1 Assisted Registration for Personally Controlled Electronic Health Records (PCEHR) Training pack.

1

Assisted Registration for Personally Controlled Electronic Health Records (PCEHR)

Training pack

2

The objective of today’s training

Our goal is to help you become effective and informed in your role as an eHealth record assisted registration facilitator!

By the end of the day, you should feel comfortable approaching healthcare consumers, explaining the eHealth system to them, and facilitating their registration

3

Personally controlled electronic health (eHealth) records: What you should know

4

Activity: Your questions (10 min)

1) Brainstorm questions you have about eHealth records, from what they are to how they affect you

2) Collate questions on a whiteboard or flip chart. We will revisit them at the end of the session to make sure they have all been answered

5

▪ What is an eHealth record?▪ Why would I want one?▪ Who can we register for an eHealth

record?▪ Privacy, security and handling your

information▪ How do I use my record?

Contents

6

The eHealth record system will allow the sharing of health information created by your healthcare providers, subject to any access controls you set

What is a personally controlled electronic health (eHealth) record?

SOURCE: Consumer Registration Booklet

It is an opt in system for both consumers and providers

7

How will the system grow?

SOURCE: eHealth.gov.au (FAQs)

Stage TwoStage One Stage Three

The Australian Government is rolling out an eHealth record system and people seeking health care in Australia can now register for an eHealth record

As the system develops over time, having an eHealth record will give your doctors and other healthcare professionals involved in your care access to a summary of your key health information, provided you have given initial consent

As people and healthcare organisations register for the eHealth record system, your health care will become more connected which will result in better, faster and more efficient care for you

http://www.achingacres.com/services/images/plants-growing.png



8




Contents

9

Activity: why would you want an eHealth record?

Do you have an eHealth record? Have you viewed it?

Why and when might an eHealth record be used?

10

Benefits for all consumers

• Best treatment – As the system grows, healthcare organisations such as a GP practice or local hospital will be able to quickly view a summary of your information, helping them to make the best possible decisions about your care.

• More convenient – You will not have to remember every medication, test or health-related incident, or when a child was immunised.

• Less stressful – Allows rapid access to information in an emergency.

• Better health – You will be able to better manage your health.

• Sharing the load – If you wish, you can share your health information with family members, carers, or other trusted people.

11

Some consumer groups are likely to particularly benefit

• There are some cohorts who are likely to particularly benefit from having an eHealth record:

– Parents and their babies

– Older Australians

– People living with chronic conditions

– Aboriginal and Torres Strait Islander people

– Mental health consumers

• The features they may particularly benefit from include:

– Better connected health records across different providers

– Better connected health records across geographies

– Better self-management

– Ability to appoint a nominated carer

12




Contents

13

We should always try to register a consumer through our Assisted Registration channel before recommending other channels

Online – visit www.ehealth.gov.au

Over the phone – call 1800 723 471 and select option 1

In person – visit a Department of Human Services service centre offering Medicare services

In writing – complete a registration form application form, available from a service centre offering Medicare services or from www.ehealth.gov.au,

Be assisted to register by an authorised employee assisting registration

Our assisted registration is one of five channels to register for an eHealth record

14

Assisted Registration offers several advantages over other registration channels

Quick Personalised Well-informed

• Registration in just a few minutes, with a 100 point check e.g. photo ID and a Medicare Card

• Face-to-face interaction and opportunity to raise any questions

• Accurate information from trained personnel

• Online and phone registrations require more lengthy ID verification

• Other forms are much longer

• Online and written registrations involve no human interaction

• Reliance on written documentation or “helpdesk” phone line to answer question

Assisted registration

Other registration channels

15

You can assist registration of anyone over the age of 14 that has a Medicare card

You can assist registration of a parent’s children

- The children must be under the age of 18

- The parent must have legal parental responsibility

- The children must appear on the parent’s Medicare card

You can assist anyone who has a DVA file number to register

Who can you give assisted registration to?

Registration of a child dependent

▪ The parent will be able to access and control their child’s eHealth record through their own eHealth record

▪ Once the child turns 14, their Medicare information will no longer be visible to the parent, and the child will have the option to take control of their own eHealth record.

▪ Once the child turns 18, the parent will no longer be able to access their record (although the child may later choose to add their parent as a nominated representative)

16

A person without a Medicare card or DVA file number

- These consumers can still register if they have an Individual Healthcare Identifier (IHI)

- Direct these consumers to the Consumer Registration Booklet (below)

A person below the age of 14 unless registering as a child dependent

A child dependent who does not appear on the parent’s medicare card

A person without capacity who seeks to register themself or whose carer seeks to register them

An adult (over the age of 18) who is not present

Direct these consumers to the Consumer Registration booklet (found online at www.ehealth.gov.au), where their steps for registering are clearly laid out

Who can you not register?

