Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, October 20, 2024

The Government Really, Really Wants You To See Your Clinical Results – Even If You Have No Idea What They Mean!

These appeared during the week:

Govt pushes ahead with real-time pathology data sharing plan


Brandon How
Reporter

17 October 2024

New laws that will force health providers to upload pathology and diagnostic imaging to My Health Record by default or forgo Medicare payments will be introduced to Parliament next month.

In a speech on Thursday, Health minister Mark Butler said “near real-time access will be the new standard” on My Health Record, confirming the government will remove the rule that patients must wait seven days before being given access to their imaging reports.

However, “in some cases a clinically appropriate delay may remain if appropriate”, which will go some way to appeasing medical professional associations, which have argued a blanket change to the rule would create misinformation and stress out patients.

The government had initially hoped default sharing of pathology and diagnostic imaging reports would be implemented from June 30, 2024 but is now targeting mid-2025.

Mr Butler announced the proposed changes in May 2023 and consultations took place between September and October 2023. Last year’s federal Budget earmarked $13 million over two-years for work on the ‘share by default’ framework.

The seven-day delay on granting patients access to pathology results was introduced in 2014 to give follow up healthcare providers sufficient time to review results and discuss them with patients before the reports are available on My Health Record.

However, as at the start of this year, the delay has been removed for a handful of tests including COVID-19 and 13 other respiratory pathogens.

While the ‘sharing by default’ framework has yet to be finalised, Mr Butler said that pathology and diagnostic imaging companies that don’t upload the data to My Health Record “will not get a Medicare benefit for that test or scan”.

“Before agreeing an approach, I will consider advice from the Clinical Reference Group, co-chaired by former AMA President Dr Steve Hambleton and Conjoint Associate Professor Carolyn Hullick, the Chief Medical Officer at the Commission on Safety and Quality in Health,” Mr Butler told the Victorian Healthcare Week conference.

The Australian Medical Association is among the professional groups opposed to a blanket removal of the seven-day delay for patient access to pathology and diagnostic imaging reports, although they have not raised concerns regarding mandatory uploads.

Since announcing plans to implement ‘sharing by deafult’, the number of diagnostic imaging reports uploaded to My Health Record has increased from one in five to one in three.

Now, more than 10 million pathology and nearly one million diagnostic imaging reports are uploaded monthly.

“While this is an improvement, it is still too low and too slow,” Mr Butler said.

All state and territory governments are sharing pathology and diagnostic imaging reports, “with most uploading more than 75 per cent of all tests and scans, and most on track to share 100 per cent of them in coming months”.

The number of private radiology clinics connected to My Health Record has doubled, with Australia’s largest private radiology providers among those that have pre-emptively made the switch to default sharing of reports with the My Health Record.

“Australia’s largest private radiology provider, I-MED has started sharing by default from all their Western Sydney clinics,” Mr Butler said.

“In the ACT and southern New South Wales, Capital Pathology is sharing by default from every one of their clinics. The third largest private radiology provider, Lumus, is the first to share by default nationally.”

Mr Butler also confirmed that the CSIRO-led Sparked consortium – which has led recent work to develop a national set of data and exchange standards – has turned its attention to digitising “Chronic Condition Management Plans, capture the reason a patient presents for healthcare, and develop the additional data-sharing attributes”.

The Department of Health and Aged Care is also looking working on a framework for rolling out electronic medication charts beyond the aged care sector, which has seen 80 per cent uptake, according to Mr Butler.

Here is the link:

https://www.innovationaus.com/govt-pushes-ahead-with-real-time-pathology-data-sharing-plan

Also we have

Butler hopes to introduce ‘sharing by default’ laws next month, warns penalties may apply

17 October 2024

By Kate McDonald

The Australian government will introduce legislation to Parliament next month to support its ‘sharing by default’ policy, which will mandate the sharing of key health information with consumers starting with pathology and diagnostic imaging report uploads to their My Health Record.

Health Minister Mark Butler told the Victorian Healthcare Week conference today that penalties may apply to healthcare providers that refuse to upload results, which will see them lose out on Medicare benefits.

The mandate to share pathology and imaging reports in near real time is expected to see the elimination of the seven-day rule for test result uploads to My Health Record, although this element is still up for consultation.

It will be followed by other mandates on sharing information such as medication events, prescriptions, dispense records, and the administration of medicines in care settings.

Mr Butler said the government’s investments in digital health, along with a collaborative engagement with clinicians and software providers, were driving an upgrade to My Health Record that will improve patient care and shift provider behaviour.

He said that My Health Record was in “dire need” of an upgrade when his government was elected in May 2022.

“It was still using the old PDF format that Labor installed when we were last in government,” Mr Butler said. “It was cutting edge then, but it is beyond clunky now. For almost 10 years, nothing was done to upgrade the technology that underpinned it.

$1.1 billion in new funding was announced in the May 2023 federal budget to modernise the digital health infrastructure and upgrade My Health Record to a data rich platform, he said.

