4th Annual Pathology Forum:

Consumers and Pathology

Rebecca Vassarotti Policy Director

Consumers Health Forum

• Advocates for appropriate and equitable

healthcare

• Undertakes consumer-based research

• Raises the health literacy of consumers,

health professionals and stakeholders

• Provides a strong national voice for health

consumers and supports consumer

participation in health policy and program

decision making.

CHF values: • Our members’ knowledge, experience and

involvement

• Development of an integrated healthcare

system that values the consumer experience

• Prevention and early intervention

• Collaborative integrated healthcare

• Working in partnership

• CHF is committed to being an active

advocate in the ongoing development of

Australian health policy and practice.

CHF and Pathology

2009-2010

• CHF addressed consumer issues on quality use

of pathology

• Consumers from every Australian state and

territory were involved in consultations

2011

• Survey of more than 350 health consumers

Since then

• Ongoing involvement in pathology policy

discussions – including on request forms

Changes to pathology request forms

• 2009-10 Budget – Government

announced that consumers would be free

to choose their own pathology provider

• Changes to Health Insurance Act allow a

patient to choose provider except when a

provider is specified on clinical grounds

• Since 1 August – all forms must include

mandatory patient choice advisory

statement

Mandatory statement

Your doctor has recommended that you use

[insert name of pathology provider]. You are

free to choose your own pathology provider.

However, if your doctor has specified a

particular pathologist on clinical grounds, a

Medicare rebate will only be payable if that

pathologist performs the service. You should

discuss this with your doctor.

CHF perspective

• A welcome change

• Key issues for consumers:

– Choice

– Cost

– Convenience

What factor is most important when choosing a

collection centre?

What factor is most important when choosing a

collection centre? Convenience

• I go wherever is the closest and for bulk billing reasons.

• Some centres are closed at the time I want to go.

Cost

• I look for the cheapest place to go.

• It will depend on what bulk billing collection centre I can use.

Availability

• Test was not available at that centre.

• Just depends on which tests I need doing & if they can be done locally (I am 4 1/2

hours from city) or at the city hospital.

Based on doctor’s referral or form

• Medical groups have agreements with or partnership with some centre and gives you

no choice.

• I go wherever the doctor recommends me to go.

Staff

• Trying to find a someone who can work with my needs.

• The people that do it, have to know what they are doing.

‘Clinical grounds’

• Requesting practitioners can indicate if

there are clinical grounds for a consumer

to use a particular provider – in which

case the Medicare benefit will only be

available from that provider

• Communication with the consumer is

essential in this situation

What is health literacy?

Health literacy is the

degree to which

individuals have the

capacity to obtain,

process, and

understand basic

health information and

services needed to

make appropriate

health decisions.

Why Health Literacy Matters

• Most health care is about how we look after

ourselves – our diet, exercise, lifestyles, etc.

• The way we are supported / cared for by our

family is also critical, as is the support of our

friends and our community – all are dependent

on individual health literacy

• Enabling people to make informed choices

about their own health and the health of those

around them is clearly fundamental to all

health care

• Consumers with functional health literacy: – More likely to take preventative health

measures

– Able to recognise the symptoms of a condition

– Less likely to be hospitalised or use

emergency services

– Able to navigate the

health system and

communicate with

health professionals

– Able to provide

informed consent,

including informed

financial consent

Benefits of Health Literacy

Factors Influencing Health Literacy

• Health literacy depends on both individual

and systemic factors:

– Communication skills of consumers and

professionals

– Knowledge of consumers and professionals

– Culture and attitudes to wellness and illness

– Demands / incentives of the healthcare and public

health systems (illness focused) (throughput

focused)

– Demands of the immediate situation, the context

and the specific health issue

• Opportunity for discussion

to support health literacy

and informed consent

• Consumers who are viewed

as partners will be in a

better position to make an

informed decision about

their provider – and make

other decisions about their

healthcare

• Interactions with health

professionals are key to

informed decision-making

Pathology, health literacy and

informed consent

The challenge of genuine change

• Increasing emphasis on the need to partner

with consumers – BUT ongoing challenges in

implementing change on the ground.

• Most services can readily put patient charters

and informed consent policies in place, but

many also find it hard to actively change the

way care is delivered, and struggle to involve

patients and learn from their experience. ACSQHC – Patient Centred Care Draft Discussion

Paper, September 2010

Meeting the challenge

• Changes to how we approach pathology

services provide an opportunity to think

about other consumer issues

– Health literacy and access to information

– Consumer empowerment

– Working in partnership with health

professionals

www.chf.org.au

r.vassarotti@chf.org.au

02 6273 5444