How the govt is using Medicare data to improve the health system

Federal health secretary Martin Bowles has unveiled some of the practical ways the government is using data to identify the areas of the health system that don’t work and target resources to fixing them.

Addressing an e-health forum in New York yesterday, Bowles revealed his department has begun to analyse Medicare claims data to identify “unwarranted variation” in the types of treatments recommended to different patients with similar ailments.

“We have data on what doctors are actually doing – because their services are claimed on Medicare,” Bowles said.

“For the first time, this data has been used in conjunction with data from our pharmaceutical benefits schedule and public hospitals and this has thrown up some fascinating and disturbing insights.”

The number crunching has produced what the health department calls its ‘Atlas of Australian Health Care Variation’.

In accordance with the findings, health bureaucrats have now settled on a specific set priority of treatments as key areas to target waste, out-of-date medical practice and unnecessary treatment:

The department plans to go after:

• the use of antimicrobials
• the use of psychotropic medicines
• fibre optic colonoscopy
• knee arthroscopy, and 
• inequitable access to cataract surgery.

Bowles advised that often the secret to breaking down barriers to properly using data was asking the right questions.

He told the crowd that when he first joined the health department he “naively” asked if he could give data on the use of subsidised medicine and Medicare services to his colleagues in the states.

“I was given 100 pages of legal advice around privacy explaining why this was impossible,” he said.

But when he demanded the bureaucracy find a way to make it happen, he recounted, the solution came to just four pages.

“They now have the data. You need to ask the right question,” he advised.

The Department of Health is currently calling on industry to help it navigate the murky waters of de-identified data sets in the hope it will be able to leverage new information collected by My Health Record personal records scheme for research and policy development.

Bowles also said his agency was looking to set up a “user-friendly” data portal that would give third party innovators access to health data.