NACCHO eHealth Clinician's User Guide
Contents
1. When you login via the provider portal you will be automatically logged out after 15 minutes of inactivity even if you have removed your PCEHR compliant digital credential Until NASH is available the Interim Authentication Solution is a modified Department of Human Services DHS PKI solution which is Government accredited and has protection capabilities to enable trusted connections to the eHealth record system and can be used for the initial registration and set up stages Software vendors can use the modified DHS PKI as an interim arrangement for connection to the eHealth record system and replace it with the NASH PKI when it becomes available This interim solution is also referred to as PCEHR compliant digital credentials 7 3 Managing a patient s eHealth record 7 3 1 Will have access to everything in a patient s record If a patient chooses to have an eHealth record they will be able to control what information is stored in the record and which healthcare organisations can access that information This ability to set access control measures is a key privacy feature of the eHealth record system While privacy is important it is best for all information to be available to enable healthcare professionals to deliver the most appropriate care Only healthcare professionals from authorised Australian organisations with software that can communicate with the eHealth record system will be able to upload information to a patie2. 7 3 8 Cana patient enter their own health information into their eHealth record Only authorised healthcare professionals can enter information in the clinical section of a patient s eHeath record ensuring it is clinically relevant and as accurate as possible Patients will be able to enter basic healthcare information which can be shared with healthcare professionals and keep private notes for their own use 7 3 9 When view a patient s eHealth record will there be any indication that certain documents have been classified as confidential or not readable If a patient has restricted your organisation s access their eHealth record will contain a message on the provider screens that states that it is not a complete record However there will be no indicator on a record to tell healthcare professionals how a patient may have set their access controls or if a document has been deleted by the patient 7 3 10 If a patient chooses to withhold information about psychiatric history will the medications the patient may be taking be visible A patient is able to choose what information is viewable through their eHealth record Just as they are able to limit access to their psychiatric information they may also limit access to any related medications prescribed or dispensed 7 3 11 What are my obligations if identify an error in a patient s eHealth record Only authorised healthcare professionals can enter information in the cli
3. NACCHO eHealth Health Professional s Guide FAQ s Resources and Support ACCHS sites to PCEHR Version 0 4 DRAFT 8 April 2013 y Aboriginal and Torres Strait Islander w eHealth eHealth Document Information Approver Project Board Owner Project Manager Contact Same as Owner Version History Lists the reviews undertaken to the document Date Version Name Comments Type of review 8 April 2013 0 1 Jonathon Siemers Draft Guide Nicolle Marchant 8 May 2013 0 2 Jonathon Siemers Changes to entire document Nicolle Marchant 24 June 2013 0 3 Jonathon Siemers New template applied Nicolle Marchant 25 June 2013 0 4 Jonathon Siemers Changes to pages 15 21 Nicolle Marchant Version 0 4 to be endorsed by the project board gt NACCHO eHealth Health Professional s Guide Page 2 of 23 eHealth Table of Contents DOCUMENT INTORMANON ccciisieesi nsdn arene ETERNAL 2 Version HiIStOry vic ieiissistinissiicancanissenieanasencaniossniannndancanadewiseindanaanedandasiedennniadaneaauedinnns 2 PERT OTTAIT i Coina 4 Te FAQ 8 science enna eeeeeen 5 Was GSMO Nal oe co sce cas ee 62 T EA A iss uate E E E A T 5 TAL How will the eHealth record system work esssesssesssesssiessirssrnssrnssrrssrnssrnssrnssrnssrnssrnnsrent 5 alee Does an eHealth record replace existing records cceccceeeeeeeeeeeceeeeeseeeeeseaeeeeeeeeeeees 5 7 1 3 Who is eligible for an eHealth record eccccecccec
4. Re NACCHO eHealth Health Professional s Guide Page 4 of 23 Aboriginal and Torres Strait Islander eHealth 7 FAQ s 7 1 General 7 1 1 How will the eHealth record system work The eHealth record system provides access to key health information drawn from a patient s health records With the patients consent this information can be quickly shared between healthcare organisations and other healthcare professionals involved in the patient s care Over time an eHealth record will grow to contain a summary of a patient s key healthcare events and activities including medical history allergies and current medications The system is designed to be integrated into existing local clinical information systems 7 1 2 Does an eHealth record replace existing records eHealth records will not replace existing medical records Healthcare professionals will continue to take and review clinical notes More detailed patient information will be available on local clinical information systems as per current practice The eHealth record system provides an active online record that follows patients as they move through Australia s health system and includes important clinical and treatment information It is expected that in the future the availability of eHealth records will save healthcare professionals valuable time 7 1 3 Who is eligible for an eHealth record People seeking health care in Australia are eligible for
