Doctors stuck in the IT waiting room

Doctors are sick of being stuck in the waiting room as the federal government makes up its mind on Health IT, according to the chairman of the Australian Medical Association's (AMA) expert advisory panel on IT Allan Zemit.

Zemit told Computerworld the AMA has watched successive government health IT initiatives rise and inevitably stall because Canberra doesn't listen to the legitimate concerns of doctors and the community until it is too late.

A prime example is HealthConnect, which aims to put patient records online and has been four years in gestation through three ministers, and still there is no rollout date.

"We are very disappointed that [the HealthConnect] initiative has taken so long to come to fruition. It has been around for five years now. It looks as if they are finally getting it right. Part of the holdup has been that the government has not fully acknowledged some of the concerns that doctors and consumers have had with regard to privacy. It is only now that they are starting to address those concerns and are moving forward with the trial," Zemit said.

Zemit argues that while doctors have been quick to harness technology in their practices, government health IT decisions can be based on political expediency rather than infomatic principles. One glaring example was an ill-fated attempt to lift the number of doctors bulk billing patients by linking doctors and Health Insurance Commission (HIC) providers such as Medicare and the Pharmaceutical Benefits Scheme (PBS) through an EDI transaction system called ProviderConnect.

"The amount of EDI varies considerably [in line with bulk billing]. The schemes that the government has come up with to try and improve that have been costly. The estimate is, to set up [a ProviderConnect terminal] properly - so that the patient can pay the gap, and that the government can pay the rebate directly on behalf of the patient, is about $7000…for what is effectively an Eftpos terminal.

"Most GPs have baulked at that. We honestly have no idea why the cost is so high and we haven't been able to find out. The reason [doctors] do not bulk bill is because it is unaffordable [for them]. It is impossible to maintain good quality medicine when you have practice overheads, computers, ADSL and all of that to run and pay for - $94 an hour doesn't do it," Zemit said.

Despite problems of band-aid IT policy, Zemit sees plenty of light on the horizon, if people are prepared to listen to the advice of the AMA expert advisory panel.

"These people work in cutting-edge IT around the country, from industry to academics. We want to see health infomatics research and specific infrastructure support for that from government. The AMA believes that IT is really crucial to the further development of medicine not just in Australia but around the world," Zemit said.

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