Ill wind blows through e-Health adoption

E-Health initiatives have medicos fuming over time-consuming software and parents traumatized over automatic rebates that not only don't arrive but disrupt childcare arrangements.

Parents applying for automatic rebates from Medicare-funded childhood immunizations are out of pocket and chasing paper, as relations between the medical lobby and government over the implementation of eHealth initiatives sink to a new low.

Computerworld has learnt Centrelink has been forced to manually process payments for about 635,000 childhood immunization payments because verification data which must be submitted by doctors - preferably online or by electronic data interchange - is simply failing to turn up in the IT systems of the Health Insurance Commission (HIC).

HIC, one of the government's largest transactional IT shops, acts as the financial clearing house for Medicare and Phamaceutical Benefits Scheme payments for Australians, releasing funds which Centrelink then directly deposits into customer accounts.

Under a government scheme known as the Childhood Immunization Register, all Australian children are expected to be vaccinated against deadly infections such as meningococcal disease. Some federal rebates for childcare are also linked to government verification of vaccination status, with childcare centres altering their fee structure for parents accordingly.

The data transfer failure has parents at wits' end. Sydney mother Elissa Baxter said she ensured both her children were immunized on time yet still received letters from Centrelink "saying they are not up to date and threatening to cut off the Child Care Benefit."

"That means I have to run around to the doctor each time to print an immunization schedule I can post back to Centrelink. Even then, the agency doesn't update its records properly. My childcare benefit was cut off a few weeks ago even after I sent in proof of immunization; now I have to go through the hassle of getting it put back on," Baxter said.

A spokesperson for Human Services Minister Joe Hockey said she was aware of some issues; however rejected any IT breakdown or problems in data interchange between HIC and Centrelink.

"As far as the immunization register is concerned, [the transactional data interchange systems] work," adding the registry is "updated every day."

However, the spokesperson conceded if data was not being forwarded "by providers" (doctors) after children were immunized, problems were likely to occur. She added that doctors had been provided with various ways to communicate immunization data to the HIC including "through a secure Web site, e-mail, fax, phone and mail", and was at a loss as to explain why the data was not arriving at the HIC.

However, doctors, especially general practitioners, have panned the HIC interface and reacted angrily to any suggestion they are to blame.

"The whole system is dysfunctional and disintegrated. It's not supported. Of course there's going to be a breakdown. The government needs to listen to what is needed in terms of infrastructure support," said Dr Rod Pearce, chairman of the Australian Medical Association's council of general practice.

Pearce also alleged HIC was suffering "linkage and processing issues and a lack of resources", saying IT support for doctors on the HIC interface had been severely cut over the last two years.

However, he rejected any suggestion the medical fraternity is lagging in IT skills, or resistant to new technology.

"That's absolute crap. GPs are incredibly good with computers. [HIC] is asking us to use software that adds 10 percent to our time. Why aren't we being compensated 10 percent for that time?"

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