5. Record systems and for authenticating or protection of confidentiality and integrity of electronic communications with other Organsiations and or their information technology providers where applicable This certificate can ONLY be used to connect to the eHealth record system and for secure sending of electronic messages to other healthcare provider organisations The certificate cannot be used for accessing the HI services or online Medicare claiming channels A nominated provider is the individual healthcare professional who agrees with you to develop and manage your shared health summary For most people the nominated provider is likely to be your GP this is because your GP is usually the person most involved in your ongoing coordinated care A nominated provider is decided by mutual agreement if you wish to change nominated providers you can agree this with another doctor or authorised healthcare professional You do not need to have a nominated provider in order to have an eHealth record An organisation maintenance officer is registered under the HI service and has authority to act on behalf of a network organisation in its dealings with the System Operator of the eHealth record system A seed organisation maintenance officer has authority to act on behalf of the seed organisation A healthcare organisation can have multiple organisation maintenance officers Personally controlled electronic health record is a secure voluntary e
6. an eHealth record Registration for an eHealth record is voluntary and is not required to receive health care 7 1 4 What information can an eHealth record contain An eHealth record can contain two sets of information clinical and personal Only authorised healthcare professionals can enter information into the clinical section of a patient s eHealth record ensuring it is clinically relevant and as accurate as possible Patients will have their own section in the eHealth record separate from the clinical section where they will be able to enter basic health information including Indigenous status and keep notes for their own use As clinical software is updated to communicate with the eHealth record system more clinical information can be added by healthcare professionals As the system grows an eHealth record may contain standardised versions of the following NACCHO eHealth Health Professional s Guide Page 5 of 23 Aboriginal and Torres Strait Islander eHealth e Shared health summary This will include information about a patient s medical conditions medications they are currently taking allergies they may have or relevant family medical history The shared health summary is prepared by a patient s nominated provider who can be a medical practitioner registered nurse or Aboriginal and Torres Strait Islander health practitioner The structure of a patient s shared health summary is underpinned by the RA
7. professionals and organisations already have a duty to keep their patient s health information confidential and secure and that requirement will continue for the eHealth record system In addition to the limits on who can access or update an eHealth record the eHealth record system is protected by legislation Security is a key design element of the system which adheres to Australian Government security frameworks Design features include audit trails technology and data management controls as well as appropriate security measures to minimise the likelihood of unauthorised access to information in a patient s record It is important to follow the guidance available from the RACGP or your medico legal organisation on information security The Australian Government strongly encourages businesses and organisations to take steps to ensure they are operating safely or providing services securely online The Australian Government s website Stay Smart Online offers a lot of useful advice and tips for small and medium businesses about IT security gt NACCHO eHealth Health Professional s Guide Page 14 of 23 8 Helpdesk Contact Details Description Understand the ePIP Requirement Helpdesk Contact ePIP enquiry line phone 1800 222 032 email pip humanservices gov au Hours of Operation 8 30am 5 00pm ACST Monday Friday Information and Assistance e ePIP requirements e ePIP Application Proces
8. usually a practice manager or the business owner eHealth combines the basic technologies of unique identification authorisation and message security to provide the safest and optimally secure method of exchanging healthcare information These technologies known collectively as secure messaging ensure that the health information exchanged by healthcare providers is protected against malicious interference A seed organisation for the purpose of participating in the eHealth record system is a legal entity that provides or controls the delivery of healthcare services This is the person with responsibility for establishing and operating the eHealth record system From the start of the eHealth record system this is the Secretary of the Department of Health and Ageing Customer service officers from the Department of Human Services will undertake some of the eHealth record system s day to day tasks on behalf of the System Operator NACCHO eHealth Health Professional s Guide gt Page 21 of 23 Aboriginal and Torres Strait Islander eHealth 10 Acronyms and Abbreviations NACCHO eHealth Health Professional s Guide Page 22 of 23 Aboriginal and Torres Strait Islander eHealth eHealth NACCHO eHealth Health Professional s Guide Page 23 of 23
