PCEHR - Genie Solutions€¦ · 1 PCEHR Genie version 8.3.4 introduces PCEHR ... Double-clicking on any one of these documents will download the document into your Genie data file

August 2013

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PCEHR

PCEHR: Genie Manual

© 2005-2013 Genie Solutions Pty Ltd2

1 PCEHR

Genie version 8.3.4 introduces PCEHR (Personally Controlled eHealth Record) functionality.

Prerequistes for Using the PCEHR

To use this feature, your practice must be issued with an Organisational Healthcare Provider Identifier (HPI-O),which you get by registering with the HI Service.

For all the details, please go to Medicare’s main website for HI Services (www.medicareaustralia.gov.au/provider/health-identifier/index.jsp).

Medicare also provides an Introduction and Overview flyer.

STEP 1Select individuals in your practice to be the Responsible Officer (RO), and Organisation Maintenance Officer(OMO). For more information about this see the Medicare document on Responsible Officer's.

STEP 2Register your practice, RO and OMO with the Medicare HI Services. This will also update your current PKIcertificate to work with the HI Service. Medicare provide this application form.

STEP 3Submit Authorised Employee details for staff, other than those with an individual Healthcare Provider Identifier (HPI-I), who will access the HI service. You can download the Application form and Online User Guide from Medicare'sForms page.

STEP 4HPI-Is are issued by AHPRA, and would have been included in the last registration letter sent to each doctor.Alternatively, you can:

Login to your account on AHPRA’s website: www.ahpra.gov.au

Call Medicare on 1300 361 457

STEP 5Ensure HIC online has been installed on ALL computers you intend to use with the PCEHR. It is likely that allreception machines already have HIC online installed, but doctors' machines may not. To install HIC online, gointo Special > Software Updates, tick the checkbox next to HIC online and press Install 1 Item.

Once you have fulfilled these prerequisites, you can continue on to PCEHR Setup.

1.1 PCEHR Setup

Setting Up Genie

Before starting the set up, it is important to familiarise yourself with the key terms used in this section.

Definitions of Key Terms

Individual Healthcare Identifier (IHI) Allocated to all individuals enrolled in theMedicare program or those who are issued witha Department of Veterans' Affairs (DVA)treatment card and others who seek healthcarein Australia.

Healthcare Provider Identifier - Individual (HPI-I) Allocated to healthcare providers involved inproviding patient care.

http://www.medicareaustralia.gov.au/provider/health-identifier/index.jsp

http://www.medicareaustralia.gov.au/provider/health-identifier/index.jsp

PCEHR: PCEHR SetupGenie Manual

© 2005-2013 Genie Solutions Pty Ltd 3

Healthcare Provider Identifier - Organisation (HPI-O) Allocated to organisations that deliverhealthcare (such as hospitals and medicalpractices).Your healthcare identifier has beencreated to be used by healthcare providers toimprove the security and efficient managementof your personal health information.

Record Access Consent Code (RAC) Individuals are able to nominate a passphraseto prevent healthcare providers andorganisations from adding themselves to theaccess list without this code.

Limited Document Access Code (LDAC) Individuals are also able to set up a moreexclusive LDAC code to prevent retrieval oflimited access clinical documents. You do nothave to have a RAC code to have an LDACcode.

To be able to download a patient's PCEHR, you must ensure you have completed the setup process inthe EXACT ORDER it is outlined in this section. Failure to complete a step, or completing a step out ofsequence, will result in error messages that prevent you from completing the process.

Step 1 - PSI Store Record

Ensure your PKI certificate and the sub-certificate provided by Medicare has been imported for your practice. Firstly, go into File > Maintenance & Reports and click on the Administrator tab. In here, click on the HICOnline PSI Store button and double-click on your GEN number in the resulting window. In this record, click onthe Import P12 File button and then browse to the file Medicare has supplied and press OK. When returned tothe previous window, press Save and close the Maintenance & Reports window.

Step 2 - Practice Preferences

To access your Practice Preferences, go into File > Practice Preferences and double-click on the clinic name.

In the Practice Details tab, ensure the practice HPI-O has been entered and verified.

If you do not type this identifier correctly, you will receive an error message.

