E health your questions answered

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  • Thank you for joining our webinar “eHealth: Your questions answered”My name is Kathy Rainbird and presenting with me today is Michelle McClure – we are the eHealth team at South West WA Medicare Local.As usual in order to keep things moving, we have muted all attendees. But if you do have any questions along the way please type them into the question box on your screen and we will endeavour to answer them, either at the end of the session or later via email. You are also welcome to contact us later with any questions that come to mind following today’s presentation.Also, just to let you know, we will be making these slides available via our website [next slide].
  • Our web address is www.sw-medicarelocal.com.au then go to the eHealth tab.Here you can also find information about our up-coming webinars and other eHealth information.
  • As many of you know, we have been hosting a number of information sessions and webinars about the new national eHealth record system (also known as the personally controlled electronic health record or PCEHR). During these sessions many of you have raised questions or concerns about the eHealth record system. We have collated these questions and hope, via this webinar, to address many of these issues today.So the questions we will be considering today are…(read from slide)
  • And…(read slides)Some of these questions have been touched on or explained in greater detail in other sessions. In particular, if any of you attended the RACGP peer-to-peer education sessions that we hosted in Bunbury or Narrogin, you may find there is some repetition. For those of you who are interested, we will be holding another one of these sessions in Albany on the 28th May (this evening).
  • You are all invited. And we would certainly encourage everyone to attend.
  • As most of you already know, in July 2012 the Australian Government introduced a personally controlled electronic health record (PCEHR) systemPeople seeking health care in Australia can now choose to register for an eHealth record.Essentially the eHealth record system is a method for consumers (patients) to share health information with their healthcare providers.Healthcare professionals that choose to participate will, over time, have access to important health information, helping provide safer, more efficient care for consumers.
  • At this stage, the eHealth record contains three types of information:Clinical documentsPersonally entered dataAnd Medicare dataI will go into a bit more detail about the specifics of each of these as they currently stand. However, I should point out that this is just the beginning. There are plans for a variety of other documents to be made available over time.
  • The clinical documents contained in the eHealth record aresummarised copies of health-related information. It should be emphasised that the eHealth record is not a replacement for clinical records and will not include clinical notes.Only authorised healthcare professionals can enter information into the clinical component of the eHealth record, ensuring it is clinically relevant and accurate.1Patients cannot alter documents created by healthcare professionals.Shared health summary – may include information about a patient’s medical conditions, history, medication they are currently taking, allergies and adverse reactions and immunisations. The Shared health summary isuploaded by the patient’s usual GP from their desktop software if requested or consented to by the patient. Some of you may have heard the term “nominated provider” used in relation to the Shared Health Summary – basically, this is the healthcare professional who is involved in the continuing, coordinated care of the patient who has agreed, with the individual, to create their shared health summary. Most often this would be the patient’s regular GP, a registered practice nurse or Aboriginal healthcare worker. Most commonly these will be created/uploaded when the patient’s regular healthcare provider feels new information might influence the treatment of a patient by other healthcare professionals (ie when their current health status has changed).
  • Just to show you an example of this, we have a scenario for a fictitious patient – Mr Vijay Engineer. He may be familiar to some of you, if you’ve seen our previous “eHealth: what will it look like” webinar.Basically, Vijay visits his regular GP, Dr Javad, who sees via his clinical information system that Vijay has an eHealth record (note: this is an illustrative example of a clinical software system and different software systems may look different).In consultation with Vijay, Dr Javad decides to create a Shared Health Summary for Vijay. He does this, by clicking on the relevant button.
  • Dr Javad can then select the key fields that will be automatically populated in the Shared Health Summary, review the draft and edit it if needed. Dr Javad then clicks “upload” to send the shared health summary to Vijay’s eHealth record.
  • And a notification is sent to the GP to inform him that the Shared Health Summary has been successfully uploaded.
  • When Vijay visits another healthcare professional, who decides to view his eHealth record, this is what they see.
  • And here is the Shared Health Summary.
  • Other clinical documents currently available in the eHealth record include:Event summary – this is a summary of a clinically significant event of care. Not every consultation will result in the creation of an event summary. But they may be particularly useful when a patient has a change in medication or dose change, an adverse reaction. It can be uploaded by a healthcare professional at any participating healthcare organisation – such as an after-hours GP clinic, hospital or allied health clinic.While the shared health summary is a template and is generated from your local clinical record, the event summary allows free text.
  • And here is an example of an event summary for Vijay which was uploaded when he attended an after-hours clinic.