“A bit over one year on, and Australia is seeing the most substantial digital health reforms in more than a decade, across three major areas: standards, medicines, tests and scans.”

He listed the development of the Sparked initiative, led by the CSIRO, to deliver a national set of data and exchange standards based on FHIR.

“The first goal was to develop standards for core patient health information covering procedures, allergies, medicines, problems, immunisations and results,” he said. “In just 10 months, that goal was achieved.

“In June this year, Australia’s first ever national information sharing standard was published and can now be built into clinical systems.

This represents more progress in 10 months than in all of the previous 10 years, combined.”

The Sparked accelerator is now looking at how to digitise chronic disease management plans, “capture the reason a patient presents for healthcare, and develop the additional data-sharing attributes needed for a national patient summary record”, he said.

Work has also been done on medicines, including the transition to a single national delivery service for prescriptions, along with the expansion of electronic prescriptions from GPs and the community into public hospitals.

He also mentioned the roll out of electronic medication charts to aged care, where nearly 80 per cent of facilities have received a grant to adopt them.

But he said perhaps the biggest revolution underway in digital health is in the availability of scans and tests in My Health Record.

“All states and territories are now sharing pathology and diagnostic imaging reports to My Health Record, with most uploading more than 75 per cent of all tests and scans, and most on track to share 100 per cent of them in coming months,” he said.

“By the end of the year, for the first time, client support plans will be able to be shared from My Aged Care to My Health Record.

“Patients expect their diagnostic scans and pathology tests to be uploaded. This only happens by exception. It is not the rule.”

The government now plans to make it the rule, he said. “Over 10 million pathology and nearly one million diagnostic imaging reports are being uploaded each month.

“In May last year, just one in five diagnostic imaging reports were being sent to My Health Record. A year later, and one in three reports are now being uploaded.

“While this is an improvement, it is still too low and too slow, which is why I will soon introduce legislation that will mandate sharing by default for all tests and scans in near real-time.

“To enable faster access, I am looking to remove the seven-day delay that prevents patients from seeing their results sooner. While near real-time access will be the new standard, in some cases a clinically appropriate delay may remain if appropriate.”

A clinical reference group, co-chaired by former AMA president Steve Hambleton and chief medical officer at the Commission on Safety and Quality in HealthCare, Carolyn Hullick.

Mr Butler was particularly critical of an unexplained decision by pathology provider Healius to cease uploading reports to My Health Record last September – which he said meant an estimated 10 million test results were missing from My Health Record and would never be able to be uploaded – although the company has since resumed uploads.

“Test results and scans belong to patients, not providers, and they need to be shared to a patients’ My Health Record,” he said.

“To show that we’re serious, the laws will include consequences for companies that do not share.”

This will include a withholding of a Medicare payment if the patient’s results are withheld, he said, as the “sharing by default framework will ensure that pathology and diagnostic imaging companies that do not upload the results of a test or scan will not get a Medicare benefit for that test or scan”.

“Withhold a patient’s results and we will withhold the Medicare payment.”

Mr Butler said this would benefit healthcare providers as it would reduce spending on needless or duplicate tests or scans, along with productivity benefits.

“Every minute a GP doesn’t spend searching through My Health Record for a result that may or may not be stuffed into the PDF shoebox, is a minute they can spend with a patient,” he said.

“Every minute a practice nurse doesn’t have to spend manually entering a patient’s data into their My Health Record, is a minute that they could be administering a childhood vaccination.

“Every minute a practice manager isn’t held up on a phone call with a patient chasing up their results, is a minute that another patient doesn’t have to wait on hold to make an appointment.”

He said the “sharing by default” legislation will be introduced to Parliament next month, and he’d like the laws to be passed and in place by the middle of next year.

Here is the link:

https://www.pulseit.news/australian-digital-health/butler-to-introduce-sharing-by-default-next-month-warns-penalties-may-apply/

And we have:

17 October 2024

‘No rebate for you’: Butler threatens path labs if they don’t upload results

By

Laura Woodrow

The health minister announced he would withhold pathology companies’ Medicare rebates if they don’t upload patients’ results to the electronic health record.

The federal government will withhold Medicare rebates from pathology services that do not comply with legislation for mandatory My Health Record uploading, says health minister Mark Butler. 

Last year, Mr Butler announced plans to implement mandatory uploading of pathology and diagnostic imaging reports to MHR and to void the seven-day delay on report availability for patients. 

Opening day two of Victorian Healthcare Week’s digital healthcare convention in Melbourne this morning, Mr Butler said laws to be introduced next month would include consequences for companies which did not comply. 

“The sharing by default framework will ensure that pathology and diagnostic imaging companies that do not upload the results of a test or scan will not get a Medicare benefit for that test or scan,” he told delegates. 

“It’s that simple. Withhold a patient’s results and we will withhold the Medicare payment.  

“It’s not a drastic position for a government to take.  

