Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, July 05, 2011

I Wonder How Much Of This Has Actually Been Thought Through? The Next Version of the PCEHR ConOps Needs to Allay these Concerns?

The following article came out a little while ago.

Fight over medical files

Source: The Daily Telegraph

DOCTORS warn they will boycott the Federal Government's multi-million-dollar plan to roll out electronic health records if patients can edit or withhold their medical history.

It is feared patients will withhold embarrassing information when they start accessing and monitoring their medical files for the first time from July next year.

Incoming Australian Medical Association president Steve Hambleton said he supported electronic health records, which would be shared with other medical professionals to provide better health outcomes, but serious concerns remained.

More than $466 million will be spent on developing personally controlled electronic health records, which is one of the Gillard Government's key health reforms.

The Federal Health Department said the system would be trialled before being rolled out.

Patients will be able to decide what is recorded on their files and which medical professional can access their health records.

It is proposed that a teenager at 14 years will be able to control their own records and after 18 years a parent will not be able to access their files.

Dr Hambleton said doctors were uncomfortable with some of the proposals.

"What's the indemnity cost if it's not updated and it's two weeks out of date (and there's an adverse outcome)?" Mr Hambleton said.

"If they can hide and/or delete (information), it's not going to be accurate and doctors won't use it.

"Consumers can delete what kind of drugs they are on."

More here:

http://www.dailytelegraph.com.au/fight-over-medical-files/story-fn6b3v4f-1226064662976

Last week we had the following from the Editor Emeritus of the Medical Journal of Australia.

Martin Van Der Weyden: From the sidelines

Brave New World of e-health a minefield

WHO owns medical information? Patients, doctors or institutions?

For some time now information technology has been heralded as a potential driver of reform, promising to improve much of the inefficiency and ineffectiveness that besets modern health care.

Indeed, it has generally been acknowledged that PCEHRs (personally controlled electronic health records) will allow timely and extensive information sharing among health care providers.

In the national sphere, federal Health Minister Nicola Roxon has long recognised the potential of e-health records, claiming that they will allow for a “seamless interconnection” and will save health professionals and patients substantial amounts of time. “Implemented properly, electronic health records will reduce inefficiencies between different parts of the health system and lower the potential for mistakes: inadvertent misdiagnosis or treatment”, the Minister is reported as saying.

To this end, hundreds of million dollars have been invested in the National E-Health Transition Authority (NEHTA) to make the idea workable. But like most things pursued by a consultative process, it has fallen victim to accommodating the pressures of powerful vested interests and the framework for the e-health record is in danger of becoming a dog’s breakfast.

The High Court ruled 15 years ago on doctors’ ownership of medical records, which was followed by changes to privacy law, giving patients the obvious and accepted right to access their own health records. But with dual ownership, PCEHRs raise new issues, such as censorship of content and restriction of access to information. In short, consumers would ultimately control what information is stored in their record and who can view the file.

In this event, the utility of such a file to doctors would be compromised and would become largely irrelevant to their practice.

This quandary raises the fundamental question: who owns the medical information? The one who provides care? The one who pays for the care? The institution, where the care is delivered? All of the above? None of the above? Some of the above? Confusion reigns supreme.

Even more crucial, is the question: who is ultimately responsible for the veracity, accuracy and currency of information?

Along with the expansion of electronic health information, there has been a potential commercialisation of patient databases. This begs the question: can patients now selectively authorise commercial access to their e-health records?

Imagine the nightmarish scenario this could unleash, especially if personal DNA information were to be added to patients’ files.

There is no doubt that the question of ownership of medical information will be acutely focused by the proposed PCEHRs, and the issue is bound to become a legal and ethical minefield.

......

Dr Martin Van Der Weyden is emeritus editor of the MJA.

Posted 27 June 2011

More here:

http://www.mjainsight.com.au/view?post=Martin+Van+Der+Weyden%3A+From+the+sidelines&post_id=5131

While I am sure the PCEHR proponents will be claiming this is all just a medical ‘winge’, I believe there are some very serious issues contained here that will need to be properly addressed if the nation’s clinicians are to be any way persuaded to come on board the program.

