Tuesday, April 10, 2012

And Now The Rubber Really Hits The Road With the NEHRS. It Will Really Cost If Adopted.

This popped up today.

AMA proposes PCEHR consult items and fees

10th Apr 2012
GPs have been advised to charge each patient up to $210 when preparing a shared health summary for the government’s personally controlled e-health record (PCEHR) system, which will be rolled out from 1 July.
AMA president Dr Steve Hambleton said government had not created any new MBS items, and had not set aside any new funding, to remunerate GPs for the work they would put into creating shared health summaries.
“The public announcements from the government suggest that patients will only get a Medicare rebate if the shared health summary is prepared as part of an existing MBS consultation,” Dr Hambleton said.
“GPs are being asked to do more work in their consultations for no reward.
“We have sought more information and clarification but no formal public response has been forthcoming.”
More here:
The triggering release is here:

AMA sets its own items for managing a shared health summary for the Personally Controlled Electronic Health Record (PCEHR)

The AMA has introduced its own items for preparing and managing a shared health summary for the Personally Controlled Electronic Health Record (PCEHR).
AMA President, Dr Steve Hambleton, said today that the Government had not created new items for doctors’ time and work with patients on the PCEHR and had not allocated any new funding in the Medicare Benefits Schedule (MBS) to cover this new clinical service to be provided by doctors.
“The public announcements from the Government suggest that patients will only get a Medicare rebate if the shared health summary is prepared as part of an existing MBS consultation,” Dr Hambleton said.
“GPs are being asked to do more work in their consultations for no reward.  We have sought more information and clarification but no formal public response has been forthcoming.
“So the AMA has taken the initiative to give doctors and their patients some certainty by setting items that realistically reflect the time, the work and the expertise required to ensure that shared health summaries are thorough, up-to-date, and useful across health care settings.
“The items provide guidance to AMA members on medical fees for this important clinical service for their patients.  It is not a recommended fee.  The AMA encourages its members to set their own fees based on their practice cost experience.
Full details here:
The recommended fees are between $53 and $210 depending on the time taken to set up and then maintain the patient’s NEHR.
At a minimum if we have a set up and then one maintenance consult for the cheapest rate over a year and the adoption reaches about 10% of the population the annual cost is $233.2 Million.
Of course of the 50% figure was reached in 5-10 years we are over the Billion p.a. figure.
I wonder did the geniuses who designed this parallel system show at that level there was value for money to be had. I suspect not.
They will be praying for zero adoption!
Nutty world we live in.
David.

8 comments:

Anonymous said...

Come on David, get real. We know it will never work, and thats a cunning plan to reduce cost in a true Yes Minister tradition. In fact they deserve a medal for ensuring it will never work, as the costs would have blown out if it did.

B said...

Let's assume, just for fun, that the Concept of Operations (Final)document actually describes what the system is going to do. (We all know it doesn't, but let's go along with NEHTA, and pretend)

Look up Assisted Registration - you know, the thing that GP's will be asked to do.

Page 31

From July 2012, the PCEHR System will support a range of assisted registration processes by Authorised Registration Agents operating within Medicare branded service points, the Medicare call centre or via Medicare’s remote area support services. Some healthcare organisations may also offer to act as an Authorised Registration Agent

and, page 33

Assisted registration agents, such as those operating within Medicare call centres and shop fronts, will not be able to view the contents of clinical documents within an individual’s PCEHR. Assisted registration agents will be limited to providing assistance with registration or managing a PCEHR.

It would appear that a) GP's are not mentioned as assisted registration agents and b) the second quote above proactively excludes them from acting as registration agents.

As we get closer to lift off date, one might expect the requirements of the system to be more and more agreed and stable. I don't get that impression. And as I've said before unstable requirements is the number one cause of system failure.

SNAFU.

Anonymous said...

PCEHR [NEHR] liability. Don't be deceived, Jane Halton has known for some time the Department has a dog in the PCEHR. That is why NEHTA has been encouraged to embrace the new term NEHR and why the doctors have been setup to have all the liability. That way when it fails, because uptake was so low, the doctors can be blamed because they didn't support their patients and they didn't use the system.

The doctors will be shown to have been the root cause of the failure - not the government's fault. The Department understands this - the doctors don't.

Anonymous said...

"charge each patient up to $210 when preparing a shared health summary" - good golly - you couldn't PAY ME $467million to HAVE ONE in the 1st place, not a snowball's chance in hell of this thing ever taking off. A real fizzer. Our GP practice won't touch it with a bargepole.

Anonymous said...

$210 for preparing a health summary from largely pre-existing data? Is it just me, or is that just a little bit... Opportunistic?

Anonymous said...

Opportunistic. It reflects the opportunistic way NEHTA has flogged this to the gullible politicians.

Paul Fitzgerald said...

If we had an opt-out system, this issue wouldn't be an issue. Now with 50-200 odd dollars to get set up, as someone else said, it dooms it to fail - so all the aged, chronically ill etc, who are the supposed main beneficiaries of this are highly unlikely to either want to spend, to have the cash to spend on this white elephant.

Anonymous said...

Opt-out or opt-in is neither here nor there. The fact is if a system is any good, if it works, if it serves a useful purpose, if it helps save time and money, if it streamlines the healthcare processes, if it is accurate, reliable, secure and fast, if it is affordable and viable it will be used. If it isn't it won't.