RecordPoint Shared Electronic Health Record System ... · PDF fileRecordPoint Clinical User Guide V2.03 Confidential Page 1 1 Overview This user guide is intended to provide the reader

Prepared by:

RecordPoint

Shared Electronic

Health Record System

Clinical User Guide

Version: 2.03 Date: 7 March 2012 Classification: Confidential Status: Released

RecordPoint Clinical User Guide V2.03

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For more information Level 17, 344 Queen St Brisbane QLD 4000 (07) 3292 0222 www.extensia.com.au © Copyright 2012 by Extensia. Notices Confidential The content of this document is Confidential. The information contained herein must only be used for the purpose for which it is supplied. Trademarks Company, product, and service names mentioned herein may be trademarks or service marks; such marks are the property of their respective owners.


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Table of Contents

1 Overview ...................................................................................................................1

1.1 Map of RecordPoint User Guides ....................................................................4

1.2 Instructions Used in this Guide ........................................................................4

1.3 Notes on Using the Application .......................................................................4

1.3.1 Do Not Use the Browser Back and Forward Buttons ................................................... 5

1.3.2 Do Not Use the Browser Reload Button ..................................................................... 5

1.3.3 Opening Multiple Windows for the Same Session ...................................................... 6

1.3.4 Mandatory Fields and Validation Errors ..................................................................... 7

1.3.5 Edit Privilege ............................................................................................................. 7

1.3.6 Consistent Data Entry ................................................................................................ 8

2 Getting Started .........................................................................................................9

2.1 System Requirements ......................................................................................9

2.1.1 Consumers ................................................................................................................. 9

2.1.2 Agents ....................................................................................................................... 9

2.1.3 Browser Support ........................................................................................................ 9

2.2 Logging In..................................................................................................... 10

2.2.1 Consumer Login ...................................................................................................... 10

2.2.2 Agent Login ............................................................................................................ 12

2.3 Changing Passphrases ................................................................................... 14

3 Searching the Shared EHR .................................................................................... 16

3.1 Searching for Consumers ............................................................................... 16

3.1.1 Find Consumer by Name and DOB .......................................................................... 16

3.1.2 Find Consumer by ID............................................................................................... 19

3.1.3 Find Consumer by Location ..................................................................................... 19

3.1.4 Add Current Location to Care Team ......................................................................... 21

3.2 Searching for Agents ..................................................................................... 23

3.3 Searching for Locations ................................................................................. 26

3.4 Searching for Organisations ........................................................................... 28

3.5 Closing a Shared EHR ................................................................................... 30

4 Viewing the Shared EHR ....................................................................................... 32

4.1 Consumer Overview Page ............................................................................. 32

4.2 Care Plan Summary Pages ............................................................................. 34

4.2.1 Viewing the Care Plan Summary .............................................................................. 34

4.2.2 Viewing the Care Plan Calendar ............................................................................... 39

4.3 Health Summary Pages .................................................................................. 39

4.3.1 Viewing the Health Summary Index ......................................................................... 41

4.3.2 Viewing Health Summary Details ............................................................................ 43

4.4 Profile Pages ................................................................................................. 51

4.5 Pathology Result Pages ................................................................................. 53

4.5.1 Viewing the Pathology Result Index ......................................................................... 53

4.5.2 Viewing the Pathology Result Details....................................................................... 55

4.6 Event Summary Pages ................................................................................... 56

4.6.1 Viewing the Event Summary Index .......................................................................... 56

4.6.2 Viewing the Event Summary Details ........................................................................ 58

4.7 Care Team Page ............................................................................................ 59

4.8 View and Update Consumer Details .............................................................. 61

4.9 Access Log Page ........................................................................................... 63

5 Submitting Event Summaries ................................................................................ 64

5.1 Creating an Event Summary .......................................................................... 66

5.1.1 Step 1 – Event Details .............................................................................................. 67

5.1.2 Step 2 – Clinical Data .............................................................................................. 67


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5.1.3 Step 3 - Preview....................................................................................................... 71

5.1.4 Step 4 - Submit ........................................................................................................ 72

5.2 Correcting Content in the Shared EHR .......................................................... 72

5.2.1 Strike Through Entire Event Summary ..................................................................... 73

5.2.2 Strike Through Individual Entry ............................................................................... 78

6 Printing ................................................................................................................... 85

7 Shared EHR Evaluation ......................................................................................... 87

8 Resolving Issues ...................................................................................................... 88

8.1 Contacting the Help Desk .............................................................................. 88

8.2 Copyright, Disclaimer and Privacy Notices ................................................... 88

8.3 About the System .......................................................................................... 89

8.4 Troubleshooting ............................................................................................ 89

Annex A - Definitions and Acronyms ........................................................................... 90

A.1 Definitions .................................................................................................... 90

A.2 Acronyms ...................................................................................................... 90

Annex B - Default Roles and Submit Privileges ........................................................... 91

B.1 Access Privileges........................................................................................... 91

B.2 Event Summary Submit Privileges ................................................................ 93


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1 Overview

This user guide is intended to provide the reader with the knowledge necessary to use the

RecordPoint software to access and contribute to a Shared Electronic Health Record (Shared

EHR) for Consumers. This applies mainly to Health Care Providers and Consumers.

The main sections are:

Getting Started Includes, setting up and logging on.

Searching the Shared EHR Includes, finding a consumer’s record,

and finding Agents and Locations.

Viewing the Shared EHR Includes, viewing the Shared EHR data

for a Consumer.

Submitting Event Summaries Includes adding clinical data to the

Shared EHR and correcting errors.

Resolving Issues Includes, who to contact and trouble

shooting.

The concept of a Shared EHR is to improve the quality and safety of patient health care by

providing more complete, appropriate and timely sharing of information amongst Health Care

Providers in a community.

This is achieved by Health Care Providers making available key health information, rather

than full records, via the submission of event summaries into the Shared EHR for a

Consumer. Other Health Care Providers can then view the more complete health record while

they are providing care to a Consumer.


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Figure 1 – Shared EHR Community

A key part of the Shared EHR is respecting the privacy of the Consumers and protecting the

integrity of the data. This is achieved at three levels as follows:

• All access to the system is authenticated. The user must identify themselves to the

system. For Consumers, this means entering their user name and password. For

Health Care Providers, this also includes use of a Medicare Australia location

certificate. The system also identifies itself to the user via a PKI certificate that the

user can validate.

• Access control is enforced based on participation, roles and care teams.

• Consumers, Agents and Locations must be registered and active in the system.

Immediately on withdrawal, access requests to information in the system related to

or by the withdrawn entity are rejected. For example, when a consumer

withdraws, Health Care Providers can no longer see the Shared EHR of the

consumer or add any further information to it.

• The role of the user grants them privileges to use certain system functions and

therefore restricts them from using others. For example a Consumer cannot add a

GP Event Summary or a Registration Officer cannot view clinical data.

Note: Due to variances in privileges between users, the pages, menu options, and

functions that are actually seen by each user will vary from the full functionality

that is presented in this user guide.


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Default Roles and Submit Privileges on page 90 for details on the default roles and

privileges configured in the system.

• The Consumer (either directly or indirectly) maintains a list of locations on their

care team. Only Health Care Providers assigned a role at one of the locations on a

consumer’s care team can access the consumer’s Shared EHR. They must also be

connecting to the system from that location.

• All access (including read) is audited by the system. The audit trail can be viewed by

the Consumer and Health Care Providers.

The Shared EHR community will use the RecordPoint software to share Consumer centric

health data according to agreements and within integrated business processes. The software

and its functions support this community in establishing and maintaining a Shared EHR. The

software by itself does not seek to address the needs and obligations of a Shared EHR

community.


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1.1 Map of RecordPoint User Guides

The following diagram maps which RecordPoint User guides are applicable for different users

undertaking different activities. For example a Consumer wishing to access their Shared EHR

would use the Shared EHR Clinical User Guide.

Figure 2 – User Guide Map

1.2 Instructions Used in this Guide

Within this user guide, text in bold computer lettering relates to keys on the keyboard, for

example, ‘Press ↵↵↵↵ENTER’ENTER’ENTER’ENTER’. Text in the bold, italic, verdana font face refers to text found

within the application and is generally highlighted with a red circle on the screen shots, for

example ‘click on Change Passphrase’ menu item.

1.3 Notes on Using the Application

The following notes apply to using the Shared EHR application and if followed will help

avoid common issues.


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1.3.1 Do Not Use the Browser Back and Forward Buttons

The Shared EHR application is not designed to support use of the browser navigation

functions, including the Back and Forward buttons, menu items and keyboard shortcuts as

shown in Figure 3. To change pages and generally navigate around the Shared EHR

application please use the application menu system, buttons and links provided as shown in

this user guide.

Although use of the browser navigation functions will not damage the system they may

produce un-desirable results, including data loss and an unusable login session.

Figure 3 - Browser Back and Forward Functions

1.3.2 Do Not Use the Browser Reload Button

The Shared EHR application is not designed to support use of the browser reload function,

including the Reload button, menu item and keyboard shortcut as shown in Figure 4. If

refreshing the page is desired please use the application menu system, buttons and links

provided as shown in this user guide to re-display the same page.

Although use of the reload function will not damage the system it may produce un-desirable

results, including data loss and an unusable login session.


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Figure 4 - Browser Reload Function

1.3.3 Opening Multiple Windows for the Same Session

Using the browser to open multiple windows and/or tabs under the same session may produce

unexpected results. Each window will share a single session with the Shared EHR

application. This means any function performed in one of the windows can be considered to

be applicable for all of the windows. For example, logging off in one window, will close the

session for all the windows. To continue to use any of the windows will require logging back

in.

Opening multiple windows under the same session will not damage the system but should be

avoided while becoming familiar with the Shared EHR application.


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1.3.4 Mandatory Fields and Validation Errors

If parts of the data entry pages are incomplete or incorrectly filled out, errors will be displayed

on the current page after attempting to proceed to the next page. All the applicable errors for

the current page will be displayed at the top of the page in red and indicate which field is

incorrect or incomplete and allow correction prior to proceeding. The example shown in

Figure 5 occurred by clicking the Next button without any of the mandatory details being

completed.

