Webinar: My Health Record in Pharmacy

HEATHER: Hello, everybody.
My name is Heather McDonald. Welcome to this webinar
that we’re presenting on behalf of the Digital
Health Agency. We’re very lucky tonight.
We’ve got Dr Shane Jackson who is the PSA
National President as well as being
a Clinical Reference Lead for the agency. Assisting Shane will be
Danny Angola who is one of our
education team members and he’s also a pharmacist,
so between the two of them they will be presenting tonight. There will be an
opportunity for you to ask questions
during the process so just type your question in and we’ll take the questions either as we go through
or at the end there will be
an opportunity for questions. First of all, I would like
before I hand over to Shane to just do an
acknowledgment to country. I acknowledge the traditional
owners of the land on which we are meeting. I pay my respect to their
elders past and present and extend that
respect to other Aboriginal
and Torres Strait Islander people and elders
from other communities who may be here today. Welcome everybody. Shane, I’ll hand over to you
to commence the presentation. SHANE: Thank you
very much, Heather. It’s an absolute pleasure
to be here on this webinar talking about
My Health Record in Pharmacy. I’ve done a number
of these presentations and so has Danny talking
about the opportunities and the role that pharmacy
can play in My Health Record. We’ll through that
in a series of slides that we’ve got tonight. As Heather noted before, there
is the opportunity for questions so you can put questions to us
and we’ll endeavour to try and get to some of those
through the presentation and, if we don’t,
we’ll certainly try and get to those at the end before the 8 o’clock
finish time. As with any of these
accredited education sessions there are some
learning objectives and I’ll just run
through those one by one at this point in time, so at the end of this webinar
you should be able to list the features and benefits
of the My Health Record system in pharmacy practice. Secondly, you should be able
to describe how to communicate the benefits of the My
Health Record system to patients and actually the benefits
of the My Health Record system for patients because they are quite
significant, describe the privacy and security measures taken
to protect My Health Records and how to discuss
those privacy concerns with patients if they have any. I think this is where the
opportunities for pharmacies to look at where there’s more
comprehensive health information which you can access
via My Health Record and how that can contribute and really can
optimise patient care. I think pharmacy really has
fairly gold standard for how the health
professional groups can interact with
the My Health Record. I think it’s been really good to
see from the profession’s point of view three major organisations
in pharmacy, the Society of Hospital
Pharmacists of Australia, the Pharmacy Guild. You see David Quilty,
the Executive Director from the Pharmacy Guild
and Tim Kelsey, the CEO from the Australian
Digital Health Agency in that photo, also the Pharmaceutical
Society of Australia of which I’m the
National President. Really those organisations have,
like I said, set a gold standard of how to interact
with the agency and they’ve also provided
great leadership I think for the pharmacy
profession in guiding the way that pharmacists can interact
with the My Health Record and how they can provide more
effective and efficient care. I’ll use that term “effective
and efficient care” probably in a number of slides. When I do it for the first time I’ll explain in detail
what I mean by that. Some of you might be able
to give your responses to this, so some things to think about
and happy for you to respond but I would like you
to give us some idea of who has a My Health Record, what dispensing software you use and whether you’re already connected to
the My Health Record. You might be able to do that
in one message, so a yes or a no
for My Health Record whether you have one personally, what software you use
within your pharmacies and whether your pharmacies are registered to
the My Health Record. That will just give us
some overview of how some of you
are progressing and also what we need
to cover off in this webinar. I’d actually like you
to give a third answer to this question as well. If you can read that,
put in your answers. I’ll pause in telling you
what it is. This what digital technologies
can help us overcome. The issue is like medication
errors through transcription or poor writing. It allows us to use
digital technologies to overcome some
of these issues. Digital technology just isn’t
about having a record that is accessible by others, it’s about using safe
methods of communication, secure messaging
so that we don’t necessarily have to use a fax
machine in the future. It’s about making sure
that we have an efficient and effective
health care system. Helen Bean if you’re on line
and Peter, well done. It is Coumadin 4mg. Nowadays we don’t see a lot
of handwritten prescriptions but we still see enough for it to be an issue and again
digital technologies help us potentially overcome
issues like this in health care which can contribute
to significant misadventure. What can digital health do
and some of you have heard my presentations in the past, I say this all the time, we have significant issues from
medication errors or medication misadventure in this country,
230,000 hospital admissions costing 1.2 billion
dollars per annum. Those hospital admissions
they’re the tip of iceberg type of medication
related problems. Those 230,000 hospital
admissions don’t include the presentations
to general practice, the presentation to
a community pharmacy because of again other
medication related problems, so again the tip of iceberg. The cost to our health care
system is probably greater, in fact is probably
well in excess of the 1.2 billion dollars, but that’s what we’re able
to account for from the 230,000 hospital
admissions each year. That’s why we need
a better system for being able to improve
medicines management but trying to be able
to improve health care generally in this
country as well. Why else should we have
digital health technologies is because we actually have
a lot of duplication in the services that
are provided to patients. 17% of pathology and radiology
tests are actually duplicated, so that costs
our health care system a significant amount of money through those
duplications in tests. About 20% of medical errors are due to incomplete
patient information. Nurses’ time a lot is spent on
basic administration paper work and we know that a lot
of pharmacists’ time, especially in the community
pharmacy setting, can also be spent
on basic administration in claiming when
we should be more focused and more able to spend those
times on clinical activity. We also have a lot of data
being created. More data has been created
in the past two years than in the entire previous
history of the human race. We see a lot of data
being created and it’s estimated that by 2020 about 1.7 megabytes
of new information will be created every second for everybody
