Sunday, February 20, 2022

There Seems To Be A Lot Of Change Happening To The GP Digital Health Infrastructure. It Might Not Go Well!

In the last week or so there have been some interesting changes announced and  happening.soon!

First we have changes with the NASH environment.

Here is a discussion from a PHN

Time critical changes to NASH and Online Claiming

Did you know that your NASH certificates and your practice management or dispensing software needs to be upgraded BEFORE 13 March 2022? If it’s not, you will need to revert to manual claiming (e.g. Medicare, PBS Online, Aged Care services) and your digital health systems will cease functioning (e.g. MHR, Secure Messaging, Electronic Prescriptions).

From 13 March 2022, the way that medical professionals interact with online claims and the National Authentication Services for Health (NASH) Public Key Infrastructure (PKI) Certificates will be changed. Both of these changes will have implications in general practice, aged care, specialists and pharmacies.

NASH SHA-2 Certificate Upgrades

The National Authentication Service for Health (NASH) is updating on 13 March 2022 to NASH SHA-2. In order to continue to receive and publish information in the Digital Health services, all practices will need a NASH SHA-2 Certificate.

From 13 March 2022, you’ll need a NASH SHA-2 PKI certificate to authenticate to these channels:

  • My Health Record
  • Healthcare Identifiers (HI) Service
  • Electronic Prescribing
  • Secure Messaging

Services Australia will no longer be issuing NASH SHA-1 PKI Certificates.

What do you need to do next?

The Australian Digital Health Agency (ADHA) has provided a thorough explanation of the NASH SHA-2 PKI Certificates and next steps for practitioners and practices. Please visit their website (see below) here for a complete run down of the process and how to prepare for moving from SHA-1 to SHA-2. The page also includes a registry of software vendors who are ready to upgrade, which will be updated regularly. To ready your software and update your practice for the installation of the SHA-2, you will need to coordinate with your software vendors. Your software vendor will also tell you if additional files must be downloaded and installed when you renew or request for a new NASH certificate.

Web Services Online

If your software isn’t web services ready by 13 March 2022, claims and transmissions may need to revert to an alternative channel where available. This may create additional administrative pressure and costs for your business. From this date onward, the following services will move to Web Services Online:

  • Medicare Online (including DVA and AIR)
  • Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE)
  • Pharmaceutical Benefits Scheme (PBS) Online
  • Aged Care Web Services.

What do you need to do next?

To prepare for upgrading to Web Services Online, Services Australia have provided the Web Services eKit. The most important thing for practitioners and practices to know right now is that the software developers should contact you when the software updates are available and what you need to do next.

Useful Resources

Services Australia – Adapters to Web Services Update

Here is the link:

https://www.chnact.org.au/for-health-professionals/digital-health/time-critical-changes-to-nash-and-online-claiming/

Here is a link to the ADHA information via a webinar and FAQs.

https://developer.digitalhealth.gov.au/events/are-your-products-nash-sha-2-ready-25-february-2022

Seemingly in parallel (as also discussed above) there are changes to online claiming and other services.

Here is the beginning of a long article on that:

18 February 2022

PRODA II: the great big practice reset

By Jeremy Knibbs

Last week’s PRODA story started zinging on doctors’ social media not long after being published, and has been zinging pretty much ever since. 

It floated the idea that having to register or re-register your practice or individual contractor business for PRODA was not quite as simple as the government moving its infrastructure to the cloud so everyone could get paid faster (as the government mostly describes it). 

It hit a nerve of some description, although it’s hard to determine what nerve precisely as, so far, the idea and the topic are still a little obscure. You have to join the dots on what is going on, then you have to believe that the dots have both been joined correctly and that there exists someone who has planned all the dots. 

As I work for an organisation mostly comprised of journalists (I’m not a journo’s little toe, to be clear), I’m not permitted to be a member of most of these doctor social media groups so I’m not able to listen in live on a lot of doctor social media. But I manage to live vicariously through some doctor friends who are members, and the odd other non-doctor professional whom they let on the sites for one reason or another.  