Note: The algorithm that verifies this identifier is the same algorithm NeHTA uses to assign thesenumbers; if Genie says this identifier is incorrect, it is definitely incorrect.

Once you have the correct HPI-O entered, you can activate PCEHR functionality for the practice in the Clinical



tab. This can be done by ticking Activate for this Practice and selecting the correct certificate from the CertificateUsed drop-down.

Remaining in the Clinical tab, ensure the same PKI certificate you imported in Step 1 has been selected.

Note: This certificate should be named general.(your HPI-O number).id.electronichealth.net.au.

Step 3 - User Preferences

To access a user's User Preferences, go into File > All User Preferences and double-click on their name.

In here, enter and verify the user's HPI-I.

If you are unsure of the user's HPI-I, you are able to do a search by pressing the Surgeons button next to the HPI-I field.

Remaining in the Details tab, tick Activate for this User tickbox, and leave Check automatically when opening aPatient's Clinical Record ticked.

Note: Do not tick Activate Debug Logging unless you are instructed to by a Genie support member.

Step 4 - PCEHR Diagnosis

Once you have completed steps 1 to 3, you are ready to test your PCEHR setup. You can test this in User

Preferences by pressing the Info button in the Details tab, or in Practice Preferences by pressing the samebutton in the Clinical tab.

When you press this button, you will be presented with the PCEHR Diagnosis window. Ideally, all of these lineswill be displayed in green text as below.



If any of these lines are displayed in red text, re-read steps 1 to 3 to identify any mistakes.

Note: The User Preferences lines are for the current user. If you are a receptionist setting this up for thedoctor, you may find that this is listed in red when you have already entered the HPI-I successfully; youcan safely ignore this warning. If you would like to ensure you have set this up correctly, access thisdiagnostic window through the doctor's User Preferences not Practice Preferences.

Step 5 - Patient Demographics

Once the practice and its providers have been set up, you can start retrieving patient IHI numbers. This process isdone on a patient by patient basis.

To access the patient's demographics window, highlight them in the Appointment Book (or Patient List) and click

on the Edit patient icon .

In here, enter the patient's IHI number or press Get IHI.

Choosing to search for the IHI will bring up the window below, which will default on an ID number search.



This allows you to perform the IHI search with the patient's details and either their DVA, Medicare, or even their IHInumber if they are able to provide it to you.

If you wish to search on address rather than an ID number, select the Address radio button to view the windowbelow.

This allows you to perform the IHI search with the patient's details and either their street, postal or internationaladdress.

Once you have selected your search method and entered any relevant details, press the Search button to searchfor the patient's IHI.

If the search is successful, you will be returned to the Patient Demographics window, and the IHI number will bepopulated in this window.

You are now ready to access this patient's PCEHR.

If the search is not successful, please review the information you have provided in the search with the patient.

1.2 Using the PCEHR

Accessing a Patient's PCEHR

The patient's PCEHR is accessed through their Clinical Window. Once you have successfully completed the setup, a colour coded box will appear in the top right corner of this window.

(White)

If Check automatically when opening a patient's Clinical Record is ticked in UserPreferences, white means that Genie is still querying the Medicare server; thechecking process can take up to 20 seconds.If Check Automatically is unticked in User Preferences, Medicare will not bequeried automatically. To force a query upon opening the Clinical Window, clickon the white box.

PCEHR: Using the PCEHRGenie Manual


(Black)

The patient’s IHI number needs to be entered in the Patient Demographicswindow, or it needs to be validated by Medicare in this window. Hover yourmouse over this box for more information.

(Red)

The patient’s PCEHR does not exist or is not publicly advertised by Medicare. Itis still possible to try to gain access to this PCEHR normally.

(Orange)

A PCEHR has been found for this patient but the current user does not haveaccess to it yet. To access this record, follow the steps in the section below.

(Green)

The patient’s PCEHR is ready to be accessed. The record has been found andthe current user has been granted access.

If the box is orange or red, you must perform a further step to gain access to the PCEHR.

Without Code:If the Patient’s PCEHR is advertised Without Code, simply clicking on the PCEHR box will grant you access tothe PCEHR. The Background colour of the box should then change to green.