Figure 5 – Field Error Examples

Note:

• Mandatory fields are preceded by a red asterisk (*).

1.3.5 Edit Privilege

The ability to use the Edit button is controlled by the update privilege which is not granted to

all users. When using Microsoft Internet Explorer, and viewing details without the update

privilege, the fields can be selected but the contents cannot be changed. In addition, any field

which is longer than the given display can only be viewed by double clicking in the field and

holding the left mouse button down whilst scrolling across the field. When using Mozilla

Firefox the fields cannot be selected or changed.


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1.3.6 Consistent Data Entry

Consistent data entry of demographic information is important to reduce the maintenance

overhead of the Shared EHR system. Particular attention should be given to the following

fields:

• Always enter telephone numbers in the same format, for example:

• Area code without spaces, 0229340937

• International format with spaces, +61 2 2934 0937

The Home Phone for Consumer’s is particularly important is this is one of the

fields used for duplicate comparison by the system when registering new Consumers.

• Enter the full details into the P.O. Box field, ie “P.O. Box E44” as shown in Figure

6. When the P.O. Box field is populated, the Street Number and Street

Name fields should generally be left blank and only be entered if they are

legitimately associated with the entered P.O. Box number.

Figure 6 - Address Details


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2 Getting Started

2.1 System Requirements

The requirements for accessing the system vary for Consumers and Agents. Agents are

effectively anyone who is not a Consumer, including Health Care Providers, Registration

Officers, Record Managers, System Administrators, etc. Agents are given greater privileges

than Consumers so the requirements for authentication are greater.

2.1.1 Consumers

Consumers wishing to access their Shared EHR will need access to a computer with a

standard web browser and internet connection, as well as an understanding of how to use the

internet. Accessing their Shared EHR requires a similar setup and similar skills to using

online banking applications.

2.1.2 Agents

Agents wishing to access the Shared EHR will need access to a computer with a standard web

browser and internet connection. They may also - subject to a suitable interface – access and

upload information into the Shared EHR via their local clinical system such as Medical

Director, practiX, pathology lab system, etc.

Agents will also require a Medicare Australia Location certificate for authentication purposes.

See the following website for details on obtaining a Medicare Australia Location certificate:

http://www.medicareaustralia.gov.au/provider/vendors/pki/. Once obtained, the Location

certificate will need to be installed into the browser either directly or via a smartcard (or other

token). The installation instructions that come with the certificate should be followed for

correct setup of the certificate.

2.1.3 Browser Support

Microsoft Internet Explorer (version 6 or higher) and Mozilla Firefox are known to work with

the Shared EHR application. Other browsers should also work but their compatibility would

need to be verified. The browser will require the Adobe Flash Player plugin (version 9 or

higher) installed.


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2.2 Logging In

2.2.1 Consumer Login

Consumers will be given a User ID and Passphrase by the Registration Officer when

they register as well as an internet address to connect to the system. To gain access to the

Shared EHR application, type the given internet address into the address bar as shown in

Figure 7 and press the ↵↵↵↵ENTERENTERENTERENTER key. For example: httphttphttphttpssss://://://://sharedehrsharedehrsharedehrsharedehr....orgorgorgorg.au/ehrweb/.au/ehrweb/.au/ehrweb/.au/ehrweb/

Figure 7 – Internet Explorer Address bar

The Shared EHR login page will appear as shown in Figure 8. To login enter the User ID

and Passphrase and click on the Log In button.

Figure 8 – Login page

If login is successful the Consumer Overview page is displayed as shown in Figure 10. A

full explanation of the information provided in this view is given in Section 4.1 – the

Consumer Overview page.

At the first login, the initial passphrase must be changed. The Change Passphrase page

appears as shown in Figure 9.



Figure 9 – Change Initial Passphrase

Enter the Passphrase provided by the Registration Officer in the Current Passphrase

field and then enter a new passphrase twice (again in the Confirm New Passphrase field) and

click the Submit button. If this is successful the Consumer Overview page is displayed

as shown in Figure 10. On each subsequent login the Consumer Overview page will be

the first page displayed.

Note:

• The only way of successfully logging on to the system is to submit a new passphrase.



Figure 10 – Consumer Overview

If login is unsuccessful, the Login failure page will be displayed as shown in Figure 11.

Figure 11 – Login Failure

Re-enter your User ID and Passphrase. If you are still unsuccessful after two to three

attempts please contact Support.

2.2.2 Agent Login

The Agent login process is similar as that for Consumers, including the first time login steps

(see Figure 8 and Figure 9). In addition Agent logins require authentication of the Location

from which the login is being made via the Medicare Australia Location certificate (see



section 2.1.2). The Location is used with the Consumer nominated Care Teams to restrict

access to Shared EHRs. The Location is also used to assign the correct role and privileges for

the session. Agents may have different roles at different locations.

If login is successful, the Home page is displayed as shown in Figure 12.

Figure 12 – Home Page

2.2.2.1 Agent Identification

For ease of identification where workstations may be shared at a particular location, the

system provides a method to identify the agent currently logged on. By placing the cursor

over the Logout hyperlink, the name, role and location of the current user is displayed as

hovertext as shown in Figure 13.

Figure 13 - Agent Identification



2.3 Changing Passphrases

The process for changing passphrases is the same for Consumers and Agents. Both may

change their own passphrase at any time.

After successful log in, click on the Change Passphrase submenu from the Settings

menu along the top menu bar as shown in Figure 14. This figure displays the Change

Passphrase menu that Agents will see. Consumers will see the same Settings menu

along the top menu bar, but without the additional Find menu between the Home and

Settings menus.

Figure 14 – Change Passphrase

The Change Passphrase page appears as shown in Figure 14. The steps are as follows:

1. Enter the current passphrase.

2. Enter the new passphrase using the recommended guidelines.

3. Re-enter the new passphrase and click Submit.

If the value entered in Current Passphrase is incorrect or if the values entered in New

Passphrase and Confirm New Passphrase do not match, then the request to change

the passphrase will be rejected. Repeat the above steps to try again.

A confirmation message of a successful passphrase change will be displayed.

If you cannot change your passphrase after following these instructions or have forgotten your

passphrase you will need to contact Support to have the passphrase reset.





3 Searching the Shared EHR

Be default, searching is only available to Agents. Consumers are not able to see other

Consumers or the demographic and personal contact details of Agents, Locations, or

Organisations.

Searches will only return matching records that the user has the authority to view. For

example, when a Health Care Provider performs a Consumer search, only those consumers

that match and have the Health Care Provider’s location on their care teams will be listed.

3.1 Searching for Consumers

There are three ways to search for consumers:

1. By Name and Date of Birth details

2. By Shared EHR Identifier

3. By Location

They are invoked from the Find menu along the top menu bar as shown in Figure 15.

Figure 15 –Find Consumer Menus

3.1.1 Find Consumer by Name and DOB

To find a consumer using their name and date of birth details invoke the Find -> Find

Consumer by Name menu item as shown in Figure 15.

The Find Consumer by Name page is displayed as shown in Figure 16 which requires

the entry and selection of one or more of the following parameters:

• Surname – a partial name may be entered i.e. ‘Jo’ for ‘Jones’, or even characters

within the name i.e. ‘hall’ will return all names containing the letters ‘hall’ within the

name.



• Given Name(s) - a partial name may be entered i.e. ‘An’ for ‘Ann’, or even

characters within the name i.e. ‘hall’ will return all names containing the letters ‘hall’

within the name.

• Date of Birth (partial search is not supported).

• Display – select from the drop down list the number of records to be displayed per

page i.e. 20 or All records.

These search fields ignore case, ie they will match any case.

Figure 16 - Find Consumer by Name

Click on the Search button to perform the search. The Reset button can be used to clear

the search fields back to their default values.

The result of the search is an alphabetical list of Consumers who match all of the specified

search criteria displaying Name, Sex, Date of Birth, Address and Consumer ID as

shown in Figure 17.

The sort order of the results can be changed, based on Name, Sex, DOB and Consumer ID,

by clicking on the blue underlined column heading.

If All was selected from the drop down list in the Display field, then a continuous list of

records are displayed. If 20 was selected and there are more than twenty records then

multiple pages of up to twenty records each are displayed with hyperlinks to each page

number and Previous and/or Next links.

The results page will always display the parameters that were specified for the search to allow

the search to be refined.



Figure 17 - Find Consumer by Name – Search Results

To open a particular Consumer’s Shared EHR, click on the name of the Consumer as shown

in Figure 17.

Note:

• Agents without Shared EHR access, (For example Registration Officers, System

Administrators and Health Care Administrators) will be taken to the Consumer

Details page rather than the Consumer Overview page as they are not

authorised to view clinical information.



3.1.2 Find Consumer by ID

If the Consumer ID is already known, the Consumer can be found directly by clicking on the

Find Consumer by ID submenu from the Find menu along the top menu bar as shown in

Figure 15. The Find Consumer by ID page is displayed. Enter the Shared EHR

Identifier (ID) of the Consumer and click the Search button as shown in Figure 18. An

exact match is required i.e. partial identifier values are not accepted.

Figure 18 – Find Consumer by ID

If the identifier is found and the consumer is on the user’s care team, the consumer’s Shared

EHR is opened.

If a valid identifier is found but the consumer is not on the user’s care team, the “Add Current

Location to Care Team” page is displayed to the user. See Section 3.1.4 for more details.

This search will never return a result list as an exact match is required.

3.1.3 Find Consumer by Location

To find Consumers based on the Locations on their Care Team, click on the Find

Consumer by Location submenu from the Find menu along the top menu bar as shown

in Figure 15.



When the Find Consumer by Location page is displayed, select a value from the drop

down list and click the Search button as shown in Figure 19.

Figure 19 – Find Consumer by Location

The result of the search is an alphabetical list of Consumers (by Surname) who match all of

the specified search criteria displaying Name, Sex, Date of Birth, Consumer ID,

Primary Contact Name, and Primary Contact Phone as shown in Figure 20.

