Putting patient data at the centre of care

Ensuring patients are better informed is critical in improving health outcomes, writes Medibank's Dr Andrew Wilson

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Although private-health insurers don’t fund GP consultations, we do play an important role in sharing information with general practitioners, and ensuring we promote and support the important work GPs do in preventative care.

There’s a lot of talk, particularly in Canberra, about the spiralling cost of healthcare. It’s something Medibank has experienced first-hand. Since 2011, the number of hospital admissions per Medibank customer has increased 19%, and the average amount Medibank pays in benefits per admission has increased 10%. These increases have seen average hospital benefits paid per customer increase by 31% in just five years.

This goes to the heart of the challenge Australia’s health system faces. How can we make the best use of our healthcare resources? We know that much can be done, and is being done, to improve Australia’s health outside the hospital walls. Delivering care in an environment that is more comfortable for the patient, in their home or in their GPs’ rooms is a solution that can improve the patient’s experience of care, and help reduce the cost of care. However, we know that investment in, and support of, primary care is vital to allow this model to flourish.

We recognise the vital role GPs play in tackling chronic conditions, delivering preventative healthcare, coordinating comprehensive care, interpreting diagnostics and providing a safe space for those dealing with abuse or mental-health issues. We know these are just some of the things GPs do on any given day.

Medibank has recognised that we can do many things to help support GPs. We want to put patient data at the centre of healthcare. This is a focus of ours as we move towards improving health system transparency for our customers.

One of the ways we are doing this is by providing data to consumers and their GPs about the cost of specialist care. Medibank’s partnership with Healthshare will enable customers and their GPs to see whether a specialist has recently participated in our GapCover scheme, meaning consumers can choose lower or no out-of-pocket costs.

We’re making this information available online, but we’re also embedding it into GP practice management software, so if it’s something a patient is worried about, it’s easy to find the information relevant to them.

It’s all very well to talk about giving patients access to more data about surgery and specialists, but interpreting that data is often difficult and wrong conclusions can be drawn. We believe the GP plays a key role in helping to ensure we have more informed patients who can make better healthcare choices which in turn leads to better health outcomes.

Our CareComplete program, one of the largest programs in Australia that supports the better management of chronic and complex health conditions, is central to how we are supporting general practice in preventative care. More than 3600 GPs are using this across Australia.

This initiative is part of Medibank’s broader commitment to supporting primary care and improving awareness, healthcare and outcomes for Australians living with chronic conditions. CareComplete recognises GPs are at the centre of their patients’ care and it helps to build the capacity of GP practices to provide evidence?based chronic disease management services to patients. The programs include:

• CarePoint – an integrated care program that provides coordination and support for patients with the highest level of chronic and complex needs;
• CareFirst – a behaviour-change program that supports patients to proactively manage their chronic condition; and
• CareTransition – a complementary program that enhances the hospital discharge process and improves a patient’s ability to manage their own recovery.

The CareComplete programs have been specifically designed to support the care the GP is providing. We don’t need, or want, to be a part of the care decisions – that’s for GPs to decide in consultation with their patients – but we are willing and able to provide the resources to bring a care plan to life.

As a practising psychiatrist, I have the greatest of respect for the huge challenges that today’s GPs face. We want to develop a range of programs and provide more information that can help ensure GPs are optimally equipped to improve health outcomes.

Dr Andrew Wilson is Group Executive, Healthcare and Strategy, for Medibank