Clarity of responsibility, and appropriate remuneration, for those accepting professional risk will be absolutely crucial. If, as I suspect, it proves impossible to blend patient control and professional accountability then the only way the PCEHR program will be able to remain viable will be via a total re-design of how the system will operate.

David.

Monday, July 04, 2011

Weekly Australian Health IT Links – 4 July, 2011.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A rather eclectic mix this week.

First we have two different states doing quite differently in terms of provision of public information in the health system. Diametrically different outcomes!

Second we have lots on telehealth.

Third there are some interesting articles on a variety of security and other areas that have arisen.

Fourth we have a very odd set of comments from the Pharmacy Guild if they have been quoted correctly.

Last we see a few comments on the Medicare Locals which seem to be a serious piece of non-reality right now. I guess the next 12 months will show if anything good will flow from the concept and the implementation.

-----

http://www.australiandoctor.com.au/articles/e6/0c0715e6.asp

Hospital waiting times live on internet

30-Jun-2011

IN what may be a world first, live waiting times in the emergency departments at Adelaide's public hospitals are now available to the public over the internet.

The operational business intelligence dashboard, used by hospitals and ambulance services, gives half-hour updates on the number of people arriving and departing and is now available to the public on the SA Health website.

The system also gives information on the number of people being treated in each emergency department and how long they spend waiting.

-----

http://www.theage.com.au/victoria/hospital-data-website-fails-to-show-waiting-times-20110630-1gsz8.html

Hospital data website fails to show waiting times

Julia Medew and Kate Hagan

July 1, 2011

THE state government has failed to deliver promised real-time data showing waiting times in Victorian emergency departments.

The site, promised during last year's election campaign, was meant to include the number of patients waiting at any given time for emergency care in hospitals.

But the website, launched yesterday, instead gives median waiting times for non-urgent patients during specified time periods based on the hospital's performance in previous weeks.

Opposition health spokesman Gavin Jennings said the website did not provide real-time data as promised and could mislead patients.

-----

http://www.theaustralian.com.au/news/health-science/scientists-welcome-bioinformatics-bonanza/story-e6frg8y6-1226085410008

Scientists welcome bioinformatics bonanza

  • Leigh Dyton, Science writer
  • From: The Australian
  • July 02, 2011 12:00AM

AUSTRALIAN researchers now have free access to one of the world's most comprehensive database resources.

Launched last month, a mirror facility at the University of Queensland in Brisbane means scientists can use their computers to enter the most used data services of the British arm of the European Molecular Biology Laboratory's European Bioinformatics Institute.

"Using the mirror, Australian researchers will be able to access important research data 10 times faster than it would normally take from the EBI, reducing download times from days to hours or hours to minutes," says EMBL Australia's chairman Richard Larkins.

"A national team of bioinformaticians can assist them with accessing data and processing the large volume of data generated by modern experimental techniques."

-----

http://www.smh.com.au/technology/security/australian-university-failed-to-secure-students-data-and-broke-law-privacy-commissioner-20110629-1gphz.html

Australian university failed to secure students' data and broke law: Privacy Commissioner

Ben Grubb

June 29, 2011 - 10:01AM

A Sydney university "did not take the appropriate steps to ensure the security of students' personal information", the NSW Privacy Commissioner has found.

Earlier this year Fairfax Media, publisher of this website, reported that the detailed records of thousands of University of Sydney students past and present were being stored online where they could be easily downloaded and read via an internet connection without a password.

Details openly available on the university's site included a student's full name, residential address, email address, which courses he/she studied and how much the course cost.

------

http://www.nehta.gov.au/media-centre/nehta-news/889-act-sc

ACT Health first to launch new Supply Chain catalogue system for health services

24 June 2011. ACT Chief Minister and Minister for Health Katy Gallagher has welcomed the official launch of a new medical supply and inventory system in Canberra, the first of its kind in Australia. "The Master Catalogue Information Service (MCIS) is part of a national program to streamline supply chain management in our healthcare system," the Chief Minister said.

"All ACT Health services and hospitals will benefit from the new Master Catalogue Information Service, which is designed to increase efficiency through reduction of product ordering errors and automation of inventory management processes."

