eHealth Record System and Healthcare Identifiers (HI)

Health information for a patient is currently distributed across a wide range of locations including their general practices, hospitals, imaging centres, specialists, and allied health practices.

The eHealth record system — launched in July 2012 — is an electronic record for a patient that contains a summary of their health information. It is a key element of the national health reform agenda around making the health system more agile and sustainable.

With the introduction of the eHealth record system, healthcare organisations will have faster, easier access to more health information, creating a more efficient system, making continuity of care easier and improving treatment decisions.

All Australians can register for a personally controlled electronic health record. All Australians can register for a personally controlled electronic health record and have access to a summary of their personal health information whenever they need it.

To register for your eHealth record, go to www.ehealth.gov.au.

The Australian Government has introduced the personally controlled electronic health record system, commonly called the PCEHR system (and officially known as the "eHealth record system") as the core component of the national eHealth system.

Health information for a patient is currently distributed across a wide range of locations including their GP, hospitals, imaging centres, specialists, allied health practices, etc. An eHealth record is an electronic summary of a patient's key health information, drawn from their existing records.

With the introduction of the eHealth record system, healthcare organisations will have faster, easier access to more health information, creating a more efficient system, making continuity of care easier and improving treatment decisions. More detailed patient information will continue to be available in health information systems held within your business or organisation, as per current practice.

What does an eHealth record contain?

The eHealth record system is designed to have the following document types and information uploaded, entered, downloaded and viewed.

Examples of Clinical Documents are available here.

  • Shared Health Summary
  • Event Summary
  • Discharge Summary
  • Medication Records
  • eReferral
  • Specialist Letter

Other information available in an eHealth record:

Medicare Records

  • Individuals can choose to have their Medicare data included in their eHealth record. This can include past (up to two years of prior transactions) and future MBS and PBS (and RPBS) transaction information, their organ donor status (sourced from the Australian Organ Donor Register (AODR)) and, if relevant, details from their Australian Childhood Immunisation Register (ACIR) records.
  • These records may be viewed individually or in summary via the eHealth record Medicare overview.

Consumer Entered Information

  • Personal Health Summary – individuals can enter information about allergies and adverse reactions, and current medications into their eHealth record. This data can be viewed by healthcare providers;
  • Advance Care Directive Custodian – individuals can enter the contact information of a person or organisation who is the holder of their advance care directive (or "living will").
  • Emergency Contact Details – individuals can create a list of important emergency contacts in their eHealth record, which is visible to healthcare providers.
  • Personal Health Notes – individuals can enter information to help them keep track of their health, i.e. like a health journal. The system dates each note, which includes an entered title and the entered text. These notes are not visible to healthcare providers.

Child Development

  • Parents can record results of their child's scheduled health checks, childhood development and other useful information. The objective is to provide an integrated view of a child's health status for the parents/guardian and healthcare providers involved in the child's care.
  • The Child Development section of a child's eHealth record contains: an Achievement Diary, Personal Observations, Immunisations, Child Health Check Schedule, Child Growth Charts and Information for Parents.
  • This information is currently only visible to healthcare providers through the National Provider Portal, as clinical information systems have not yet built this functionality into their systems.

The ability for a healthcare provider to use the features described above will depend on whether their software vendor has included the functionality in the provider's clinical desktop software. See 'Software Products using eHealth' for information on software products that are eHealth conformant.

The eHealth record system will continue to evolve to include other document types and services – according to the needs and priorities of the healthcare system.

Which patients will benefit most from having an eHealth record?

Any Australian can register for and benefit from an eHealth record, but people from the groups below are likely to derive the greatest benefit from registration:

  • People with chronic and complex conditions;
  • Older Australians;
  • Aboriginal and Torres Strait Islander peoples;
  • Mothers and newborns;
  • People with mental health conditions; and
  • People in regional, rural and remote communities.

How do providers access the eHealth record system?

Healthcare providers can access the eHealth record system via two methods:

1. Conformant Clinical Software

  • A number of clinical software vendors have software which is conformant with the eHealth record system. This means that healthcare provider organisations can access eHealth records directly from their clinical software. See which software products are conformant here.

2. National Provider Portal (read-only via an internet browser)

Individuals can access their eHealth record through the Consumer Portal.

Key design principles for the eHealth record system

  • Participation is voluntary (opt-in) for both individuals and healthcare providers;
  • Individuals can control which healthcare organisations can access their record;
  • The eHealth record is a summary of key health information and as such healthcare provider need to exercise their normal clinical judgement remembering that information may be absent of not complete;
  • The eHealth record is not a replacement for organisational or clinical records, i.e. the "source of truth" remains where it is today – in local clinical records, and is not a replacement for current point to point sharing of health information;
  • The eHealth record includes two components – clinical and personal (or individual-entered) information – and the clinical component contains copies of healthcare-related information; Only healthcare providers authorised by their healthcare organisation, and providing healthcare to the individual, can view an individual's eHealth record and enter information into an individual's eHealth record.

The delivery of safe, effective and efficient healthcare relies on good communication and systems that share information, where the subject of care can be reliably and consistently identified. The Healthcare Identifiers (HI) Service is a national system for uniquely identifying healthcare providers, healthcare organisations and individuals receiving healthcare.

The service is operated by the Department of Human Services and is a foundation component of all national eHealth products and initiatives, such as the national eHealth record system. Healthcare Identifiers help ensure individuals and healthcare providers can have confidence that the right information is associated with the right individual at the point of care.

