Healthcare Identifier (HI) Service

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1 Digital Health for Practice Managers Healthcare Identifier (HI) Service PAGE 1 The HI Service, operated by the Department of Human Services, gives individuals and practitioners confidence that the right health information is associated with the right individual at the point of care. This is achieved with the allocation of unique 16-digit numbers called healthcare identifiers which are assigned to patients, practitioners and healthcare organisations. You may have two patients with the same name, for example, Mr A Smith, but each patient will have a unique healthcare identifier number. Healthcare identifiers are part of the core infrastructure needed to support secure electronic communication across Australia s healthcare system. Without this infrastructure, our existing health networks and technologies have a limited capacity to talk to each other which is why healthcare identifiers are one of the foundations for a national digital health system. Secure Messaging Exchanging clinical information about a patient via is not secure because of the risk of interference. Secure Messaging is an additional key digital health foundation, defining the protocols for safe and efficient transmission of sensitive healthcare information. The specifications that have been developed will allow health information to flow securely between the many different types of software systems used in different parts of Australia s health system.

2 ereferrals PAGE 2 It is not uncommon for a patient to either misplace their referral or forget to take it with them to see the practitioner. Even if referrals are faxed, their paperbased nature creates the need for data entry into local electronic systems. Since referrals from general practitioners to allied health services have increased by 63% 1. There is great variability in the content, General Practitioner quality and clarity of the referrals created and sent today which can adversely impact the effective and efficient assessment of and subsequent care given to the individual. ereferrals will allow for referrals to be sent electronically along with all the relevant information including the patient s case history and relevant diagnostic tests. A referral is followed by a specialist letter. especialist Letters will be sent electronically from the specialist to the general practitioner. Specialist ereferrals 1 Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, O Halloran J & Fahridin S General practice activity in Australia General practice series no. 27. Cat. no. GEP 27. Canberra: AIHW ereferrals will: spend hours printing, folding and putting referrals in envelopes. Reduce the number of letters sent and received and eliminate the need to fax referrals. Reduce postage and stationery costs. Reduce the size of your database as you will not need to scan referrals into the system. Eliminate the need to manage paper referrals in folders. Save time by not trying to decipher the hand-written information. call other practices looking for lost referrals. Ensure referrals are clear and legible. Reduce the number of queries between referrer and referee. Improve process of referral transfer to ensure that the right consumer information is held in the right place. Improve communication between specialists and general practitioners due to the timely availability of information, eventually leading to improvements in quality and safety of patient care.

3 ediagnostics PAGE 3 Many patients leave a consultation with a referral for a blood test or visit a practice with a paper report and an X-ray film. In Australia each year there are approximately 16 million diagnostic imaging examinations performed 2 and 33.6 million pathology episodes 3. Up to one in six (17%) pathology and diagnostic tests are unnecessary duplicates 4. This adds between $162 million and $306 million annually to health costs 5. There are issues with the current processes for diagnostic tests which include misdiagnosis, illegible and poorly completed request forms, no record of attendance and inadequate screening of previous medical conditions before testing. Many diagnostic service providers have well established processes and systems for the electronic storage and communication of pathology information, but there is often considerable variability of terminology and system capabilities between diagnostic service providers and requesters. ediagnostic tests include both pathology and diagnostic imaging, which will be available in the next two years. ediagnostics will: Allow practices to receive and access diagnostic reports electronically with confidence that the test results are linked to the right patient and care provider. match diagnostic result reports with requests. Reduce the chances of mis-matching when results are received. manually enter the details of a request into provider systems. Save time by reducing the need to respond to queries about requests and reports. General Practitioner Diagnostic Imaging & Pathology Laboratories ediagnostics 2 QUDI: The Quality Use of Diagnostic Imaging Program. The Royal Australian and New Zealand College of Radiologists, Available From: 3 Medicare Australia Statistics. Medicare by MBS category processed from July 2007 to June Minister Nicola Roxon speech, Health-e-Nation Conference, 19 August Australian Institute of Health and Welfare and the University of Sydney report, Clare Bayram.

4 edischarge Summaries PAGE 4 Discharge summaries enable patients to receive continuity of care after a hospital event and provide the practice with the information that they need to know about the episode of care the patient received whilst in hospital. Hospital There is a wide range of variations in health facilities around discharge summaries, but the most significant issue is that discharge summaries are often misplaced and do not reach the intended practitioner. edischarge Summaries will be sent electronically and contain information about a patient s episode of care, including their diagnosis and medication while in hospital, to provide the practitioner with the information required to determine the patient s ongoing care needs. General Practitioner edischarge Summaries edischarge Summaries will: Save time at the practice by not having to chase-up information from the hospital. Improve the process of discharge transfer to ensure that the right information is held in the right place. Improve continuity of care through accurate and timely communication and clinical handover across practitioners. Reduce scanning and faxing. Ensure discharge summaries are clear and legible removing the risk of miscommunication through illegible handwriting. Provide the opportunity to share discharge summaries with a wider range of practitioners involved in the care of a patient, such as allied health, specialists and aged care facilities. Create efficient clinical systems through direct download of the discharge summary to clinical desktop.

