part of the routine business processes of a busy medical practice would do all that ‘time consuming’ work pretty much automatically. Wouldn’t it, or rather shouldn’t it?"
And where is the practice to acquire this paragon of a system and who is to pay for it, even if it actually exists - which I doubt.
David.
If the AGPN gets the $31 million it seems to have asked for to implement its ehealth strategies then the college will become irrelevant as far as ehealth is concerned. Even more so if Roxon consolidates the divisions into 50 or so large primary care bureaucracies and then passes funding control over to the divisions for the delivery of primary care services
"And where is the practice to acquire this paragon of a system and who is to pay for it, even if it actually exists - which I doubt."
Good question - such a system (a paragon) obviously doesn't exist today. Is this a role for NEHTA? How much would it cost? Where might the money come from - Government, NEHTA, health funds? or should it just be left to market forces to fight over?
It's not a job for NEHTA, they've spent 5 years ignoring us.
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