-----

http://www.computerworld.com.au/article/392016/nehta_act_govt_kicks_off_mcis_trial/

NEHTA, ACT Govt kicks off MCIS trial

The state government, in collaboration with NEHTA will trial the system in the ACT before extending it to other states

The National E-Health Transition Authority (NEHTA), in collaboration with the ACT Government, has kicked off the trial of a medical supply and inventory system in the state.

The Master Catalogue Information Service (MCIS), part of the national program to streamline supply chain management within the Australian healthcare system, aims to provide a national uniform set of data around medication.

The system will be implemented in the ACT initially, due to the state’s single existing local system and “defined geography”, and will be expanded to other states and territories with which NEHTA is currently in discussions with.

-----

http://www.rheumatologyupdate.com.au/news/Telehealth-bonus-not-enough-for-specialists

Telehealth bonus not enough for specialists

The Federal Government’s bonus for specialists who do video consultations is not as generous as it may sound, according to the president of the RACP, who says it falls far short of college demands.

Dr Les Bolitho told Psychiatry Update that even though the government had a promised 50% loading on existing MBS items for services conducted by video from July 1, specialists who bulk billed would still only receive 85% of that total.

“We were arguing for the rebate payment to be 100% of the scheduled fee, instead they said ‘Oh no we’ll only give you the patient’s rebate fee’,” he said.

For most private practice specialists, this would not be a good enough incentive to come on board, he added:

-----

http://www.medicalobserver.com.au/news/telehealth-lots-of-risk-but-very-little-guidance

Telehealth: lots of risk but very little guidance

27th Jun 2011

Dr Andrew Jeremijenko MBBS, MAE, FRACGP, MHA, FAFOEM

TELEHEALTH MBS items, due to be available from 1 July, offer GPs and specialists the opportunity to conduct video consultations and represent an important reform that should improve patient access to medical services, in particular to specialist services.

However, a number of issues need to be addressed to ensure patient safety is maintained, doctors are not put at medico-legal risk and, importantly, that the $250 million program represents money well spent.

A major concern is the fact that currently there is no requirement for training before doctors start providing these services.

The introduction of funded video consults can be compared with the introduction of laparoscopic surgical techniques, in that the task remains the same but the new tools makes the process more complex.

-----

http://www.theaustralian.com.au/national-affairs/health/gps-get-bonus-for-e-health-video-consultations/story-fn59nokw-1226083776439

GPs get bonus for e-health video consultations

DOCTORS who work as close as 20km from the nation's capital city centres will get a $6000 incentive payment the first time they help a patient take part in a videoconference consultation with a city specialist.

The payments are designed to encourage take-up of the government's $620 million telehealth program.

Patients in Altona in Julia Gillard's western Melbourne electorate and North Altona in federal Health Minister Nicola Roxon's neighbouring electorate, those in Blacktown and Penrith in western Sydney, and patients in Redland Bay and Strathpine in Brisbane will be able to take advantage of the telehealth scheme.

-----

http://www.zdnet.com.au/racgp-helps-gps-with-telehealth-kit-339317736.htm

RACGP helps GPs with telehealth kit

By Suzanne Tindal, ZDNet.com.au on June 30th, 2011

The Royal Australian College of General Practitioners (RACGP) has urged its member GPs not to rush out and buy telehealth equipment before the college can finish writing an implementation guide, having reviewed the different technologies and connection options available.

"The RACGP is currently reviewing the different technologies and connection options to provide a choice from a range of vendor equipment as a means of ensuring interoperability between them," Dr Mike Civil, chair of the RACGP Telehealth Standards Taskforce, said in a statement.

The college is also working on the development of clinical telehealth standards for general practitioners, expected to be ready in October.

The program provided a real opportunity for GPs, 96 per cent of which used computers for some clinical purpose, the college said, but it was concerned that many specialists didn't use computers.

-----

http://www.cio.com.au/article/391895/pm_previews_gp_telehealth_conference

PM previews GP telehealth conference

Seeing a medical specialist via videolink will be Medicare-funded for the first time

  • AAP (AAP)
  • 29 June, 2011 15:09

Seeing a medical specialist via videolink will be Medicare-funded for the first time starting Friday.

It's part of the federal government's big $620 million telehealth push which aims to bring rural patients and doctors together regardless of distance.

