Exploit GPs or patients to pay: PCEHR dilemma
GPs will have to choose between being “exploited” or charging elderly patients more than $200 each to create shared health summaries for the personally controlled electronic health record (PCEHR) unless the government “foots the bill”, experts say.
The comments came as United General Practice Australia leaders unanimously expressed concern over the lack of preparation ahead of the system’s 1 July launch date and called on the government to ensure GPs were “properly funded and supported”.
A schedule of recommended fees for GPs who take on the ‘nominated provider’ role and create the summaries is still in development by the AMA, but Council of General Practice chair Dr Brian Morton said the fees were likely to be time-based and include an intellectual property component.
“If you have an elderly patient or someone with chronic disease, then [creating a summary] might involve the same sort of time as a Level C or Level D consultation and then you would have to factor in a component for the intellectual property contributed by the GP,” Dr Morton said.
The AMA-recommended fees for Level C and D consultations are $126 and $192 respectively.
RACGP e-health spokesperson Dr Mike Civil said GPs were once again being put in a position where they were being “almost exploited”.
“I think it’s very useful to put a value on the time costs involved, but the part of the population that would benefit most from an electronic health record is the part which can least afford those sort of out-of-pocket costs,” Dr Civil said.
“A lot of GPs just won’t feel comfortable charging that sort of fee.
“We’re trying to offer a good service and we feel altruistically it should be freely available [and] we’re not very good at charging privately.”
Australian Patients Association CEO Stephen Mason said the “strong feeling” was most patients would refuse to pay $150–$250 for a shared health summary and the government should provide an MBS item so GPs don’t have to charge a private fee.
“The government and the AMA will need to sit down in a spirit of cooperation and determine an appropriate cost sharing arrangement,” Mr Mason said.
Centre for Health Informatics director Professor Enrico Coiera said the questions around the funding of the PCEHR had to be answered.
“Clearly, GPs and doctors are going to have to invest time and expertise in creating and maintaining summaries and that cost has to get supported somewhere,” Professor Coiera said.
“It is important to put a price on the time costs involved, but what we do with that price is a separate issue that has to be discussed by the profession, government and consumers.”
A department of health spokesperson declined to comment.