HI-Service

As illustrated in the above diagram, the HI Service allocates and manages the following types of healthcare identifiers:

  • Healthcare Provider Identifier – Individual (HPI-I) – for individual healthcare providers involved in providing patient care;
  • Healthcare Provider Identifier – Organisation (HPI-O) – for organisations that deliver healthcare (such as medical and allied health practices, or hospitals); and
  • Individual Healthcare Identifier (IHI) – for individuals receiving healthcare services.

The diagram below illustrates how these identifier types work together in the context of a healthcare event.

HI Identifier Types

Healthcare Identifiers can only be used for the purposes described in the Healthcare Identifiers Act 2010 and Healthcare Identifiers Regulations 2010, e.g. for communicating and managing healthcare, which covers documents and processes such as electronic referrals, discharge summaries and medication management.

Access to the HI Service requires registration and digital credentials, namely PKI certificates (refer to 'Authentication Using PKI Certificates') to authenticate the identity of the organisation and individual accessing the Service.

The Healthcare Provider Directory (HPD)

An important component of the HI Service is the Healthcare Provider Directory (HPD), which is an opt-in listing of healthcare providers (individuals and organisations) registered with the HI Service.

Once a healthcare provider (organisation and individual) is registered with the HI Service, they can choose to be listed in the HPD. The HPD is not a public directory and is only available to healthcare providers and authorised users of organisations registered with the HI Service.

It is extremely important for your organisation and clinicians to be listed and linked in the HPD so that key identifying information can be available, e.g. in searches performed by other healthcare providers. This will enable your organisation and clinicians to be selected to receive referrals and other forms of secure electronic communications.

Healthcare Identifiers (HI) Service

With our partners in the Department of Human Services (DHS) and through significant stakeholder consultation we have designed, built and now implemented the Healthcare Identifiers Service (HI Service). Healthcare Identifiers are necessary to ensure that only the right people have access to patient information and to ensure that newly acquired patient information is matched correctly with the existing patient records.

Vendors, Healthcare Identifiers Specifications can be found on the NEHTA website as per:

Download: Healthcare Identifiers Specifications

 

Use of the HI Service has grown steadily, driven by NEHTA's implementation activities. There were more than 3.1 million IHIs downloaded into clinical systems during the year. There were 13,182,937 disclosures of IHIs from the HI Service via business-to-business (B2B) channels during the year due to downloading of IHIs into clinical systems, validation testing, and data quality activities undertaken on jurisdictional health data.

The HI Service was enhanced during 2012 in preparation for the launch of the national eHealth record system.

Operated by DHS Medicare, the Healthcare Identifiers Service is a national system for uniquely identifying healthcare providers and individuals. Healthcare identifiers help ensure individuals and providers deliver the right health information to the right individual at the point of care.

Download: NEHTA eHealth Brochures

Conformance Compliance and Accreditation (CCA)

Clinical software systems must demonstrate the capability of direct access to the Healthcare Identifiers (HI) Service by completing HI conformance testing, as documented in the HI Conformance Assessment Scheme.

Clinical software systems must demonstrate the capability of direct access to the Healthcare Identifiers (HI) Service by completing HI conformance testing, as documented in the HI Conformance Assessment Scheme. The CCA tests are performed by independent National Association of Testing Authorities (NATA) accredited testing laboratories to assure the safe use of Healthcare Identifiers by clinical software systems. Conformance assessment must be performed by a test laboratory accredited by NATA under its classification 22.40.02 in the NATA Information and Communications Technology Testing, Classes of Test.

Healthcare Identifiers (HI) Conformance Assessment Scheme

The Software Conformance Requirements for HI provide detail of the clinical software system behaviour and refers to relevant Business Use Cases. Refer to the HI Conformance Assessment Scheme for more information on the Business Use Cases and the Software Conformance Requirements. The Implementation Resources to access the HI Service can be found in the following links:

Products, services and organisations are eligible for inclusion on the Registers if they have been assessed for conformance or compliance with national eHealth requirements. Listing is voluntary and reflects information supplied by the conforming organisation or product owner. Software products are eligible for inclusion on this Register if the software developer declares conformance with the requirements for each product by completing and submitting a Declaration of Conformity.
  • Personal Health Summary – individuals can enter information about allergies and adverse reactions, and current medications into their eHealth record. This data can be viewed by healthcare providers.
  • Advance Care Directive Custodian – individuals can enter the contact information of a person or organisation who is the holder of their advance care directive (or "living will").
  • Emergency Contact Details – individuals can create a list of important emergency contacts in their eHealth record, which is visible to healthcare providers.
  • Personal Health Notes – individuals can enter information to help them keep track of their health, i.e. like a health journal. The system dates each note, which includes an entered title and the entered text. These notes are not visible to healthcare providers.

The information will be loaded as a structured document and included in the Consolidated View.

During 2011-12 NEHTA completed the design for the personally controlled electronic health record (PCEHR) system, and published the technical specifications for software vendors to interface with the system. A key achievement was delivering Release 1A — the software vendor testing environment which provides the infrastructure for hosting and retrieving documents from the eHealth record system.

The eHealth record is a voluntary 'opt-in' system. It does not replace the records that GPs hold or the way they communicate with their patients. Rather it provides a summary of key medical information that can be very useful for other clinicians. The eHealth system facilitates the secure sharing of that information in a way that is controlled by the patient.

To find out more or to register for an eHealth record, visit these eHealth FAQs and Resources pages.

Specifications are now available for the personally controlled electronic health (eHealth) record system. To access the specifications and related documents go to www.ehealth.gov.au.