NEHTA and Department of Health & Ageing hosted a Software Developer Conference in conjunction with CHIK's Health-e-Nation 2012 conference in March 2012. Peter Padd of NEHTA took part in the "Getting started with PCEHR” panel describing the process and outcomes of Cairns health region study.

1. Healthcare Identifier Service
Peter Padd
27 March 2012
1 National E-Health Transition Authority
www.nehta.gov.au

2. Healthcare Identifier Service
•Helps to uniquely identify individuals and organisations involved in
healthcare across Australia
•Uses a unique 16 digit number
•4 types of identifiers
• IHI - Individual Healthcare Identifier
• HPI-I - Healthcare Provider Identifier - Individual
• HPI-O - Healthcare Provider Identifier – Organisation
• Contracted Service Provider (example: SAAS, PAAS, IAAS)
2 National E-Health Transition Authority
www.nehta.gov.au

3. Individual Healthcare Identifier
(IHI)
•Allocated to all individuals enrolled in
• the Medicare program
• Department of Veterans’ Affairs (DVA)
• others who seek healthcare in Australia
•Allows healthcare organisation the use of the Medicare card & number,
DVA treatment card &number or an IHI card with demographics to obtain
the IHI from the HI Service
•Also can use demographic searching if you don’t have one of the above
cards & numbers
3 National E-Health Transition Authority
www.nehta.gov.au

4. IHI Functions
Service B2B HPOS MSO Use
This service allows for a verified IHI to be created for a healthcare
Create Verified IHI
individual.
This service allows for an IHI record to be created for a healthcare
Create Unverified IHI
individual whose identity has not been verified by Medicare Australia
This service allows for an IHI record to be created when a
Create Provisional IHI
healthcare individual is unable to be identified
Update IHI Record This service allows for details of an IHI record to be updated
IHI Single Search This service allows for IHI records to be searched individually
IHI Batch Search This service allows for IHI records to be searched in a batch
Resolve Provisional IHI Record – This service allows for the resolution of a provisional IHI record
Create Unverified IHI through the creation of an unverified IHI
Resolve Provisional IHI Record – This service allows for the resolution of a provisional IHI record
Merge Records through merging IHI records
This service allows for the HI Service to be notified of potential
Notify Duplicate IHI
duplicate IHI records
This service allows for the HI Service to be notified of potential
Notify Replica IHI
replica IHI records
4 National E-Health Transition Authority
www.nehta.gov.au

5. Healthcare Provider Individual
HPI-I
•To be eligible to apply for an HPI-I, a healthcare provider must:
•be registered by a registration authority as a member of a health
profession
OR
•be a member of a professional association that
• relates to the healthcare that has been provided by the member
• has uniform national membership requirements
5 National E-Health Transition Authority
www.nehta.gov.au

6. Provider Registration
How to ....
•Providers registered with Australian Health Practitioner Regulation
Agency (AHPRA) automatically are allocated and HPI-I. These groups
include:
• Chiropractic, Dental, Medical, Nursing and Midwifery, Optometry,
Osteopathy, Pharmacy, Physiotherapy, Podiatry & Psychology
•From 1 July 2012, the following professions must be registered with
their National Board to practise anywhere in Australia:
• Aboriginal and Torres Strait Islander health practitioner
• Chinese medicine practitioner
• Medical radiation practitioner and
• Occupational therapist.
•A Healthcare Provider may register with the HI Service where they are
not registered in a profession covered by AHPRA.
6 National E-Health Transition Authority
www.nehta.gov.au

7. HPI-I Functions
Service B2B HPOS MSO Use
Healthcare Provider Directory – This service allows for a trusted party to manage entries for healthcare
Manage Provider Directory Entry providers and organisations within the HPD
Healthcare Provider Directory –
This service allows for a trusted party to search for entries within the
Search for Individual Provider
HPD
Directory Entry
Read Provider or Administrative This service allows for a trusted party to read the details of a RO,
Individual Details OMO or healthcare provider record within the HI Service
Manage Provider or Administrative This service allows for a trusted party to create and amend the details
Individual Details of a RO, OMO or healthcare provider record within the HI Service
This service allows for a trusted party to read the current reference
Read Reference Data
data values held within the HI Service
7 National E-Health Transition Authority
www.nehta.gov.au

