Country hospitals do not have an electronic health record and RDASA has previously alerted the SA Department of Health to the pitfalls of EPAS after it was imposed on country doctors at Port Augusta.
Due to the lack of IT systems, many rural doctors are reliant on their own practice software, which is installed at the clinic’s expense to create discharge summaries and medication management. RDASA believes this should be recognised in the discussion of the new Agreement.
Fee For Service Changes in SAMSOF
RDASA firmly believes that all SAMSOF payments must have 6 monthly CPI increases. RDASA consistently argued for this in the last negotiation process. The current linking of SAMSOF to Medicare CMB increases has resulted in a prolonged freeze in state FFS payments which is inappropriate. The precedent to use a CPI increase has already occurred with CHSA LHN paying CPI increases for emergency item numbers as per the amended offer in April 2015. RDASA also calls for a significant corrective increase in SAMSOF to recognise the extended freeze that has occurred thus far.
Introduction of long consult item number Level E (Extended) indicating that a doctor has spent considerable time on a specific clinical scenario. For example, long psychiatric counselling and organising referrals for telepysch or mental health reviews for in patients who don’t fit SAMSOF 50 or 160 triage level 1 or 2 posing a risk to themselves or others.
There have been many occasions reported by members where fee-for-service officers have claimed that consultation time is only to include the time spent face-to-face with the patient. This neglects the significant amount of time that must be spent performing duties directly related to patient care, including writing of notes and referrals, liaising with other hospitals when arranging transfers, counselling family members, coroner’s paperwork, SAPOL paperwork etc.
Complexity around referrals for transfer continues to be a major issue, often requiring multiple phone calls to Tertiary centres and bed managers, Medstar SAAS etc for advice and arranging transport. This is becoming an even greater problem under the current Transforming Health environment. We expect that the time required to perform these tasks be adequately recognised.
Remuneration for forensic examinations as requested by SAPOL remain an issue. RDASA believes that these should be paid under SAMSOF.
RDASA also wishes to discuss consideration of a change to flat-rate time based remuneration for all Triage 1-3 emergency presentations, irrespective of admission status or patient category.