Under the scheme starting on July 1, patients in remote areas who undergo a video conference with a medical specialist will have the consultation paid for by Medicare.

The government is also pressing hard to get doctors and other medical workers to embrace the scheme.

------

http://www.zdnet.com.au/doctors-better-use-the-telehealth-hand-out-339317649.htm

Doctors better use the telehealth hand out

By Suzanne Tindal, ZDNet.com.au on June 29th, 2011

From Friday, Medicare will provide doctors with funding for holding video-conference appointments with customers in rural, regional and outer metropolitan areas.

The idea is that the user goes to a GP or other health centre (for example, nursing homes) to have a conference with a specialist who is farther away than the patient would like to travel.

As part of a $620 million initiative, the doctors who decide to do telehealth consultations in 2011/12 get a $6000 one-off payment to fund set-up costs. However, this amount drops to $4800 in 2012/13, $3900 in the next year and $3300 the year after that.

------

http://www.pharmacynews.com.au/news/Google-Health-discontinuation-vindicates-Guild-str

Google Health discontinuation vindicates Guild strategy

By Nick O'Donoghue on 27 June 2011

Australia must adopt personally controlled electronic health records (PCEHRs) that are managed by health professionals, according to the Pharmacy Guild of Australia, after Google announced it will shutdown Google Health.

On Friday, internet giant, Google, revealed it was giving up on its vision of helping users to live healthier lives by discontinuing its patient managed online health record system.

The announcement backs initial research carried out by the Guild, which found only a minority of people would be in a position to upload the necessary data, Kos Sclavos, Guild national president said.

-----

http://www.techworld.com.au/article/391661/microsoft_says_healthvault_still_going_strong/

Microsoft says HealthVault still going strong

Microsoft said it's committed to the service, after Google said it would shut down a similar offering

Microsoft said it remains committed to HealthVault, its service that lets users store all their medical information in one place, despite Google's announcement last week that it would shut down a similar service because it wasn't popular enough.

"What does this mean for HealthVault? The 'buzz' online ranges wildly, but the real and simple answer is: nothing," Sean Nolan, chief architect for Microsoft's Health Solutions Group, wrote in a blog post Sunday.

He pointed to some advancements to show Microsoft's commitment to the service. It recently made HealthVault accessible from mobile phones and released a software development kit for third parties to develop mobile applications for the service.

-----

http://www.computerworld.com.au/article/391673/queensland_health_staff_pay_back_overpayments/

Queensland Health staff to pay back overpayments

Though Queensland Health says demands overpayments due to its bungled rollout of a new payroll system will be handled sensitively.

  • AAP (AAP)
  • 28 June, 2011 11:08

Queensland Health is to begin pursuing staff who have received overpayments as the result of its bungled payroll system.

While the agency says overpaid staff shouldn't be surprised by efforts to reclaim the money, the issue of the overpayments will be handled sensitively, it says.

Queensland Health is trying to claw back $62 million overpaid to staff who recently received letters advising how much they must repay.

-----

http://www.computerworld.com.au/article/392041/payroll_fiasco_could_spark_compo_claim/

Payroll fiasco could spark compo claim

Queensland Health could face compensation claims if it takes a hard line against staff who were accidentally overpaid

  • AAP (AAP)
  • 30 June, 2011 12:07

Queensland Health could face compensation claims if it takes a hard line against staff who were accidentally overpaid, a lawyer warns.

Queensland Health is trying to claw back $62 million in overpayments to thousands of workers caught up in the rollout of a defective payroll system.

Queensland Health has written to workers detailing how much they owe and says it will be sensitive as it tries to recover the money.

-----

http://www.scoop.co.nz/stories/GE1106/S00127/medtech-global-to-work-on-e-health-records.htm

Medtech Global to work on e-health records

Tuesday, 28 June 2011, 9:33 am

Press Release: MedTech

Media release

Medtech Global and Rajiv Gandhi Cancer Institute to work on e-health records

New Delhi, India June 27 2011 – Rajiv Gandhi Cancer Institute and Research Center (RGCI) has signed a Memorandum of Understanding (MOU) with international healthcare IT provider Medtech Global for the digitisation and provision of electronic medical record (EMR) software.

