Electronic Health Record Sharing System (ehrss) Registration Checklist for Healthcare Staff (HCS)

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1 Electronic Health Record Sharing System (ehrss) Registration Checklist for Healthcare Staff (HCS) Please refer to Note and Personal Information Collection Statement before you collect information of your healthcare staff for account creation. 1.1 Personal Particulars English Title: Mr/ Mrs/ Miss/ Ms/ Doctor/Professor Chinese Title: 先 生 / 太 太 / 小 姐 / 女 士 / 醫 生 / 教 授 / 醫 師 Surname in English (must be the same as shown on HKIC / Travel Document) Given name in English (must be the same as shown on HKIC / Travel Document) Full name in Chinese (must be the same as shown on HKIC / Travel Document) Hong Kong Identity Card number. (If not a HKIC holder, state travel document type, no., and issuing country) If not a HKIC card holder Travel document type. Travel document number Travel document issuing country Current participant in PPI-ePR Sharing Pilot Project? (Yes / No ) Address: Contact Phone number 852- Communication means for receiving notification about ehrss (choose one only) SMS User Account Details

2 Name of Healthcare Service Location where the staff mainly work and access ehrss Preferred user name (must be 6 to 20 alphanumeric characters) - 1 st - 2 nd Second authentication factor for login to ehrss Not required (login via connection mode A) Second password (for HCR registration staff only) e-cert USB Security token Sharing security token issued by ehealth System (Subsidies), serial number: To share the token issued by ehealth System (Subsidies), HCS consent to the release of his/her Hong Kong Identity Card number to the Hong Kong Government for disclosure of the serial number of the security token issued to him/her under ehealth System (Subsidies) User Role Healthcare Professional (for viewing HCR records) Professional Category: Professional Registration Number: Professional Category Sample format of Professional Registration Number: Registered medical practitioner Mxxxxx / MLxxxxx / MPxxxxx Registered dentist Dxxxxx Registered nurse / RNGxxxxxxx / RNGFxxxxxx / RNGMxxxxxx / RNCxxxxxxx / RNSxxxxxxx / RNPxxxxxxx Enrolled nurse ENGxxxxxxx / ENPxxxxxxx Registered chiropractor CCxxxxxx Registered medical laboratory MT1xxxxx/ MT2xxxxx / MT3xxxxx technologist Registered occupational therapist OT1xxxxx/ OT2xxxxx Registered physiotherapist PT1xxxxx / PT2xxxxx Registered radiographer RD1xxxxx / RD2xxxxx / RD3xxxxx / RD4xxxxx / RT1xxxxx / RT2xxxxx Chinese medicine practitioner xxxxxx / LRxxxx / Lxxxxx Registered pharmacist Pxxxxx Enrolled dental hygienist DHxxxx Registered optometrist OP1xxxxx / OP2xxxxx / OP3xxxxx / OP4xxxxx Registered midwife Healthcare Administrative / Ancillary Perform HCR registration

3 Manage healthcare staff account and other administrative functions Account Effective Date (DD/MM/YYYY) Account End Date(DD/MM/YYYY)

4 Note 1) HCP shall comply with, and take all reasonable steps to ensure that its staff comply with ehrsso, Personal Data (Privacy) Ordinance (Cap. 486) (PD(P)O), Code of Practice (COP), policies, rules, specifications, standards and requirements set out by ehrc. 2) HCP shall take all reasonable steps to prevent unauthorised access to ehrss and ensure proper and safe use of ehrss by its staff to access only data in the ehr of any HCR that is relevant for providing healthcare to the HCR.

5 PERSONAL INFORMATION COLLECTION STATEMENT Purposes of Collection We may collect your personal information including name, title, contact information (e.g. address, telephone number(s) and address) and professional registration information (if applicable). The personal data or any information we collected from you is used for the creation and maintenance of your user account as an authorised healthcare staff working under a healthcare provider who have participated in the Electronic Health Record Sharing System (ehrss) and related matters under the ehrss Ordinance (Cap 625) Your registration is essential as only users with valid user account can access information and function(s) in the ehrss. Unless for specified purpose stated in the ehrss Ordinance, using your personal information in ehrss for direct marketing is an offence Classes of Transferees Except with your prior consent, we will not transfer or disclose the collected personal information to any third party except as stated below: (1) the Department of Health, Hospital Authority or any person or entity whom we may appoint in writing to assist in performing a function and exercising a power, pursuant to ehrss Ordinance; (2) any personnel, agent, adviser, auditor, contractor or service provider engaged by us to provide services or advice (e.g. technical, security or data processing service etc.) in connection with our operations; (3) any person to whom we are required to make disclosure under any law or court order applicable in Hong Kong. Access and Correction of Your Personal Data You have the rights of access and correction with respect to your personal data provided under Personal Data (Privacy) Ordinance. A reasonable fee will be charged for complying with your request. Enquiries Enquiries concerning personal data provided, including the making of access and correction should be addressed to: Electronic Health Record Registration Office Unit 1193, 11/F, Kowloonbay International Trade & Exhibition Centre, 1 Trademart Drive, Kowloon Bay, H.K. Fax: Hotline: ehr@ehealth.gov.hk

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