8. Healthcare Provider Organisation
HPI-O, How to ...
•A healthcare organisation can apply to the HI service for a Healthcare
Provider Identifier – Organisation (HPI-O) number.
•A healthcare organisation is an entity, or a part of an entity that provides
healthcare (including healthcare provided free of charge).
•To be eligible to apply for an HPI-O, a healthcare organisation must:
• be an entity as defined in the Healthcare Identifiers Act 2010
• have an employee who is an identified healthcare provider and
provides healthcare as part of his or her duties
• have one Responsible Officer
• have at least one Organisation Maintenance Officer
8 National E-Health Transition Authority
www.nehta.gov.au

9. HPI-O Functions
Service B2B HPOS MSO Use
This service allows for a trusted party to read the details of an existing
Read Provider Organisation Details
healthcare organisation within the HI Service
This service allows for a trusted party to either create a new network
Manage Provider Organisation Details healthcare organisation or amend the demographic and service details
of an existing healthcare organisation within the HI Service
Manage Organisation Maintenance This service allows for the links between HPI-Os and OMOs to be
Officer Links amended
Search Healthcare Provider Directory
This service allows for a trusted party to search for the details of a
– Search for Healthcare Organisation
healthcare organisation’s record within the HPD
Entry
This service allows for a RO to register a seed organisation with the
Create HPI-O for Seed Organisation
HI Service
This service allows for OMOs to modify the links between network
Manage HPI-O Links
healthcare organisations
This service allows for a trusted party to read the current reference
Read Reference Data
data values held within the HI Service
9 National E-Health Transition Authority
www.nehta.gov.au

10. Contracted Service Provider
(CSP)
•CSP entities are specifically defined in the Healthcare Identifiers Act as
providing:
• information technology services relating to the communication of health
information or
• health information management services
• A CSP can access the HI Service on behalf of healthcare organisations
using a Medicare PKI digital certificate.
• A CSP can register with the HI Service but cannot interact with the HI
Service until a healthcare organisation has authorised it to do so.
10 National E-Health Transition Authority
www.nehta.gov.au

11. For Developers
11 National E-Health Transition Authority
www.nehta.gov.au

12. National Authentication Service for
Health (NASH)
Peter Padd
27 March 2012
12 National E-Health Transition Authority
www.nehta.gov.au

13. NASH Objectives
•Establish a national framework for the issue and
management of trusted digital credentials to all
entities in the healthcare sector;
•Enabling the traceability of e-health transactions
with trusted identities;
•Delivering appropriate levels of authentication
for healthcare providers, both individuals and
organisations;
13 National E-Health Transition Authority
www.nehta.gov.au

14. NASH Objectives
Providing the foundation for NEHTA initiatives:
• the HI Service,
• Secure Messaging
Enabling the delivery of major new e-health services:
• electronic referrals,
• diagnostic services,
• discharge summaries,
• medications management and
• the personally controlled electronic health records
14 National E-Health Transition Authority
www.nehta.gov.au

15. NASH – Key Design Principles
• Must have HPI-I/-O numbers inside certificates
• Must be able to use tokens as a flexible container
• Service must have improved usability
• Must have Allow healthcare communities to issue and
manage authentication credentials locally. i.e. local
issuance capability
• Must have good software vendor support
15 National E-Health Transition Authority
www.nehta.gov.au

16. The NASH Blueprint
Enrolment Credential
Credential issuance & Management Usage
Management
NASH Governance
Business policy, practices, guidance and contract management
e-health
Health
Identifier NASH Service
Service
Local Reporting
Issuance & Billing
HPOS
TDS
TDS
Central
Production
Token Identity Secure
Report & Audit
Management Management Messaging
Services
Services Services
Credential
Requests Credential Management Workflow Engine Physical
Access
Credential
Fulfillment
Management Service Desk
Services
Other Services
communities Logical
Access
Services
Catalogue Directory Help
Validate Deliver
Interface Requests
Local Token
16 Management National E-Health Transition Authority
Systems
www.nehta.gov.au

17. NASH in 2012
• NEHTA has established e-Health Authentication Services
PTY LTD a wholly owned subsidiary of NEHTA
• IBM Australia has been awarded by NEHTA to design,
build and operate the NASH
• NASH will be operational for subscribers from June 2012
• HPI-O, HPI-I and administrative roles in support of the
PCEHR, secure messaging and the HI Service
• Developer service desk and materials available this week
to enable authentication required of PCEHR, secure
messaging
17 National E-Health Transition Authority
www.nehta.gov.au