The agreement was announced by New Zealand Prime Minister, the Right Honorable John Key, during his state visit to India. Medtech Global’s executive chairman Vino Ramayah is accompanying Prime Minister Key during his visit.

Medtech Global is a leading provider of health management solutions which enable comprehensive management of patient information through all aspects of the healthcare environment. It was founded in New Zealand and its growing global presence includes a software development centre in Chennai and presence in Delhi.

-----

http://www.theaustralian.com.au/news/nation/false-start-for-medicare-locals-as-transition-may-take-months/story-e6frg6nf-1226085926151

False start for Medicare Locals as transition may take months

  • Adam Cresswell, Health Editor
  • From: The Australian
  • July 02, 2011 12:00AM

PATIENTS, doctors and other health workers may not see any tangible differences for up to a year under the federal government's $416 million network of Medicare Locals, despite the first 19 being launched this week.

The head of the national umbrella body for the existing 118 divisions of general practice, which are expected to evolve into the 62 planned Medicare Locals in most cases, has conceded that "transitioning" into the new bodies may take months, because of the complex contractual and governance arrangements required.

GP Emil Djakic, chairman of the Australian General Practice Network, which represents the existing divisions, told The Weekend Australian there was "no capacity for these organisations to start from stationary from July 1".

-----

http://www.theaustralian.com.au/national-affairs/elderly-blamed-for-long-hospital-waiting-lists/story-fn59niix-1226083056058

Elderly blamed for long hospital waiting lists

HEALTH Minister Nicola Roxon has blamed the increase in the number of older Australians for the failure of her reforms to cut hospital waiting lists three years after they were introduced.

Ms Roxon yesterday conceded elective surgery waits were getting longer despite a $600 million federal spending boost, but said things would be worse if the money had not been spent.

The concession comes shortly before Ms Roxon receives a blueprint detailing potential trouble spots with the implementation of Labor's health reforms based on a two-day workshop conducted by the Australian Healthcare and Hospitals Association.

The results show more guidance is needed on how Medicare Locals will work, where commonwealth funding to the states will be directed and whether hospitals will face a crushing red-tape burden reporting to different performance authorities.

-----

http://www.smh.com.au/technology/technology-news/tech-toys-help-brain-injury-patients-20110627-1gmsw.html

Tech toys help brain injury patients

Belinda Tasker

June 28, 2011 - 8:10AM

Smartphones and tablet computers might be the latest playthings for tech fans but they could also play lifesaving roles for brain injury patients.

After suffering a brain injury many people struggle to remember anything for more than a few minutes.

They have to rely on writing endless notes in diaries or on having carers, relatives and friends to remind them to do a range of tasks including taking vital medication or shopping.

-----

http://www.6minutes.com.au/news/phone-triage-advice-wrong-on-chest-pain

Phone triage advice wrong on chest pain

A coroner called for new phone triage protocols after the healthdirect advice line and a GP locum service failed to advise a heart attack patient with chest pain to call an ambulance.

The phone operators and the 41-year woman had been falsely reassured by misinterpreted ECG tests carried out by doctors at the Royal Adelaide Hospital, which also came in for criticism by the South Australian coroner.

He said the woman’s ECGs and troponin T tests had been incorrectly interpreted and she should have been admitted for further evaluation, but instead she was discharged from the emergency department with a diagnosis of reflux.

-----

http://www.smh.com.au/business/nbns-assumptions-just-dont-stack-up-20110628-1gp48.html

NBN's assumptions just don't stack up

Peter Martin

June 29, 2011

The trouble is in the detail for the network and its business model.

YOU know a business case is hopeless when the company that's drawn it up has to bribe its competitors not to compete against it. The NBN Co business case has a tenuous relationship with reality. The corporate plan detailing how the company will spend $27 billion of public money and hit its targets reads like a cry for help, and also an exercise in laying down a paper trail so its executives can say ''we told you so'' when their targets are nowhere near met.

Optus cable passes 1.4 million homes in Sydney, Melbourne and Brisbane. Fast already, it is capable of being upgraded to a top speed of 240 megabits per second, far faster than anyone needs for conceivable uses; way faster than NBN's entry-level speed of 12 Mbps, and on the way to the maximum NBN speed of 1000 Mbps.

