21 MARCH 2016

Dr Steve Hambleton

Immediate Past President AMA

Chair Primary Health Care Advisory Group

Deputy Chair MBS Schedule Review Task Force

Chairman NEHTA

Member eHealth Transition Taskforce

Is the consumer at the centre of your business model?

More than 1 in 3 Australians have at least one chronic condition, and this is expected to increase as the population ages

Medicare spending is projected be the fastest growing area of Australian Government expenditure over the coming decades

Risk factors for chronic conditions such as obesity are already at high levels and are increasing

There is a potentially preventable hospitalisation for chronic disease in Australia every 2 minutes – for diabetes alone every 2.5 hrs

Nearly a quarter of people who visited an emergency department felttheir care could have been provided by a general practitioner (GP)

What is the problem?

Minicons - CC by 3.0

Primary Health Care Advisory Group

• Final report was handed to government on 4 December 2015• Better care for people with complex and chronic illness;

• Innovative care and funding models;

• Better recognition and treatment of mental health conditions; and

• Greater connection between primary health care and hospital care.

Features of high performing Primary Care Systems

Patient engagement

Care delivery

Risk stratification

Continuous quality improvement systems

Care plans and team care arrangements

Care coordination

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Canterbury District Health Board – Our Health SystemReorienting the system around the needs of the patient

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Guiding Principles

24 March, 2016 5

A sustainable primary health care system for patients should:• Engage patients and carers as active partners in decisions about their health and 

wellbeing. • Ensure service and funding models are based on best practice to maximise 

patients’ health improvement, service safety and quality, and allow flexibility.  • Deliver efficient health care, eliminating waste and duplication. • Ensure potentially avoidable hospitalisations are minimised. • Facilitate integration and coordination of patient care across care settings and 

support health care professionals to work as multidisciplinary teams.• Encourage all primary health care professionals to work to their full scope of 

practice.• Support the collection, reporting and use of primary health care outcome. 

Feedback from consultations and written submissions

• There is strong support for voluntary patient enrolment and team based care for people with chronic and complex health conditions.

• There is strong support for myHealth records and an opt-out approach.

• This is an untapped opportunity to engage patients in their own care, particularly with technology that people already want to use (e.g. smart phones, home based monitoring).

• There is very strong support for the reporting of outcomes and changes in health status at an individual and at an aggregate level.

• There is support for a blended payment mechanism which recognises and caters for different complexities and levels of care.

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“We’re committed to delivering a strong primary care system for all Australians and all of the feedback I’ve received from doctors and patients throughout my recent Medicare consultations is that a functioning national eHealth system is critical to achieving this.” Media release 10 May 2015

This is part of the great digital health revolution that literally lies in the hands of consumers. Speech to Australian Professional Pharmacists on the Gold Coast 17 March 2016

Digital Health

The Hon Sussan Ley MP Minister for Health

Individuals sharing their health information electronically will lead to:• Increased availability and quality of health

information• Less occurrences of adverse medical events• Decreases in the number of tests, less duplication• Better coordination and quality of healthcare

Ultimately, better health outcomes for Australians.

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My Health Record

New digital health governance arrangements

• Australian Digital Health Agency one accountable organisation one governance process for all digital health activities Reflects the key stakeholders/beneficiaries will have skills

and experience with; consumers advocacy, medical practice, innovative use of technology,

private health, public health, health informatics and standards, financial and legal.

Strategic role to evolve national digital health services

• Implementation Taskforce to manage the establishment of and transition to new governance arrangements

My Health Record

Trials of Participation Arrangements -Timeline• 4 March – Ministers launch• 10-22 March – letters to individuals living in trial areas• 4 April to 27 May - individuals can tell us if they don’t want

a My Health Record (they can opt out) • By 15 June – individuals can access their My Health

Record, and set access controls• By 15 July – healthcare providers in trial areas can begin

to view and contribute information• 31 October – evaluation period concludes• Early 2017 – recommendation to Government

My Health Record

• 2.6 million consumer registrations, increasing by 1350 per day• Over 8,000 healthcare organisations are registered to access the

PCEHR System, increasing at a rate of 20-30 per month• Included in this number there are:

– 5,774 General Practices uploading on average 500 SHS per week– 471 Public Hospitals and community clinics and 27 Private Hospitals,

between them 4000-5000 discharge summaries/week– 155 Aged Care Residential Services– 1,441 Retail Pharmacies– 1,925 registrations from other provider types including Dental Services,

Optometry, Allied Health and Chiropractic Services.

53 Software Products have access to the PCEHR Production System enabling them to support healthcare providers by connecting their Clinical Information Systems to the PCEHR system.

Current state - UptakeMy Health Record