PCEHR legislation passes but soft launch expected

The legislation enabling the personally controlled electronic health record (PCEHR) passed the Senate last night, less than two weeks before the system is due to launch.

Opposition and Greens senators had previously indicated they would support the legislation. It passed unopposed.

Consumers will be able to register for a PCEHR on July 1, either by calling 1800 PCEHR1 (1800 723 471) or at a Medicare shopfront. While the Department of Health and Ageing has established a consumer website to provide information on the system, online registration is not yet possible.

While the government has been touting the long-term benefits of the PCEHR, including the claim that it will save $11.5 billion over 15 years, it has not conducted a public information campaign to encourage consumers to sign up for a PCEHR.

Health Minister Tanya Plibersek and the Department of Health and Ageing have repeatedly stated that the plan is to target certain segments of the population in the first instance rather than consumers as a whole.

According to a recent presentation by Mick Reid of McKinsey and Co, which is leading the National Change and Adoption Partner (NCAP) consortium for the implementation of the PCEHR, these target populations are mothers and newborns, older Australians, people with chronic conditions like diabetes, those being treated for prostate, breast and bowel cancer, mental health consumers, clients of the Department of Veterans Affairs (DVA), the Department of Defence and private health insurers, and clients of Aboriginal Controlled Community Health Services (ACCHS).

The marketing plans for the Wave sites responsible for implementing the PCEHR have not factored in broad consumer information activities, and consumer recruitment from the target demographics has only begun in the last few months.

DoHA secretary Jane Halton recently told the Health-e-Nation conference that close to 1.4 million people have been recruited to the Wave sites, but according to a spokeswoman for DoHA, the information collected by the Wave sites will not necessarily transfer to the PCEHR from July 1. Consumers involved in those projects will have to register just like everyone else.

Steve Saunders, project manager for the Eastern Sydney Connect Wave site, said that as of May 4, 424 GPs from 100 practices and 4444 consumers had been recruited for the St Vincent's & Mater Health project, but these consumers will need to re-consent to their information being used in their PCEHR should they register for one.

The DoHA spokeswoman said participants in the lead eHealth sites “have been provided with information to inform them of the benefits of participation in their local network. Information regarding registration for the eHealth record for these patients and the wider community will be released following passage of the eHealth record legislation.

“Information collected by local systems established as part of the lead eHealth sites will not in itself transfer to the national infrastructure from 1 July 2012. However, a GP can post a patient’s shared health summary generated in the local system to the eHealth record from 1 July 2012, with the patient’s consent.”

It is not clear as yet whether consumers will be able to register through Medicare Online or the australia.gov.au site, which links various online accounts from the Department of Human Services – Medicare, Centrelink and Child Support – as well as the DVA.

And as the consumer portal being built by Orion Health, part of the National Infrastructure Partnership consortium, has not yet been finalised, it is unclear whether the consumer will be able to have anything uploaded at all. Orion Health is also building the provider portal, but the company is tight-lipped on when that will be ready.

The project has also run into a security stumbling block, with the National E-Health Transition Authority (NEHTA) last week announcing the National Authentication Service for Health (NASH) will not be ready for its planned release on June 26.

NEHTA CEO Peter Fleming said arrangements had been put in place to provide an interim NASH delivered by the Department of Human Services to enable the eHealth records system to launch and begin operations as planned.

"NEHTA will work closely with our key vendors involved in the eHealth sites program to roll out the interim NASH to allow the launch to go ahead as planned,” he said.

The DoHA spokeswoman said that once a consumer has registered for their PCEHR, they can then ask their GP to set up a shared health summary, as long as the GP has compliant software and has registered for an HPI-O and HPI-I.

“Organisations that have upgraded to eHealth record-compliant clinical software with the support of their software vendor will be able to create shared health summaries,” she said.

It was recently revealed in a Senate estimates committee hearing that this should be ready in September.

“As eHealth record-compliant software is progressively made available, healthcare professionals will be able to facilitate the registration of consumers for an eHealth record within their own practice,” the DoHA spokeswoman said. “Where GPs do not have the required software, consumers can register for an eHealth record at a DHS Medicare shop front, by calling 1800 PCEHR1 or by submitting a paper application form.”

She said consumers do not need to know their Individual Healthcare Identifier to register for an eHealth record. “When a consumer registers and their eHealth record is created it will be automatically linked to their IHI. If consumers would like to know their IHI they can contact the HI Service. [Medicare] operates the HI Service and consumers can obtain their IHI by going into a Medicare shop front, contacting the HI Service on 1300 361 457 or via Medicare Australia’s Online Services.”

She also said an events program is underway. “This has involved presenting to and having exhibition displays at conferences targeting key consumer cohorts, including Aboriginal and Torres Strait Islander peoples, older Australians and mothers and their newborn children.”

According to Mr Reid, part of the promotional plan was to launch the national PCEHR call centre in April, along with a second wave of e-collaboratives. The Wave 1 sites have already set up an eHealth Network e-collaborative, taking in the catchment areas for the four organisations involved – Metro North Brisbane Medicare Local, Accoras, Hunter Urban Medicare Local and Inner East Melbourne Medicare Local.

A website has been created and a call centre is being manned by Health Industry Exchange (HIE), which is sub-contracted by the sites to develop shared services.

The PCEHR marketing plan was also to include a pre-registration announcement and activities such as the launch of the electronic blue book for newborns, which is being developed by the Greater Western Sydney Wave 2 site. Industry sources have indicated that this will be launched later in July.

A staged media event of the Minister for Health signing up for an eHealth record was planned for July 1, although The Australian newspaper is reporting that this has been cancelled.

Posted in Australian eHealth

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