“eHealth is the electronic collection, management, use, storage and sharing of healthcare information. This information can include individual items such as test results, discharge summaries, vaccination history, medication history and diagnoses to comprehensive medical records which keep all of this information about a person in one place.” National E-Health Transition Authority1

Currently, the most important developments in the national eHealth record system are moves towards:

  • A personally controlled electronic health record (PCEHR) for every person in Australia;
  • A unique identifying number for
    • every citizen of Australia – the Individual Health Identifier (IHI )
    • every health provider – the Health Provider Identifier – Individual (HPI-I)
    • every healthcare organisation – the Health Provider Identifier – Organisation (HPI-O)
  • Software that can guarantee secure messaging and communication between providers, and ultimately, computer software and hardware that will enable a web-based national network to effect communication across health providers in Australia.

In practice, for example, this will mean that when a person walks into a GP's surgery, while on holiday in Cairns, Queensland, that GP would be able to access (with the person's permission) a summary of their history, medication and test results from their current GP in Shepparton, Victoria. In addition, if necessary, the GP could access the discharge summary from a hospital accident and emergency centre in Sydney, New South Wales, some recent pathology results from the patient obtained while passing through Brisbane, Queensland, and a summary of recent treatment by a psychologist in Bendigo, Victoria. All of this would be dependent on the consent of the client and transmitted via a secure messaging system.

For psychologists, the major aspects of the eHealth record system that are likely to be of both relevance and interest are the PCEHR, measures to protect patient privacy and establish consent, electronic claiming from funders (like private health insurers and Medicare), and systems for transmitting and receiving referrals and reports securely.

Elements of the national eHealth record system are still being developed, but over the next five years these major changes will gradually reform the way psychologists provide services to clients in the health domain.

1 NEHTA (2009) NEHTA Strategic Plan 2009/10, 2011/12. Retrieved from http://www.nehta.gov.au/component/docman/doc_download/840-nehta-strategic-plan-2009-2012.

Personally controlled electronic health record (PCEHR)

This is one of the major features of the eHealth record system. The PCEHR or ‘eHealth record’ is a secure, electronic record that uses an indexing system to provide access to parts of a consumer’s medical history from a number of sources that could be viewed in one place by the consumer and their approved health practitioners. It is termed ‘personally controlled’ because, in addition to the consumer being able to access their own record online, they have power of consent over additions and updates to their healthcare record, as well as who can view the information that has been recorded. There will even be a section where they can record their own information.

The PCEHR has the following components:

  • The Consolidated View
  • The Shared Health Summary
  • The Event Summary
  • The Specialist Letter
  • The Consumer Entered Health Summary or Notes

Foundations for the PCEHR

Before the PCEHR can be fully implemented, a number of foundation elements must first be in place across Australia’s health system. Put simply, eHealth foundations allow a system to be developed where consumers and healthcare providers can be accurately identified, where a variety of computer systems can communicate with each other, where information is exchanged securely, and where use of standardised terms and systems allow senders and receivers to be sure they are interpreting information in the same way.

There are four eHealth foundations:

  1. Healthcare Identifiers including:
    • Individual Healthcare Identifiers (IHIs)
    • Healthcare Provider Identifier - Individual (HPI-I)
    • Healthcare Provider Identifier - Organisation (HPI-O)
  2. Authentication of users
  3. Standardised terminology and clinical terms
  4. Secure message delivery.

Future capabilities of the eHealth record system

eHealth solutions are systems, processes or procedures that take advantage of eHealth foundations to produce faster, more effective results for both practitioners and consumers.

A typical solution will seek to replace manual, paper-based processes with electronic processes. Standard mail will be replaced by secure messaging, and couriers will be replaced by central online systems to deliver health information such as medical images, referrals and prescriptions.

More eHealth solutions will emerge throughout the coming years, as technology improves and foundational elements are implemented nation-wide. Most eHealth solutions are still in the conceptual phase and there will be a staged release of these capabilities after July 1 2012.

Some capabilities that are currently being developed are:

  • eDiagnostic Imaging
  • eMedication Management
  • eDischarge summaries
  • ePathology
  • eReferrals