  • And finally, the other clinical documents currently available on the eHealth record includese-referrals, specialist letters and e-discharge summaries – these can be exchanged by secure messaging and uploaded to/retrieved from the eHealth record system.It should be emphasised the eHealth record is not a replacement for organisation or practitioner clinical records. And it does not replace point-to-point communications between healthcare providers – current standards of communications between healthcare professionals still need to occur.The eHealth Record is never intended to contain all health information. However, it can provide additional clinical information to healthcare professionals who may not have previously had access to the information (eg After Hours clinician) and reduce reliance on patient’s memories.
  • So we’ve talked in some detail about the clinical documents that are contained in the eHealth record.In terms of the other types of information included, we have personally entered data
  • And that is basically, as it sounds, information that the patient may enter themselves.It includes…(read from the slides)Eg Personal health summary – might include information entered by the patient about reactions to medications or other over-the-counter medications they are using. As noted here – this data can be viewed by healthcare providers authorised to access the patient’s record.Eg Personal health notes – where patients can enter information to help them keep track of their personal health (eg a health journal), these are not viewable by healthcare providers)
  • And there is Medicare data.When an individual registers for an eHealth record, they can choose to have the data held by the Department of Human Services – Medicare included in their record. This can include past (2 years) and future MBS and PBS claims information, their organ donor status and if relevant, details from the Australian Childhood Immunisation Register records. This data is visible to healthcare professionals who are authorised by the patient to access the record.
  • So, going back to our original list of questions, I think we have addressed most of the ones on this list, we’ve talked about what it is, what it includes, how it works and shared health summaries. In terms of what it will look like. We’ve given you a bit of a brief look today, but we do also have a more thorough presentation, as mentioned previously, called “eHealth: what will it look like.” A recording of this webinar is available on our website. Or, if there is sufficient demand, we’d be happy to run this webinar again. If you are interested in this, then please note this in your evaluation form following this session.In relation to how much time it will take – you saw how easy it was to generate a Shared Health Summary. It is acknowledged that during the initial stages it may take a bit of extra time for the GP or other healthcare professionals to create shared health summaries or event summaries. The amount of time this will take will depend on the complexity of the patient’s health conditions and the quality and currency of information already available in the local clinical record.1In the longer term, the eHealth record will potentially save time for healthcare providers, by providing better access to health information including information about allergies, previous adverse reactions, medical history and treatment. It will mean less time spent finding or chasing information, less reliance on patient’s memories, as well as quick and efficient sharing of patient information.
  • So moving on to these questions…what can patients see? Well I’ll bring up an example…
  • Individuals can access their eHealth record via the internet.So here we’re back to Vijay after his first visit to his GP where Dr Javad uploaded the Shared Health Summary. He clicks on Open your eHealth Record and…
  • This is what he sees.The Health Overview Screen is the landing page with an eHealth Record and provides a summary of the latest shared health summary, personal information, Medicare data and recent documents. Just as an aside – you’ll see that the colour theme for the consumer portal is orange, while the provider portal is blue.Patients can view the same information that healthcare professionals have access to.So, from here, Vijay could view his Shared Health Summary or any other events that have been uploaded to his eHealth record.
  • And as mentioned before – patients cannot alter documents created by healthcare professionals.But, what can they do??
  • So, what can patients do with their record?? They can (and this is why it is called the personally controlled electronic health record)Decide whether or not to have an eHealth record – it’s opt-inChoose levels of access for different healthcare providers (eg female IVF treatment) It’s worth noting that very few individuals who decide to have an eHealth record choose to restrict access settings. The default setting when patients register is general open access for all healthcare professionals.Choose which information goes into their eHealth record (eg male taking Viagra)[For example, a male patient may not want information that he is currently taking Viagra included in his shared health summary. In discussion with his GP, he comes to realise that it may be important for other healthcare providers to know about this medication. He then can make an informed decision as to whether or not to ask the GP to share this information.]The eHealth record does not replace the need for good patient/provider communication.
  • While healthcare provider access is under the patient’s control, in situations where it is the treating healthcare professional’s clinical judgement that access is required and patient consent it not possible, they can “break glass” and gain emergency access to the eHealth record. Situations include where the patients life or safety may be at risk.Using this emergency access overrides permissions & generates an audit alert.
