Can EHealth in Australia be private?

I spent Wednesday in Melbourne attending the workshop arranged by the ACHR and GAP on the paper by Associate Professor Leanne Rowe "Primary Health Care and The Private Patient Journey: Towards a new generation of private health care in Australia”.

The goal of the event was to get the full range of stakeholders in the room to discuss how private health insurers, private hospitals and primary care could work together to deliver better healthcare.

The first challenge was in defining who is a private patient in Australia. We agreed that the patient who is admitted into a private hospital for a procedure by a private practicing clinician whose procedure is paid for by a private health insurer is a given. As we start looking at the average patient who rocks up to their GP clinic, it can be well argued that they are also effectively a private patient. Whilst their insurer may well be the federal government trough Medicare, from the perspective of the patient and the provider, especially in the much more common non bulk billing practices out there now, it is a series of private transactions.

So the private patient remains a mysterious entity. In a fee for service model as we currently have in Australia, effectively every health transaction is a private transaction between a provider and patient.

How does ehealth play in the private healthcare transaction world? In reality technology has been used for tracking transactions for many years. Even the least technically literate practice is likely to have some sort of electronic system for billing, be it a basic MYOB accounting application, or a specialised healthcare system. Accounting took up technology very quickly, it made a lot of sense to them. With the advent of services like HICAPS for private insurance billing and ECLIPSE for Medicare billing healthcare providers also took advantage of it.

However the same capability to manage clinical information for private patients and sharing it with their care team hasn’t had the same uptake.  We keep on hearing about silos in healthcare, and the silo mentality around healthcare data propagates this further. I hope that the Personally Controlled Electronic Health Record may be the critical factor that breaks these silos. To do this, it needs to be adopted not just by patients, but also by providers, public and private. I believe the best way to do this is add a little carrot, maybe a couple of cents extra for transactions that have also sent data to, or used data from the PCEHR. In a private payment world, maybe those few extra cents will drive adoption in the beginning when there isn’t too much data there. Over time as the data builds up, clinicians will see value in the data, and will be more likely to use it without the extra incentive. Its the beginning which is the hardest, so makes sense to spend a bit of money up front to get adoption ramped up quickly.


One Response to “Can EHealth in Australia be private?”

  1. Lisa New Says:

    Whilst a financial incentive is an option, health practitioners might find greater incentive from the angle of limiting their professional indemnity, i.e. be provided with a personal health record application that supports the practitioner in preventing preventable health risk, without having to wait for the data to build up.

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