PenCS now in the MyMedicare game

The Aussie health tech offers help wrangling the patient enrolment workload.

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Primary care providers now have more choice in dealing with the MyMedicare administration workload. 

Australian health informatics firm PenCS recently launched a tool to identify primary care patients who might be eligible for MyMedicare. The functionality, released in December, followed new MyMedicare registration tools by Healthily, launched in September and Cubiko, released in November 2023.  

New filters and reports have been added to PenCS’s existing Clinical Audit Tool (CAT) to identify all the potential MyMedicare patients in a primary care clinic. 

CAT can integrate with MyMedicare to identify patients who may be eligible and is also currently interoperable with 12 different patient management systems, a PenCS spokesperson told HSD. 

“CAT also provides a recall option, using SMS and voicemail, so the practice manager is not downloading exhaustive lists,” the spokesperson said. “CAT and PenCS can provide a report about patients with chronic diseases.” 

CAT’s “risk-of-hospitalisation module” uses a predictive risk algorithm to estimate the probability of a patient making an unplanned hospital visit within 12 months and “proactively identifies individuals at risk of health deterioration”. 

The filters used to identify eligible patients include possession of a valid concession card, being under 16 years old, requiring a review of a chronic disease management plan or having a chronic and complex condition that elevates the risk of hospitalisation. Patients living in a residential aged care facility are also flagged as potential MyMedicare candidates. 

PenCS chief executive Edweana Wenkart said the new functionality streamline the process for health providers to enable improved, proactive patient care.  

“The integration of CAT with MyMedicare aligns with PenCS’ commitment to use innovative health informatics technology to achieve optimal health outcomes. 

“It also supports a more effective model that allows certainty for providers to plan around regular revenue instead of uncertain events.” 

MyMedicare kicked off in October last year with the aim of giving patients better continuity of care for chronic and complex conditions.  

When eligible patients register with a general practice, the clinic can access special funding and services for that patient such as access to longer telehealth consultations and better visibility of treatment across the health network, through MyHealth Record. 

From July this year, practices and patients who are not registered for MyMedicare will not be eligible for two new incentives, one for general practice in aged care and one for frequent hospital users.  

However, a new General Practice in Aged Care incentive will become available in August this year to providers who regularly visit registered patients in residential aged care facilities with a pre-determined “quality bundle of care”. 

Getting patients registered into MyMedicare has landed clinics with an extra administrative task load and confusion among GPs and practice managers. The impact of the initiative was also assessed as only “adequate” by the Office of Impact Assessment inside the Department of Prime Minister and Cabinet. 

Doctors or practice staff with questions about the scheme are encouraged to visit the Services Australia Health Professional Education website and follow the prompts.