SOURCE: This information is from the Learning Centre module “How to register”

You cannot assist registration of any of the following categories of health consumers:

If you cannot provide assisted registration, the consumer can still register by another channel

http://www.ehealth.gov.au/

17




Contents

18

The consumer is in control of what information is visible

• Most people are likely to allow any healthcare provider organisation involved in their care to access their eHealth record. This is therefore the default access control setting.

• You can, however, set access controls for your and/or your dependent's eHealth record by limiting access to:– The whole of the eHealth record – A specific document in the eHealth record

• If you realise that you do not want a specific document to be available in the eHealth record, you are still able to “effectively remove” it from view. It will not be available to either you or healthcare provider organisations, including in an emergency

19

Access to information without your consent

• There are some circumstances where the Personally Controlled Electronic Health Records Act 2012 authorises the collection, use and disclosure of health information without consent

• The main circumstance where this occurs is likely to be when it is necessary to lessen or prevent serious threat to an individual’s life, health or safety (and your consent cannot be obtained)

• Other circumstances are set out in the Personally Controlled Electronic Health Records Act 2012

20

Privacy and Security FAQs

See Privacy FAQ in the facilitator handbook or information online at ehealth.gov.au

• Who can see the information on my eHealth record?

• How will my personal information be kept private?

• What happens if someone accesses my record without my permission?

• How can I view my eHealth record?

• How do I get a log-in and password?

• Who has access to my log-in details?

• Will I be able to see who has accessed or updated my eHealth record?

• Who has access to my eHealth record?

• Will my eHealth record be as safe as my current medical records?

• Where is the data on the eHealth record system kept?

• Where can I find further information on privacy?

21




Contents

22

What will be on my eHealth record?

• Medicare data will appear if you have chosen for it to do so, including:

– Child immunisation

– Organ donor register

– Medicare claiming events

– Subsidised medications dispensed

• As the system develops, more of your health care information can be added by the healthcare professionals involved in your care, including any treatment you may receive or medication you are prescribed

23

You can review information uploaded by others

Over time you will be able to review your clinical information including your shared health summary, discharge summary, event summaries and Medicare information

You can add information yourself

What can I do with my record?

24

FAQs for target consumer groups

Consumer portal of the Learning Centre

Consumer registration booklet and brochures

Registering for your own eHealth record online

Information about Assisted Registration including the “Essential Information” sheet

Further details can be found online at www.ehealth.gov.au

25

1) Watch videoHear from a number of clinicians about how the eHealth record will benefit them and their consumershttp://www.youtube.com/watch?v=7EbwtLnaetk

2) Read through the PCEHR material provided [15 minutes]• Brochures (General, IVC)• Essential information on registration form

3) Work with a partner to write down what you think from the materials are the key messages for communicating with consumers [10 minutes]

4) Discuss and structure these key messages as a group [15 minutes]

Activity: What is important to communicate to a consumer

http://www.youtube.com/watch?v=7EbwtLnaetk

26

Activity: Engaging with a consumer about the eHealth record (40 min)

1) Develop your own ‘elevator pitch’ about the eHealth record. Answer the questions: [10 minutes]- What is an eHealth record?- What are the benefits of an eHealth record?

2) In small groups share your elevator pitch with each other and give feedback (include something you think they could have improved on) [20 minutes]

3) Share lessons with the large group [10 minutes]- What was a particularly strong elevator pitch?- What worked well (both verbal and non verbal)?

27

How we assist a consumer to register for a Personally Controlled Electronic (eHealth) record: The theory

28

▪ Step 1: Identify the consumer

▪ Step 2: Fill in the registration form

▪ Step 3: Process the registration

The Assisted Registration process

29

Step 1: Identify the consumer

Identification check may be via the setting of care verifying the consumer as a known customer, or via you performing a 100 point identity check.

▪ You assert the identity of the consumer as a known customer, or using documentary evidence, according to the relevant policy

▪ For a child: You assert the identity of the parent (as above) AND you check that the child is on the same Medicare card as the parent who signed the form

30

What the 100 point check is

▪ Different documents are assigned a certain number of ‘points’ toward proving your identity

▪ In almost all cases, the 100 points that you will be shown by consumers will be a combination of:

a) Medicare card (35 points)

b) Driver’s licence (70 points)

c) Foreign driver’s licence (35 points)

d) Credit card (35 points)

▪ In your Handbook is a definitive list of what constitutes a 100 point ID check

31




Contents

32

Step 2: Fill in the registration form

Unless the details on the form are EXACTLY right, the registration will fail. It has not been uncommon to get 1 in 3 forms with errors in them. Checking the forms thoroughly is very important!