With RAC or LDAC Code:If the Patient’s PCEHR is advertised with a Code, simply clicking on the PCEHR box will prompt the user for thecode and try to gain access to the PCEHR Record using this code. If the process is successful, theBackground colour of the box should then change to green.If the Patient’s PCEHR is not advertised with a Code, it is still possible to try to gain access to it by right-clicking on the PCEHR box and selecting the “Gain Access with a Code” button.

Note: Even though you already have access to the patient PCEHR, some documents may be hidden bythe patient. Gaining access again using a specific code provided by the patient will make thesedocuments visible for the provider.

Emergency Access:It is possible to gain Emergency Access to a patient PCEHR, overriding all the codes set by the patient by right-clicking on the PCEHR Box and selecting the 'Emergency Access' Option.

Once this box is green, you are able to access the PCEHR tab in the patient's Clinical Window.

The PCEHR Tab

The PCEHR tab contains all of the patient's electronic health information.



To view all documents for this patient, click on the List Documents button. This will display all of this patient'sdocuments available to you.

Double-clicking on any one of these documents will download the document into your Genie data file. When youdo this, you may find that some of the information in the CDA document conflicts with the information you alreadyhave stored in Genie.



The two columns of radio buttons allow you to choose which information you would like to keep. If you select anyradio buttons in the CDA column, you will overwrite your Genie information with the information in the CDAdocument upon pressing Confirm.

You will then be presented with the CDA document.



This document's format is standardised, and cannot be modified by users. If you wish to print this document, pressthe Print button at the bottom of this window. The Update Stylesheet button can also be pressed under Geniesupport's instruction, or if you find that the CDA document is not displaying correctly. Once you have finishedviewing this document, press the Save button to download the file and return to the PCEHR tab.

This file is now stored in your database in the Main tab of the patient's Clinical Window in the contacts list. It willalso now have a Yes in the Downloaded column of the document list in the PCEHR tab.

If you are having trouble locating the document you would like to download, you are able to use filters to make yoursearch more simple.

Once you have put the relevant filters on, press the List Documents button to limit your document list todocuments that fit your criteria.



In addition to downloading and viewing, you have several other ways to interact with documents in the PCEHR.

This button performs the same action as double-clicking. It allows you to view and then save the document.

This button allows you to see the history of the document you have highlighted.

This button allows you to remove this document from the patient's PCEHR. Before deleting the document,you will have to download it and save a local copy. This is to make sure that you are aware of the content ofthe document you are trying to delete.Note: This will only work if it is a document that you created, you will receive an error message ifyou try to delete another provider's document.

Allows you to create a document for this patient's PCEHR.

Adding to the PCEHR

Before adding to the patient's PCEHR record, you must obtain verbal consent from the patient. Once you haveobtained consent, please tick the Consent Recorded checkbox in the bottom right of the Clinical Window.

To add to this patient's PCEHR, press the Create and upload button . You will then be presented with thewindow below.

When you do this, you may receive a prompt stating that you are missing information from your PatientDemographics window.

Return to the Patient Demographic window and ensure you are not missing any of the following:Full address (including country)Date of BirthMedicare NumberMedicare Expiry NumberPatient IHI Number

Note: This alert window will only display one piece of the missing information at a time. It is a goodidea to return to the Patient Demographic window and check all of these details before returning to thiswindow to proceed.



Once you have updated the missing information, you will be able to create either an Event Summary or a SharedHealth Summary.

Event SummaryIf you choose to create an Event Summary, you will be presented with the window below.

To include any of the displayed information in the Event Summary, tick the relevant checkbox.

New Diagnoses Imports selected Current Problems, Date of onset, and anythingentered in the Current Problems Notes field.

New Procedures Imports selected Procedure name, Date, ICD10/ICPC code.

New Allergies Discovered Imports selected allergy names and a Snomed code (if it exists).

New Vaccines Administered Imports selected Vaccination name, Date, and a Snomed code (ifit exists).

Pathology Results to Include Imports selected pathology results.

Radiology Results to Include Imports selected radiology results.