Optus was in the process of upgrading its cable from 30 to 80 Mbps. Instead it will ''decommission'' it in return for payments from NBN worth $800 million.

Telstra is already offering 100 Mbps on its Foxtel cables in Melbourne. As a condition of taking $9 billion from NBN over time, it will ''disconnect'' its broadband customers from the cable, although in its case it will continue to use it to deliver pay TV.

-----

http://www.computerworld.com.au/article/391683/after_mining_health_next_goal_telstra_smart_camp_services/

After mining, health next goal for Telstra smart camp services

Telco hooks up miners with Foxtel IP network deal

Telstra has sought to capitalise on the lack of entertainment and connectivity options available at mining sites in remote and regional Australia, launching a 'Smart Camp' service.

The service combines IPTV setop boxes, content from pay TV provider Foxtel, telephony services, television channels, on-demand movies and a high-speed fibre broadband connection.

Telstra resources sector marketing and strategy executive, Alan Hindes, told Computerworld Australia that the development of the services was created to cater to demand from the resources sector for entertainment and as a tool for retaining staff situated in remote locations.

-----

http://www.computerworld.com.au/article/391395/what_lessons_should_learned_from_distribute_it_meltdown_/

What lessons should be learned from the Distribute.IT meltdown?

Now is a good time to look at Cloud compliance, SLAs and legal ramifications says the ACS

As Distribute.IT's server compromise and subsequent acquisition by Netregistry Group[1] this week has shown, companies who are the subject of a hack attack can be taken out of business permanently. The scale of the Distribute.IT disaster raises issues both for customers who use hosting providers to store sensitive business information and for the providers themselves.

That the incident should happen when there is increasing hype around the use of Cloud services, with organisations either hosting assets in the Cloud or using hybrid private/public models, throws into stark relief the legal minefield enterprises face when they rely on another party to store their data.

-----

Enjoy!

David.

AusHealthIT Poll Number 77 – Results – 4 July, 2011.

The question was:

What Chance Do You Give NEHTA / DoHA of Delivering A PCEHR That Is Useful For Consumers By July 2012?

The answers were as follows:

100%

- 2 (4%)

80%

- 4 (8%)

60%

- 3 (6%)

40%

- 4 (8%)

20%

- 7 (14%)

0%

- 29 (59%)

A pretty clear poll. 81% of readers thought the chance of something useful by the deadline was below 50%

Votes : 49

Again, many thanks to those that voted!

David.

Sunday, July 03, 2011

The Submissions on the PCEHR ConOps have begun to Appear on the Web. Good News I Think!

I have just noticed we have now started to see some of the submissions on the PCEHR Concept of Operations appear on the web.

Submissions received on the PCEHR Draft Concept of Operations – Relating to the introduction of a PCEHR system.

This page lists received submissions that comply with the submission terms of use.

Submissions closed on 7 June 2011. Review this consultation's context

Submissions will be progressively published to the yourHealth website over the next few weeks.

The following list of submissions is a subset, and includes only those submissions where consent to publish was provided. Overall, 165 submissions were received from a wide range of stakeholders and individuals.

All mention of third party individuals or organisations have been removed to comply with privacy guidelines.

----- End Extract

The submissions are found here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/PCEHRSubmissionsReceived

I am not sure just what this means however?

“All mention of third party individuals or organisations have been removed to comply with privacy guidelines.” Does that mean DoHA, NEHTA and Ms Roxon and removed?

As of late Sunday evening (03/07/2011) there are 27 published - all of which are pretty short and many of which raise all sorts of interesting issues. Some of these will make the next version of the ConOps very interesting reading!

It is worth browsing what is there already and re-visiting every few days to see what else turns up.

Enjoy!

David.

Well The One Year Anniversary for the Health Identifier Service Has Come and Gone - And What Has Changed?

It is just over a year ago that the legislation for the Health Identifier Service passed the Senate and most citizens were allocated their 16 digit IHI.

