Avant Medical Student

What’s new? 

Big news on the e-health front in 2011 and 2012 has been the commencement of Medicare funding for medical specialist video consultations and the soon to be introduced Personally Controlled Electronic Health Record (PCEHR). Both are developments that will have a significant impact on medical practitioners.

Telehealth video consultations 

Medicare funded medical specialist video consultations commenced on 1 July 2011. In line with the Connecting Health Services with the Future: Modernising Medicare by Providing Rebates for Online Consultations initiative, rebates are available for telehealth services provided to patients in regional, remote and outer metropolitan areas, and in aged care facilities and eligible Aboriginal Medical Services throughout Australia. Rebates are also available for an eligible healthcare provider to provide clinical services at the patient-end of the video consultation. Incentives are also provided to encourage the uptake of telehealth services.[1]

Who can provide telehealth consultation? 

• Specialist-end: Video consultations can be provided by any medical practitioner who is registered or authorised to practise (as described in the Health Insurance Act 1973), as a consultant physician, psychiatrist or specialist.
• Patient-end: Clinical services can be provided at the patient-end of a video consultation by any medical practitioner, participating midwife or participating nurse practitioner who has a Medicare number linked to an eligible patient location. In addition a practice nurse or Aboriginal health worker can provide a patient in-service ‘for and on behalf of a medical practitioner’ to a patient located in an eligible geographical area.

What is an eligible area?

Eligible areas for telehealth are those areas in Australia not defined as inner metropolitan. Patients who are residents at residential aged care facilities or who are receiving health services at an Aboriginal Medical Service are eligible to receive telehealth services under the Medical Benefits Schedule (MBS) anywhere in Australia.

• Medicare items: There will be 11 new MBS items available for video consultations provided by specialists, consultant physicians and psychiatrists. The new items will link to a range of existing MBS attendance items that can be provided by video conferencing and at a derived fee to the base item fee.
• Patient-end items: There will be 23 new MBS items available for patient-end services enabling other medical practitioners, participating nurse practitioners, participating midwives, Aboriginal health workers and practice nurses to provide clinical assistance to the patient during the specialist video consultation.

What is a Personally Controlled Electronic Health Record?

The PCEHR is a system developed by the Government to allow the secure sharing of health information between an individual and their health care providers.[2] Individuals will be able to register for a PCEHR from July 2012.

What will the PCEHR assist with? 

The PCEHR will allow users to view a consolidated overview of an individual’s allergies, adverse reactions, medicines, medical history, immunisations, directives and recent healthcare events from different information sources.[3] The PCEHR will support the collection of a range of clinical documents including shared health summaries, event summaries, discharge summaries and consumer entered information.[4]

• Control: Individuals will have the choice whether or not to have a PCEHR (an opt in approach) and will be able, if participating, to access the information in system, set controls around which healthcare providers have access, authorise others to access their PCEHR, choose which information is published to the PCEHR and view an activity history for their PCEHR.[5] Individuals will be able to withdraw from the system at any time.
• Healthcare Providers: Participating healthcare organisations (providing they meet certain criteria) will be able to access an individual’s key health information.[6]