Les Schumers Presentation Pcehr Nsw Health Update 23 June 2011

PCEHR – NSW Health Briefing

Les Schumer

Manager – PCEHR Design Authority

23 June 2011

Overview of the PCEHR consultation to date

Group Work Package

Stakeholder Reference Forum

• Used to review PCEHR wide issues and deliverables (escalated from co-chairs)

Co-Chairs • Co-ordination of PCEHR work packages• First point of contact for resolution of cross group

issues• Tiger team for indexing service

Identification, Authentication and Access (IAARG)Tiger team

• Consumer Registration• Provider Registration• Privacy Controls• Access Channels (Consumer Portal, Provider

Portal and Call Center)• Participation and Authorisation Service• Audit Service• HI / NASH integration with PCEHR

PCEHR consultation since November 2010

Group Work Package

Medication Management (MMRG)Tiger team

• Medicines List/Profile Detailed Clinical Model • Integration of PCEHR with sources of medication

information (e.g. GPs, Pharmacies, Hospitals, PES, PBS, etc)

Diagnostic Services (DSRG) Tiger Team

• Pathology and Diagnostic Imaging Detailed Clinical Models

• Pathology and Diagnostic Imaging integration with PCEHR

Clinical Terminology & Information (CTIRG) Tiger Team

• Detailed clinical models for PCEHR content (joint work with other groups)

• Clinical Terminologies for supporting detailed clinical models

PCEHR consultation since November 2010

Group Work Package

Continuity of Care (CCRG)tiger team

• Health Summary• Event Summary• Discharge, Referral, Specialist Letters• Care plans• Template Service• Provider Service Directory

Clinical Leads

• Individual leads participate in relevant groups

• Clinical Leads meeting provides sounding board for provider issues (e.g. Provider Registration, Provider Portal, Privacy and Control, PCEHR records, implementation, etc)

PCEHR consultation since November 2010

Group Work Package

Consumer Reference Forum

• External representation for review of design decisions

• Includes Privacy lobby groups and Privacy Commissioner

NEHIPC sub-committee

• Jurisdictional governance of PCEHR implications and investments

NHCIOF • Jurisdictional impacts and investment planning assessment

PCEHR consultation since November 2010

Further consultations

“Four-cornered Roundtable”

DoHA public consultation process

Chronic Disease Management Groups

Aboriginal & Torres Strait Islander Community

Rural & Remote

Aged Care

Mental Health

ICT Industry Forums

What we have done with this input?

Input from all these groups has informed the Personally Controlled Electronic Health Record (PCEHR) draft system design and Concept of Operations

PCEHR Design Elements

The PCEHR is a vehicle for Consumers to: Share key pieces of their Health

Information with Providers of their choice

It is not a replacement for existing point to point messaging

Principles of the PCEHR

Participation is voluntary – “Opt-In” Provider Access is under Consumer

Control The PCEHR is not a replacement for

organisational clinical records The clinical component contains

Copies, not Originals The “Source of truth” remains where it is

today – in local clinical records

The PCEHR - How is it different?

Is the PCEHR a complete health record?

No, it will only contains clinically significant information that is deemed important to the ongoing care of an individual

Individuals may request that information not be loaded on to their PCEHR.

Individuals may limited access to certain classes of information

Product & Solutions Development Update

Product & Solutions Development Roadmap

Healthcare Identifiers

(inc. Implementation Collateral)

NASH

Secure Messaging

Continuity of Care

Medications Management

eDiagnostics

Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12

P&SD PROGRAMME MILESTONES

Token Mgmt Services released (pre-production

only)

Full Credential Mgmt Services released (pre-production only

Vendor Support/Early SDK)

SMD Test Harness V1.0 released

?11_Q2 Release:Contracted Service Providers

Implementation Collateral V1.0 released

?11_Q3 Release:Webforms HPI-I/HPI-O

registration

?11_Q4 Release:Service Improvements

?12_Q1 Release:Service Improvements

?12_Q2 Release:NASH Integration

PCEHR Enhancements

eSignature Solution R1 released

?Analysis and design for Endpoint

Location Service (ELS) V2.0 complete

eMed Profile V2.0 released- Business Requirements Specifications v1.0

- Solution Design v1.0- Core Information Components v1.0

- Technical Service Specification v1.0eMed Profile Release 1 for Health Summary

?eDischarge Final ATS released by SA

?ETP Final ATS released

?eReferral Final ATS published by SA

?Implementation Collateral V2.0 released

?P&SD draft milestone

P&SD Baselined milestone

Shared Health Summary V1.0 released

- Information Requirements Spec v1.0- Shared Health Summary CDA Implementation

Guide v1.0

Event Summary V1.0 released- Information Requirements Spec v1.0

?SM Delivery Agent V2.0 released

?Implementation Collateral V3.0

released

BU

ILD

NASH requirements definition complete

?SM drafts for WSP, XSP, SMD and ELS v1.0 provided to SA to progress

Specialist Letter requirements

specifications released

Draft AS4700.2 provided to SA to progress

eReferral Release

1.1

ETP Package 1.1 Released

SMD Test Harness V2.0 released

?Scoping of 11/12 Diagnostics Work Programme complete

?NASH Operations Contract evaluations complete

NASH Design complete

? AS4700.2 published by SAStandards Australia process

? Published by SAStandards Australia process

?NASH Systems Development Kit

(SDK) complete

??

eSignature Solution R1 Approved

eSignature Solution R2 released

?eSignature Solution R2

Approved

AS4700.2 Internal Review Complete- CTI Review and feedback on AS4700.2 and HB262 complete- Assessment of terminology development capability for next 14

months complete

?

Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12

ü

üPCEHR Deliverable

Implementations Projectü

üü

üü

IHI

HPI-O

HPI-I

üü

üü

üü

üSM Delivery

Specifications

ü

ELS v1.0

ü

üü

ü

üü

Pathology Position Paper

Standards Australia process Published by SA?

PCEHR Proposed Scope

Opt-In Participation

Consent to View established through Personal Access Controls “Open” Consent “Specific” ConsentConsent to View “Limited” information

Ability to obtain “Forward Consent”

Consent to Post is “Opt Out”

Consent Model

Requires IHIAssume Verified IHI is required

Self-Registration via Internet PortalVOI as per Federated AGOSP Model

Facilitated RegistrationVOI at point of Registration

Postal RegistrationVOI supplied through notarised

documents

Consumer Registration

Option #1 – “Open Access”

Option #2 – “Access Code” (PAC)Option to Override for “Emergency” or

“Forgotten PAC”Support for Limited Information Access

through “PACX”

Support for Consumer NotificationsNew ProviderOverride Access

Provider Access Controls

Health SummaryEvent SummaryDischarge SummaryMedicare Data (MBS, PBS, ACIR, ODR)Consumer Data

Personal Health DiaryAdvanced Care Directives (Custodian)Medicines & Adverse Reactions

Support for Diagnostic ReportsConsolidated View

Supported Content – 1/7/12

Referrals

Specialist Letters

Prescriptions and dispense notifications

State based registries

Future Content

Clinical Record

GP Health Summary

Event Summary

Provider

PCEHR

Clinical Record

GP Health Summary

Event Summary

Provider

Prescriptions ReferralsDiagnostic Requests

Event Summaries

Discharge Summaries

Specialist Letters

Dispense Notices

Diagnostic Reports

HospitalsPharmacists

DentistsOptometrists

PhysiotherapistsSpecialists

Diagnostic LabsEtc…

Other Providers

Registries

Immunisations

Directives and Notices

PCEHR Consolicated

View

View Service

Nominated

Nominated Provider Health

Summary

Abstract

Consolidated View

Participation “By Behaviour” No anticipated requirement for separate

“Participation Agreement” or Registration

Will require:-Registration of HPI-OPublication in HI PDS Implementation of Conformant SoftwareNotice of Connection with PCEHR Service

Operator

Organisational Participation

Authorised RepresentativesAuthorised under Law to “Stand in the

shoes” of the IndividualHas the full Authority to manage the

PCEHR on their behalf

Nominated RepresentativesAuthorised through an agreement with

the Individual Individual may establish the “limits of

access and control”

Authorised & Nominated Representatives

Affords Read Only Access to the PCEHRIndividual Authentication through the

use of a PKI CertificateOrganisational Authorisation

established by the OMO (HPI-O/HPI-I Link in the HI PDS)

Where an Individual Provider has Authorisation from multiple Organisations, the Individual may select the Organisation they are acting for

Provider Portal

Audit log records all PCEHR “Events”Access by ProvidersAccess by RepresentativesChanges to Access ControlsChanges to Individual Details

Views Provided for IndividualsProvider Organisations (OMO)Contracted Service ProvidersConformant Portal Providers

Audit Log and Views

Change and Adoption: bringing eHealth reality into play

Dr. Chris Mitchell, NEHTA Change & Adoption Lead, FRACGP, FACRRM, FAICD

Sep 10 Sep 12

Oct-10 Jan-11 Apr-11 Jul-11 Oct-11 Jan-12 Apr-12 Jul-12

eHealth Conference

National Change & Adoption Partner

CommencesNational Change & Adoption Program Package Delivered

National Change & Adoption Strategy

National Infrastructure “Go Live”

Final Concept of Operations

National Infrastructure Partner Commences

Systems Specifications Released

NovMay

Aug

Jun

Jan

Jun

Jun

eHealth Sites Operational

Apr

Build & Test Complete(Release 1)

Benefits Evaluation

Acceptance Testing

Key milestones

National change and adoption strategy

Analyse the needs and expectations of consumers, clinicians and health care providers

Provide an impact assessment of PCEHR across key groups

Provide a training needs assessment

Provide a methodology and approach to change and adoption

Identify initiatives to promote take up of eHealth solutions

Provide a training capability for the PCEHR Program

Develop training materials, guidance materials and other tools suitable for use by a third party

Develop content for inclusion in online consumer and provider portals

Develop training materials which can be integrated with software vendor and National Infrastructure Partner training products

Develop a centralised help-desk facility

National change and adoption training

Change and adoption services

Implement the National Change and Adoption Strategy by providing change and adoption services to key stakeholder groups

Deliver services such as training, customised programs for targeted stakeholder groups and online webinars

Develop a delivery plan of all change and adoption activities to be rolled out nationally