In recognition of the one year anniversary I thought I would go and have a look at the Medicare Site for the latest news. Here is what I found:

Healthcare Identifiers Service

About the Healthcare Identifiers Service

The Federal, state and territory governments have developed a national Healthcare Identifiers Service (HI Service) which will uniquely identify healthcare providers and individuals who seek healthcare. Medicare Australia is the operator of the HI Service.

The HI Service will give individuals and healthcare providers confidence that the right health information is associated with the right individual at the point of care.

There are three types of Healthcare Identifiers.

  • Individual Healthcare Identifier (IHI)—allocated to all individuals enrolled in the Medicare program or those who are issued with a Department of Veterans' Affairs (DVA) treatment card and others who seek healthcare in Australia.
  • Healthcare Provider Identifier—Individual (HPI-I) –allocated to healthcare providers involved in providing patient care.
  • Healthcare Provider Identifier—Organisation (HPI-O) –allocated to organisations (such as a hospital or medical clinic) where healthcare is provided.

IHIs have been created to be used by healthcare providers to improve the security and efficient management of an individual’s personal health information with strict privacy laws governing how these numbers are used.

IHIs do not replace Medicare or DVA numbers and do not affect the way medical benefits are claimed.

Individuals can view their IHI history online by registering for Medicare Australia's Online Services.

IHIs are not health records. The information held is limited to demographic information (such as name, date of birth and sex) which is needed to uniquely identify an individual and their healthcare providers.

IHIs are an essential building block needed to support the future of eHealth in Australia.

HI Service Updates

On 25 June 2011, new HI Service functionality to include contracted service provider (CSP) organisations and their officers (CSP officers) and authorised employee logging was introduced.

CSP organisations

CSP organisations provide:

  • information technology services relating to the communication of health information and/or health information management services under contract to healthcare provider organisations registered with the HI Service.

Before CSP organisations can access the HI Service on the healthcare organisation’s behalf, it must:

  • be registered with the HI Service
  • have an active status, and
  • be linked to a registered healthcare organisation.

A CSP organisation must have a minimum of one and a maximum of three CSP officers linked to the CSP organisation.

A CSP organisation can be linked to a healthcare organisation (in the HI Service) by the responsible officer of the healthcare organisation.

Authorised employee logging

The Healthcare Identifiers Act 2010 requires a healthcare organisation registered with the HI Service to keep authorised employee information for seven years after an employee has ceased working at the organisation.

The new authorised employee logging function lets healthcare organisations store authorised employee details (demographic information and limited personal details) within the HI Service rather than in their local systems. Authorised employees can also contact Medicare Australia for HI Service support.

Authorised employee details must be submitted by an organisation maintenance officer (OMO). Go to Healthcare Identifiers Service - Authorised employee register form to complete authorised employee details.

Go to Online User Guide – Healthcare Identifiers (HI) Service for information on how to submit the completed spreadsheet using the Health Professional Online Services (HPOS) email facility.

----- Page Update - 26 June 2011

The full page is here:

http://www.medicareaustralia.gov.au/provider/health-identifier/index.jsp

Also worth looking at is this page:

http://www.medicareaustralia.gov.au/provider/vendors/healthcare-identifiers-developers/licensed-material/licence-agreement.jsp

It is here you can obtain a license to obtain the ‘Licensed Materials’ you need to start to develop the software which will allow connection of practice and hospital software to the HI Service. The license is dated 29 April 2011.

Basically what we have had since the big announcement on July 1 has been a year of behind the scenes activity that does not seem to have actually moved along much in terms of any practical outcomes.

The saga prior to the July 1, release is found here:

http://health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation-previousannouncments

The bottom line is that only in the last few weeks have software providers been given access, on sensible terms, to start to work to connect to the HI service and the appropriate permissions developed to have software support staff be able to work with clinical staff to make sure the HI Service is doing as expected in the individual practice.

It is clear that at this rate of progress we will all be pushing up daisies before any actual clinical outcomes and benefits are delivered.

I am sure we are going to be waiting a good while before the HI Service is seamlessly integrated into clinical software and even longer before it actually works to deliver the planned and intended benefits.

All the hype around the July, 1 2010 start-up date was just that, hype - as will be the July 1, 2012 start-up for the PCEHR I can confidently predict.

I look forward to still being around to hear of all the success stories - but I sure would not hold my breath!

David.