Interfacing to the PCEHR from Best Practice Setting up Before you can access the PCEHR, there are a number of steps that have to be set up. First, you must have the Medicare HI Service set up and functioning. See the document Medicare Australia Health Identifiers in Best Practice for details on setting up this service. Installing certificates To access the PCEHR, you need to install the practice s NASH certificate. This should have been obtained from Medicare Australia. To install it in Best Practice, from the main menu, open Setup- >Configuration. Click on the Install PCEHR certificate button at the bottom of the opening page. You will be prompted for the location of the certificate. Navigate to it and double click on the certificate file. You will then be prompted to enter the password that was provided by Medicare Australia along with the certificate. A message will be displayed indicating whether the certificate has been successfully installed or not.
Entering Health Identifiers Access to the PCEHR requires that both the Practice s HPI-O and the accessing provider s HPI-I have been entered. To access a patient s PCEHR record, the patient s IHI must have been entered. It must be an Active and Verified IHI. If these conditions are not met, a warning will be displayed when an attempt is made to use any of the PCEHR functions. Practice The practice s HPI-O is entered via the Setup/Practice details menu item. On the Practice details window, click the Change button to open the window shown below. Enter the 16 digit HPI-O number as shown below. This number will be validated before it can be saved. Provider Each provider s HPI-I identifier can be entered via the Setup/Users menu item. After opening the list of providers, double click on each provider to edit their details in the window shown below. The 16 digit HPI-I is entered into the Health Identifier field and is validated before saving.
Patient The patient s Individual Health Identifier (IHI) is entered via the patient demographic details window. This can be opened from a number of places, including the View/Patient menu item, the Open patient window and from within the patient s clinical record by double-clicking in the demographic area at the top of the screen. Within the Demographic details window, the Health Identifier field is at the top right. If an internet connection is available, a Lookup button will be available adjacent to the Health Identifier field. If the patient has their surname, date of birth, sex and Medicare number entered, this button can be used to obtain the IHI from the Medicare HI Service. If the patient knows their IHI, it can be manually entered. In this case, when the Save button is pressed, the Medicare HI Service will be contacted to validate the IHI that has been entered. Only valid IHIs will be saved. When the IHI is looked up or validated, its status is also checked. Only verified IHIs will be stored by Best Practice.
PCEHR If the prerequisites of a HPI-O, HPI-I and an IHI have been met and an internet connection is available, A PCEHR menu item and a PCEHR button will be present in the patient s clinical record window. If the patient has not had an IHI entered, neither of these will be present. The border of the PCEHR button will vary in colour depending on whether the patient is known to have a PCEHR or not. If the patient s PCEHR has never been accessed, it will be orange. If it has been successfully accessed through Best Practice in the past, it will be green, as in the images below.
Regardless of the PCEHR button s border colour, clicking it will attempt to access that patient s PCEHR and retrieve the list of available documents for that patient. This is the same function that is performed if the PCEHR/Document list menu item is selected, or if the Ctrl-F9 hot key combination is used. If the patient s PCEHR exists and they have given open access to the practice s doctors, the document list will be downloaded. If the patient has opted to require a password for access to their PCEHR, then a window will be displayed prompting for the password to be entered. If the PCEHR is successfully accessed, this is recorded in the patient s record and the PCEHR button s border will be coloured green from then on. The downloaded document list is displayed in the PCEHR Document List window, shown below.
Individual documents can be displayed by double clicking on the document on the list, or by highlighting the document and clicking the Open button. PCEHR documents can be downloaded and stored into the local patient record by clicking the Store button. The document list can be filtered using the drop down list at the top of the window so that only documents of a specific type, e.g. Shared Health Summary, are displayed. Some PCEHR documents can be updated by their author. It is possible to see the revision history of a document by clicking the History button. Shared Health Summary Best Practice can produce a Shared Health Summary that can be uploaded to the PCEHR for a patient. It can include lists of current medications, adverse drug reactions, past medical history and immunisations. To create and upload a Shared Health Summary when in the patient s clinical record, select the PCEHR/Shared Health Summary menu item, or use the Shift-F9 hot key combination. The Shared Health Summary window displays 4 list boxes containing the patient s current long term medications, allergies and adverse drug reactions, medical history items and immunisations.
Immediately above each list box is a button. When these buttons are pressed, the Shared Health summary window is minimised and the relevant page of the patient s clinical record is opened. Here adjustments can be made to the record before returning to the Shared Health Summary window by clicking on its icon in the Windows taskbar. Clicking the Refresh button will update the Shared Health Summary window with any changes that were made in the clinical record. Before uploading to the PCEHR, the Shared health Summary can be reviewed and the check boxes adjacent to the items in the list boxes can be used to include and exclude specific items from the summary that will be generated for upload. The Past history list box initially displays all history items that have had the Include in summaries checkbox checked when they were originally saved, but were not marked as Confidential. Two checkboxes below the Past history list box allow the excluded items to be added to the list. An additional Send to PCEHR checkbox has been added to the Past History entry window. Unchecking this option can be used to prevent entries from being included in the list box at all. Marking an entry in this way removes the need to remember to specifically exclude it every time that a Shared Health Summary is generated. Once the Shared Health Summary has been generated, it can be uploaded to the PCEHR by using the Send button. When this is pressed, a CDA document is generated and displayed in a viewer exactly as it will be sent to the PCEHR.
It is a requirement of the PCEHR that the provider who is uploading a Shared Health Summary attests to the accuracy of the data and that they are a nominated HealthCare Provider for the patient as defined by the Personally Controlled Electronic Health Records Act 2012. It is the authoring provider s responsibility to verify the accuracy of the data contained in this document and by pressing the Upload button, they are formally attesting to the following statement that is printed in bold, red characters at the bottom of this screen: By uploading this Shared Health Summary, I attest that this data is correct and accurate and I acknowledge that I am a Nominated HealthCare Provider for this patient as defined by the Personally Controlled Electronic Health Records Act 2012. A record of this attestation is recorded into the log file when the Upload button is pressed and the CDA document will then be signed and transmitted to the PCEHR. If the author is unable to attest to this statement, the Cancel button can be pressed and the window will be closed without sending anything to the PCEHR. Uploaded documents A copy of every document uploaded to the PCEHR is kept within the patient s record. The list of these documents can be seen by selecting the PCEHR/Uploaded documents menu item. The list that is displayed includes the date of upload, type of document and the name of the author. The documents can be opened and viewed by double-clicking on them in the list, or by highlighting the document and clicking the Open button. Documents that have been uploaded can be removed from the PCEHR by the document s author by highlighting the document and pressing the Remove button. The list can be filtered by document type using the drop-down list at the top of the window. A checkbox on this window allows documents that have been removed to be included in the display.