GPs seeking separate remuneration for maintaining e-health records

By Dr. Ananya Mandal, MDApr 11 2012

Doctors have risen together towards their campaign to be paid a separate fee for setting up patient summaries when electronic health records are rolled out from July.

A health-record summary is a quick fact sheet of a patient's health that their GP will create and keep up to date. The health summary is a key element of the government's personally controlled electronic health record (PCEHR) scheme, which the government is starting from 1 July.

The Australian Medical Association (AMA) has released a guide that encourages its members to charge between $53 and $210 to prepare and manage a shared health summary. Everyone who opts to use the e-health system will have a summary record containing information such as current medications, allergies and major conditions. Hospitals will be able to access it in emergencies.

“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,” AMA president Steve Hambleton said in a statement on Tuesday. “GPs are being asked to do more work in their consultations for no reward.” Dr Hambleton said the association's suggested fees were a guide only and GPs should “set their own fees based on their practice cost experience”. Doctors had to ensure the summaries were thorough, up-to-date and useful for all healthcare professionals, he said.

Federal Health Minister Tanya Plibersek in late March said GPs managing shared health summaries could access existing Medicare items for “taking a patient's medical history as part of a consultation”. She added that Labor had helped doctors prepare for e-health through incentive payments worth $85 million in 2010/11. Some 4200 general practices received up to $50,000 each.

For consultations that take less than 20 minutes, GPs will receive a Level B benefit of $35.60. For consultations that are longer, a Level C benefit of $69 would be provided, and, in the case where consultations go for more than 40 minutes, a Level D, $101.55 benefit would be provided, Plibersek said.

But the AMA insists there needs to be separate MBS items for managing patients' health summaries aside from regular consultation fees. The $53 fee would be for visits lasting less than 15 minutes. There'd then be intermediate fees of $104 and $154 with a service lasting more than 45 minutes costing $210.

If a consultation went over the 20-minute time purely because of the time taken to create an e-health summary, the doctor wouldn't feel justified in charging the higher rate, according to the AMA, because he or she could be asked difficult questions by auditors.

Plibersek addressed this in her speech, saying, “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.”