The sort order of the results can be changed, based on Name, Sex, DOB and Consumer ID,

by clicking on the blue underlined column heading.









Figure 20 - Find Consumer by Location – Search Results

To open a particular Consumer’s Shared EHR, click on the name of the Consumer as shown

in Figure 20.

Note:

• Agents without Shared EHR access, (For example Registration Officers, System

Administrators and Health Care Administrators) will be taken to the Consumer

Details page rather than the Consumer Overview page as they are not

authorised to view clinical information.

3.1.4 Add Current Location to Care Team

This function supports the situation where a Consumer attends a new Location for the first

time and that Location has not been added to the Consumer’s Care Team. At this point it

would be possible to call the Registration Office to add the Location but this function

provides a more convenient method.

Note:

• To use this function the Consumer’s identifier (Consumer ID) must be known and

the Consumer must be present to enter their password to authorise the Care Team

addition. If the Consumer has forgotten their identifier or passphrase then the Care

Team will need to be updated via the Registration Office.

The first step in adding an Agent’s Location to the Consumer’s Care Team is to search for the

Consumer’s record via the Find Consumer by ID search, see Section 3.1.2. If the

entered Consumer ID is currently registered and active, but the Agent’s Location is not



already on the Consumer’s Care Team, then the Add Current Location To Care Team

page is displayed as shown in Figure 21.

Figure 21 - Add Current Location to Care Team

The Location field is pre-populated with the logged in Agent’s Location and cannot be

edited. The Consumer ID field is also pre-populated but can be modified if necessary.

The Consumer Passphrase field is blank awaiting the Consumer to type in the

passphrase to authorise the Care Team update.

Click on the Submit button to add the Location to the Consumer’s care team. If successful,

the Consumer’s Shared EHR will be opened.

For convenience when using Microsoft Internet Explorer, the Copy Consumer ID to

clipboard button is available to retain the Consumer ID so it can be copied to local systems

if needed. Simply click on the copy button and use the PastePastePastePaste facility (CTRLCTRLCTRLCTRL++++VVVV) in the local

system where the Consumer’s Shared EHR identifier needs to be entered.

Note:

• The Care Team contact details for the Agent who added them will be automatically

updated into the Care Team unless the Agent is a Health Care Administrator or Nurse.

In any case the Agent should confirm that they are the most appropriate contact for the

Consumer’s Care Team relationship or change the contact details as shown in Section

4.7.



3.2 Searching for Agents

This search allows Agents to find other Agents and is invoked from the Find menu along the

top menu bar as shown in Figure 22.

Figure 22 – Find Agent Menu

The Find Agent page is displayed as shown in Figure 23 which allows the entry and

selection of one or more of the following parameters:

• Agent ID - an exact match is required i.e. partial identifier values are not accepted.

Note: when specifying an identifier there is generally no reason to supply any other

search criteria. The identifier on its own will find the required Agent.

• Surname – a partial name may be entered i.e. ‘Jo’ for ‘Jones’, or even characters

within the name i.e. ‘hall’ will return all names containing the letters ‘hall’ within the

name.

• Given Name(s) - a partial name may be entered i.e. ‘An’ for ‘Ann’, or even

characters within the name i.e. ‘hall’ will return all names containing the letters ‘hall’

within the name.

• Role – select the required role from the drop down list. This will only include Agents

that have this role at one of their Locations.

• Location – select the required Location from the drop down list. This will only

include Agents that have been given a role at this Location.

Note: If both Role and Location are specified then the Agent must have the specified

Role at the specified Location to be included in the results.

• Display – select from the drop down list the number of records to be displayed per

page i.e. 20 or All records.

These search fields ignore case, ie they will match any case.



Figure 23 - Find Agent



The result of the search is an alphabetical list of Agents (by Surname) who match all of the

specified search criteria displaying Name, Role, Location(s), and HCP Provider

Number(s) as shown in Figure 24.

The sort order of the results can be changed, based on Name by clicking on the blue

underlined column heading.









Figure 24 – Find Agent - Search Results

To open a particular Consumer’s Shared EHR, click on the name of the Consumer, or to view

the Location details, click on the name of the Location as shown in Figure 24.



3.3 Searching for Locations

To find a Location, click on the Find Location submenu from the Find menu along the top

menu bar as shown in Figure 22.

Figure 25 – Find Location Menu

The Find Location page is displayed as shown in Figure 26 which requires the selection of

the required Location or option from the drop down list.

Figure 26 - Find Location

To find a location by Name, select Partial Search from the drop down list as shown in

Figure 27. The Location Name field will appear where a partial name may be entered i.e.

‘Ho’ for ‘Hospital’, or even characters within the name i.e. ‘ology’ will return all Location

names containing the letters ‘ology’ within the name. The Location Name search field

ignores case, ie it will match any case.

Select the required number of records to Display per page from the drop down list, i.e. 20

or All records.





Figure 27 - Find Location – Partial Search

If a specific location was selected its details will be displayed.

If All was selected or a partial search was performed, the result of the search is an

alphabetical list of Locations that match displaying Name, and ID as shown in Figure 28.

The sort order of the results can be changed, based on Name or ID by clicking on the blue










Figure 28 – Find Location - Search Results

To open a particular Location, click on its name as shown in Figure 28.

3.4 Searching for Organisations

To find an Organisation, click on the Find Organisation submenu from the Find menu

along the top menu bar as shown in Figure 29.

Figure 29 – Find Organisation Menu



The Find Organisation page is displayed as shown in Figure 30 which requires the

selection of the required Organisation or option from the drop down list.

Figure 30 - Find Organisation

To find an Organisation by Name, select Partial Search from the drop down list as shown

in Figure 31. The Name field will appear where a partial name may be entered i.e. ‘Ho’ for

‘Hospital’, or even characters within the name i.e. ‘ology’ will return all Location names

containing the letters ‘ology’ within the name. The Organisation Name search field

ignores case, ie it will match any case.

Select the required number of records to Display per page from the drop down list, i.e. 20

or All records.



Figure 31 - Find Organisation – Partial Search



If a specific organisation was selected its details will be displayed.

If All was selected or a partial search was performed, the result of the search is an

alphabetical list of Organisations that match displaying Name, and ID as shown in Figure

32.

The sort order of the results can be changed, based on Name or ID by clicking on the blue








Figure 32 – Find Organisation - Search Results

To open a particular Organisation, click on its name as shown in Figure 32.

3.5 Closing a Shared EHR

When viewing a consumer’s Shared EHR, a Close Record button is available on the top

right hand corner of the page as displayed in Figure 33. Once the user has viewed the record

they can either click on the Close Record button to return them to the Home page, or

select a different view from the menus or hyperlinks.



If evaluation of the system has been enabled, clicking the Close Record button will display

the evaluation questions (See Section 7).

Figure 33 - Close Record button



4 Viewing the Shared EHR

A number of views are provided for authorised users to view summarised or aggregated

information gathered from a single Consumer’s Shared EHR. These views are available after

a Consumer’s Shared EHR has been opened (see Section 3.1) and are navigated via the Left

Hand Side Menu (LHS Menu) shown in Figure 34. These views mostly contain clinical data,

but also include demographic, care team and audit log details.

4.1 Consumer Overview Page

The Consumer Overview page is divided into three segments that summarise the

following:

1. The top segment displays a summary of the Consumer’s demographic details. This

segment is important when transferring from another system (for example Medical

Director or practiX) to confirm that the correct Consumer’s Shared EHR is being

viewed.

2. The middle segment displays the three main Health Summaries that have been

aggregated from the Shared EHR. Brief Health Summary details for the Adverse

Reactions and Alerts, Current Medications and Problem/Diagnosis

History show at a glance a key overview. Any Adverse Reactions and Alerts

data is highlighted in bold red characters to draw attention to any potential issues in

providing care to this Consumer. See section 4.3 for more details on Health

Summaries.

3. The bottom segment displays a care team summary. This segment provides a very

useful Consumer centric view of their recent health care activity. The locations where

the Consumer has received care are shown along with a key contact. Recent activity is

shown in the Last Event Summary column which represents the last time the

Consumer received care from that location (and also shows the name and role of who

provided that care). This can be used to review recent care provided and identify gaps

where the Consumer has not received the care they may need (for example regular

podiatrist checks). To view the details of the most recent visit to a location, click on

the hyperlink shown in this column, for example Pathology Event Summary as

shown in Figure 34.

From the overview page, authorised users can drill down for further information by clicking

on any of the available hyperlinks displayed in Figure 34 such as Full Details (same as

Consumer’s Details on the LHS Menu), Full Health Summary (same as Health

Summary on the LHS Menu), or Full Care Team (same as Care Team on the LHS

Menu).

The LHS Menu is the primary point of navigation around the Shared EHR views.

The warning message above the Consumer Details segment is displayed to remind

Providers to confirm all information with the Consumer where possible to ensure that it is

complete or up to date. The Shared EHR content should be viewed as one of the possible

sources of clinical information for the Consumer. It can be considered one of the broadest

sources available, but it can not and should not be considered the only or most authoritative

source. The Shared EHR is most successfully used as a convenient starting point when



establishing the relevant health background for a Consumer or reviewing recent activity

provided by other providers.

Figure 34 - Consumer Overview Page



4.2 Care Plan Summary Pages

To view a summary of the Care Plans stored in the Consumer’s Shared EHR, click the Care

Plans menu item in the LHS Menu as shown in Figure 35.

Figure 35 – Care Plan Summary Menu

4.2.1 Viewing the Care Plan Summary

The Care Plan Summary page contains four segments:

1. The top segment is the Care Plan Index segment. This contains the filter and

index list sub-segments. The filter sub-segment is used to select which of the

available Care Plans are shown. By default, only Active Care Plans are shown. The

index list sub-segment displays the filtered and sorted list of Care Plans which have

been submitted into the Consumer’s Shared EHR.

2. The next segment is the Care Plan Goals Summary segment which displays all

the Care Plan Goals extracted from the Care Plans shown in the Care Plan Index

segment.

