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Last updated 25 May 2017

Frequently Asked Questions – ePIP

Over the quarter, 5 shared health summaries for one patient or 1 shared health summary for each of 5 patients or any combination amounting to 5 would all meet an upload requirement of 5 shared health summaries. Each upload is counted; the shared health summary upload count is for total shared health summary uploads to the My Health Record per PIP practice.
The PIP eHealth Incentive is a practice based payment and eligibility is based on each PIP practice meeting all the requirements across the quarter. For PIP practices that share a Healthcare Provider Identifier Organisation (HPI-O), each PIP practice must still meet its requirements individually, including shared health summary upload targets. Uploads cannot be shared across a group of practices underneath a HPI-O as the upload targets are linked to the PIP ID and SWPE count for the PIP practice. How the minimum upload target will be met in a practice is up to the discretion of the practice.
Existing practices For an existing PIP practice the minimum shared health summary upload target is calculated using your practice’s SWPE. Every quarter your practice is sent a Payment Advice which advises your current SWPE count. The SWPE count provided in your last Payment Advice is the SWPE value to be used to calculate your shared health summary upload target for the current quarter. To determine your practice’s minimum upload target, multiply the SWPE in your Payment Advice by 0.5%. Please refer to ‘New and small practices’ below if the SWPE of your practice is less than 1,000. For example, to determine your minimum shared health summary upload target for the May to July 2016 quarter, multiply the practice SWPE provided in your May 2016 Payment Advice by 0.5%. The calculation for a practice with a SWPE of 5,000 would be 5,000 x 0.5% = minimum shared health summary upload target of 25. New and small practices If your practice is new to PIP or has a SWPE of less than 1,000 your practice will be given a default SWPE level of 1,000 to determine the minimum number of shared health summaries that are required to be uploaded. This equates to a minimum shared health summary upload target of 5 per quarter. If your practice’s SWPE grows to be more than 1,000 (as per your Payment Advice) the actual SWPE will be what you use to calculate your minimum shared health summary upload target. The default SWPE is only used to calculate your minimum shared health summary upload target and is not used to calculate any PIP payments. Please note - where the specific target calculated is not a whole number, targets will be rounded down.
As requirement 5(iii) is linked to the quarter for the activity, practices cannot carry forward any uploaded shared health summaries that exceed their current quarter to count to towards the next quarter. For example, if a practice with a SWPE of 5,000 had a minimum shared health summary upload target of 25 for the May to July 2016 quarter actually uploaded 28 shared health summaries, the 3 extra shared health summaries created will not be deducted from the practice’s August to October 2016 shared health summary upload target.
Yes. To update a shared health summary in the My Health Record system, a new shared health summary must be created and uploaded, and each upload counts towards meeting the practice’s upload target. When a shared health summary is updated and uploaded to the individual’s My Health Record, all the other shared health summaries in the individual’s My Health Record still exist and can be viewed. The individual’s nominated healthcare providers are expected to make a professional judgement as to whether there is clinically relevant information that requires a shared health summary to be updated.
As requirement 5(iii) is linked to the quarter for the activity, practices cannot carry forward any uploaded shared health summaries that exceed their current quarter to count to towards the next quarter. For example, if a practice with a SWPE of 5,000 had a minimum shared health summary upload target of 25 for the May to July 2016 quarter actually uploaded 28 shared health summaries, the 3 extra shared health summaries created will not be deducted from the practice’s August to October 2016 shared health summary upload target.
Yes. The count of shared health summaries will be directly linked to the practice that uploaded the shared health summary, regardless of whether that patient visits other practices as well.
General practices will continue to receive an annual confirmation statement to confirm or amend whether they have met all the eligibility requirements for PIP and the eHealth Incentive. This is a legal declaration that practices have met the incentive requirements.
There are no instances where multiple practices share a PIP Practice ID. However, there is the potential for multiple practice locations to be within a PIP Practice ID. The multiple locations within a practice are considered as a single entity therefore share only one target. It is up to the discretion of the practice to determine how it will meet its target.
To ensure that you have sufficient knowledge of your targets and time to meet them, no changes will be made to targets during the course of the quarter if there are changes to your SWPE/practice circumstances in that time, except where practices amalgamate. From the next quarter, the minimum upload target may change if your SWPE has changed. This target will be based on your new SWPE, as advised in your Payment Advice.
Practices will need to have policies and procedures in place to show that they have met their minimum shared health summary upload target. Where a practice does not believe that they will meet all eligibility requirements by the point in time, including their upload target, they must withdraw from the eHealth Incentive, or opt out of the incentive for that specific payment quarter by the point in time date for that quarter.
For PIP, the main practice location should be the one that provides the highest number of Medicare Benefits Schedule (MBS) services each year. For the purposes of the PIP, additional practice locations are known as practice branches. The SWPE from all practice branches are added to the main practice location to calculate the minimum number of shared health summaries required to be uploaded to the My Health Record by the combination of the practice branches and the main practice location. Where a practice has more than one location and each location has a separate unique HPI-O, the practice should use the HPI-O associated to the main location. If a practice with more than one location changes the main practice location to a practice branch location (or vice versa) they should update the HPI-O associated to the new main practice location. The practice will still need to meet the shared health summary upload target calculated using their SWPE for the last payment quarter for the PIP ID. Changing the main practice location during the quarter will not alter the shared health summary upload target for the practice.
Practices will be responsible for monitoring and satisfying themselves that they have met the minimum upload requirements for each quarter or opting out of relevant quarter payments if they will not meet the requirements. If multiple practices share a PIP ID, then the target is based on the shared SWPE of all of these practices and the linked practices will be responsible for determining how the minimum upload target will be met and how individual practices will contribute to meeting the upload target for the PIP ID. The group of practices must assure themselves that the group has met the minimum target allocated to that PIP ID. Some clinical information systems and sidebar tools allow practices to track the number of shared health summaries they have uploaded.
Where two or more practices are amalgamated during the quarter: The shared health summary minimum upload target will be based on the last payment quarter SWPE or default SWPE of the remaining practice; Subsequent quarter shared health summary upload targets will be calculated using the practice’s amalgamated or default SWPE to calculate the shared health summary upload target. For example: Practice A had a calculated upload target for the current quarter of 50; Practice B had a calculated upload target for the current quarter of 65; The two practices merge during the quarter; The merger is completed before the point in time and Practice A is the remaining practice; The upload target of 50 for Practice A is the target to be achieved.
Practices are responsible for monitoring and satisfying themselves that they have met the minimum upload requirements for each quarter or opting out of relevant payment quarters by the point-in-time if they will not meet the requirements. Some clinical information systems and sidebar tools allow practices to track the number of shared health summaries they have uploaded.
For the May to July 2016 payment quarter, you need to calculate your practice’s minimum shared health summary upload target using your previous quarter’s Payment Advice. In your August 2016 Payment Advice you will be able to view your practice’s upload target for the August to October 2016 reference period if you elect to receive your practice’s Payment Advices online via HPOS Messages. For future quarters, practices will be able to view their current eHealth Incentive details, (including their minimum shared health summary upload target) in the PIP Online eHealth Incentive Details screen.
All practices must upload shared health summaries for a minimum of 0.5% of their practice SWPE count regardless of the size of the SWPE associated with their PIP ID.

Last updated 28 April 2016