  • There are five different ways that a patient can register for an eHealth record…[read from slide]Assisted Registrations – this is where healthcare organisations such as General Practices or Pharmacies, can assist target patient groups (such as those with low computer literacy or chronic disease) to register.South West WA Medicare Local will have eHealth Support Officers available soon to provide support and training about Assisted Registration to interested practices or businesses. And we are planning to have a webinar about this in the next few months.
  • And that brings us to our last couple of questions…
  • As many of you know, we have been running a number of information sessions and webinars for healthcare professionals about the new eHealth record system. We know that for many of the GP practices the focus has been on meeting the ePIP requirements and we’ve been running workshops and webinars specifically around this. The next step of course is to ensure the you, as healthcare professionals, can understand the benefits of opting-in to the eHealth record system and we hope this webinar has gone some way to addressing some of your questions or concerns. As mentioned before, we have also been co-hosting some RACGP peer-to-peer education sessions across the region. (don’t forget to come along on 28th May if you are near Albany).Over the next few months we will also be looking at ways to support other healthcare professionals who want to opt-in.We are also undertaking a program of consumer engagement. The engagement will be for specific target groups who will particularly benefit from having an eHealth record. (eg parents with new babies, ATSI, grey nomads or travellers and people with chronic disease)We are also planning a consumer media campaign, which will include TV advertisements, and probably radio and newspaper ads. This will be happening in mid-June.And finally, a bit further down the track, we will be implementing programs to support meaningful use in practice. And this links back to the ultimate goal of eHealth, which is…
  • Making a our health care better connected.
  • So, hopefully this session has gone a long way to answering your eHealth questions. [check online questions]We realise that some of this information may have raised further questions for you. Please complete the brief evaluation that follows this webinar today and let us know any other queries you would like addressed and we will endeavour to do so.
  • And don’t forget.
  • E health your questions answered

    1. 1. eHealth: Your questionsansweredPresenters: Michelle McClure & Kathy RainbirdMay 2013
    2. 2. South West WA Medicare Local webaddresswww.sw-medicarelocal.com.au
    3. 3. the new eHealth recordQuestions? Questions? Questions?• What is it?• Does it include all health information?• How does it work?• Who creates the Shared Health Summary?• Who is the “nominated provider”?• Will it replace point-to-point communication?• Can we see what it will look like?• How much time will it take?
    4. 4. the new eHealth recordQuestions? Questions? Questions?• What can patients see?• Can patients change the information?• Can practices assist patients to register fortheir own eHealth record?• What is South West WA Medicare Local doingto help health professionals that opt-in toeHealth?• What is happening in terms of consumerawareness campaigns?
    5. 5. You are invitedto the RACGP peer-to-peereducation session“Using the eHealth record system to add value toclinical consultations”Date: Tuesday 28 May 2013Time: 6.00pm to 8.30pmVenue: South West WA Medicare Local, Head Office106 Stirling Terrace, AlbanyFor more information or to register visit:www.racgp.org.au/education/courses/racgpevents/wa/or contact Amy Felton p: 9489 9555 e: amy.felton@racgp.org.au
    6. 6. The eHealth record systemReference: The Royal Australian College of General Practitioners (2013) eHealth record system: Adding value to clinicalconsultations. Peer-to-peer seminar. Participant guide. Victoria, Australia.
