GPs win e-health concession

Doctors need not stress about the complexity of the consultation when billing for the creation of e-health records, the Australian health minister has said.

The Gillard government has relented to a demand by doctors that they be paid for helping to set up patients' electronic health records.

The Australian Medical Association (AMA) and other medical organisations have been fighting to make sure that GPs will be adequately compensated for their efforts in filling out e-health records for patients who have set a record up after the scheme went live on 1 July.

Minister for Health Tanya Plibersek previously said that Medicare Benefits Schedule consultation payments would be available for GPs creating e-health records as part of consultations .

However, the AMA was concerned that there were no new item numbers specifically for creating an e-health summary, meaning that the creation of the summary would occur during a normal consultation.

Doctors charge based on the time and complexity of a session. Both factors need to be considered when thinking about whether to claim Level B, C or D benefits, with documentation to back up their choices. Level B requires the creation of a patient history; Level C requires the creation of a detailed patient history; and Level D requires the creation of a comprehensive history. This is checked by auditors.

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 about the complexity of the consultation. The AMA believed that in cases where a doctor attends to the patient's needs in a consultation, and then creates a basic e-health summary and goes over time, the doctor would be out of pocket because the document created would not be complex.

Plibersek has now said that doctors need not be concerned about the complexity.

"In deciding which item to bill, GPs will only have to consider the reasonable time it would take — not the complexity of the consultation," Plibersek said in a statement.

Everyone who opts to use the new 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.

While GPs wanted a separate fee for setting up patient summaries, the AMA has welcomed Plibersek's announcement that they would receive up to AU$100 for working on e-health records under existing Medicare items.

"The government has clarified that additional time spent by a GP on a shared health summary or an event summary during a consultation will count towards the total consultation time," AMA president Steve Hambleton said in a statement.