In the last few days we have had the release of some consultation documents on possible legislation for the PCEHR.
The documents can be accessed from this link:
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehrlegals-document
As I have read this there is one amazing oddity that has popped up.
First we know that Medicare Australia issues HPI-I to all the health practitioners it registers. (HPI-I and Individual Identifiers for Providers -as opposed to Organisational Identifiers HPI-O)
See here:
http://www.medicareaustralia.gov.au/provider/health-identifier/index.jsp
Second here is the list of provider types that can obtain an HPI-I
These include
See here:
In the legal discussion paper we read:
Page 23
Nominated healthcare providers
Section 4.2 of the draft Concept of Operations describes clinical documents that will provide information that can be indexed by the PCEHR system and accessed through the consolidated view10 of a patient’s PCEHR.
Most of the clinical documents described are already part of the healthcare information created in the current healthcare system, such as discharge summaries, referrals, specialist letters, and pathology or imaging reports. However, healthcare providers are proposed to have a key role in creating documents specifically for the PCEHR such as shared health summaries and event summaries. The shared health summary would contain key pieces of information about an individual’s health status, such as allergies and adverse reactions, medicines, medical history and immunisations. The event summary would contain similar information in relation to a healthcare episode and would be created when something significant happens that is important to the individual’s ongoing care.
The draft Concept of Operations proposes at 3.2.5 that an individual will be able to nominate a healthcare provider organisation, or individual healthcare provider, to be responsible for establishing and maintaining the individual’s shared health summary. An individual could only nominate one healthcare provider organisation at a time to manage their shared health summary, however it would not be essential to have a nominated healthcare provider in order to have a PCEHR.
The legislation would not describe criteria or specific functions for the role of the nominated provider, however it would provide a framework for rules and standards to which a nominated provider must comply in managing a shared health summary. These rules and standards may also relate to the authorship of other documents on the PCEHR system, such as event summaries.
----- End Extract.
Nowhere can I find any suggestion that the nominated provider has to be a medical doctor. Why on earth would this not be explicitly stated or is it intended that nurses or dentists etc. can assume the role? This section seems to leave the choice of provider type wide open.
A search of the whole document does not clarify the point as far as I can see.
If that is the case we can be and it will be a wide choice of healthcare provider types then this entire project will be still born.
Of course it may be that the reason for this is that the powers that be don’t want GPs in the role - as they may have to pay them - and so this is a cost saving measure. How silly would that be?
Now I know the doctors are a pain in the neck as far as the Health Department is concerned but really this seems to be going just a little far. No doctor is going to be relying on health summaries developed by other than other doctors - I promise!
David.
