We will not accept a ‘second best’ PCEHR

THE AMA is a great supporter of the government’s efforts to introduce a shared electronic health record.

In fact, we have just circulated a draft guide for doctors on how to use the personally controlled electronic health record (PCEHR). And we have for years worked closely with the National E-Health Transition Authority (NEHTA), especially more recently with my friend and former AMA president, Dr Mukesh Haikerwal, who is running the NEHTA Clinical Leaders operation.

The road to the PCEHR has its origins back in 2005 when NEHTA was established. Tony Abbott was health minister at the time. The AMA has worked with NEHTA, the health department, and the offices of health ministers Abbott, Roxon and Plibersek over that period.

Our consistent message all along has been that we have to get the shared electronic health record right – right for patients, right for doctors and other health professionals, and right for the community and the health system.

It has to be right to help improve patients’ health, enhance quality of life, and save lives.It has to be right so doctors will choose to use it and ensure that the correct health information is included in the record.

And it has to right for the community and the health sector by being safe, secure, affordable and private.

The 1 July deadline for what is now the commencement of the PCEHR implementation is getting very close – but are we ready? 

Recent events indicate that there will need to be a lot of catch-up activity over coming months if we are to see a smooth implementation.

The case for doctors to sign up to the PCEHR is currently not attractive. There are few, if any, incentives.

During a recent interview on ABC Radio, Health Minister Tanya Plibersek admitted there was no new money to support doctors to provide shared health summaries for the PCEHR. This is what the AMA has been saying all along. 

The minister said “that the idea that they [GPs] 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… Their work will not change dramatically.”

We do not agree.

I firmly believe that if we can have an accurate, up-to-date medication summary, we will save lives.

But the government has made it clear that it has not created any items for doctors’ time and work with patients. It has not allocated any funding in the Medicare schedule to cover this new clinical service.

The public announcements from the government to date suggest that patients will only get a Medicare rebate if the shared health summary is prepared as part of an existing MBS consultation.GPs are being asked to do more work in their consultations for no reward. 

So the AMA has introduced its own items for preparing and managing a shared health summary for the PCEHR.The items provide guidance to AMA members on medical fees for this important additional 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.

But this is only part of the problem. We still have to sort out the PCEHR registration process.

The AMA has written to the health department slamming the proposed registration conditions placed on GPs, many of which are outside of their control.

We have said if the conditions remain in their current form, we will be advising our members not to register to participate in the PCEHR system.

As AMA president, I see it as my responsibility to make every effort to get the best possible arrangements in place for all GPs, not just AMA members, to sign up to the PCEHR and be part of the e-health revolution. If the system is right for doctors, the benefits will flow on to patients and the health of the community.

The AMA will not accept a ‘second best’ PCEHR.

Dr Steve Hambleton

President, AMA