3. The next segment is the Care Plan Referrals Summary segment which displays

all the Care Plan Referrals extracted from the Care Plans shown in the Care Plan

Index segment.

4. The bottom segment is the Care Plan Steps Summary segment which displays

all the Care Plan Steps extracted from the Care Plans shown in the Care Plan

Index segment.



4.2.1.1 Care Plan Index Segment

By default, the index list is sorted in reverse chronological order displaying Date

Occurred, Item, Author, Role, and Location Name as shown in Figure 36.

The Date Occurred column is the date the Care Plan was originally recorded, as compared

to the date the Care Plan was actually submitted into the Shared EHR.

Figure 36 – Care Plan Summary Index

The Care Plans displayed in the index can be filtered (ie display only a subset of the available

records) by changing the filter criteria. Select the required status of Care Plan from the

Filter Status options and click the Filter button. Care Plans that match the selected status

will be displayed in the index. The filter can be reset to the default value by clicking the

Reset button.

The sort order of the index can be changed, based on Date Occurred, Item, Author, Role,

and Location Name, by clicking on the blue underlined column heading.

The full details of any Care Plan can be viewed by clicking on the link for the Care Plan

under the Item column, for example Team Care Arrangement as shown in Figure 36.

This will display the standard Event Summary Details page as described in section 4.6.2.



4.2.1.2 Care Plan Goals Summary Segment

The Care Plan Goals Summary displays all the Goals extracted from the Care Plans

shown in the Care Plan Index segment. The details displayed are Statement of Goal,

Status, Start Date, Next Review Date and Extracted from and are sorted by

Statement of Goal in alphabetical order as shown in Figure 37.

Figure 37 – Care Plan Goals Summary

If a status indicates that the Goal may need attention, the status will be highlighted in yellow.

If a Goal is overdue for review, the review date will be highlighted in red.

The Extracted from column shows which Care Plan contains the Goal. The full details of

the related Care Plan can be viewed by clicking on the link under the Extracted from

column, for example Team Care Arrangement as shown in Figure 37. This will display

the standard Event Summary Details page as described in section 4.6.2.

Click on the Calendar View link to open a calendar with the review milestones marked for

all the active care plans.



4.2.1.3 Care Plan Referrals Summary Segment

The Care Plan Referrals Summary displays all the Referrals extracted from the Care

Plans shown in the Care Plan Index segment. The details displayed are Health

Professional, Location, Status, Start Date, End Date and Extracted from and

are sorted by Health Professional in alphabetical order as shown in Figure 38.

Figure 38 – Care Plan Referrals Summary

If a status indicates that the Referral may need attention, the status will be highlighted in

yellow.

The Extracted from column shows which Care Plan contains the Referral. The full details

of the related Care Plan can be viewed by clicking on the link under the Extracted from

column, for example Team Care Arrangement as shown in Figure 38. This will display

the standard Event Summary Details page as described in section 4.6.2.





4.2.1.4 Care Plan Steps Summary Segment

The Care Plan Steps Summary displays all the Steps extracted from the Care Plans

shown in the Care Plan Index segment. The details displayed are Step Description,

Assigned To, Status, Start Date, Next Review Date and Extracted from and

are sorted by Step Description in alphabetical order as shown in Figure 39.

Figure 39 – Care Plan Steps Summary

If a status indicates that the Steps may need attention, the status will be highlighted in yellow.

If a Step is overdue for review, the review date will be highlighted in red.

The Extracted from column shows which Care Plan contains the Step. The full details of

the related Care Plan can be viewed by clicking on the link under the Extracted from

column, for example Provider Specific Care Plan as shown in Figure 39. This will

display the standard Event Summary Details page as described in section 4.6.2.





4.2.2 Viewing the Care Plan Calendar

The Care Plan Summary Calendar displays the review milestones of all the active

Care Plans stored in a Consumer’s Shared EHR as shown in Figure 40. To open the calendar

view, click any of the three Calendar View links on the Care Plan Summary page

(see section 4.2).

Figure 40 – Care Plan Summary Calendar

The full details of the related Care Plans can be viewed by clicking on the links in the relevant

calendar days, for example Review Goal: Team Care Arrangement by Dr Kate

Richards[General Practitioner] as shown in Figure 40. This will display the standard

Event Summary Details page as described in section 4.6.2.

4.3 Health Summary Pages

Health Summaries are collections of data taken from a single Consumer’s Shared EHR that

are related to a single topic or subject.



The following Health Summaries are supported:

• Adverse Reactions and Alerts – providing a list of all the distinct reactions,

precautions and alerts found in the Shared EHR.

• Problem/Diagnosis History – providing a list of all active and resolved

problems/diagnoses found in the Shared EHR.

• Current Medications – providing the most recent list of current medications

submitted to the system by the Consumer’s designated clinic.

• Prescribing History – providing a list of all the prescriptions found in the Shared

EHR.

• Procedure/Treatment History – providing a list of all the procedures and

treatments found in the Shared EHR.

• Lifestyle Health Summary – providing a list of all the general lifestyle entries

found in the Shared EHR, including details on smoking, exercise, diet assessment and

diet prescription.

• Family Clinical History – providing a list of all the general family history entries

found in the Shared EHR, including descriptions of any familial or hereditary

conditions.

• Immunisations Health Summary – providing a list of all immunisations found

in the Shared EHR.



4.3.1 Viewing the Health Summary Index

To view the Health Summary Index, click the Index Page sub-menu from the Health

Summary menu item in the LHS Menu as shown in Figure 41.

Figure 41 - Health Summary Menu

The Health Summary Index provides a summarised view of all the supported Health

Summaries on a single page. Only limited details for each Health Summary are displayed and

where feasible, duplicate values are removed.

Each Health Summary is listed in the order shown in Section 4.3, along with the Summary

data and the Last Updated date which represents the most recent data associated with any

of the data in the Health Summary (ie the Health summary is an aggregation of data from

many different event summaries), as shown in Figure 42.



Figure 42 - Health Summary Index

The following details are included in the Summary view:

• Adverse Reactions and Alerts – shows each distinct Description and

Reaction pair separated by a colon ‘:’.

• Problem/Diagnosis History – shows each distinct Problem/Diagnosis

Name along with the most recent date it was found in the Shared EHR and the

Provider details who recorded it.

• Current Medications – shows for each medication, Date of Script (followed

by a colon ‘:’), Drug Name, Strength, Form, Dose, Frequency, and

Instructions.

• Prescribing History – shows the most recent three distinct Drug Name,

Strength, Form, Dose, Frequency, and Instructions.

• Procedure/Treatment History – shows the most recent three distinct

Procedure/Treatment Date and Procedure/Treatment Type pairs

separated by a colon ‘:’.

• Lifestyle Health Summary - shows a summary line for each general lifestyle

entries as follows:



• Smoking - Frequency if Status is Yes.

• Exercise – Not shown in summary.

• Diet Assessment – Low Fat, Low GI, and Nutritionally Adequate on the

first line, and Understanding on the next line.

• Diet Prescription - Special Diet Required.

• Family Clinical History – shows each Description.

• Immunisations Health Summary – shows each Immunisation Date

(followed by a colon ‘:’), Vaccine Code, and Vaccine Name.

Click on the links under the Item column to view the details for a particular Health

Summary, for example Problem/Diagnosis History as shown in Figure 42.

4.3.2 Viewing Health Summary Details

To view the details of a Health Summary, either click the required Health Summary sub-menu

from the Health Summary menu item in the LHS Menu as shown in Figure 41, or click

the required link under the Item column in the Health Summary Index, as shown in

Figure 42.

All Health Summary detail pages provide Extracted from links to relate each data item in

the summary back to the source Event Summary. This provides the appropriate context for

the summaries items in the Health Summary. The full details of the related Event Summary

can be viewed by clicking on the link which will display the standard Event Summary Details

page as described in section 4.6.2.



4.3.2.1 Adverse Reactions and Alerts Health Summary

The Adverse Reactions and Alerts Health Summary details page shows each entry

found in the Shared EHR, grouped and alphabetically sorted by Description and includes

Description, Reaction, Precaution Type, Identification Date, Resolved Date

and Extracted from as displayed in Figure 43.

Figure 43 – Adverse Reactions and Alerts



4.3.2.2 Problem/Diagnosis History Health Summary

The Problem/Diagnosis History Health Summary details page shows each entry found

in the Shared EHR, grouped and alphabetically sorted by Problem / Diagnosis Name

and includes Problem / Diagnosis Name and Extracted from as displayed in

Figure 44.

Figure 44 - Problem/Diagnosis History

This particular format and grouping allows patterns to be identified, for example the number

of times ‘Lower limb ulceration’ has been diagnosed.



4.3.2.3 Current Medications Health Summary

The Current Medications Health Summary details page shows each medication in the

most recent current medications list submitted. The list is alphabetically sorted by Drug

Name and includes Drug Name, Strength, Form, Dose, Frequency,

Instructions, Date of Script, and Extracted from as displayed in Figure 45.

Figure 45 - Current Medications

The Current Medications list can only be updated by the Consumer’s designated clinic.

Whenever another provider submits a prescription into the Shared EHR, the system notifies

the designated clinic in order for them to update the Consumer’s current medications list.



4.3.2.4 Prescribing History Health Summary

The Prescribing History Health Summary details page shows each prescription entry

found in the Shared EHR, grouped and alphabetically sorted by Drug Name, Strength,

Form, Dose, Frequency, and Instructions and includes Drug Name, Strength,

Form, Dose, Frequency, Instructions, Date of Script, and Extracted from as

displayed in Figure 46.

Figure 46 - Prescribing History



4.3.2.5 Lifestyle Health Summary

The Lifestyle Health Summary details page shows each Smoking, Alcohol,

Exercise, Diet Assessment, and Diet Prescription entry found in the Shared EHR,

grouped by Lifestyle, Exercise, Diet Assessment, and Diet Prescription as

displayed in Figure 47.

