Sunday, February 26, 2012

Very Interesting Material Has Been Revealed About Consumer Registration for a PCEHR. This Dog Will Not Hunt and It Is Delayed Already!

A few days ago there was a presentation from NEHTA on the Consumer Registration Process for a PCEHR.
You can download the presentation here:
22 February 2012 - PCEHR registration process and demonstration of Source Forge
  • Click here to access the recording (22MB)
  • Click here to download the presentation (1.13MB)
The talk covered the so-called Assisted Registration Process.
The talk was by Les Schumer - Design Authority Manager at NEHTA.
There was no discussion of unassisted processes which I assume must also exist.
The aims of the process are to make it quick and simple to register and for it to be able to happen while sitting in the waiting room assisted by receptionist using a B2B process.
Known Customer Approach will be used for identification checking. The criteria will be that the consumer has visited the facility 3 times in past. Any health facility will do apparently (GP Practice, Pharmacy, Hospital, Aged Care Home etc.)
The work flow is intended to be:
1. Consumer reads descriptive brochure which includes terms and conditions - not discussed at talk.
2. Hands brochure to receptionist with a request to register for PCEHR, having signed the brochure saying I want a PCEHR (Here comes paperwork back to Medicare Australia!).
3. The receptionist opens patient record (which has IHI).
Registration screen comes up:
Check Boxes cover 4 areas:
1. Acceptance of the PCEHR Terms and Conditions
2. Receptionist checks box to assert this is a known customer.
3. Receptionist asks does consumer want Medicare Information included in their PCEHR (presumably explained earlier)
4. Asked how would you like you Identity Verification Code (IVC) to be sent:
a. Letter
b. Text
c. Email.
In each case this will be some information already attached to patient’s Medicare file (home address, mobile number etc.).
The registration then fires off - makes the fully set up record can be used by GP and patient when they get their IVC - in the meantime the GP or whoever has created a Health Summary.
Apparently you then log on to - using the code you are given to confirm identity - and then set up privacy controls.
It seems any healthcare organisation that wants to can provide the registration service.
Apparently there will be a soft launch of the registration process after July, 1 2012.
But after all this we are told:
NEHTA do not have all the policy settings or specifications as yet however - this is just early warning.
And, right at the end of the presentation Andrew Howard informed the audience that this process would not be ready for July 1, 2012 but some 2-3 months later.
Presumably the registration portal - with a different approach - will be available earlier.
Comments on All This:
1. The amount of time taken from the receptionists day to do all this will be a major issue for the doctors who pay them to do other things!
2. There is still no incentive for GPs etc. to do anything that will muck up work flows in their practice.
3. It is not clear what happens if you move into an area and then want a PCEHR - you have to run up three visits (and the costs) before you can start?
4. How does the system deal with all those who already have a second ID for a particular practice for a particular purpose (e.g. Aids treatment, Mental Health etc.) - it can easily be fake but long standing! We know Medicare has more than one of these!
No wonder the launch will be soft (i.e. slow and unpublicised) - to avoid embarrassment I suspect.
We will await developments.
If you want to see what the consumer and providers are  being told here are the recent links:
Enjoy - they are short and colourful!


Anonymous said...

I think you'll find there are 4 registration channels, this is only one of them, as you note it isn't mentioned in the concept of operations, and therefore not necessarily going to be delivered 1st of July.

As you say, there's a registrations portal that will be available on the committed date.

This new function is an extension that some groups have asked for, and I haven't heard that it would be mandatory (i.e. only those groups that want to use it would do so). There are some gruops that have indicated they would use it, and there is a belief that it's useful to allow consumers to sign up at point of care.

(Your captcha clearly thinks I'm a pig - phrase "oinca". Heh)

Anonymous said...

"unassisted" registration is already specified in the Con Ops and some of the NEHTA specifications. My current understanding is that this will be available on 1 July.

Dr David More MB PhD FACHI said...

I agree. Page 30 of Conops talks about this and I think this will be registration via a portal. How identity will be managed will be interesting. It will need to be a process a bit like the assisted I suspect with MA using information it already has to try and verify ID - like Medicare Number etc.

It sounds like this is all that will be there as of July 1.

Mail in registration will need 100 point ID apparently.

I didn't hear much discussion of the use of MA and Centrelink Offices for assisted. I wonder what is happening there?



Anonymous said...

I believe there are 4 channels for registration. Three are mentioned in the concept of operations and being progressed - online, phone, in person at Medicare/DHS office.

In addition, the new assisted registration channel has been suggested. This channel would be useful for some people, as they are more likely to register at point of care, and it allows someone who unexpectedly comes in for care to register and capture that clinical record, v's having to go home and register and miss the record of that episode.

My understanding is that this channel is optional - clinicians who don't feel there is sufficient incentive or controls around usage do not need to offer it. There are a number of players in the clinical sector who might offer registration via this channel, not just GPs.

As this is a late addition, it might not be available on delivery date. But it needs to be visible to software vendors so they can choose whether or not to add it to their software.

Anonymous said...

"There was no discussion of unassisted processes which I assume must also exist."
You know what the definition of "assume" is...............
Come July 1?