PCEHR upload easy but registration needs streamlining

A general practice IT manager who has set his practice up to connect to the PCEHR has urged the system developers to streamline the registration process.

Luke Moloney, IT manager of the Samford Valley Medical Centre near Brisbane, which uploaded its first shared health summary and event summary using Genie's PCEHR-compatible software last week, said sending documents to an individual's PCEHR was very easy but getting set up to use the system in the first place was overly difficult.

Mr Moloney said the main issues were the multitude of confusing acronyms, the amount of paper forms that need to be filled out and a lack of easy-to-follow guidelines to help practices register to take part.

“Medicare really should think about some of the acronyms that they use,” he said. “There are 'seed' organisations and 'network' organisations and HPI-Os and HPI-Is and the HPD. Most people would think there are many seeds in the network – when I was reading it I thought presumably the network organisation is the key organisation and the seeds are the subsidiary ones.”

Mr Moloney estimates it took seven weeks from the time he first applied to take part to the time the practice was authorised. There was a great deal of paperwork to go through and matters weren't helped by the unfamiliarity of staff at both the HI Service and the PCEHR helpdesk with the system.

“We applied to get our HPI-O and the associated HPI-Is but they wouldn't process that until the PCEHR contract had been sent through,” he said. “It gets a bit overwhelming and the problem is that if you happen to accidentally say the wrong acronym to the person on the end of the line, that can cause all manner of problems.”

Mr Moloney did not receive any training in the system and attacked the job himself. He said training sessions would be useful but that an easy-to-follow guide that translates some of the terms Medicare is using would be far more helpful.

“The amount of people who are going to be confused by the seed organisation and the network organisation is going to be massive. It is never clearly spelled out in the documents – it is only when you go to the NEHTA website. NEHTA puts out probably the best material about it, but the problem is the Medicare forms that you have to fill in are pretty confusing in their terminology.

“There is also a lot of confusion between the HI Service desk and the PCEHR people. There were points where the PCEHR helpdesk thought we weren't registered for the HI Service. That combined with the fact that it's pretty new means that hopefully those teething issues will go away.”

He said once it actually came to creating and uploading the summaries, it was a very straightforward process. Genie has designed its PCEHR interface with several preferences that the user can select.

“You can choose to always check and connect to the PCEHR when you go into a patient's record,” Mr Moloney said. “If they have one, then the PCEHR button will go green. You can query if the patient has one but if you don't open it, then it will turn white. If they don't have an IHI, it will turn black. It doesn't interfere with anything or cause any delays.”

Many doctors will not want their full consultation notes uploaded, so the option is to copy and paste part of the note or to write a new summary, he said. “For uploading the health summaries, it is a pretty simple process and it will take a bit of time, but it's certainly not as laborious as it otherwise could have been.”

He said the main issue was not whether doctors would use the system, but whether patients would take the time to register themselves. Again, he urged the system developers to streamline the application process, perhaps by allowing an authorised person such as the GP to apply for a patient's PCEHR through HPOS.

“I don't think the issue will be with people uploading shared health summaries or event summaries,” he said. “It is going to be getting patients registered for their PCEHR.

“We don't know when any of the hospitals in our local area are going to come online. Even in the future when they do come online, the very sorts of people who will most benefit from this sort of system – mostly the elderly and people with severe health issues – the problem is that they, out of everyone, are the least likely to go through the registration process. That is probably a concern and I'm not sure how you address that.”

Pulse+IT understands that NEHTA and the Department of Health and Ageing (DoHA) are working on 'assisted registration', where a doctor in a general practice or in the hospital setting encourages the patient to set up a PCEHR and assists them to do it there and then, but Mr Moloney doubted any doctor would have time to do so.

He also said doctors would rarely have the time to explain to patients what the PCEHR is and how to register.

“I registered for mine over the phone and had a paper form to fill out. The nurse or receptionist might help the patients to register but there should be some way that we could do it through the HPOS system, for example. They should reduce the proof that the patient needs to provide – doctors are asked to verify identity all the time so if the doctors could do it and then send it off through HPOS…

“Another question is whether doctors will actually log in and look at it. This is an issue that needs to be dealt with.”

For practices, he said the most pressing concern was the lack of simple, step-by-step guidelines through the process. “NEHTA has a good flow chart with all the steps you have to go through, but unfortunately some of the hyperlinks in the PDFs don't match. It can be annoying – they really need something that spells it out.”

Posted in Australian eHealth

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