Figure 47 - Lifestyle Health Summary

The Lifestyle entries include Substance Use, Status, Frequency, and Extracted

from. The Exercise entries include Activity, Level of Exertion, Frequency, and

Extracted from. The Diet Assessment and Diet Prescription entries include

Notes, Details, and Extracted from.



4.3.2.6 Procedure/Treatment History Health Summary

The Procedure/Treatment History Health Summary details page shows each entry

found in the Shared EHR, in reverse chronological order by Extracted from and includes

Procedure/Treatment Type, Procedure/Treatment Date, and Extracted

from as displayed in Figure 48.

Figure 48 – Procedure/Treatment History



4.3.2.7 Family Clinical History

The Family Clinical History Health Summary details page shows each entry found in the

Shared EHR, in reverse chronological order by Extracted from and includes

Description and Extracted from as displayed in Figure 48.

Figure 49 - Family Clinical History

4.3.2.8 Immunisations Health Summary

The Immunisations Health Summary details page shows each entry found in the

Shared EHR, in reverse chronological order by Extracted from and includes Vaccine

Code, Vaccine Name, Immunisation Date, Sequence, Batch Code, Notes and

Extracted from as displayed in Figure 50.

Figure 50 - Immunisations Health Summary



4.4 Profile Pages

The concept of a profile is to display historical collections of test results and observations

considered key in managing particular aspects of care for a Consumer. For example the list of

markers used to manage diabetes patients. This allows for trending of results.

Profiles are configured in the system with the default three, Diabetes Profile, Renal

Failure Profile, and Congestive Heart Failure shown in Figure 51. Click the

required profile sub-menu from the Test Results menu item in the LHS Menu to display

the profile.

Figure 51 – Profiles Menu



The profile page contains selection boxes for each of the test results and observations

included in the profile set as shown in Figure 52.

Figure 52 – View Profile

Checking any of the boxes on this page will show the last five records relating to the selected

test results or observations. The list is sorted in reverse chronological order displaying Date,

Measurement, Units, Reference Range, Criticality and Extracted From as

shown in Figure 52.

If more than five are available the More Results link will display the full list. If no

information on a specific result or observation type is available then the box will be greyed

out and will not be selectable.

All results with a criticality of LL, HH, +++ or --- are highlighted in red. If the criticality

is L, H, +, ++, - or --, the background is yellow. If any result is highlighted it means that

they are outside the reference range values.

The Extracted from column shows which Event Summary contains the Pathology Result

or Observation. The full details of the related Event Summary can be viewed by clicking on

the link under the Extracted from column, for example Diabetes Specialist Clinic

Event Summary as shown in Figure 52. This will display the standard Event Summary

Details page as described in section 4.6.2.



4.5 Pathology Result Pages

To view the available pathology results stored in a Consumer’s Shared EHR, click the

Pathology Results sub-menu from the Test Results menu item in the LHS Menu as

shown in Figure 53.

Figure 53 – Pathology Index Menu

4.5.1 Viewing the Pathology Result Index

The Pathology Result Index page contains two segments:

1. The top segment is the filter segment which is used to select which of the available

pathology results are shown. By default, the pathology results submitted for the

Consumer within the past year are shown.

2. The bottom segment displays the filtered and sorted list of pathology results which

have been submitted into the Consumer’s Shared EHR.



Figure 54 – Pathology Index

By default, the index list is sorted in reverse chronological order displaying Date/Time

Performed, Test Name, Results, Lab, Lab Reference and Extracted From as

shown in Figure 54.

The Date/Time Performed column is the date given to the pathology result from the

Lab, as compared to the date the pathology result was actually submitted into the Shared

EHR.

The pathology results displayed in the index can be filtered (ie display only a subset of the

available records) by changing the filter criteria. Select the required date period from the

Filter Period option and click the Filter button. Pathology results from within that period

will be displayed in the index. The filter can be reset to the default value by clicking the

Reset button.

The sort order of the index can be changed, based on Date/Time Performed, Test Name,

Lab, Lab Reference, and Extracted From, by clicking on the blue underlined column

heading.

The full details of any pathology result can be viewed by clicking on the View link under the

Results column as shown in Figure 54. This will display the Pathology Result Detail page

as described in section 4.5.2.

The Extracted from column shows which Event Summary contains the Pathology Result

(ie an Event Summary can contain many tests). The full details of the related Event Summary

can be viewed by clicking on the link under the Extracted from column, for example

Pathology Event Summary as shown in Figure 54. This will display the standard

Event Summary Details page as described in section 4.6.2.



4.5.2 Viewing the Pathology Result Details

The Event Summary detail page contains two segments:

1. The top segment is the context segment and contains the link to the Event Summary

which contains this pathology result.

2. The bottom segment displays the contents of the pathology result.

This is shown in Figure 55 using a HbA1c result as an example.

Figure 55 – Pathology Result Details

All results with a criticality of LL, HH, +++ or --- are highlighted in red. If the criticality

is L, H, +, ++, - or --, the background is yellow. If any result is highlighted it means that

they are outside the reference range values.

The link in the Extracted from segment shows which Event Summary contains the

Pathology Result (ie an Event Summary can contain many tests). The full details of the

related Event Summary can be viewed by clicking on this link, for example Pathology

Event Summary as shown in Figure 55. This will display the standard Event Summary


At the top and bottom of the pathology result details page are index navigation links that

provide a convenient way of viewing the details of multiple results. Clicking the Index link

will display the Pathology Index page showing the list of pathology results based on the

most recent filter options and in their most recently sorted order. This list shows which



pathology results and in which order they will be displayed by the Previous and Next

links. To change the filter or sort order in the Pathology Index page, see Section 4.5.1.

To return to the pathology result details page simply click any View link.

Clicking the Previous link will display the details of the pathology result above the current

pathology result in the Pathology Index page. Clicking the Next link will display the

details of the pathology result below the current pathology result in the Pathology Index

page. When there is no previous or next pathology result (ie the current pathology result is at

the top or the bottom of the list) the Previous and Next links will not be clickable.

If there is any struck through data shown on this page it will be clearly highlighted as struck

through as described in Section 5.2.

4.6 Event Summary Pages

To view the available event summaries for a Consumer’s Shared EHR, click the Index

Page sub-menu from the Events menu item in the LHS Menu as shown in Figure 56.

Figure 56 – Event Summary Index Menu

4.6.1 Viewing the Event Summary Index

The Event Summary Index page contains two segments:

1. The top segment is the filter segment which is used to select which of the available

event summaries are shown. By default, all event summaries submitted for the

Consumer within the past year are shown.



2. The bottom segment displays the filtered and sorted list of event summaries which

have been submitted into the Consumer’s Shared EHR.

Figure 57 - Event Summary Index

By default, the index list is sorted in reverse chronological order displaying Date

Occurred, Item, Author, Role, and Location Name as shown in Figure 57.

The Date Occurred column is the date the event summary was originally recorded, as

compared to the date the event summary was actually submitted into the Shared EHR.

The event summaries displayed in the index can be filtered (ie display only a subset of the

available records) by changing the filter criteria. Select the required type of event summary

from the Filter Type options and the required date period from the Filter Period options

(only one can be selected from each list) and click the Filter button. Event summaries that

match both criteria will be displayed in the index. The filter criteria can be reset to their

default values by clicking the Reset button.

The sort order of the index can be changed, based on Date Occurred, Item, Author, Role,

and Location Name, by clicking on the blue underlined column heading.

The full details of any event summary can be viewed by clicking on the link for the event

summary under the Item column, for example Diabetes Specialist Clinic Event

Summary as shown in Figure 57.



4.6.2 Viewing the Event Summary Details

The Event Summary detail page contains two segments:

1. The top segment is the context segment and contains details about the event, this

includes the details and status sub-segments.

2. The bottom segment displays the contents of the event summary.

This is shown in Figure 58 using a Diabetes Specialist Clinic Event Summary as an

example.

Figure 58 - Event Summary Details

The contents of the event can be transferred to other applications via the workstation

clipboard. To copy the Event Summary, click the Copy to Clipboard link when using

Microsoft Internet Explorer (or alternatively for Mozilla Firefox, use the mouse to highlight

the required contents and press ControlControlControlControl----CCCC). Open the application where the Event

Summary is to be copied and press ControlControlControlControl----VVVV (or alternatively use the paste function of the

application).

To print the contents of the event, click the Printable Version link. This will open a new

window showing a preview what will be printed which includes the Consumer Name and date

of birth at the top of every page and the date printed and page numbering at the bottom of



every page. This makes is suitable for including into a paper clinical record. To print, press

ControlControlControlControl----PPPP (or alternatively use the browser print function).

At the top and bottom of the Event Summary details page are index navigation links that

provide a convenient way of viewing the details of multiple events. Clicking the Index link

will display the Event Summary Index page showing the list of Event Summaries based

on the most recent filter options and in their most recently sorted order. This list shows which

Event Summaries and in which order they will be displayed by the Previous and Next

links. To change the filter or sort order in the Event Summary Index page, see Section

4.6.1. To return to the Event Summary details page simply click any link under the Item

column.

Clicking the Previous link will display the details of the Event Summary above the current

Event Summary in the Event Summary Index page. Clicking the Next link will

display the details of the Event Summary below the current Event Summary in the Event

Summary Index page. When there is no previous or next event summary (ie the current

Event Summary is at the top or the bottom of the list) the Previous and Next links will not

be clickable.

If there is any struck through data shown on this page it will be clearly highlighted as struck

through as described in Section 5.2.

4.7 Care Team Page

The Care Team is a list of Locations which provide health care to a Consumer. It is an

important entity because it is used for access control in that only Health Care Providers that

have been assigned a role at a Location on the Consumer’s care team are allowed access to the

Consumer’s Shared EHR. The Consumer, either directly themselves, or via an Agent acting

on the Consumer’s request is responsible for maintaining the Locations on the Care Team.

To view the Care Team details, click the Care Team menu item in the LHS Menu as shown

in Figure 59.

The Care Team page contains two segments:

1. The top segment lists the Locations currently on the Care Team. This contains the

same content as shown on the Consumer Overview page.

2. The bottom segment lists the Locations that have previously been on the Care Team

but have since been removed.



