Over 56,000 individuals have registered for a PCEHR since its launch last July, along with 1171 healthcare organisations and 1325 individual practitioners who are authorised to access the system, according to the Department of Health and Ageing (DoHA).
DoHA and National E-Health Transition Authority (NEHTA) representatives told a Senate Estimates committee hearing in Canberra yesterday that with 98 per cent of general practice software now PCEHR-compliant, it was expected that real growth in the numbers of individuals registering would begin.
Committee member Concetta Fierravanti-Wells queried whether DoHA's target of 500,000 registrations in the first year, as outlined in the May 2012 budget papers, could be achieved.
“The targets in the 2012 budget were 500,000 sign-ups by 2013 – very ambitious I would have thought,” Senator Fierravanti-Wells said. “You are clearly not going to reach that target.”
DoHA deputy secretary Rosemary Huxtable said the 500,000 figure was the department's expectation based on international evidence of what it could expect within the first full year of operation.
However, Ms Huxtable said that with PCEHR-compatible GP software now finally rolling out, she expected to see numbers of registrations increase.
“Getting that GP software in place is the time when the real value is in the record,” Ms Huxtable said. “This is the time that can really begin.
“The figure of 500,000 in the first year of operation, I think that is still achievable given that I would really argue we are now in a place where we are beginning to see the more comprehensive operation of the PCEHR system, not just registration but also clinical use.”
Senator Fierravanti-Wells also asked how many healthcare providers had registered to use the system. A DoHA representative said 1171 healthcare organisations had been registered to use the PCEHR, with 1325 individual providers given authorisation links.
Individual practitioners do not have to register to use the PCEHR but the organisations they work for do. Healthcare organisations are issued a Healthcare Provider Identifier – Organisation (HPI-O) number, which is allocated by the Department of Human Services.
To begin using the PCEHR, organisations must have registered for an HPI-O and stored it in the practice's clinical software. They must also apply for a NASH PKI digital certificate to both access the PCEHR and use secure messaging.
Practitioners do not register individually, but their Healthcare Provider Identifier – Individual (HPI-I) must also be stored in the practice's software in order to be authorised to use the PCEHR.
Last month, a DoHA spokeswoman told Pulse+IT that 2867 HPI-Os had been assigned to healthcare providers and another 1400 applications were being processed by DHS.
Pulse+IT understands that a backlog in processing these applications, and in issuing NASH digital certificates, means that while many practices have the software to access the system, they cannot do so until their NASH certificate arrives.
It is also understood that in some GP software packages, practitioners' HPI-Is cannot be stored in the software until the NASH certificate is installed.
Last month, the DoHA spokeswoman said that as at January 22, 4267 healthcare provider organisations have been or will be assigned an HPI-O number. Of these, approximately 3300 are from general practice, which is roughly half of all general practices in the country.
Pulse+IT has asked for clarification on how many HPI-O applications from general practices have been received to date, how many HPI-O and NASH certificates have been issued to general practices and how many are still being processed, and when the department expects to clear the backlog.
Senator Fierravanti-Wells also asked how many shared health summaries had been uploaded to the system.
Ms Huxtable could not give an exact figure. “At this point there is a fairly low number of summaries because the GP software hasn't had the capacity to upload a shared health summary,” Ms Huxtable said.
“There is a fairly high number of consumer-entered documents, so the records are populated with a variety of documents. There are also Medicare documents. There is a very large number of documents in that regard.”
Asked how many practice management software packages were compatible, NEHTA CEO Peter Fleming said he estimated that 98 per cent of GP-specific software was PCEHR-compatible.
Mr Fleming said that in addition to two companion tools produced by HIE and Pen Computer Systems, which are plug-in tools that can allow software to access the PCEHR, there were seven practice management packages that are now compliant, which he said represented about 98 per cent of software on GP desktops.
“For example, I was in HCN's offices last week and they are the major vendor in this space, and they represent something of the order of 50 per cent [of the market],” Mr Fleming said. “They have updated their systems like the others and in talking to them, they were able to tell me at the time that 1400 of their customers have taken the latest release.”
Asked why there was such a delay in the major practice management software vendors becoming compliant, considering the PCEHR launched on July 1, 2012, Mr Fleming said there were a number of steps required to roll out these systems.
“Provider software is one of the last steps,” he said. “In perspective, they needed to make changes to their systems … there is a huge amount of changes that needed to be made to those systems, and they needed to be tested, both in the environment we set up and in the local environments before they go out on a larger scale.”
“Why didn't you wait until you were sure the practice management software was ready for the 1 July launch?” Senator Fierravanti-Wells said. “That would have been a more prudent approach, would it not?”
Mr Fleming said there were many steps in the program. “The reality is this is one of the final steps, we are getting registrations, so the infrastructure is in place.”
Ms Huxtable said that in addition to the PCEHR, there were many other dimensions to eHealth that have been worked on for some years and are now bearing fruit.
“These are complex issues: one is the HI Service, which as we know is a fundamental precondition for the PCEHR, but equally is required for secure messaging to work appropriately,” Ms Huxtable said.
“We are seeing many of the features that have been worked on for some time, not just in the PCEHR space but more broadly … we are at the point where we see that coming to fruition now and we can see the benefits coming out of that.”
She said the department was pleased with the amount of general practices that had applied to take part in the eHealth Practice Incentives Program (ePIP).
“What we know is that there has been a quite high take-up of the ePIP, which was required from 1 February, and the first of those required the organisations to have an HPI-O/HPI-I. Given that our focus is really around general practice, we are very encouraged by the rate of take up within general practice.”
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