Appropriate support inappropriate, says minister

by Charles Wright on April 11, 2012

You might recall my confusion about the meaning of the world “additional” in relation to the provision of MBS item numbers that would allow doctors to claim payment for creating or adding to their patient’s electronic health records.

This morning’s item on the ABC’s AM program has done a good deal to clarify what Health Minister, Tanya Plibersek actually meant when she said she was “in a position to detail additional support for GPs” and was “pleased to confirm MBS consultation items will be available to GPs as part of providing continuity of care to a patient, and if they are creating or adding to a shared health summary on an eHealth record which involves taking a patient’s medical history as part of a consultation”.

What she actually meant, it seems, is the opposite of what she said.

In her earlier address, she declared, “I want to confirm that the use of the longer consultation items will be seen as appropriate by the Medicare Australia Practitioner Review Process and the Professional Services Review in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history.”

This morning the minister told AM that  “The idea that [doctors] would during a longer consultation be paid extra for recording that information in a computer program that many of them are already using is probably not the best use of extra health funds.”

That seems pretty clear: the “additional support” she detailed in her address was not actually “additional”. It wasn’t “support”, either. And indeed, according to Ms Plibersek, there is no need for such a thing, because doctors won’t be called on to do much in the way of extra work:

“I think what GPs on the ground will find is that many of them are using software at the moment that will simply be upgraded to include an integration with the personally controlled e-health record summary and their work will not change dramatically.”

Right. That would make the $53 to $210 the AMA is proposing doctors should charge patients for preparing the new health summaries, according to Medical Observer … what? Unreasonable?

Somehow, I really don’t think so. While my understanding of the changes that desktop vendors are making to doctors’ software is that they do make uploading the data a matter of ticking boxes and clicking on an upload button, the work of selecting what items to include, and for that matter presumably cleaning up the data is going to represent a significant loss of productivity for doctors.

I’ve said earlier that the government and the AMA were locked in a battle of brinkmanship. (This afternoon, for instance, AMA president Dr Steve Hambleton told the ABC that the government was making the PCEHR too complex, with too much red tape.) It seems increasingly clear that the Treasurer’s determination to declare a surplus, however small, is likely to make that struggle even more intense.

What odds, I wonder, on patients actually opting in to the PCEHR if they are going to have to pay up to $210 for the privilege?

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