▪ The consumer should have their attention directed to the Essential Information section

▪ The consumer or facilitator completes and signs the one page application

▪ You check the form is complete and signed by the consumer

33

Registration form and potential pitfalls

▪ 1. Family name – Entered first (even though it is second

on the Medicare card)

▪ 1. First name – Entered to match their Medicare card

i.e. often a full name like “Christopher” rather than “Chris”

– Middle name/initial does not need to be entered

▪ 2. Date of birth – Common error is to put today’s date

rather than year of birth, so this is important to check

▪ 3. Sex of applicant– Make sure to fill this in. It can be easy

to skip to the Medicare number

34

▪ 4. Medicare number/DVA file number – For a Medicare card, enter the full

number above the name (ignore the single-digit number to the left of the name)

– Number of digits on the card should match number of boxes on the registration form

▪ 5. Identification as Aboriginal or Torres Strait Islander – entirely optional for the consumer to answer– Never answer this question on their

behalf – always ask!


35

▪ 6. Opting to receive an Identity Verification Code (IVC) – Enter contact details if consumer opts

to receive an IVC– Explain that the IVC will allow them to

access and control their details online– Enter either an email address or phone

number as method of delivery– Check that the email address is legible!– If opting to receive by phone, ensure

the number specified is a mobile phone, not a landline


36

▪ 7. Opting to receive Medicare information – Explain that the consumer can opt to

receive past and ongoing Medicare information currently held by the government

– The consumer can freely choose all, none, or some of the categories

– Most consumers opt into everything, and this can be encouraged if asked what to do

– If the consumer is unsure, remind them that they always change what documents are able to viewed on their eHealth record

– Note that the organ donor box is NOT consenting to becoming an organ donor. It just means that the their existing donor decision is published on their eHealth Record


37

▪ 8. Sign and date the form– Ensure the form is signed and dated!– If you have filled out the form for the

consumer, ask them to review their information and sign when they are confident the form is correct

▪ “Authorised staff use only” box– Put your initials– Note the ID used to reach 100 points

(e.g. Medicare card and Driver’s Licence)

– Include a contact phone number! This allows the consumer to be contacted if there are any problems with their registration


38

▪ The top section still relates to the parent– Information here will be identical to the

parent’s registration form

The form for children is very similar

▪ The child’s details are entered according to how they appear on the Medicare card– Ensure the date of birth is correct

(avoid the “today’s date” pitfall)– Ask the child’s gender rather than

assuming based on their name– Ask if the children are of Aboriginal or

Torres Strait Islander origin even if the parent did not identify as such

▪ Opting to receive an IVC is unnecessary if the parent is already receiving one– If so, leave this section blank– The parent will be able to use their

personal IVC to access their child’s account

39

▪ Place child forms within their parent’s registration form

Handling child dependent registrations

1 child

▪ Write the number of child forms on the front of the parent’s registration form

▪ If filling in multiple child forms, check if it is ok with the parent for you to only fill in the child section and to copy the parent’s details across later– If you do this, make sure that you

double-check child information (name, DOB, gender)

– Also ensure that the child form is signed and dated by the parent

40

Information to tell the consumer after registration

▪ If the consumer has opted to receive an Identity Verification Code, tell them they can use it to set up online access to their eHealth record– The brochure “Accessing your personally

controlled electronic health (eHealth) record online” contains a step-by-step guide of this process.

– This brochure should be given to all consumers who register and opt to receive an IVC code

– Tell consumers that they should receive their IVC within the next few days

▪ Tell the consumer that if there is a problem with the processing of their form, that they will be contacted

41

Completed forms must be guarded closely

▪ Privacy of forms must be ensured at all times – Information on handed-in forms should

not be shared with anyone

▪ Security of forms must be ensured at all times– Forms must be closely guarded – Ideally, file them away in a folder

immediately– Keep this folder of completed forms on

your person

42




Contents

43

The Assisted Registration Tool mirrors the form: Details must be perfectly accurate!

44

Troubleshooting for submission errors

There are various errors that you may be presented with. The two most common are:

PCEHR_ERROR_5006 No unique active IHI found

▪ This will be because the information provided does not 100% match those in their Medicare record. This is why the information collected on the forms must be 100% accurate!

▪ You may check for obvious errors, e.g. if the consumer has stated their name as “Chris”, you may try “Christopher”.

