Concept of Operations: Relating to the introduction of a Personally Controlled Electronic Health Record System
2.3 Vision and concept
The national PCEHR System aims to place the individual at the centre of their own healthcare by enabling access to important pieces of health information when and where it is needed by individuals and their healthcare providers.
Individuals will be able to choose whether or not to have a PCEHR, and if they choose to participate, they will be able to set their own access controls. Using the PCEHR System, individuals will be able to access their own healthcare information and allow their healthcare providers to access and use this information to provide more coordinated and effective care for the individual.
Individuals will have greater involvement in their care through increased access to their information and other resources and will not be required to remember all the details of their previous healthcare.
Figure 4: PCEHR System concept
In order to deliver this vision, the PCEHR System will provide:
- Secure access for individuals and their healthcare providers to their eHealth records via a range of access channels.
- A national set of services that will allow streamlined access to eHealth records, drawn from multiple repositories, such as:
- A Shared Health Summary including allergies and adverse reactions, medicines, medical history and immunisations.
- Clinical documents such as Discharge Summaries, Event Summaries, and over time, other documents (e.g. Pathology Result Reports, Specialist Letters, etc.).
- Governance, legislation and oversight to ensure trust and confidence in the PCEHR System.
- The national specifications, standards, planning and core national infrastructure required to use the PCEHR System.
Key design features of the PCEHR System are explained below.
|The PCEHR System|
|is||opt in – if an individual or healthcare provider wants to participate, they need to register with the system.||and not||compulsory – both individuals and healthcare providers choose whether or not to participate.|
|is||an enhancement to medical treatment – the PCEHR System will allow an individual’s health information to be shared as and when needed to support the best possible care.||and not||a requirement for medical treatment – if a person does not wish to participate in the PCEHR System, they will continue to be able to access treatment and Medicare benefits.|
|is||a source of selected clinical data and documents – in addition to a Shared Health Summary in each PCEHR (which contains basic health data about an individual), clinical documents may be added to that individual’s PCEHR.||and not||a replacement for normal sharing of information between an individual and their healthcare provider – as currently occurs in medical practice, existing medical records are used as the starting point for the discussion about the individual’s health, rather than as the complete and authoritative source of current information.|
|is||an information system – where participating healthcare providers can access additional selected clinical documents during a consultation with an individual.||and not||a communication system – where participating healthcare providers are expected to review any new clinical documents loaded into a PCEHR in between consultations with the individual.|
|is||aligned with current privacy obligations – healthcare providers will have the same responsibilities in relation to privacy of information in PCEHRs as they currently do in relation to clinical information from other sources.||and not||immune to current sharing and reporting rights and obligations of providers – healthcare providers currently have rights and obligations in relation to disclosure of health information which will continue. These include the ability to access health information in life-threatening situations and the obligation to notify instances of certain diseases to government authorities.|
|is||a distributed system of service providers working in concert – government and private sector organisations will work together to deliver the PCEHR System to individuals and healthcare providers. The PCEHR System will be underpinned by a legislative framework intended to impose appropriate controls and standards on all the system participants.||and not||a single government store of personal information – while public sector bodies may provide some of the repositories which hold information for the PCEHR System, other private sector organisations may also participate as repositories where they meet relevant specifications and standards.|
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