Figure 59 – Consumer Care Team

By default, the lists are sorted in alphabetical order by Location, displaying Location,

Contact Person, and Last Event Summary.

The sort order of the lists can be changed, based on Location and Contact Person, by

clicking on the blue underlined column heading.

The Contact Person is optional and can be used by Health Care Providers to contact a

Location about the care received by the Consumer at that Location.

Recent activity is shown in the Last Event Summary column which represents the last

time the Consumer received care from that Location (and also shows the name and role of

who provided that care). The full details of the most recent Event Summary can be viewed by

clicking on the link under the Last Event Summary column, for example Diabetes

Specialist Clinic Event Summary as shown in Figure 59. This will display the

standard Event Summary Details page as described in section 4.6.2.



4.8 View and Update Consumer Details

To view and update the demographic details of a Consumer, click the Consumer’s

Details menu on the LHS menu bar as shown in Figure 60.

Figure 60 - Consumer Details – View Mode

The Consumer Details page is opened in view mode. In this mode the contents cannot be

changed and the fields are greyed out and not selectable. This means the cursor cannot be

placed in the fields or any action performed on the fields, for example selecting the contents

for copying or showing a pull down list. The contents can only be viewed. The only

exceptions are view only fields which display normally (not greyed out) and their contents

can be selected in both modes, for example the HealthConnect Consumer ID.

To change to edit mode, click the Edit button. The editable fields will be displayed normally

(not greyed out) and the contents can now be changed.



Figure 61 - Consumer Details – Edit Mode

Make the required changes and click the Save Changes button to save the changes, or the

Cancel button to revert back to the original contents, as shown in Figure 61. In both cases

the page will then be re-displayed in view mode.

If the changes are invalid then the errors will be displayed and the page will remain in edit

mode so the changes can be corrected. In edit mode, clicking any link (for example a menu

item) will cancel the changes and the requested page will be displayed.



4.9 Access Log Page

The Access Log shows all read and write access to a Consumer’s Shared EHR. To view

the Access Log, click the View Access Log menu item in the LHS Menu as shown in

Figure 62.

Figure 62 – View Access Log

By default, the Access Log is sorted in reverse chronological order displaying Access

Date, User, Role, and Location.

The sort order of the Access Log can be changed, based on Access Date, User, Role, and

Location, by clicking on the blue underlined column heading.

If there are more than twenty records then multiple pages of up to twenty records each are

displayed with hyperlinks to each page number and Previous and/or Next links as shown

in Figure 62.



5 Submitting Event Summaries

An Event Summary is a collection of information related to a single Consumer to be

contributed to their Shared EHR. An Event Summary is usually related to a single healthcare

event, for example a GP Consultation, but may also contain information from multiple events,

for example Clinical History, or may even be non-health care related, for example consent

forms.

Event Summaries can be submitted into a Shared EHR either via the browser (as shown in

Figure 66) or via a computer interface from another clinical system. GP desktop systems or

Pathology lab systems are examples of clinical systems that would submit Event Summaries

via a computer interface. See the RecordConnect Installation and Configuration User

Guide for details on how a local clinical system submits Event Summaries.

To view the available Event Summary types, click the Add Event sub-menu item from the

Events menu item in the LHS Menu as shown in Figure 63.

Figure 63 - Add Event Menu

The Shared EHR system is designed to be able to store any type of document. This is

achieved via Archetypes which allow the configuration of new document types to be

supported by the system. See the Archetype Wizard and Import User Guide for details

in how to create new Archetypes and import them into the system.

The system is installed with a default set of Archetypes as follows:

• Document – used to record information that is only available in a document/image

form, for example Word documents, RTF documents, HTML documents, PDF

document, JPG images, etc. This Event Summary is typically entered via the browser and supports the attachment of a document from the user’s computer.



• Over 75 Health Assessment – used to record assessment information on a

Consumer over 75 and typically is directly entered via the browser.

• Consumer Background Event Summary – used to record information about

the family history of the Consumer and typically is entered directly via the browser during the Consumer registration process.

• Diabetes Educator Event Summary – used to record information about a

Consumer’s consultation with a Diabetes Educator and typically is directly entered via

the browser.

• Diabetes Specialist Clinic Event Summary – used to record information

about a Consumer’s consultation with a Diabetes Specialist and may be either generated by the Diabetes Clinical System or directly entered via the browser.

• Dietitian Event Summary – used to record information about a Consumer’s consultation with a Dietitian and typically is directly entered via the browser.

• Discharge Summary – used to record information about a Consumer’s Hospital stay and typically is automatically generated by the Hospital Discharge System.

• GP Event Summary – used to record information about a Consumer’s

consultation with a GP and typically is automatically generated by a GP desktop

system (for example Medical Director or practiX).

• GP Management Plan – used to record GP centric care planning information about a Consumer and typically is directly entered via the browser.

• Initial Health Summary – used to record information about a Consumer's health

history and typically is automatically generated by a GP desktop system (for example

Medical Director or practiX). Ideally at least one of these would be submitted during the Consumer registration process.

• Nephrologist Event Summary – used to record information about a

Consumer’s consultation with a Nephrologist and typically is directly entered via the

browser.

• Ophthalmologist Event Summary – used to record information about a

Consumer’s consultation with an Ophthalmologist and typically is directly entered via the browser.

• Pathology Event Summary – used to record information on pathology results

and may be sourced directly from the pathology lab or via the GP desktop system (for

example Medical Director or practiX).

• Podiatrist Event Summary – used to record information about a Consumer’s consultation with a Podiatrist and typically is directly entered via the browser.

• Pregnancy Assessment – used to record assessment information about a Pregnancy and typically is directly entered via the browser

• Provider Specific Care Plan – used to record discipline centric (for example for

a podiatrist, or ophthalmologist) care planning information about a Consumer and

typically is directly entered via the browser.

• Team Care Arrangement – used to record team care planning information about a Consumer and typically is directly entered via the browser.

• Vascular Surgeon Event Summary – used to record information about a

Consumer’s consultation with a Vascular Surgeon and typically is directly entered via the browser.



The administrator of the system can customise the Archetypes as required by the users of the

system and also assign which roles have the privilege to submit each type of Event Summary.

It is expected that the list of available Event Summary types, as shown in Figure 64 will be

different to what is actually available for each user.

The tables in Annex B.2 contain the default privileges for the default list of Event Summary

types.

Figure 64 – Available Events List

The following section describes how to submit Event Summaries via the browser application

and will use the Dietitian Event Summary as an example. Although this Event

Summary type does not show all the data entry variations, the process and wizard in the

browser application is the same for all Event Summary types.

5.1 Creating an Event Summary

Click on the required link to begin the Event Summary data entry wizard, as shown in Figure

64. The Dietitian Event Summary is used as an example for the screen shots.



5.1.1 Step 1 – Event Details

The first page in the data entry wizard is the Step 1 – Event Details page, as shown in

Figure 65.

Figure 65 – Step 1 – Event Details

The Event Details need to be checked before clicking the Next > button. If the Subject

is not correct, open the correct Customer Shared EHR as described in Section 3.1. If the

Author or Location is not correct, logout and log back into the application using the

correct authentication credentials as described in Section 2.2.2.

The Date/time occurred should represent the appropriate period when the clinical

information being recorded took place, for example the actual consultation time verses a later

time when the data is being entered into the system (if there has been a delay). The

Date/time occurred defaults to the current date and time but can be changed as needed.

Typically the consent of the Consumer will be needed to submit an Event Summary, however

depending on the participation agreements this may be assumed or some other variant. If

explicit consent is required and it has not been previously obtained, it should be obtained at

this point.

Click the Next > button to proceed to Step 2, entering the clinical data.

5.1.2 Step 2 – Clinical Data

The second page in the data entry wizard is the Step 2 – Clinical Data page, as shown in

Figure 66. This is where the main data entry occurs.

The Step 2 – Clinical Data page may contain up to two segments:



1. The top segment shows the Event Summary Sections (if more than one) within the

Event Summary. By default none of the sections are selected.

2. The bottom segment is initially empty (unless there is only one Event Summary

Section), but as Event Summary Sections are selected the bottom segment will display

a data entry panel for each selected Event Summary Section.

Figure 66 - Step 2 – Clinical Data

Click on the required checkboxes in the top segment to open the data entry panels as shown in

Figure 66. The Diet Assessment and Exercise Event Summary Sections are used as

examples for the screen shot.

Enter the clinical data into the bottom segment as required. Any fields that are mandatory (ie

they need to be filled in) are marked with a small red asterisk (*).

Data can be freely typed into free text fields as shown in the Notes field of the Diet

Assessment Entry. If the browser being used supports spell checking, this can be turned



on to spell check the content typed. The text in these fields will automatically wrap to the

size of the field, but if content is entered that exceeds the size allocated scroll bars will

automatically appear to allow navigation to hidden text.

Radio buttons (as shown in the Low Fat field of the Diet Assessment Entry) are initially

set to all options off. Any one of the options can be selected. Once an option is selected, the

field cannot be returned to the blank state, ie one of the options must be selected.

Pull down lists allow selection from the pre-set list of values. The list is displayed by clicking

the downward facing arrow (as shown in the Level of Exertion field of the Exercise

Entry). Selection can also be made with the keyboard using the first letter of an option and/or

the upupupup and downdowndowndown arrow keys. For example clicking the ‘mmmm’ key will select the moderate

option, and then clicking the upupupup arrow key will select the light option. Selecting the ‘–‘

option at the top of the list of options will clear the field to empty.

Date and Time data entry fields support a default button (Left Facing Triangle as shown in

Figure 66) that will populate the field with the date and time entered in Step 1 for the Event

Summary. Some dates and times will automatically default to this date if the field is left

empty. For example, the date and time for each Entry (usually shown at the end of the data

entry panel) will automatically default if left empty. Figure 66 shows the default button has

been used for the Diet Assessment Entry and for the top Exercise Entry. The bottom Exercise

entry has been left blank, but as shown in Figure 68, this date will also default. The default

button is useful for pre-filling the fields to allow minor modifications, for example to enter the

date of the previous day.