In addition to this information, you can also add a file from your hard drive by clicking on Select File.... If youselect the wrong file, you can remove it again by highlighting it in the list and pressing the Garbage bin button.

Pressing OK will display your Event Summary in CDA format. This allows you to see it as it will look once it isuploaded.



In this window, you will be able to see all the information you selected in the previous window. You will also beable to see any attachments you have added in this window as a blue hyperlink. If you do not see the bluehyperlink, the attachment was not added successfully.

Once you are happy with this document, press the Send button. This document will now be uploaded and appearin the list along with the other PCEHR documents.

Shared Health SummaryIf you choose to create a Shared Health Summary, you will be presented with the window below.

This will result in an almost identical window to the Event Summary, however, you do not specify the informationincluded, Genie simply selects all relevant data on the patient. This function is generally intended to be used by



GPs. There is only ever to be one current Shared Health Summary for a patient.

After clicking the Send button, it is necessary to attest that you are a nominated healthcare provider for thepatient and attest to the contents of the document.

Superseding/Updating a Document

It is possible to supersede (upload a new version) of a document you have previously uploaded. Before supersedingthe document, you will have to download it and save a local copy. This is to make sure that you are aware of thecontent of the document you are trying to replace.

To supersede a document, right-click on it in the document list and select the Supersede option.

Once you have superseded this document, it should be displayed in the list with an updated Creation Date.

Viewing the History of a Document

To view the history of a document, click on the Magnifying glass button . This will allow you to see a list ofall the previous versions of this document if they exist.This can be also done in the Clinical Window's Contact List by right-clicking on a document and selecting the History on PCEHR option.

Audit View

Clicking on the Audit View button in the PCEHR tab will display the PCEHR Audit View. In thisview, you are able to select From and To dates and click on Access History.

This allows you to check who accessed and what happened on this patient PCEHR during a selected period.

If you have any queries about the PCEHR area of Genie, please contact Genie support.

PCEHR: Assisted RegistrationGenie Manual


1.3 Assisted Registration

Prerequisites

To utilise the PCEHR (Personally Controlled E-Health Record) and its assisted registration, you must follow the

PCEHR setup process in the PCEHR Setup chapter.

Assisted registration

Upon going into a patient’s clinical file, go into Tools > Register for a PCEHR. Genie will perform a check to

validate the patient’s IHI number. You will then be presented with the following window, click Next.

When presented with the following window, ensure the patient details are correct and click Next.

Select the appropriate Evidence of Identity option, and click on the IVC Correspondence drop-down to select the



relevant option.

Enter the Consent Status of each option in the details section, using the drop-downs. You can also use the

buttons located at the top of the screen to apply Consent Given for all options, or Consent not Given for all

options.

Press Next to continue.

Follow the relevant instructions outlined in the Consent Form window below.



Ensure that the patient accepts the terms and conditions and tick the appropriate checkbox, then click on Submit

.

Your patient is now registered to the PCEHR service.

For more information on the PCEHR service, please see our PCEHR training videos on the Genie website.

1.4 Using the NPDR

The National Prescribe and Dispense Repository (NPDR) allows providers and pharmacists to create a medicationhistory for patients with a PCEHR.

Prerequisites

The following criteria must be met to add information to the NPDR:

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PCEHR: Using the NPDRGenie Manual


The practice and provider have completed all steps required to store their HPI-I number. Please refer to the PCEHR Prerequisites and PCEHR Setup sections for further information.The practice and provider must be registered and setup for eRx. Please refer to the Electronic Transfer ofPrescriptions section of User Preferences for further information.The patient must have applied for a PCEHR record.The patient's demographic window must contain all the valid information required for retrieval of their IHI number:

o Full address (including country)o Date of Birtho Medicare Numbero Medicare Expiry Numbero Patient IHI Number

The patient must have given consent for each individual medication to be uploaded to the NPDR.The provider must have the Retrieve Medicare Overview when opening PCEHR Tab preference ticked in File >User Preferences.

Setting up the NPDR

Highlight the patient in the Appointment Book (or Patient List) and enter the Clinical Window. In this window, verifythe patient's PCEHR status by clicking on the PCEHR Exists button toward the top right of the window .