18. Services by Channel
18 National E-Health Transition Authority
www.nehta.gov.au

19. HPI-O, HPI-I, CSP, admin roles
How to
• Existing providers, CSP, administrative roles will
automatically be provided NASH credentials and tokens
• Post June 2012 - new enrolments via the HI Service will
automatically create fulfilment requests to the NASH in
an on going basis
• So all you need to do to get started, contact DHS
Medicare to enrol your organisation in the HI Service
19 National E-Health Transition Authority
www.nehta.gov.au

20. For Developers
• NEHTA have produced developer materials and test certificates to enable
development of secure messaging and PCEHR B2B integration
• Developer Pack comprises:
o NASH HPI-O Generic Test Certificates
o Draft NASH Certificate Profiles, providing necessary technical details of the
Certificate design.
o NASH Smartcard Reader Information
o NASH Interim Middleware
o Draft Token Specifications
o NASH Concept of Operations
o Developer Materials Terms and Conditions
• The Developer Material and support will be available later this week via the
NCAP portal or by calling the NASH Service Operator on
o 1-300-307-086 or
o Servicedesk@Nehta.gov.au
20 National E-Health Transition Authority
www.nehta.gov.au

21. PCEHR B2B Gateway
Werner Van Huffel
27 March 2012
21 National E-Health Transition Authority
www.nehta.gov.au

22. Interactions with the B2B gateway
CIS* Consumer Portal
Core B2B services:
1. Does PCEHR Exist
Record Access Service
2. Gain Access to PCEHR
View Service
3. Get Index View
Document Exchange Service
4. Get Specific Document
Registration
5. Submit Document to PCEHR
Account Management 6. Register Document with PCEHR
B2B gateway 7. Remove Document from PCEHR
Provider Portal Repository
22 National E-Health Transition Authority
www.nehta.gov.au

23. Record Access Services
•Does PCEHR exist
– Provides the ability to for PCEHR-accessing organisations (HPI-O)
systems to verify the existence of a given IHI registered individual.
• Check that the record exists for a provided IHI
• Notify the requestor if a an access code is required to gain access to the PCEHR
•Gain Access to PCEHR
– Provides the ability for PCEHR-accessing organisations (HPI-O) to be
placed on the Provider Access List of the given PCEHR IHI
• Gain access for provided IHI with the asserted HPI-O, the Accessing Mode (e.g.
emergency, with or without Access Code)
• Notify of success or failure
23 National E-Health Transition Authority
www.nehta.gov.au

24. View Services
•Get Index View
– Retrieves a list of documents related to a given IHI and authorised to be
accessible by the asserted HPI-O
• Retrieve document list (index view result) for provided IHI with the asserted HPI-O
• Provide requestor with list of document IDs they are entitled to view given their access
request level
24 National E-Health Transition Authority
www.nehta.gov.au

25. Document Exchange Services
•Get Specific Document
– Retrieves an identified document related to a given IHI and authorised to
be accessible by the asserted HPI-O
• Retrieve document for provided IHI with the provided document ID
• Provides the requestor with a CDA document
•Submit Document to PCEHR
– Post a CDA document package with XDS-metadata to the PCEHR
• Given an IHI and a HPI-O a signed CDA document package is posted to the PCEHR
• A success or failure message is returned to the requestor
25 National E-Health Transition Authority
www.nehta.gov.au

26. Document Exchange Services
•Register Document with PCEHR
– Record a previously validated CDA document package, stored within a
conformant repository with the PCEHR
• Given an IHI and a HPI-O a signed CDA document package and an XDS metadata
description of the document.
• A success or failure message is returned to the requestor
•Remove Document from PCEHR
– Logically remove an identified document related to a given IHI and
authorised to be removed by the asserted HPI-O
• Remove document for provided IHI under the asserted HPI-O with the provided Doc ID
• A success or failure message is returned to the requestor
26 National E-Health Transition Authority
www.nehta.gov.au

27. PCEHR and CCA
CCA
Connectivity
Clinical Documents
Health Identifiers
NASH
Find a PCEHR
Privacy and Security Management
Industry Development platform
CCA
User interface
Developer ability
[PCEHR objective] Risk
Draft Requirements out today!
Products
supporting PCEHR
CCA Testing
1
27 National E-Health Transition Authority
www.nehta.gov.au