    7. 7. The eHealth record containsClinical documentsPersonally entered dataMedicare data
    8. 8. The eHealth record containsClinical documents(uploaded by a healthcare professional)• Shard health summary• Event summary• e-referrals, specialist letters and e-discharge summaries
    9. 9. vMr Vijay EngineerRetiredMr Vijay EngineervvFull Blood Count (FBC), Bay Hill PathologyFull Blood Examination(FBE), Bay Hill PathologyMr Vijay EngineerCurrent RXMorphineeHealth RecordExistsCreate SHSEvent SummaryCurrently logged in: Dr Chris JavadTramadol Delirium ModerateLipitor 40 mgOnceDailyMetformin 500 mg Twice Daily25/09/1958 Male4903 1234 5678 0413 564 229VijayEngineer56 Pitt, St, Nehtaville, Vic, 300089213198951Retired Factory Worker
    10. 10. Lipitor 40 mgOnceDailyMetformin 500 mg Twice DailyvMr Vijay EngineerMr Vijay EngineervvFull Blood Count (FBC), Bay Hill PathologyFull Blood Examination(FBE), Bay Hill PathologyMr Vijay EngineerCurrent RXeHealth RecordExistsCreate SHSEvent SummaryUploadCurrently logged in: Dr Chris JavadTramadol Delirium ModerateMorphine25/09/1958 Male4903 1234 5678 0413 564 229VijayEngineer56 Pitt, St, Nehtaville, Vic, 300089213198951Retired Factory Worker
    11. 11. ModeratevMr Vijay EngineerMr Vijay EngineervvFull Blood Count (FBC), Bay Hill PathologyFull Blood Examination(FBE), Bay Hill PathologyMr Vijay EngineerCurrent RXMorphinePCEHR ExistsCreate SHSEvent SummaryShared Health Summary successfully uploaded to the NationaleHealth Record SystemOKMr Vijay Engineer25-09-1958Currently logged in: Dr Chris JavadTramadol DeliriumLipitor 40 mgOnceDailyMetformin 500 mg Twice Daily8921319895 18003 6085 0000 887525/09/1958 Male49VijayEngineer56 Pitt, St, Nehtaville, Vic, 300089213198951Retired Factory Worker
    12. 12. 4901-Apr-200827-Apr-2008
    13. 13. 49
    14. 14. The eHealth record containsClinical documents(uploaded by a healthcare professional)• Shard health summary• Event summary• e-referrals, specialist letters and e-discharge summaries
    15. 15. Exit50
    16. 16. The eHealth record containsClinical documents(uploaded by a healthcare professional)• Shard health summary• Event summary• e-referrals, specialist letters and e-discharge summaries
    17. 17. The eHealth record containsClinical documentsPersonally entered dataMedicare data
    18. 18. The eHealth record containsPersonally entered data• Personal health summary• Advanced care directive custodian• Emergency contact details• Personal health notes (not viewable by healthcareproviders)
    19. 19. The eHealth record containsMedicare data• Medicare services (MBS & DVA)• Prescription information (PBS & RPBS)• Immunisations (ACIR)• Donor details (AODR)
    20. 20. the new eHealth recordQuestions? Questions? Questions?• What is it?• Does it include all health information?• How does it work?• Who creates the Shared Health Summary?• Who is the “nominated provider”?• Will it replace point-to-point communication?• Can we see what it will look like?• How much time will it take?
    21. 21. the new eHealth recordQuestions? Questions? Questions?• What can patients see?• Can patients change the information?• Can practices assist patients to register fortheir own eHealth record?• What is South West WA Medicare Local doingto help health professionals that opt-in toeHealth?• What is happening in terms of consumerawareness campaigns?
    22. 22. ExitVijay EngineerVijay Engineer
    23. 23. Exit01-Apr-200827-Apr-200849
    24. 24. What patients can and cannot do?They cannot:• Alter documents created by healthcareprofessionals 
    25. 25. What patients can and cannot do?They can:• Decide whether or not to have an eHealthrecord – it’s opt-in • Choose levels of access for differenthealthcare providers • Choose which information goes into theireHealth record 
    26. 26. Emergency access?• “Break glass” emergency consent 
    27. 27. How can patients register for aneHealth record?Online: www.ehealth.gov.auPhone: 1800 723 471In person: at Medicare officesIn writing: filling in a registration formAssisted registration
    28. 28. the new eHealth recordQuestions? Questions? Questions?• What can patients see?• Can patients change the information?• Can practices assist patients to register fortheir own eHealth record?• What is South West WA Medicare Local doingto help health professionals that opt-in toeHealth?• What is happening in terms of consumerawareness campaigns?
    29. 29. What is our eHealth team doing?• Encouraging patients and healthcareprofessionals to use the eHealth record• Assisted registrations• Meaningful use in practice
    30. 30. eHealth: Connecting health care• Better decisions• Better access to information• Better co-ordination• Better care for individualsBetter health
    31. 31. Questions???
    32. 32. For more informationVisit the eHealth Learning Centre atwww.ehealth.gov.auContact usKathy Rainbird, Project Officer eHealthp: 9842 1006 m: 0417 060 376email: krainbird@sw-medicarelocal.com.auMichelle McClure, Program Manager eHealthp: 9842 1006 m: 0409 692 970email: mmcclure@sw-medicarelocal.com.au
    33. 33. You are invitedto the RACGP peer-to-peereducation session“Using the eHealth record system to add value toclinical consultations”Date: Tuesday 28 May 2013Time: 6.00pm to 8.30pmVenue: South West WA Medicare Local, Head Office106 Stirling Terrace, AlbanyFor more information or to register visit:www.racgp.org.au/education/courses/racgpevents/wa/or contact Amy Felton p: 9489 9555 e: amy.felton@racgp.org.au

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