If verification is successful, you will receive a prompt stating that you now have access to the patient's PCEHRrecord.

Provided you have fulfilled all the prerequisites above, you will notice a new column has been added to yourprescription list.

After you have verified the patient's PCEHR, the default value of the NPDR checkbox will be true (checkbox ticked)if the PCEHR exists.

If the patient does have a PCEHR, the prescription will be sent to the NPDR by default.

If the patient does not have a PCEHR, or it is not advertised, the default consent will be false (checkbox unticked)and the prescription will not be sent to the NPDR. The default value will be used whenever a new medication isadded to the prescription list.



Note: Every time the PCEHR check is made, the default value will be applied to any listed medications ifthey have not yet been printed.

After the PCEHR check has been made, the NPDR column will no longer be greyed-out, regardless of the resultreturned. The checkboxes in the NPDR column can now be manually checked/unchecked, as instructed by thepatient. For example, they may remove consent for any items they don't want sent to the NPDR. They can giveconsent for an item even if it Genie indicates that they do not have a PCEHR.

A mixture of consent values can be set for a prescription with multiple items; the medications do not have to all betrue, or all be false.

Note: The consent value is only relevant when the medication is printed. Changing the value afterprinting does not affect that script.

Consent for Information Sent to a PCEHR

The default within the National Prescription and Dispense Repository is that the patient provides standing consent for both the prescribing and dispensing records to be sent to their PCEHR. The patientmay however request for an item or all items on the script to not be sent to their record.

It is the responsibility of the doctor to comply with the patient's request.

The consent for the prescribe record is initiated once the PCEHR is verified. This consent can bechanged by following the Adding to the NPDR instructions below.

Adding to the NPDR

After following the setup procedure, you can add prescriptions to the NPDR by following these steps.

1. Click on the Blue plus button above the prescription list and add your prescription(s) as normal.2. Untick the NPDR checkbox in the NPDR column beside any prescriptions the patient does not wanted added to

the PCEHR (if applicable).

3. Press the Printer button to print the prescription(s) and transmit to eRx and the NPDR. After confirmingyour print settings, you will receive an alert.

4. Once this prescription has been sent to eRx, eRx will forward the prescription to the PCEHR. No further actionis required.

Prescriptions and Dispense View (NPDR Documents Only)

Click on the PCEHR tab to enter the patient's PCEHR. If you do not automatically see the PCEHR Views headingin this window, click on the NPDR button at the bottom of your window.

In the PCEHR Views area, change the View Type to Prescription & Dispense and enter in a date range.



With this information entered, click on Get View to retrieve the patient's NPDR records. A message will appear inthe viewing pane.

Once the information has been successfully retrieved, you will see the patient's NPDR records in CDA format.

Hovering over a prescription will highlight it in red, and clicking on the prescription will expand to display all records(within the selected date range) for that prescription.

Documents List View (All PCEHR Records)

Click on the PCEHR tab to enter the patient's PCEHR. If you do not automatically see the Document List headingin this window, click on the Basic View button at the bottom of your window.

In the Document List area, leave all checkboxes blank and enter in a date range.



With this information entered, click on List Documents to retrieve the patient's PCEHR records. You will now bepresented with a list of all PCEHR documents, including your Prescribing and Dispensing entries from the NPDR.

If you would like to download a local copy of any of these records, you can do so by highlighting the record and

clicking on the Download and View button . You many be presented with a confirmation prompt if you havedifferent demographic details to the file you have highlighted. It is up to you to decide whether you would like toretain your own information or accept the changes.



Once you have decided which changes to keep, if any, click on Confirm to view the CDA document.

Press Print if you would like a paper copy of the document. This will open the document in your web browser,allowing you to right-click on the document and proceed with printing.

You can then save the document by pressing the Save button at the bottom of the window.

Viewing Downloaded Documents



Once you have downloaded a local copy of a PCEHR document, you are able to view it in the contacts list of theClinical Window by clicking on the Documents tab.

You will be presented with a list of all PCEHR documents, and any other documents you have saved in Genie.Documents that have been downloaded from the PCEHR will have PCEHR in the Origin column.

Highlighting any of these documents will display a preview of the CDA document in the preview pane.