▪ It may be possible to phone the consumer, and ask them to update their information, which you may need to collect in writing

PCEHR_ERROR_5005 No connection to HI server

▪ This error will often go away if you try again later

45

Once submitted, the system sends a response

• The eHealth record system will send the outcome of the application: successful or unsuccessful

– If successful, the consumer will receive an Identity Verification Code

– If unsuccessful, the consumer needs to be notified and advised that they can apply through other channels

46

A. Check that they are an Australian citizenB. Use their Medicare card to check family name, given name and Medicare card numberC. Ensure that there are no lipstick or other marks on the form D. Ensure within the Notes section that you have initialled, noted ID method, and that there

is some way to contact the consumer E. Ensure all these steps are also carried out for children’s forms, especially the signature.

Note that the parent does not have to fill in the IVC section on the child forms. Ensure each child’s name is sighted on the consumer’s Medicare card. Check all children are under 18.

F. Store all documents securely in your satchelG. Check that their GP practice is registeredH. Check that they are 18 or overI. Ensure that if the consumer has opted to receive an IVC, that the email or mobile phone

number they have provided is clearly legible J. Check that they have internet access at homeK. Use their other piece of ID to check photo, date of birth and name L. Ensure the form is signed and datedM. Fill in the form, being wary of common errors

Which of these do you need to check?

47

1. Use the consumer’s Medicare Card to check family name, given name and Medicare card number

2. Use their other piece of ID to check photo, date of birth and name3. Fill in the form, being wary of common errors4. Ensure that if the consumer has opted to receive an IVC, the email or mobile

phone number they have provided is clearly legible 5. Ensure the form is signed and dated 6. Ensure within the Notes section that you have initialled, noted ID method, and

that there is some way to contact the consumer 7. Ensure all these steps are also carried out for children’s forms, especially the

signature. Note that the parent does not have to fill in the IVC section on the child forms. Ensure each child’s name is sighted on the consumer’s Medicare card. Check all children are under 18

8. If the consumer has opted to receive an IVC, give them an “Accessing your personally controlled electronic health (eHealth) record online” brochure

9. Give the consumer a survey slip to fill out10. Store all documents securely in your satchel

Summary of assisted registration steps

48

In action

49

In action

50

Be sensitive to the context in which you are facilitating

• Make sure you follow sign-in protocol and WH&S requirements (e.g. a safety induction)

• If someone is called away for an appointment, let them go immediately and tell them that they can come back to you after

• Only approach people in areas that have been agreed-upon with the site’s management team

• Do not approach very sick or suffering people

• Avoid clinical areas where treatment is occurring

• Do not approach anyone talking on a Department of Health Services phone

• Avoid giving details about total number of registrations, your pay, and other confidential information

51

Use your brochures to spread awareness

Steps through what an eHealth record is, and the different channels to register

Provides instructions for how to register by each of the four other channels

• You should attempt to give out one of these brochures to anyone who is not interested in Assisted Registration!

• These brochures can also be left on your table for anyone to take

52

Brochures for specific consumer groups

• The brochures for specific consumer groups can be kept in your bag• If someone identifies as being a part of one of these groups, feel free to give them a

specific brochure

Parents with newborns

Older Australians

People with chronic conditions

Aboriginal or Torres Strait Islander people

Mental health consumers

53

Booklets with detailed information

• A copy of the essential information contained in the assisted registration form

• Contains general eHealth information as well as detailed instructions on how to register individually

• These booklets should be kept in your bag for when a consumer specifically requires them

54

Your facilitator handbook

• Your Handbook provides you with key information about your role as a facilitator

• It will help you with:– Important contacts– A checklist of collateral– Suggestions for setting up on-

site– A list of ID for the 100 point ID

check– A general FAQ and a

privacy/security FAQ to help you answer tough questions from consumers (very helpful!)

• Not to be given to consumers – for your reference only

55

More lessons learned: Assisted registration on-the-ground

Lessons learned

▪ Diligent checking of forms will reduce error rate

▪ Take initiative and approach people

▪ Wait for people to be seated before approaching them

▪ There is a ‘domino effect’ when registering people. Approach consumers who may be likely to register first.

▪ Find the information about the PCEHR that resonates most with consumers in your current healthcare setting

▪ Consumer’s can find answers to more complex questions through www.ehealth.gov.au or the helpline (1800 723 471)

▪ Be flexible based on the needs of the healthcare environment you are operating in

http://www.ehealth.gov.au/

1 Assisted Registration for Personally Controlled Electronic Health Records (PCEHR) Training pack.

Documents

ehealth system

ehealth record system

health care

better health

ehealth recordas

sharing of health information

key health information

healthrelated incident