Some Entries can be repeated, for example allowing multiple referrals to be recorded in the

one Event Summary. New blank Entries can be added by clicking the Add button as shown

in Figure 66.

Notes:

• If an Event Summary Section is left blank it will not be included into the Event

Summary. If too many entries are created via the Add buttons, they can just be left

blank and they will be ignored.

• If an Event Summary Section is de-selected from the top segment it will retain any

data that has been entered. This data will be visible if it is re-selected again, even after

proceeding to Step 3 and returning back to Step 2.

• If an Event Summary Section contains data, but has been de-selected in the top

segment it will not be included in the Event Summary.

• If the < Back button is clicked to go back to Step 1, any entered data on this page

will be retained. The data will be displayed again when returning to Step 2.

• If the < Next button is clicked to go to Step 3, any entered data on this page will be

retained. The data will be displayed again, upon returning to Step 2.

Click the Next > button to proceed to Step 3, to preview the entered clinical data. At this

point the system will validate the entered data to ensure the Event Summary is been correctly



completed. If there are any errors, they will be shown at the top of the page in red as shown

in Figure 67. The page will remain on Step 2 to allow correction of the errors before

proceeding to Step 3.

Figure 67 – Step 2 – Clinical Data - Errors

In this example, the day value in the date for the Diet Assessment Entry has an invalid

value as shown in Figure 67.



5.1.3 Step 3 - Preview

The third page in the data entry wizard is the Step 3 – Preview page, as shown in Figure

68. This is final stage in the data capture process before the Event Summary is submitted into

the Shared EHR. All the details should be carefully reviewed before proceeding.

Figure 68 – Step 3 - Preview

The Step 3 – Preview page contains two segments:

1. The top segment shows the Event Summary details from Step 1.

2. The bottom segment shows the Entry details entered in Step 2.

To make any changes to the data click the < Back button to go back to Step 2.

The top segment also contains two links allowing the data to be copied or printed. The Copy

to Clipboard and Printable Version links are documented in section 4.6.2. These

functions are useful for transferring the data into another filing system (paper or computer)

that is not integrated with the Shared EHR.

When all the previewed details have been reviewed, click on the Next > button to Step 4,

and submit the data into the Shared EHR. This is the final step and cannot be undone.



5.1.4 Step 4 - Submit

The fourth page in the data entry wizard is the Step 4 – Submit page, as shown in Figure

69. This page confirms that the Event Summary has been successfully stored in the

Consumer’s Shared EHR.

Figure 69 - Step 4 - Submit

The details of the Event Summary just submitted can be viewed by clicking on the link for the

event summary under the Item column, for example Dietition Event Summary as

shown in Figure 69. Clicking on the link which will display the standard Event Summary


If the system has been configured to collect evaluation feedback, this page will also contain

the evaluation questions. See section 7 for more details on providing evaluation feedback.

5.2 Correcting Content in the Shared EHR

The system allows errors to be corrected through the use of the strike through functionality

aligned with the associated business processes. Errors include data that has been mistyped, or

stored in the wrong consumer’s health record, or information that is later discovered to be

incorrect, for example an incorrect diagnosis. Content may also need to be struck through

where the Consumer changes their consent and wishes to remove some data from their Shared

EHR.

Struck through data is hidden from the Shared EHR and can no longer be seen by the

Consumer and most other users. This includes all summary views, indexes and profiles. This

ensures that once struck through, the error can no longer cause confusion or issues. The only

exception is for users with the privilege to view struck through data, and in this case it will be

displayed with the strike through text effect. By default only the Record Manager can view

struck through data.



The ability to strike through is granted as a privilege and should only be made available to

those users who are trained on the associated business processes and implications of removing

data from the Shared EHR. By default only the Record Manager can strike through data.

Struck through data is not deleted from the Shared EHR to preserve the historical integrity of

the record. The data that is being struck through has been made available to the care team and

may have been previously viewed. Before data is struck through an assessment should be

made of how viewing the data could have impacted the care team or how now making it

invisible could impact the care team. If any issues arise, viewing the history of changes can

help resolve the issue. This can only be done by a user with the privilege to view struck

through data.

Strike through can be done for an entire Event Summary or for one or more Entries within an

Event Summary.

Note: Once an Entry or entire Event Summary has been struck through, it cannot be

unstruck.

5.2.1 Strike Through Entire Event Summary

When an entire Event Summary is struck through, all content is struck through and no part of

the Event Summary will be included in the Shared EHR views. The only exception is for

users with the privilege to view struck through data, and in this case, the Shared EHR views

will display the data with the strike through text effect according to the following notes:

• The Health Summary Index and Consumer Overview pages will not

include struck through data.

• The Care Plan Index, Care Plan Summary Calendar, Health Summary

detail views, Profile pages, Pathology Index, and Event Index, pages will

include struck through data shown with the strike through text effect.

To strike through an Event Summary open the Event Summary detail page as described in

Section 4.6.2.



When Event Summary detail page is viewed with the strike through privileges (ie perform

strike through and view strike through) additional version (replaced/replaces) links and strike

through links are displayed as shown in Figure 70.

Figure 70 - Strike Through Event Summary Link

The Event Summary Status segment contains the Strike through this Event

Summary link. To display the Strike Through Event Summary Preview page click the

Strike through this Event Summary link. The Strike Through Event Summary

Preview page will be displayed as shown in Figure 71.



Figure 71 - Strike Through Event Summary Preview

The Event Summary that will be struck through is shown on this page for careful review.

Enter the reason why this data is being removed from the Shared EHR. This reason is shown

to users with the View Struck Through data privilege when viewing the Event Summary as

shown in Figure 73.

To strike through the Event Summary, click the Strike Through button. The confirmation

pop-up message box will be displayed as shown in Figure 72.

Figure 72 - Strike Through Event Summary Confirmation

Clicking OK will permanently strike through the Event Summary as Event Summaries

cannot be unstruck.



The Event Summary will be displayed with the content shown in the strike through text effect

and the strike through details will be displayed including the Strike Through Reason as

shown in Figure 73.

Figure 73 - Struck Through Event Summary Details

The page title and all the event contents are shown with the strike through text effect and the

Struck through status value is set to Yes.



Viewing the Event Index page will show the Event Summary row of the struck through

Event Summary with the strike through text effect as shown in Figure 74.

Figure 74 – Strike Through Event Summary Index Page



Viewing a summary page that supports display of struck through data and that contains any

Entries from the struck through Event Summary will now show those Entries as struck

through. For example, viewing the Diabetes Profile and selecting Blood Pressure will

show the list of blood pressures in the Shared EHR along with the struck though Entry from

the Diabetes Specialist Clinic Event Summary as shown in Figure 75.

Figure 75 – Struck Through Event Summary Profile

If the Event Summary struck through was the Last Event Summary from a location on

the Consumer’s Care Team, the Last Event Summary link on the Care Team pages will

now be a link to the next most recent Event Summary from that location. If there are no other

events for that location, No event summaries will be displayed.

5.2.2 Strike Through Individual Entry

When an individual Entry in an Event Summary is struck through, the system creates a new

Event Summary with exactly the same details as the original Event Summary minus the Entry

that was struck through. When viewing the Shared EHR, the original Event Summary will be

ignored and only the new Event Summary (which has had the Entry removed) will be

included in the Shared EHR views. The only exception is for users with the privilege to view

struck through data, and in this case, the Shared EHR views will include the Entry from the

original Event Summary and display the data with the strike through text effect according to

the following notes:

• The Health Summary Index and Consumer Overview pages will not

include struck through data.

• The Care Plan Index, Care Plan Summary Calendar, Health Summary

detail views, Profile pages, Pathology Index, and Event Index, pages will

include struck through data shown with the strike through text effect.

To strike through an Entry open the Event Summary detail page containing the Entry as

described in Section 4.6.2.



When the Event Summary detail page is viewed with the strike through privileges (ie perform

strike through and view strike through) additional version (replaced/replaces) links and strike

through links are displayed as shown in Figure 76.

Figure 76 - Strike Through Entry Links

The Event Summary Status segment shows the Replaces and Replaced by links.

These links show previous or newer versions of this Event Summary.

Versions are created whenever the content of an Event Summary is changed. For example,

when an Entry is struck through, a new version of the Event Summary is created as discussed

above. When a new version of an Event Summary is created, it is linked to the previous

version. This creates a history of changes for the Event Summary. The Replaces and

Replaced by links allow each version of the history to be displayed.

When the current event has previous versions, clicking the Previous Event Summary

link will display the previous version. When the current event has been superseded by a

newer version, clicking the Next Event Summary will display the newer version. When

a link is not displayed (ie ‘n/a’) then a previous or newer version does not exist.



Each Entry displayed will show a Strike Through entry link (unless the entry is not

eligible for strike through, see the Notes below). To display the Strike Through Entry

Preview page click the associated Strike Through entry link for the Entry that needs to

be struck through. The Strike Through Entry Preview page will be displayed as shown in

Figure 77.

Figure 77 - Strike Through Entry Preview

The details that will be struck through are shown on this page for careful review. The actual

Entry that will be struck though is shown along with the details of the Event Summary it

belongs to.

Enter the reason why this data is being removed from the Shared EHR. This reason is shown

to users with the View Struck Through data privilege when viewing the original version of the

Event Summary as shown in Figure 79.

To strike through the Entry, click the Strike Through button. The confirmation pop-up

message box will be displayed as shown in Figure 78.



Figure 78 - Strike Through Entry Confirmation

Clicking OK will permanently strike through the Entry as Entries cannot be unstruck. The

newly created Event Summary will be displayed showing that the Entry has been removed.

Clicking the Previous Event Summary link, next to the Replaces: label, will display

the original Event Summary showing the Entry with the strike through text effect and the

strike through details including the Strike Through Reason as shown in Figure 79.



Figure 79 - Strike Through Entry – Original Event Summary

The page title and Event Details are shown with the strike through text effect and the

Struck through status value is set to Yes as this entire Event Summary is a superseded

version and has been struck through (ie only the latest version is shown in the Shared EHR

views).