“In the United States, for example, the 21st Century Cures Act requires the portability of health records with open access to consumers to their own health information.  

“Under that legislation, providers that do not have modern, cloud-based systems in place to enable this sharing can be sent to jail, which is not something we’re considering.” 

Mr Butler acknowledged a heckle of “yet” from the audience.  

“Our health systems are obviously different to America’s,” he said. 

“[But] since the US laws were introduced eight years ago, study after study has shown a range of benefits to consumers and health providers after the removal of delays to patients viewing their own results.” 

The Department of Health and Aged Care did not respond to The Medical Republic’s request for information on how the legislation would affect rebates to patients for non-bulk-billed services. 

While near real-time access would be “the new standard”, Mr Butler said he would consult with the Clinical Reference Group about “clinically appropriate” cases where the delay may remain. 

By the end of the year, client support plans will be able to be shared between My Aged Care and My Health Record, added Mr Butler. 

Since the announcement of the plans last year, all states and territories were now sharing imaging reports to MHR, with most uploading over 75% and “on track” to share 100% in the coming months, he said. 

“Since [the] announcement … the number of private radiology clinics connected to MHR has more than doubled.” 

While the needle is shifting, progress remains “still far too low and far too slow”, said Mr Butler. 

“It’s clear that we cannot leave patients to rely on the benevolence of private providers,” he said. 

Healius – Australia’s second largest private pathology provider, which received almost a billion dollars in Medicare benefits in the 2022/23 financial year – was named and shamed. 

“In August of that year, Healius was uploading over 800,000 pathology reports a week to MHR,” said Mr Butler. 

“No sooner had we released [the] proposal for public consultation, that very same day, Healius wrote to DoHAC to say that it would imminently suspend the upload of pathology reports.” 

Despite resuming 12 weeks later, approximately 10 million test results were not uploaded during the boycott. 

“Companies that have built their business model on channeling and control of a patient’s health data will have to find a new way to drive profit margins for shareholders,” said Mr Butler. 

Mr Butler said he hoped the laws would be passed and in place by mid-next year. 

The federal government’s $1.1 billion digital upgrade promises to revolutionise the “shoebox of PDFs” that is the MHR.  

“By the time Medicare reaches its next milestone birthday, we can confidently expect that the humble fax machine will no longer clutter the offices of health settings,” he said. 

“Like the Sony Walkman or Apple Macintosh, the fax machine will finally become little more than a museum relic.” 

Here is the link:

https://www.medicalrepublic.com.au/no-rebate-for-you-butler-threatens-path-labs-if-they-dont-upload-results/111763

It is going to be interesting to see how this all works out – as it will also be interesting to see if any obvious benefits flow from all this, and of course that no harm is caused with patients spooked by results they don’t understand.

The theory is great – I hope it works out as hoped when implemented. There has to be a good chance this will be the case…..I am still waiting to have any of my results mailed to me for my files, despite repeated requests!!!!

David.

6 comments:

Dr Ian Colclough said...

The ‘sharing by default’ framework has yet to be finalised. Oh!

Even so, the big stick threat of not being paid seems to have had the desired effect as a lot of service providers have started sending imaging and pathology results to the MHR.

Mmm, presumably the patients who do not want their results sent to MHR will continue to have their wishes respected!

Or maybe it would be simpler if a new law was passed overriding the patient's wishes making it mandatory for ALL results to be sent to MHR regardless of any patient's wishes!

Mr Butler said that pathology and diagnostic imaging companies that don’t upload the data to My Health Record “will not get a Medicare benefit for that test or scan”. Oh!

Who will be responsible for notifying Medicare that the results have been received by MHR; or NOT received if that was the patient's wish? The MHR or the service provider?

Perhaps the service provider should be made responsible for notifying Medicare when they lodge their claim.

Get Outlook for Android

Anonymous said...

The federal government’s $1.1 billion digital upgrade promises to revolutionise the “shoebox of PDFs” that is the MHR.

So, here we go again! The beginning of another multi-billion project to replace the old MHR with a new all swinging, all dancing, big bang, nation-wide My Health Record project. The BIG consulting firms are all hoping some of the riches will flow their way one more time.

Anonymous said...

Mr Butler said he hoped .... HOPE springs eternal.

Anonymous said...

By the end of the year, for the first time, client support plans will be able to be shared from My Aged Care to My Health Record.

What exactly does Mr Butler mean? Who will this help?
In what way will it help?
When will it help?

Anonymous said...

What is the purpose of this new CLINICAL REFERENCE GROUP?

A clinical reference group, co-chaired by former AMA president Steve Hambleton and chief medical officer at the Commission on Safety and Quality in HealthCare, Carolyn Hullick.

Anonymous said...

The Clinical Reference Group membership comprises 24 representatives.

That is one mega-big committee - they should be able to cook up a pretty tasty broth taking it in turn to stir clockwise then anti-clockwise according to taste!