9. 7 9 Key DefiMtioNS ieee eee aea eee aa EARE aeaa aE EES EEEE EESE 19 10 Acronyms and Abbreviations cccccceeeseeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeeneees 22 Important Note This guide does not replace the advice guidance and support provided by your software vendor The new eHealth features will include the ability for your health service to share clinical patient data electronically inbound and outbound possibly for the first time As with all eHealth systems there is a small risk of unintended consequences if not implemented and operated correctly This risk should be lower than at present as the new healthcare identifiers will act as a key to correctly match patient practitioner and health service data In addition as the new eHealth features require your health services computer systems to access external online services via the Internet if not done already you should also e Review the IT security arrangements in your health service and take action to address any shortcomings or areas of risk and e Review the reliability and performance of your health services internet connection and consider upgrading if warranted It is recommended that you seek advice and support from your software vendor or other organisation that provides you with IT and or eHealth support NACCHO or your Medicare Local may also be able to provide assistance or services to support implementing the new eHealth features in your health service
10. CGP Royal Australian College of General Practitioners template for a GP health summary e Event summary This is a summary of a significant consultation It can be uploaded by a healthcare professional at any participating healthcare organisation that is authorised to use the eHealth record system such as an ACCHS hospital or allied health clinic e Hospital discharge summary This can be uploaded by healthcare professionals who have access to the eHealth record and were involved in the patient s hospital care e Specialist letter When a specialist creates a specialist letter it will be sent directly to the intended recipient as per current practices and a copy of the specialist letter may also be uploaded to the eHealth record system e Referral letter When a healthcare professional creates a referral it will be sent directly to the intended recipient as per current practices and a copy of the referral may also be uploaded to the eHealth record system 7 1 5 What is the physical form of the eHealth record An eHealth record will be held online on secure servers Patients can choose whether or not they want to view their record online Some patients may only make enquiries by telephone or at Department of Human Services service centres offering Medicare services If they do want to view their eHealth record online they can login and access it 7 2 Registering for an eHealth Record 7 2 1 How can patients register People
11. H individual Public Key infrastructure PKI COnmiiCate nearen eooni a ee sd eero er a E 9 7 3 Managing a patient s eHealth reCord sseccceseeseseeneeseseeneeseseeneeseseenenseseeneeseseenenseseeeenees 10 7 3 1 Will have access to everything in a patient s record esseeessereseeirssrerresrerssns 10 7 3 2 What does this mean for my existing records ceccceceeeeeeeeeeeeeeeeeeeeeseeeeeeaeeeeaeeeeeeees 10 recnen Can import data from the eHealth record system back into my own local clinical information System 2 ccccceeeeeeeeeeeeee eens eeeaaeeeeeee eae eeeaaesaaaeeeaeeecaaesgeaaeseaeeeseaeeseaaesseneeesaes 10 7 3 4 Are patients able to read what doctors and other healthcare professionals write about iheni siaeatacssaeccdanastedusasidacesstaueensacasdasedsoueansadenadenidssandanaedgenddoulania reaueaadevesneateoubeade 11 7 3 5 Once the information is in the eHealth record system how can be sure that it is up to 8 211 AEEA ectushacvetuesosccuusends SOE E AA T E A P 11 7 3 6 Is there a log showing who has looked at eHealth records cecceceesseeeeesteeeeeeeaes 11 7 3 7 What aboutiin atv GMerge ney icciseicdicdasofacaisa re taldeteacentsststexdiesiecztaa ls tela us andes EANA 11 7 3 8 Can a patient enter their own health information into their eHealth record 12 7 3 9 When view a patient s eHealth record will there be any indication that certain documents have been classified as confid
12. Service on 1300 361 457 7 2 8 Is my HPI I unique What if work for more than one healthcare organisation Your HPI I is unique to you You will only need one HPI I regardless of the number of qualifications obtained or healthcare organisations for which you work 7 2 9 have obtained my HPI I from AHPRA but where do I obtain an HPI O A healthcare provider organisation will need to register for an HPI O with the HI Service Department of Human Services Organisations that are eligible for an HPI O must be an entity that has conducted conducts or will conduct an enterprise that provides healthcare services An HPI O may be linked to all relevant HPI Is in the organisation Organisations can apply directly to the HI Service by completing the application form on the Medicare Australia website 7 2 10 What is a National Authentication Service for Health NASH individual Public Key Infrastructure PKI certificate A National Authentication Service for Health NASH individual Public Key Infrastructure PKI certificate is a part of the security measures put in place to protect the privacy of eHealth records and is an important part of the system A NASH location PKI certificate is needed to authenticate healthcare professionals accessing the eHealth record system These certificates can be loaded onto iy smart cards NACCHO eHealth Health Professional s Guide Page 9 of 23 Aboriginal and Torres Strait Islander eHealth
