April 2006
By Reinhold Glehr, Austrian EQuiP delegate
Electronic social insurance card
At the end of 2005 all Austrian citizens will have to use an e-card to access medical care. The card contains administrative data about the cardholder, but no health data at the moment. Further extensions are in preparation: electronic prescription, extension to a European-wide accepted health insurance smart card, integration of social security registration procedures, application of the e-card as a key card for the transmission of sensitive data on the health sector (i.e. secure transmission of diagnostic findings).
One consequence of the introduction of the e-card will be the computerization of every medical practice at the end of the year.
Evaluation of practice standards
National standards for medical practices are still developed and negotiated by the doctors-chamber and the ministry of health. Attainment of a minimal standard will be pre-condition for office-based medical activities. The assessment procedure will consist of an obligatory self-assessment process followed by a random external audit procedure (approximately 10% of practices will be audited).
New control system for cost-effective prescribing
A new control system for cost-effective prescribing was established in January 2005.
Expensive medications have to be justified by a detailed documentation in a medical report. Every three months a doctor gets an evaluation of his prescribing behaviour. If his prescription rate is higher than an age-quantified average of the prescription level of doctors in a comparable setting an external audit will take place.
Disease Management Programmes
DMP-programmes will start in the second half of the year. Patients can choose to participate on a voluntary basis. The first will be a DMP for Diabetes mellitus, the second this for Hypertension. In the Austrian out-patient sector general practice is in competition with specialist care. The DMP-programmes will hopefully bring a better understanding of the role of General Practitioners.
A different type of DMP is a new quality improvement programme for substance misuse replacement therapy which is currently being implemented. Benchmarking, improvement in education of doctors, documentation, communication, networking and financial incentives will be the corner stones of this concept.
