Medical software providers were given just 14 working days to implement the chronic disease management changes, a process that would normally take months.
Alongside the rest of the primary healthcare industry, GP software vendors like Best Practice and MedicalDirector only found out the detail of the incoming chronic disease management changes six weeks before those changes were due to be implemented on 1 July.
That alone would have been a stretch for vendors. But to make matters worse, the government did not release the data files needed to build the software until last Friday.
It gave vendors just 14 working days.
“It would have been really great if we were able to directly brief the minister’s office and advisers on digital about the enormous technical change here,” Medical Software Industry Association CEO Emma Hossack told Health Services Daily.
“It’s not just a normal drop-in of XML [code file] item numbers.
“You want to have the logic right, so that when people turn on their computers they don’t have to think about whether they have to code something in differently to make the invoice or the rebate from Medicare happen.
“It’s kind of nuanced.”
The XML (extensible markup language) files are released by Services Australia on MBS Online ahead of any changes to the MBS.
These contain the most recent version of the current items for the MBS and are generally released about a month before each scheduled update.
“[Under normal circumstances,] XML can be delivered late and it’s a pain, but it’s not irretrievable because it’s not complex,” Ms Hossack said.
“This is complex because, with a new policy change, you want to get serious engagement and uptake.
Related
“If the users have a negative first experience either at the front desk, because the practice management isn’t certain on what to do in their situation, or the doctors aren’t 100% certain on their actions, the consumer is the one that loses out.”
Both Ms Hossack and Best Practice group manager for partnerships Jessica White told HSD that they had been working under the assumption that the chronic disease management changes would be delayed a second time.
“[When the details did come,] it was a surprise to us, just like it was to everyone else,” Ms White said.
“We just have to roll with the punches … obviously a lot more notice would have been great, but we just have to make the changes work the best that we can.
“From the software vendor perspective, I’m really proud of everyone in the industry for hustling and making sure that we can support our customers through these changes that are coming out on 1 July.”
A spokesman for MedicalDirector told HSD that, while the changes were complex from a technical perspective, they “involve implementing a new template and item number workflows which will be available to GPs in July 2025”.
Both software vendors said the updates will be available for customers on the go-live date.
Earlier this week, Best Practice ran a webinar for customers on the chronic condition management changes; about 1500 people attended, and around 200 questions were submitted.
“Of those 200 questions we answered, we had zero to do with our software,” Ms White said.
“They were questions about the scheme itself.
“A lot of software vendors are becoming a delivery mechanism for … change and managing the change process on behalf of government.”
It would be great, Ms White said, if the government could work more closely with industry groups like MSIA to acknowledge the part that vendors play in delivering its initiatives.
Ms Hossack has been advocating for a closer working relationship between the medical software industry and government agencies.
Her concern was that the Department of Health, Disability and Ageing treated the upcoming changes as it would any other routine update, without recognising the added complexity of chronic disease items.
Chronic disease management items consistently have the highest bulk-billing rate of all the GP non-referred attendance items, at 99% so far this financial year.
They’re also relatively commonly used; around 16% of Australians access GP chronic disease management plans each year, and Medicare statistics for this financial year so far show that a GP chronic disease items have been accessed more frequently than Level A consults or after hours consults.
“[We want] good, solid engagement … across the whole community – the workforce, the tech industry, the consumers and government,” Ms Hossack said.
“And we know it can work; e-prescribing was a classic.
“By May 2020 it was all done, all dusted, everyone actually enjoyed it and no one had to be paid to use the technology because it had a clear purpose and it worked.
“Medicare is an institution in Australia, and we should respect it and make sure that when there are changes, we get a chance to make them work perfectly for the users of Medicare.”