Responses to the idea that there’s a lot more to PRODA coming down the line than just a more efficient way to get your Medicare claim done seem to fall into four categories: 

  • ·         PRODA? I’ve had a PRODA account forever, there’s nothing to see there 
  • ·         I’ve joined the dots the wrong way and don’t understand how all this works 
  • ·         The government would never do that, would they, we’re doctors and we’ve worked this way forever? 
  • ·         Shiiiiiitttttt!! 

PRODA has been around forever. But the government is requiring that everyone re-register for PRODA to enable its new web services (cloud) functionality regime.  

When you re-register, you are in a manner updating an “understanding” with the government on how you as an individual doctor, or practice, structure your claiming and finances (when you think about it). 

The government isn’t about to look at what you do with your new PRODA registration using the web today. But in time, it will be able to, and a lot of things have changed in the past few years about how governments view how doctors and their practices should be structured for tax and payroll tax. 

We are going to design a survey to get a more quantitative take on where everyone sits on the issue, but the fourth response above seemed to be the most common. 

That is probably a good thing.  

As the saying goes, “failing to prepare, is preparing to fail” (Ben Franklin), and it looks like now is the time to start preparing.  

Here is the link:

https://medicalrepublic.com.au/proda-ii-the-great-big-practice-reset/63310

All this has implications for cashflow, access to all sorts of services and the need to obtain updated versions of Practice Management Software.

(Note: I don’t think all this changes access to services via myGOV)

Given it is the 20th of February I have to say I have a bad feeling that this could all result in considerable confusion and anything up to and including panic.

Practice Managers would be well advised to get on top of what is needed quickly and get on with it!

What is the bet there is a mess brewing?

David.

 

7 comments:

  1. Are they going for a national, on off switch over? or a transition period during which systems can be migrated/updated? From what has been posted, it looks like a big bang switch over.

    In the middle of a pandemic and just before an election. Good luck with that.

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  2. It would seem they are planning a nationwide, all encompassing, big bang approach. That seems like a great way to kill-off some troublesome systems like ..... and .... and ... .

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  3. This is certainly a test of the new ADHA management team. They are clearly in charge and own this. I cannot predict the outcome but glad I am not a practice owner.

    I look forward to the well crafted excuses.

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  4. I look forward to the well crafted excuses.
    They'll probably adopt Boris's strategy: Never apologise, never explain, deny everything.

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  5. Surely all part of a digital health evergreen environment. Automated updates are the norm these days and digital health is quite a constrained market. The vendors need a good kick up the profit margin

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  6. @Paul you have a point in that statement. The vendors should be making this easy. Seems going to the cloud is useful

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  7. And then there is this to add to the risks.

    Discontinuation of TLS 1.1 access to Verizon certificates-australia websites

    https://developer.digitalhealth.gov.au/resources/news/discontinuation-tls-11-access-verizon-certificates-australia-websites

    Verizon Australia is a third party organisation who manages the issuance of both Medicare and NASH PKI certificates that are used by Healthcare Organisations to undertake electronic business with Services Australia.
    Hide Overview

    Verizon Australia is a third party organisation who manages the issuance of both Medicare and NASH PKI certificates that are used by Healthcare Organisations to undertake electronic business with Services Australia.

    Verizon have notified Services Australia that they must make an upgrade to the Transport Layer Security that’s used on their website
    www.certificates-australia.com.au from TLS1.1 to TLS1.2. The proposed date of upgrade is 31 March 2022.

    Software vendors who are currently using TLS1.1 will need to upgrade to TLS1.2 to avoid any impact.

    Who does this affect?

    All systems that use NASH or Services Australia (Medicare) PKI certificates, that have also been hardcoded to use TLS 1.1, or are running on Windows Server 2008 or Windows 7 or earlier.

    These systems may experience issues with the following digital health services:

    * The My Health Record B2B gateway

    etc...

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