AMA submission on proposed changes to the PIP eHealth Incentive

12 Oct 2015
In a strong submission to the Department of Health (DoH), the AMA has outlined its opposition to proposed changes to the Practice Incentive Program (PIP) eHealth Incentive that would require GPs to demonstrate 'meaningful utilisation' of the MyHR.  
The DoH is considering requiring a target number of Shared Health Summaries to be uploaded and wants to determine the appropriate patient base for this. It is also considering other measures to measure active and meaningful use of the MyHR, related to:
  • secure messaging
  • assisted registration
  • mandatory upload of SHS post training
The submission outlines a number of concerns with the initiative. In particular:
  • that the MyHR requires considerable improvement before it is useful and reliable and clinicians are willing to interact with it,
  • that an MBS item and Service Incentive Payment is a more appropriate funding mechanism to encourage uploading of SHS and recognising the work involved
  • requiring GPs to send secure messages is inappropriate until hospitals and specialists have the same capacity to send and receive them
  • assisting patients to register for MyHR should not be the responsibility of clinicians or practices
The AMA Recommendations are:
Recommendation 1

Current requirements for the eHealth Incentive should remain unchanged until such time as the My Health Record is an easy to use, clinically relevant and reliable, and an interoperable eHealth record for the majority of the population (ie for all patients other than those who choose to ‘opt-out’).

Recommendation 2

The Government’s primary and initial focus should be on make the necessary improvements to the MyHR.

Recommendation 3

The Department start exploring changes to the eHealth Incentive that would facilitate the use of eHealth technologies to enhance patient care from and access to their usual GP.

Recommendation 4

That the Department at a minimum delay the start date of any revised eHealth Incentive as per Recommendation 1 until there is a commitment to move the MyHR to an ‘opt-out’ basis but preferably until after the outcomes of the Opt-Out trials are known. The eligibility requirements for any PIP incentive should be advised at least 6 months in advance with a clear communication strategy to all GP’s.

Recommendation 5

That the Department refrain from amending Requirement 2 to include demonstration of active and meaningful use until specialists, allied health provider and hospitals can securely interact with GPs via secure messaging.

Recommendation 6

That a MBS item number and SIP be introduced to support the active and meaningful use of the My Health Record.

Recommendation 7

Leave Requirement 5 unchanged as it already requires the creating and posting of shared health summaries but if the Department is determined to link the incentive to greater usage it should focus on the simplest and most relevant measure possible.

Recommendation 8

Choosing a patient base should be put on hold until the outcomes of Primary Health Care Review are known as this may provide a distinct patient base, ie patients registered with a Medical Home.

Recommendation 9

That assisted registration is an administrative task that Government through the Department of Human Services should be tasked with and funded to provide.

Recommendation 10

Give further consideration to how the eHealth incentive could be redesigned to support ongoing eHealth capacity and use.

Recommendation 11

Retain quarterly payments unless changed warranted by a redesigned eHealth incentive.