5 emedication Management PAGE 5 Prescriptions play a significant role in healthcare in Australia. On average well over two hundred million scripts are dispensed yearly in Australia6. Manual prescribing and dispensing these prescriptions requires repeated data input, manual signing, lots of paper and restricts practitioners from fully utilising clinical support software. Patients are inconvenienced by delays in obtaining prescriptions, issues when prescriptions are lost and even confusion over exactly what medications they should be taking and when. General Practitioner Nearly one in three unplanned hospital admissions in those over 75 years is associated with prescribing errors 7. Hence, preventable medication errors cost around $380 million per year in the public hospital system 8. Encouragingly in some sectors emedication processes are mature, but as further emedication initiatives gather pace, such as medication history lists and medication profiles, more comprehensive medication information will be available to assist in reducing medication errors. emedication Management Pharmacies emedication Management emedication Management will enable point-to-point (practice-to-pharmacy) communication to: Enable the practice to check the validity of a lost prescription. re-issue a lost prescription. Enable the practice to verify if a prescription has been filled and dispensed. Allow practitioners to access accurate and up-to-date information about the patient s medications and medication history as digital health initiatives roll out. manage discrepancies on the prescription. Save time by reducing queries from pharmacies that may have problems deciphering the hand-written information on the prescription. 6 The Pharmacy Guild of Australia: Media release: Health Minister views erx Script Exchange. Canberra: The Pharmacy Guild of Australia; Available from 7 Chan. M, 2001, Internal Medicine Journal, Adverse drug events as a cause of hospital admission in the elderly; 31: Australian Institute of Health and Welfare, Australia s Health no 8, June 2002.

6 Digital Health Journey PAGE 6 An example of a patient s Digital Health journey: Visiting a GP ediagnostics ereferral Getting an X-ray or pathology test Visiting a specialist Hospital admission ediagnostics emedication Hospital discharge Going to the pharmacy edischarge Summary Back to the GP

7 My Health Record system PAGE 7 The My Health Record system previously known as Personally Controlled Electronic Health Record (PCEHR) was rolled out nationally in July Having a My Health Record means your important health information like allergies, current conditions and treatments, medicine details, pathology reports or diagnostic imaging scan reports can be digitally stored in one place. Healthcare providers like doctors, specialists and hospital staff can see these details online from anywhere at any time when they need to, such as in an accident or emergency. Information will be collected in the form of an electronic document and could include event summaries, discharge summaries, pathology result reports and medications. How can Practice Managers prepare for digital health? Practice Managers can prepare for digital health by: Ensure that patient demographic data is accurate By clarifying personal data with patients when they visit, your practice will be well placed to get the most out of digital health. Make sure: There are no duplicate records for the same patient Date of birth is correct Names are accurate First and last names are the right way around Address is up-to-date Medicare number is correct including IRN and expiry date Phone numbers are relevant and up-to-date It is important to have accurate information to get accurate information back. For more information on patient identification and the standard expected of practices, go to page 78 of the RACGP Standards for general practices (4th ed.). Register for the Healthcare Identifier (HI) Service To use the HI Service your practice needs to sign up for a Healthcare Provider Identifier Organisation (HPI-O) number. Talk to your software provider Ask them whether their systems are compliant with national Digital Health specifications and standards. Make sure you have the latest versions of software installed so you can use the HI Service and the My Health Record system. Discuss digital health with your colleagues Having everyone in your practice; medical receptionists, health practitioners and practice managers, well informed is important for getting the most out of digital health. Eventually, you may find that patients will want to know more about their Digital Health options so keeping yourself and others in your practice up to date with developments is advised.

8 The publication was produced by the National e-health Transition Authority (NEHTA) on behalf of the governments of Australia. This publication may be reproduced in whole or in part for work, study or training purposes, subject to the inclusion of an acknowledgement of source. Any enquiries about or comments on this publication should be directed to: National e-health Transition Authority (NEHTA) Level 25, 56 Pitt St, Sydney NSW 2000 T (02) E NEHTA The Australian Association of Practice Managers (AAPM) is the national peak body representing Practice Managers and the profession of Practice Management. Founded in 1979, AAPM promotes professional development and ethics through leadership and education and provides specialised services and networks to support quality Practice Management. AAPM has a National Board of Directors consisting of elected representatives made up from AAPM s state branches. The board s function is to manage the overall direction of AAPM including areas such as membership and accreditation, education, marketing, publications and regulations. State Branches conduct education programs, including courses, seminars and workshops. Australian Association of Practice Managers Limited (AAPM) Level 1, 60 Lothian St, North Melbourne VIC T E AAPM For more information: Cert no. XXX-XXX-XXXX XX%

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