13. a secure consistent and accurate manner Healthcare Organisation An organisation that has conducted conducts or will conduct an enterprise that provides healthcare Health Provider Identifier A HPI I is a unique 16 digit number that is allocated by the Healthcare HPI I Identifier HI Service to the provider It ensures that providers can be identified A HPI I is required to access the HI Service and eHealth record Health Provider Identifier A HPI O is a number that uniquely identifies organisations where Organisation HPI O healthcare has been provided Individual Healthcare An individual healthcare identifier IHI is a unique 16 digit number used Identifiers IHI to assist health providers communicate health information about an individual An IHI provides a reliable and accurate way of uniquely identifying a person to provides healthcare and manage healthcare records gt NACCHO eHealth Health Professional s Guide Page 19 of 23 Key Definition National authentication service for health public key infrastructure certificate for healthcare provider organisations NASH PKI digital certificate Nominated provider Organisational Maintenance Officer OMO PCEHR PCEHR compliant digital credentials far Aboriginal and a Torres Strait Islander e ANM eHealth Description The NASH PKI provides digital certificates for healthcare providers to authenticate to and access the eHealth
14. can register for an eHealth record in the following ways e Online e Over the phone by calling 1800 723 471 and selecting option one e In person by visiting a Department of Human Services service centre offering Medicare services e In writing by completing a registration application form available from a service centre offering Medicare services or from www ehealth gov au and posting it to Personally Controlled eHealth Record Program GPO Box 9942 In your Capital City e Assisted registration gt NACCHO eHealth Health Professional s Guide Page 6 of 23 Aboriginal and Torres Strait Islander eHealth eHealth 7 2 2 How can participate in the eHealth record system Healthcare professionals do not need to register individually for the eHealth record system Only healthcare organisations need to register Healthcare organisations in Australia can register now to participate in the eHealth record system Once an organisation is registered authorised users in that organisation will be able to access the system via either a conformant clinical information system with an individual logon or via the eHealth record provider portal read only using their PCEHR compliant digital credential To participate in the eHealth record system your healthcare organisation will need to authorise you to access the system on their behalf once it has registered with the eHealth record system Healthcare professionals with a Heal
15. cts progressively become available the information contributed to the eHealth record system by registered healthcare professionals will increasingly become available to those other healthcare professionals accessing the provider portal only 7 2 5 What is the benefit of upgrading to Clinical Information System CIS desktop software If your organisation upgrades to clinical software that is conformant with the eHealth record system you will be able to perform additional functions such as e Create an event summary This is a summary of a significant consultation It can be uploaded by a healthcare professional at any participating healthcare organisation authorised to use the eHealth record system e Create a shared health summary This is a clinical document summarising a patients health status The shared health summary includes information about a patient s medical conditions and medications they are currently taking and allergies they may have This is likely to be the first document accessed by any new healthcare professional viewing a patient s record This document is created by the healthcare professional who is responsible for the coordinated care of the patient 7 2 6 What are Healthcare Identifiers The Healthcare Identifiers HI Service is a national system for allocating a unique identifier to healthcare professionals organisations and consumers Healthcare Identifiers will help ensure consumers and healthcare pro
16. eeceeneeeeeeeeceaeeeeaaeseeeeeseeeeesaeeeeaaeseeeeeees 5 7 1 4 What information can an eHealth record contain ceecceceeeeeeeeeeeeeeeceeeeeseaeeeeneeeeeeeeees 5 TIS What is the physical form of the eHealth record ccceecceceeeeeeeeeeeeeeeceeeeeseaeeeeaeeeeeeeee 6 7 2 Registering for an eHealth Record ss sssseusnssnnnnnonnunnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnmnnn nnmnnn nnana 6 7 2 1 How can patients register as iscseseseccudetends Jaap ascenescccad onan ascends oea a aa eaaa aaan adada 6 7 2 2 How can participate in the eHealth record system cc ccceeeeeeeeeeeeeeeeeeeeeseaeeeeneeeeeeees 7 72 8 How does a healthcare organisation register for the eHealth record system 7 7 2 4 How do access the eHealth record system cccceeeeeceeeeeeeeeeeeeaeeeeeeeseeeeesaaeeeeaeeeeeeees 8 7 2 5 What is the benefit of upgrading to Clinical Information System CIS desktop SOWAT sec cscs isarate aneri aenda ied anes deetspeaeaessa EEA RAE EVENE DEA iad NaPA aia 8 726 What are Healthcare Identifiers ascinsioni enii ai 8 ETA How do get an HPI I or HPI O sesseesseesssessesssesssenssrnssrnosrnosrnosnnonnssnnsonnssnnssrnssnnnsrensrnnt 9 7 2 8 Is my HPI I unique What if work for more than one healthcare organisation 9 7 2 9 have obtained my HPI I from AHPRA but where do obtain an HPI O osese 9 7 2 10 What is a National Authentication Service for Health NAS