The content of the Event Summary highlights the difference between this version and the next

by just showing the removed Entry (Blood Pressure in this example) with the strike

through text effect.

Clicking the Next Event Summary link, next to the Replaced by: label, will display

the newly created Event Summary that contains the latest version (ie the struck through Entry

is not displayed).

Viewing the Event Index page will also show the Next Event link in the Replaced by

column for Event summaries that have been superseded as shown in Figure 80. The Event

Summary row of the struck through Event Summary will be shown with the strike through

text effect. Clicking the Next Event link will display the newly created Event Summary.



The newly created Event Summary is also shown in the index listing immediately below the

original struck through Event Summary.

Figure 80 – Strike Through Entry - Index Page



Viewing a summary page that supports display of struck through data and contains Blood

Pressure Entries will now show this Entry as struck through. For example, viewing the

Diabetes Profile and selecting Blood Pressure will show the list of blood pressures in the

Shared EHR along with the struck though Entry from the Diabetes Specialist Clinic

Event Summary as shown in Figure 81.

Figure 81 – Struck Through Entry – Profile View

The following notes relate to strike through of an Entry:

• If there is only one Entry in an Event Summary then the entire Event Summary must

be struck through – not just the Entry. In this case the Strike Through entry link

will not be shown against the Entry.

• If the last Entry is struck through in a Section, then the Section will be removed from

the Event Summary as well.

• If the Entry is mandatory then it cannot be struck through and the Strike Through

entry link will not be shown against the Entry.

• If the Entry struck through was contained in the Last Event Summary from a

location on the Consumer’s Care Team, the Last Event Summary link on the

Care Team pages will now be a link to the newly created Event Summary.



6 Printing

Any page displayed in the RecordPoint application is printable. The formatting of the printed

pages is slightly different to what is seen in the browser to better suit the printed format. Use

the Print Preview function of the browser to see the printed format that is applicable for

each page.

Click the Print Preview sub-menu from the File menu in the browser. Print Preview

is useful for selected the most appropriate printing orientation. In some cases landscape may

produce better results. If the orientation cannot be changed directly on the Print Preview

page, then use the Page Setup option.

The header and footer settings can also be checked via Print Preview. By default the

header and footer settings for the browser will output the title of the page, the page numbering

and the date and time printed. The page titles for the Shared EHR pages include the

Consumer’s name, date of birth and Shared EHR identifier which will be printed on every

page. This makes the printed pages suitable for including in paper medical records. If the

header and footer settings are not correct they can be changed with the Page Setup sub-

menu option under the File menu in the browser (this option is also generally available on the

Print Preview page).

The browser Print function is used to print the pages. This is generally invoked by pressing

CTRL+PCTRL+PCTRL+PCTRL+P or clicking the Print sub-menu from the File menu in the browser.



A sample print preview, for a Diabetes Specialist Clinic Event Summary, is shown in Figure

82.

Figure 82 - Sample Print Preview



7 Shared EHR Evaluation

Evaluation questions on the system are provided for user feedback. The evaluation page is

automatically displayed when the user closes a Shared EHR.

Figure 83- Shared EHR Evaluation on Close

The evaluation questions can be changed to suit the community using the system. The default

questions are shown in Figure 83. After answering the questions, click the Send

Feedback button to save the feedback in the system.

To cancel providing feedback, choose one of the options from the top menu bar, for example

to find another Consumer.



8 Resolving Issues

8.1 Contacting the Help Desk

The Contact details page contains the details for getting help with the system and can be

accessed by clicking on the Contact link located at the top right corner of each page (after

successful log in) as displayed in Figure 84.

Figure 84 - Contact Details Link

8.2 Copyright, Disclaimer and Privacy Notices

To access the Legal Notices page, click on the Legal Notices link located on the bottom

right corner of each page (after successful log in) as displayed in Figure 85.

Figure 85 –Legal Notices Link



8.3 About the System

The About page contains the version of the system. This information is important when

getting help with the system or reporting issues. Click on the About link located on the

bottom right corner of each page (after successful log in) as displayed in Figure 86.

Figure 86 –About Link

8.4 Troubleshooting

This section will be expanded and updated as common issues are experienced by users of the

system. Users should always log out, log back in again, and retry a task as a first checkpoint

before calling the Help Desk.

Problem Resolution

I’m a Provider and I know my User ID and passphrase are correct but I still can’t login

Your Location certificate may have been revoked or incorrectly installed. Contact

Support.

I’m a Provider but can’t find a Consumer for

whom I know I am part of the care team

Check with the Registration Officer that the

Consumer is still participating in the Shared EHR system.

I used the web browser Back button and

now I get a message stating ‘The Page cannot

be displayed’.

The web browser Back button should not be

used as the system state cannot be guaranteed.

This also applies to the mouse right click,

Back and Forward commands. You may

need to log in again.



Annex A - Definitions and Acronyms

A number of terms and abbreviations are used throughout this document which are explained

below.

A.1 Definitions

Term Description

Agent is a person who is not a Consumer, for example Provider or

Registration Officer. By default they are granted privileges

to access the private data of other Consumers and/or Agents.

Consumer is a person who is receiving health care treatment

Event Summary is a set of information related to a single Consumer to be

contributed to their shared EHR as a logical unit. A logical

unit is usually related to a single healthcare event, but may

also be a history.

Health Summaries are collections of data taken from a single Consumer’s

Shared EHR that are related to a single topic or subject.

Location is an identifiable entity that has been issued with a Location

certificate. A Location is typically only related to a single

administrative entity, such as a general practice, a clinic or a

cell within a large hospital.

Organisation is an Organisational entity participating in the Shared EHR

community. Organisations can be large complex entities

with sub-groups such as the local Health Authority or a

hospital, or a smaller simple entity such as a GP clinic. An

Organisation may have one or more Locations.

Shared EHR is an EHR that is Consumer centric and available and

suitable for contribution by all the Providers that provide

care to a Consumer, regardless of which organisation they

work for or where they are located.

Provider is a person involved in the provision of health care to a

Consumer, and usually has some specialised healthcare

knowledge.

Location

Certificate

is a certificate issued by a PKI authority that verifies and

authenticates the validity of a location involved in an

internet transaction.

A.2 Acronyms

Acronym Expansion

EHR Electronic Health Record

GP General Practitioner

PKI Public Key Infrastructure



Annex B - Default Roles and Submit Privileges

Please note: This table reflects default system configuration. The actual roles are

expected to be different for each Shared EHR community.

B.1 Access Privileges

The default system roles and a summary of their access privileges are shown in the following

table. This configuration is maintained by the System Administrator.

Role Description View Demo-

graphics

Maintain

Demo-

graphics

View

Shared

EHR

Maintain

Shared

EHR

Diabetes

Educator

All Consumer

only

Care

Team

Care Team

Dietition All Consumer

only

Care

Team

Care Team

Endocrinologist All Consumer

only

Care

Team

Care Team

Evaluation

Officer

Can view all data

to validate data

quality

All

(including

non-

participating)

N/A All

(including

struck

through)

N/A

General

Practitioner

All Consumer

only

Care

Team

Care Team

Health Care

Administrator

All N/A Care

Team

N/A

Health Care

Professional

Generic role used

if the required

role is not

available

All N/A Care

Team

N/A

Hospital Doctor All Consumer

only

Care

Team

Care Team

Nephrologist All Consumer

only

Care

Team

Care Team

Nurse All Consumer

only

Care

Team

Care Team

Ophthalmologist All Consumer

only

Care

Team

Care Team

Pathologist All Consumer

only

Care

Team

Care Team

Podiatrist All Consumer

only

Care

Team

Care Team

Psychiatrist All Consumer

only

Care

Team

Care Team

Radiologist All Consumer

only

Care

Team

Care Team



Record Manager Can view all

clinical data for

correction and

issue resolution

purposes

All

(including

non-

participating)

N/A All

(including

struck

through)

All

Social Worker All Consumer

only

Care

Team

Care Team

System

Administrator

Can also access

and modify

system

configuration

data

All All N/A N/A

Registration

Officer

Manages

participation and

consent.

All All N/A Background

Health

History

Vascular

Surgeon

All Consumer

only

Care

Team

Care Team

Note:

• Cells containing ’Care Team’ represent that the role has the privilege to access a

function but only on Shared EHRs where the Care Team permits them access.



B.2 Event Summary Submit Privileges

The default Event Summary submit privileges (for the default Event Summaries) are shown in

the following table. This configuration is maintained by the System Administrator.

Event Summary Roles authorised to submit

Document • General Practitioner

• Nurse

Over 75 Health Assessment • General Practitioner

• Nurse

Consumer Background Event

Summary • Registration Officer

• Nurse

• Dietitian

• Diabetes Educator

• Podiatrist

• General Practitioner

• Endocrinologist

• Ophthalmologist

• Registration Officer

• Hospital Doctor

Diabetes Educator Event Summary


Diabetes Specialist Clinic Event

Summary • Endocrinologist

• Hospital Doctor

Dietitian Event Summary • Dietitian

Discharge Event Summary • Hospital Doctor


GP Event Summary • General Practitioner

GP Management Plan • General Practitioner

• Nurse

Initial Health Summary • General Practitioner

• Hospital Doctor

Nephrologist Event Summary • Nephrologist

Ophthalmologist Event

Summary • Ophthalmologist



Pathology Event Summary • General Practitioner

• Hospital Doctor

• Endocrinologist

Podiatrist Event Summary • Podiatrist

Pregnancy Assessment • Hospital Doctor


• Nurse

Provider Specific Care Plan • Nurse

• Dietitian


• Podiatrist


• Endocrinologist

• Ophthalmologist

• Hospital Doctor

Team Care Arrangement • General Practitioner

• Nurse

Vascular Surgeon Event

Summary • Vascular Surgeon

RecordPoint Shared Electronic Health Record System ... · PDF fileRecordPoint Clinical User Guide V2.03 Confidential Page 1 1 Overview This user guide is intended to provide the reader

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