Tuesday, January 15, 2013

The Countdown Has Now Really Started For The NEHRS / PCEHR To Prove Itself Adoptable and Useable.

2013 is going to be the year that makes or breaks the NEHRS. A couple of key facts point me to this view.
First we need to have a Federal Election before the end of the year and I suspect the outcome of that election will result in a binary outcome for the NEHRS. If Labor is re-elected the project will go on - at a level yet to be determined - and we will probably reach the stage where it becomes some sort of fixture. On the other had if the Coalition wins I suspect there will be a fairly quick review followed by a determination that enough money has been burnt on the current approach and a revised plan is needed. It may or may or not be funded in the remaining life of that Government.
Second with the commencement of the new upgraded e-PIP requirements in early February and early May we will be able to assess late in 2013 just what impact that upgraded incentive program has had on adoption and use of the NEHRS.
Third it is clear that neither the AMA or the RACGP are entirely comfortable with the various requirements and deadlines that are being imposed. This is the latest I have seen from the AMA.

Renewed calls for e-PIP extension

11th Jan 2013
MANY GPs could lose their eligibility for the e-health Practice Incentive Program (e-PIP) unless the 1 February deadline for software compliance is extended, says the AMA.
Prior to Christmas, AMA president Dr Steve Hambleton was calling for an eleventh-hour delay in the cut-off for payments if doctors do not achieve software compliance – required under new legislation to remain eligible – by the deadline.
Under the new arrangements practices can apply online through the Department of Human Services National Authentication Service for certification that their software is compliant.
However, Dr Hambleton argued during the holiday period many doctors in non-compliant practices were away and would not have been able to do any work to complete this process.
In an AMA poll taken in December asking GPs if they will be ready to have the first of the four e-PIP requirements in place by 1 February, 67% of 139 respondents said they would not be ready with just 33% saying they would make the deadline.
Dr Hambleton told MO he predicted it would be some months until most GPs would be fully compliant and renewed his call for the government to extend the deadline until at least 80% to 90% of practices are ready.
More here
I also note a distinct lack of confidence in being ready has not changed - Results  of GP Poll 13/01/2013 :

Will your general practice have the first four ePIP requirements in place by 1 February 2013?

Yes 32% (48 votes)
No 68% (102 votes)
Total votes: 150
To not have the clinical actors all lined up, trained and confident bodes pretty badly for what we are going to be seeing in the next 12 months. The bottom line is that this change and adoption task has simply not been managed properly or adequately resourced in my view.
In summary the next 12 months look to me to be make or break for all sorts of reasons, including that covered in Monday’s blog.
Time will tell and I don’t think many of us will die wondering.


Anonymous said...

Only 32 percent of practices ready for ePIPS. Surely to goodness they have had plenty of warning.

Those of us who are ready will get our ePIPS from time GO 1 Feb.

To crank up the slackers and get them off their proverbials the ePIPs they can claim should decline by say 15 percent each month for the next 6 months.

The sooner they get ready the more they can claim. Only those ready by 1 Feb should be entitled to claim 100 percent, followed by 75 percent if ready by 1 March and so on. That seems fair to everyone.

Terry Hannan said...

1. Labor is unlikley to be returned so that solves that problem.
2. Liberals-I believe have NFI about an effective e-health policy or they are hiding it. Regardless it will likely see a non continuation of the Laabor e-heallth model.
3. How many "medical bodies" actually understand e-health/informatics and the importance of clinical decsion making? If they did I am sure their voices would have been heard long before now. Many of these organisatiosn will be challenged in their roles in the future because the health costs and associated inefficiencies and poor quality will drive (enforce) chnage for the current models of care delivery. In particular fee for service models and hospital based care models.

Anonymous said...

1/16/2013 07:09:00 AM said ... Only those ready by 1 Feb should be entitled to claim 100 percent, followed by 75 percent if ready by 1 March and so on.

To be arithmetically precise I think you mean 85 percent on 1 March, 70 percent on 1 April - April Fools Day LOL, 55 percent on 1 May, 40 percent on 1 June and so on.

Anonymous said...

So by that reckoning a practice which could earn up to 50K in ePIPs for the year could miss out on 40 percent of those incentives if it wasn't ePIP ready to 1 May. Crikey Moses 20K that adds a whole new meaning to the word incentive.

Anonymous said...

I think its time for GPs to cut the strings that the PIP rules have around their necks and stop bulk billing to make up the shortfall. The idea that the clowns in DOHA and NEHTA can actually come up with sensible things for them to be rewarded for is doubtfull in any case. eHeath would advance more quickly if the government stopped trying to "help" in any case.

If the ability to make eHealth work is any guide to their ability the best strategy to advance health may be to do the exact opposite of anything they suggest.

Trevor3130 said...

How often have we heard the mantra "life saving" when someone wants to sway public opinion, usually for increased funding for a drug or procedure?
While Labor will want to peg the NEHR to the NBN, it will need actual episodes of "lives saved" to go halfway to clinching the deal in voters' minds.
The problem with that approach, strategically, is that all who work at the "life-saving" edge of healthcare are bedevilled by increasing complexity. Is Health IT a magic bullet that can cut through those layers, or is it seen as an additional burden to get in the way of decisions?
When I read this story by a young doctor in USA I wondered how something similar would be received here. Who would be first to congratulate "Elaine" and promise to stand by her and provide counsel when needed? Her immediate boss, the Unit manager, the hospital CEO, Board Chair, President of her College, the chief of ACSQH, the Chief Medical Officer, any Minister for Health, perhaps a departmental head?
I think you all know the answer, one that comes from the same lexicon as Terry Hannan's NFI.

Anonymous said...

"Crikey Moses 20K that adds a whole new meaning to the word incentive."

What's the minimum they need to do to not miss out on the 20K?
Get their HPI-O and HPI-Is (they probably have these already), have some fancy brochures on hand, upgrade their practice software to the conformant version (not their fault if their vendor is not ready with a new version), and sign up their practice to register as a participant through the not-so-user friendly Commonwelaht HPOS/Service Directory systems/forms. They don't actually have to send any records up to the NEHRS unless a patient asks them to, to get the ePIP??

And if this all seems to hard, then there is probably a friendly funded Medicare Local person to help them fill in the numerous forms to become registered and compliant. Not a bad deal for 20K eh?

Is there an incentive for the non-GP participants like public hospitals and health services?