17. ential or not readable 1 12 gt NACCHO eHealth Health Professional s Guide Page 3 of 23 Aboriginal and Torres Strait Islander eHealth 7 3 10 If a patient chooses to withhold information about psychiatric history will the eHealth medications the patient may be taking be Visible ccceceseeeeeeeeeeeeeeeteeeeeeeeeeeeeeaes 12 7 3 11 What are my obligations if identify an error in a patient s eHealth record 04 12 7 3 12 Can lists of medications in the eHealth record be altered ee cceceeseeeeeeesteeeeeeeaes 13 7 3 13 Cana patient have more than one nominated provider e g a GP and a renal NOTA SICTAIN 2 se oh ac aein eee REAREA once sages ace tinct ta tected asa aE EA ESS 13 7 3 14 Will the eHealth record system be available on smart devices e g iPad tablet smart OMG ses cecetes anain neeg anao raean ie araea aiaa avez Geeta caidas levees AEE ENA Ea eiai 13 7 3 15 How will consent be managed with children ssesssssssessssssesssrsesrnesrresrnssrnssrnsernsennsens 13 7 3 16 What clinical safeguards are being developed as part of the eHealth record system 14 7 3 17 How can I be sure that health information will be secure sssssssssnssssnnsseennnnnnnenennn 14 8 Helpdesk Contact Details nis seiisccssiniscnnevedsncnvsniecssnnaiecsssneinenhnuasunnssanheecsnaniaenseneinn 15 8 1 Related RESOUICES useisiin eanan aasan aaae seana hn aaiae aaia Eare eeaeee ee aiaa ES 1
18. er healthcare professionals write about them in full Patients can read in full everything that is added to their eHealth record You may choose to include additional information in your own local clinical information system that is not included in the eHealth record In any event patients have a right under the Privacy Act 1988 Cth to access the personal information that healthcare professionals hold about them For more information please contact the Office of the Australian Information Commissioner or 1300 363 992 7 3 5 Once the information is in the eHealth record system how can I be sure that it is up to date All clinical documents in the eHealth record system will be accompanied by document source information stating where when and by whom the document was created All clinical documents will also be digitally signed by the supplying healthcare organisation to ensure they have not been modified since they were submitted Based on the above information a healthcare professional will then be able to make a professional judgement about the reliability of the information It should also be noted that healthcare organisations have an obligation to take reasonable steps so that any personal and health information uploaded to a person s eHealth record is as accurate as possible and up to date at the time of uploading 7 3 6 Is there a log showing who has looked at eHealth records Yes A patient s eHealth record will have a view sho
19. fessionals can have confidence that the right information is associated with the right individual at the point of care The HI Service allocates three types of healthcare identifiers gt NACCHO eHealth Health Professional s Guide Page 8 of 23 Aboriginal and Torres Strait Islander eHealth he e Individual Healthcare Identifier IHI for individuals consumers receiving healthcare services e Healthcare Provider Identifier Individual HPI I for healthcare professionals involved in providing patient care e Healthcare Provider Identifier Organisation HPI O for organisations that deliver health care such as hospitals or general practices 7 2 7 How do I get an HPI I or HPI O You can obtain a HPI l and a HPI O now Healthcare professionals who are registered with the Australian Health Practitioner Regulation Agency AHPRA will have been be assigned a HPI I and AHPRA will advise them of this number Healthcare professionals in a field of practice not covered by AHPRA must complete an application for a HPI I via the Department of Human Services Go to www medicareaustralia gov au follow the link to individual healthcare provider forms and click on the application to register a healthcare professional You can also follow the links on this page to download the forms to register your organisation for an HPI O If you have not received your HPI I or have forgotten it call the Healthcare Identifiers
