Wednesday, January 20, 2016

It Really Looks Like There Is Going To Be Major Pushback On The Government ePIP Proposals.

While we were all having a break this little storm was brewing:

GPs must upload PCEHR summaries for PIP

| 13 January, 2016 |
GPs will have to upload shared health summaries to the PCEHR in return for e-health PIP payments, Australian Doctor has been told.
Leaked details on the new requirements of the E-health Practice Incentives Programme emerged last month following a consultation by the Federal Department of Health in September.
It is understood that under the revamp, each practice will be required to upload a shared health summary onto the PCEHR for 0.5% of its standardised whole patient equivalents (SWPEs) each quarter.
Australian Doctor has been told this would mean each GP creating and uploading around five shared health summaries per quarter for the practice to meet the new requirement.
A key element of the PCEHR system (now renamed the MyHealth record), the summaries are meant to provide clinical information for health professionals across the health system, including for doctors working in ED.
The summaries include the patient’s current diagnoses and medications, as well as allergies and immunisations.
Australian Doctor has been given no official confirmation from the Federal Government of the new rules, which are due to be in place in May this year.
However, the RACGP last year said it could not support any move for GPs or practices to hit fixed targets for shared summaries, claiming the changes would be “misaligned, ill-timed, superficial, will not support meaningful use”.
More here:
There is also more coverage here:

New ePIP rules ripe for 'gaming': RACGP

15 January 2016
GOVERNMENT plans to tie e-health practice incentive payments of $50,000 a quarter to GPs uploading a specified number of shared health summaries leaves "the door wide open" for "gaming the system", the RACGP says.
Under changes flagged in a Christmas Eve email from the Department of Health, practices will need to upload a shared health summary for 0.5% of the their "standardised whole patient equivalent" per quarter to maintain ePIP eligibility.
The RACGP says the policy misses its target because it aims incentives at practices rather than practitioners.
"Practices cannot directly influence the actions of practitioners," says chair of the college's expert committee on eHealth and Practice Systems, Dr Nathan Pinskier.
“If you fail to fulfil [a] requirement because the practitioners don’t want to do it or are unable to... then the practice will forfeit the whole of its ePIP payment.”
Practices will hit likely hit targets by uploading the “easiest” shared health summaries, which may in themselves not be useful information but “just achieving a statistical result”, he says.
More here:
and here:

Practices to lose thousands if GPs don't create PCEHR summaries

| 14 January, 2016 |
Practices will lose their entire e-health Practice Incentive Program payment if their GPs refuse to upload shared health summaries to the PCEHR, the Federal Department of Health has confirmed.
On Wednesday it emerged that the E-health Practice Incentive Porgramme requirements will be revamped.
From May, each practice will have to upload a shared health summary for 0.5% of its standardised whole patient equivalents (SWPEs) each quarter.
Australian Doctor has been told this would mean each GP creating and uploading around five shared health summaries per quarter for the practice to hit the target.
However, the health department says failure to hit the target will mean practices being denied the entire incentive payment — even if they meet the four other e-health PIP requirements.
The RACGP has blasted the reform, saying that practices cannot force GPs to upload the summaries.
Dr Nathan Pinskier, chair of the RACGP expert committee for eHealth and Practice Systems, said: "It is a serious concern. The e-health PIP is there to support practice IT infrastructure. It is not a payment to GPs in the practice.
More here:
What to say. The RACGP does not like the plan and the requirement to upload is so low that there will be no perceptible clinical impact for years - if ever and the bar for payments is set so low a caterpillar could make its way over!.
More amusingly we see the DoH attempting a form of so called ‘Meaningful Use’ (which they really don’t know what it means) just as the US is giving it up. See here:

Meaningful use will likely end in 2016, CMS chief Andy Slavitt says

New regulations aimed at value-based payment models demand a more streamlined regulatory approach, acting administrator tells audience at J.P. Morgan Healthcare Conference.
January 12, 2016 04:32 PM 
The meaningful use program is on the cusp of major changes, the Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt said late Monday, adding that 2016 would likely see the end of the program altogether.
The Medicare Access & CHIP Reauthorization Act of 2015, with its emphasis on a new Merit-Based Incentive Payment System and alternative payment models, demands a new streamlined regulatory approach, he said, speaking at the J.P. Morgan Healthcare Conference in San Francisco.
Slavitt also posted the news on Twitter on Monday.
Lots more here:
Talk about policy incoherence!


Anonymous said...

Give people a bureaucratic target and they will game it. Need five health summaries? Well here they are. Hope you don't mind, but these five folk are young, healthy, with no-cormodities and on no meds. Creating the summary was a push of a button because there was nothing to summarise. Information actually added to PCEHR approaching zero. Cheque please.

Bernard Robertson-Dunn said...

Today's Non Sequitur cartoon rather says it all:

If you just want the gif:

Anonymous said...

The PIP always starts out ridged and ends up so relaxed it resembles the symptoms of a laxitive ingestion. I wonder if it is simp,y used as a bargaining chip in a broader set of negotions, government gets something and everyone comes away saving face.

As for MU, looks like a simple case of 'run out of ideas and imagination', copying an idea that looks good from someone else and hoping it will replicate successfully is naive and really reflects desperate need to stay relevant.

Anonymous said...

Hi Bernard, that is such an appropriate cartoon to summarise where this has gotten to. I really do hope that the Minister has someone monitoring this blog. That cartoon should be pasted on her wall (or used as her screen saver). It is the PCEHR (or whatever we are calling it this week) to a tee.

Happy New Year everyone. I have been forced into the ranks of the "annonymists", fearful that my commentary might result in professional misadventure at the hands of the Stasi, if I am identified.

I am aghast at the direction this farcical ePIP nonsense is taking. The policy itself is so feeble it would hardly be worth doing if it were a good idea, (which it clearly most certainly isn't).

For me, the big issue is the opportunity cost. The Australian health system is really poorly automated. Automation of healthcare information systems provides the single greatest opportunity we have to improve efficiency and lower costs, yet we are messing around with this stuff!

The Emperor has no clothes. Keep up the good work everyone on this blog, especially you David (Saint David). This nonsense has to stop.

Best wishes for the year ahead.