GPs are calling on the Federal Government to recognise their role to the success of My Health Record with appropriate financial incentives, and just over a week out from the start of the opt-out period claim they can’t be required to obtain consent from patients every time a clinical document is uploaded into the system.

According to its latest My Health Record Position Statement, the RACGP said it supports the vision for a national electronic health record and is committed to making sure GPs can make informed decisions about participation in My Health Record.

But the organisation representing Australian general practitioners is seeking greater recognition for the role its members play in producing the Shared Health Summaries that are cornerstone documents in the My Health Record system. The RACGP is also pushing back against the Australian Digital Health Agency’s expectation that GPs are responsible for gathering patient consent.

“There is no legal requirement for a healthcare provider to obtain consent from a patient on each occasion prior to uploading clinical information, or to provide an opportunity for a patient to review clinical information prior to upload.

“However, where a patient explicitly requests that specific information is not uploaded to My Health Record, the healthcare provider must comply with that directive.”

The RACGP says standing consent, which applies from the creation of a My Health Record until a patient explicitly communicates its withdrawal, should suffice.

The organisation’s position is in contrast to comments made by Australian Digital Health Agency CEO Tim Kelsey in his address to the National Press Club in May when he said patients have control over each document uploaded to their My Health Record.

“With all these reports, including the Shared Health Summary from the GP, you have to give your consent to that being uploaded,” Kelsey said.

“That's why it's called a Shared Health Summary, because the GP actually asks you whether you're happy with the way that episode of care has been described and for it to be uploaded to My Health Record." 

[Read more: GPs and hospitals claim My Health Record is not fit for purpose as alarmingly low usage figures are released | “There is no Big Brother”: Tim Kelsey sells My Health Record as an innovation in consumer empowerment]

Asked to clarify the comments at the time, an ADHA spokesperson said even with standing consent “it is good practice to discuss with the patient what is being uploaded for a Shared Health Summary”.

The process would not be time-consuming given the healthcare benefits of the system.

“The upload of a patient’s Shared Health Summary using the majority of general practice clinical information systems (CIS) typically takes three to four mouse clicks and can be completed in under a minute.”

The RACGP also claims GP practices are required to “meet technological and regulatory requirements” to support My Health Record.

“This time and effort might appear to have no initial direct benefit to the general practice, as the relevant information is already in the local clinical information system. There is, however, a potential benefit to other healthcare providers and therefore the patient,” the position statement says.

The organisation is calling for an incentive scheme that rewards individual healthcare providers and eliminates upload targets to replace the existing unpopular model.

[Read more: AMA calls for improvements to My Health Record for it to reach potential | How disparate EHR systems, lack of interoperability contribute to physician stress, burnout]

“As a key contributor to My Health Record through the creation of SHSs and other forms of health data, general practice should be financially supported to participate through an appropriate incentive scheme.

“Incentives should be service-based, paid to the individual healthcare provider responsible for upload, and support the upload of accurate, high-quality data. The RACGP does not support the current Practice Incentive Payment – eHealth Initiative (ePIP), under which benefits are paid solely to the practice, and which uses arbitrary upload targets as a criterion for eligibility.”

Currently under the ePIP eligibility criteria general practices must upload SHSs for 0.5 per cent of the practice’s standardised whole patient equivalent (a calculation of a practice’s size). Late last year, of the approximately 7000 GP practices in Australia, only about 65 per cent were enrolled in ePIP.

The ADHA responded to the position statement saying it was delighted with the RACGP’s support.

“We are delighted to see RACGP support My Health Record in its most recent statement. The RACGP’s support is significant in ensuring consumers and clinicians can securely and quickly access health information via My Health Record to help improve health outcomes across Australia,” Dr Monica Trujillo, the ADHA’s Chief Clinical Information Officer and Executive General Manager of Clinical and Consumer Engagement and Clinical Governance, said.

Over 137 million general practice consultations take place each year with 85 per cent of Australians seeing a GP at least once a year.

From July 16 Australians will have three months to opt-out or a My Health Record will be created for them by the end of 2018.

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