20. ficates installation support PKI Certificate and Tokens lost forgotten passwords Complex Seed and Network Organisation HPI O Structures Secure Message Delivery SMD Nehta Helpdesk email nehtasupport nehta gov au phone 1300 901 001 8 00am 5 00pm QLD Monday Friday e Seed and Network structure questions e Questions relating to secure message delivery SMD Page 16 of 23 8 1 Related Resources The following is a list of information resources that you may find useful for introductory or other reference purposes on eHealth generally and on the national eHealth program specifically It is not essential that you read through all of these at this point in time as many are referred to later in the guide itself Resource Website Australian Government s web sites which have information including brochures on eHealth and the ability to subscribe for updates and notification of key events http www ehealth gov au Introduction to the eHealth record system for healthcare professionals http publiclearning ehealth gov au modules hcpIntro index htm a Learning Module Department of Health and Ageing s website on eHealth http www health gov au internet main publishing nsf Content eHealth Healthcare Identifiers Act 2010 http www comlaw gov au Details C2010C00440 Healthcare Identifiers Consequential Amendments Act 2010 http www comlaw gov au Deta
21. ils C2010A00073 Healthcare Identifiers Regulations 2010 http www comlaw gov au Details F2010L01829 DHS web site for healthcare providers Includes information and resources about the HI Service http www medicareaustralia gov au provider http www medicareaustralia gov au provider health identifier DHS web site for individuals http www humanservices gov au customer services medicare healthcare identifiers service RACGP s eHealth web site Includes resources on clinical governance quality improvement and computer security http www racgp org au ehealth Page 17 of 23 Resource Website The AMA s Guide to Using the PCEHR Draft is available at Draft available http ama com au node 7648 The eHealthAus YouTube Channel that includes videos demonstrating http Awww youtube com user eHealthAus many features and benefits of eHealth NEHTA web site to support General Practice http www nehta gov au registration support general practice NEHTA web site for Healthcare Identifiers http www nehta gov au connectingaustralia healthcare identifiers The NEHTA Model Healthcare Community web site Includes a video http www nehta gov au connectingaustralia healthcare identifiers discover themodel that shows how the Healthcare Identifier Service will work healthcare community Page 18 of 23 far N Aboriginal and Ls _ Torres Strait Islander IAY eHealth 9 Key Definit
22. ions Key Definition Description Authorisation links An authorisation link connects a healthcare professional to an organisation so that an authorised individual can access the eHealth record via the provider portal on behalf of their organisation Authorisation links only apply for organisations that want their healthcare professionals to use the provider portal Authorisation links do not need to be created for healthcare professionals who use a conformant clinical information system to access the eHealth record system to view a consumer eHealth record eHealth Record Individual The eHealth Record PKI provides digital certificates for healthcare Public Key infrastructure providers to authenticate to and access the eHealth Record system PKI Individual certificate An individual healthcare provider MUST have a Department of Human Services eHealth Record Individual Public Key Infrastructure PKI certificate Electronic transfer of Electronic prescriptions are sent from your clinical software system to a prescriptions ETP Prescription Exchange Service PES where prescriptions are stored and can be retrieved later by a dispenser at the time of dispensing Healthcare Identifiers The HI Service provides a consistent set of identifiers for healthcare Service individuals consumers and healthcare providers organisations and individual professionals The HI Service enables providers to link health information and data to the right consumer in
23. lectronic record PCEHR compliant digital credentials are used to authenticate system access and are part of the security measures put in place for the eHealth record system PCEHR compliant digital credentials can only be obtained by healthcare organisations and individuals who are registered with the HI Service gt NACCHO eHealth Health Professional s Guide Page 20 of 23 Key Definition PKI organisation certificate Responsible Officer RO Secure Messaging Delivery SMD Seed Organisation System Operator EEA Aboriginal and NI Torres Strait Islander eHealth Description A PKI acts as a secure electronic signature and enables the secure exchange of data by ensuring 1 Authentication disclosing the sender of the message 2 Integrity ensures the message has not been altered 3 Non repudiation the sender cannot dispute the creation or sending the message 4 Confidentiality only the person that is designated to receive the message can open it A PKI organisation certificate used for Medicare purposes can be HI enabled A responsible officer is registered under the HI service and has authority to act on behalf of the seed organisation and relevant network organisations in its dealings with the System Operator For large organisations the responsible officer is usually the chief executive officer or chief operations officer and for small organisations the responsible officer is
24. nical record ensuring it is clinically relevant and accurate However if you or a patient find an error in a clinical document you or the patient must notify the healthcare organisation from which the document originated That organisation can then upload a corrected document NACCHO eHealth Health Professional s Guide Page 12 of 23 Aboriginal and Torres Strait Islander eHealth eHealth 7 3 12 Can lists of medications in the eHealth record be altered To maintain the integrity of the system information uploaded to the eHealth record system including medications cannot be altered or edited The system requires a new document to be uploaded so while the old version will still be visible the uploaded document will take precedence If a nominated provider wishes to change the medications listed in the shared health summary they will need to upload a new shared health summary with the updated medication information 7 3 13 Can a patient have more than one nominated provider e g a GP and a renal physician The nominated healthcare provider is the author of a shared health summary There can only be one nominated provider at one time If a patient wishes to appoint a new nominated provider they can ask another authorised healthcare professional to author and upload their shared health summary for them For example a renal physician could meet the legal requirements to be a nominated provider but is unlikely to be involved in
25. nt s eHealth record 7 3 2 What does this mean for my existing records The eHealth record system does not replace existing clinical records It is an additional tool that provides a summary of patient information entered by healthcare professionals from different healthcare organisations It will enable a single view of a summary of a patient s information from across the health system It will only contain information that a patient has consented to have included in their eHealth record If a healthcare professional sees a new patient with an eHealth record for a consultation with the patient s consent the healthcare professional can view their key medical information which will save time questioning the patient or chasing missing information 7 3 3 Can I import data from the eHealth record system back into my own local clinical information system A healthcare organisation that is registered for the eHealth record system will be able to copy information out of the national system into their local clinical information system NACCHO eHealth Health Professional s Guide Page 10 of 23 Aboriginal and Torres Strait Islander eHealth i he In the early stages of implementation this will be done manually from the web based provider portal In time there will be integrated access to the eHealth record system via conformant clinical information system desktop software 7 3 4 Are patients able to read what doctors and oth
26. s Sign the PCEHR Participation Agreement phone 1800 723 471 EST Monday Friday 2 Review the ePIP Product Register Online enquiry form 8 00am 5 00pm e Information on your software vendor s web QLD conformance with the ePIP requirements https epipregister nehta qov au enquiry Monday Friday 3 Register fora Seed HPI O HI Service enquiry line 8 30am 5 00pm e HI Service general information and questions phone EST e Completing Seed Organisation HPI O 1300 361 457 Monday Friday Applications email e Registering or updating an ROs OMOs details healthcareidentifiers humanservices gov au 4 Register for the PCEHR PCEHR enquiry line 8 30am 5 00pm e PCEHR general information and questions e Completing PCEHR Applications e Completing PCEHR Participation Agreements Page 15 of 23 Description Helpdesk Contact Hours of Information and Assistance Register for a NASH PKI Certificate for Healthcare Provider Organisation Apply Renew a Human Services PKI Site Certificate if required eBusiness Service Centre phone 1800 700 199 option 2 Operation 8 30am 5 00pm EST Monday Friday eHealth Record PKI general information and questions NASH PKI general information and questions Medicare Location PKI Certificates general information and questions Completing NASH PKI Certificate for Healthcare Provider Organisations Applications PKI Certi
27. tem by completing and submitting the Application to register as a healthcare provider organisation form and the Participation agreement for healthcare provider organisation For more information download the Registration booklet for healthcare organisations gt NACCHO eHealth Health Professional s Guide Page 7 of 23 Aboriginal and Torres Strait Islander eHealth eHealth 7 2 4 How do I access the eHealth record system If you have been authorised to access the eHealth record system on behalf of a healthcare organisation you will be able to access the eHealth record system via either a conformant clinical information system or via the provider portal using their PCEHR compliant digital credential To gain access via clinical software you will need to use registered and approved clinical information system CIS desktop software and have a PCEHR compliant digital credential installed Vendors are expected to have upgraded software available shortly Please contact your software vendor for more information To gain access via the provider portal go to www ehealth gov au to log in The provider portal is a read and download only facility and will not enable healthcare professionals to contribute to a patient s eHealth record Over time if healthcare professionals and their organisations are registered the provider portal will give them access to the information that has been entered by patients As software vendor produ
28. thcare Provider Identifier Individual HPI I will be able to upload information to the clinical section of a patient s eHealth record once their organisation has a conformant clinical information system Authorised users who don t have an HPI I but are important to an individual patient s care will be able to access that patients eHealth record but will not be able to upload information To register for an HPI l or to find out what your HPI I is and to obtain a PCEHR compliant digital credential please go to the HI Service page on the Medicare Australia website and download the appropriate application form If you have your own practice you will need to register your organisation and designate yourself as an authorised user 7 2 3 How does a healthcare organisation register for the eHealth record system To register for the eHealth record system a healthcare organisation will first need to register with the Healthcare Identifiers HI Service for a Healthcare Provider Identifier Organisation HPI O They will also need to apply to the HI Service to obtain PCEHR compliant digital credentials To register an organisation for an HPI O and to obtain PCEHR compliant digital credentials go to the HI Service page on the Medicare Australia website and download the appropriate application form or go to www ehealth gov au Once an organisation has registered with the HI Service they will need to register for the eHealth record sys
29. the ongoing coordinated care of the patient and may not be best suited to fulfil this role 7 3 14 Will the eHealth record system be available on smart devices e g iPad tablet smart phone Patients will be able to view their own eHealth record on a device of their choosing However specific applications for mobile devices such as iPads tablets and smart phones have not been developed 7 3 15 How will consent be managed with children Except in special circumstances parents or authorised representatives will have control of their children s eHealth records from 0 to 14 years including decisions as to which healthcare organisations have access to the child s record and which clinical documents they can see After a child turns 14 they will be able to choose whether to manage their own eHealth record in the same way they can apply for their own Medicare card This includes which healthcare organisations have access to their record which clinical documents they can see and which representatives are authorised to access to their record If a child chooses not to take control of their eHealth record between 14 and 17 their authorised representative s can continue to manage their record until they turn 18 Once an individual turns 18 authorised representative s will automatically lose access to their eHealth record If an individual still wants their parent s or guardian s to view information in their eHealth record after they
30. turn 18 they will need to take control of their record and set up nominated representatives In line with Department of Human Services policy regarding the Medicare Benefits Schedule MBS parents will not be able to view the MBS details of children aged over the age of 14 b NACCHO eHealth Health Professional s Guide Page 13 of 23 Aboriginal and Torres Strait Islander eHealth a 7 3 16 What clinical safeguards are being developed as part of the eHealth record system The eHealth record system is expected to improve access to clinical information and enhance patient health outcomes over time As such the eHealth record system has been designed with active contribution from healthcare professionals from across the health sector key professional bodies and other quality and safety experts Existing clinical standards apply to the use of information sourced from the eHealth record system Healthcare professionals can access further information about the safe use of eHealth records including how eHealth considerations can be integrated into existing standards and clinical governance frameworks across the health sector on the eHealth website 7 3 17 How can be sure that health information will be secure The eHealth record system implements high grade security protocols to detect and mitigate against external threats The system will be tested frequently to ensure these mechanisms are in place and robust Healthcare
31. wing the activity history related to their record This will show when information has been added or removed as well as the organisation that viewed the record and when Healthcare professionals will be able to see an audit log of their own activity on the eHealth record system 7 3 7 What about in an emergency Healthcare organisations participating in the eHealth record system may access a patient s eHealth record in an emergency where patient consent is not possible This is consistent with existing privacy laws gt NACCHO eHealth Health Professional s Guide Page 11 of 23 Aboriginal and Torres Strait Islander eHealth i In life threatening cases where it is unreasonable or impractical to obtain a patient s consent to access the eHealth record healthcare professionals may assert emergency access This will override any access controls that have been set and provide your organisation with unrestricted access to a patient s eHealth record for five days Your use of the emergency access function will be logged in the audit log and may be notified to the patient if they requested notifications Asserting emergency access is warranted where you believe that access to the information is necessary to lessen or prevent a serious threat to e an individual s life health or safety and the patient s consent cannot be obtained This might occur for example if the patient is unconscious or e public health or public safety
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