on the face of the earth, so it’s quite significant. Why else do we need
digital health is because we actually
need digital health to improve the significant
issues we have with health care in Australia. The health landscape
in Australia as you can see here is that chronic diseases are
the leading cause of illness, disability and death and account
for about 90% of all deaths, the major contributors
being things like cardiovascular diseases. We also have an impending crisis
with the number of people who are overweight or obese and the number
of Australian children, about one in four children
who are overweight or obese. We have about a million people
with diagnosed diabetes and a good rule of thumb here
is one for one, so for every person
who is diagnosed with diabetes there’s probably
another person has diabetes who isn’t diagnosed. We also have about 40%
of Australians who are aged over 45 years who have two or more of the
eight major chronic conditions, so we have significant levels
of chronic disease and, as most of you know
being pharmacists, with chronic disease comes
a number of medications that are used to manage
those chronic diseases and as you increase
the number of medications that are used you
have increased susceptibility to drug interactions, drugs interacting with the
person’s comorbidities etc. Why else do we need a national
My Health Record system? It’s because a lot of people
with chronic disease visit a number of
different specialists, a number of different
health care providers and often information
might just be kept by those health care providers. So, it doesn’t assist patients
if we don’t have a national My Health Record system to transition between those
different care settings if there isn’t a system whereby significant information can be available for the people who are
delivering care to patients. Every year Australians have
about 22 interactions with the health care system, four visits to a GP,
three visits to a specialist, around about 14 visits
to a community pharmacy. We see from that perspective
community pharmacy as a significant health
care contributor. We also see that one in eight
people have missing information being obtained by their
health care providers and with that missing
information increases the risk of medication
misadventure and also just health care
misadventure in general. The Australian Digital
Health Agency is a joint funding between the Commonwealth
and all the States through the Council
of Australian Governments and it’s designed to operate the
national digital health services and set data standards
which ultimately give consumers more control
of their health care, so the My Health Record system is under control
of the individual. It is also there to connect
and empower health care professionals so that we make sure
that we communicate in the best ways possible and that we make sure that
we have information available to health care providers to deliver effective
and efficient patient care and also to make sure that
Australia is a global leader in digital health
and innovation. The agency is the system
operator for the My Health Record system and a number of other
clinical information systems and standards and commenced
operations in July 2016 and transitioned from
the National eHealth Transition Authority which was responsible
for a large number of those types of activities prior to the agency
being established. What is the
My Health Record system? I’m just going to run
through these components. It’s a summary of an
individual’s key health information. It’s not a complete record
of every single activity or intervention that’s delivered by every
health care professional in the care of a person. What it is though it’s a summary
of significant events, say for example
if you go to a hospital or if a patient
goes to a hospital and they’re discharged then we would
expect a discharge summary, which again is a summary
of the intervention that occurred in hospital, to be uploaded to the person’s
My Health Record system. Again from a pharmacy
perspective, dispense records are uploaded
to the My Health Record as a summary of that medicine that was supplied
to the patient, so it’s a summary record comprising the individual’s
key health information. It’s part of a national system. We will be going to opt-out which means that
unless an individual, a resident of Australia opts out of being allocated
a My Health Record we will have a high proportion
of individuals with a My Health Record meaning that we will have a very
large scale national system that allows that information
to essentially travel with them and be accessible by people involved in the treatment
of that patient. This is a really key point,
it is personally controlled. The patient, the individual
has a say in what gets uploaded, has control over
what gets uploaded, what stays in their record
and who can see their record. So, the patient can set
access controls so that only individuals that they give an access code to
can see their My Health Record. They can set access for people who are just involved
in their care. They can say what gets uploaded
to the My Health Record and what is visible
in their My Health Record, so it is personally controlled. It’s accessible at all times
mainly at the point of care for individuals. For example,
in an emergency department you can see the information that is available
in the My Health Record which again might deliver
safer care to patients. It’s protected. The security mechanisms are
protected in legislation, the consent is protected
in legislation and incorporates bank
strength security mechanisms to make sure that
the My Health Record system is a secure system. This is really
the important point for health care practitioners and I’m going
to concentrate on this mainly from a pharmacy
perspective. What you see here
on the top line are who can contribute
to the My Health Record system. It’s health care practitioners
and health care entities that are delivering
care to the patient, entities like general practice, hospitals,
specialists, pathology and diagnostic imaging, allied health care providers,
pharmacy and aged care. They can all contribute, they can also view
the My Health Record but they contribute information
to the My Health Record system. What you see here on the bottom
line is what those individuals can contribute to the
My Health Record system. You can see here you start off
with shared health summary. A shared health summary is like
a medical summary provided by general practice that can be
useful for other health care providers in understanding
the medical conditions and the allergies and the vaccination
status of that person that they might
be delivering care to. The shared health summary
contains a list of medical conditions
of the individual. It also contains
a list of the medicines that the GP thinks that the patient is taking
at that point in time, contains allergies and contains
vaccination status as well. You can think a shared health
summary might be really useful if you’re in
a community pharmacy and you might sit down to do
a meds check with a patient. If you have that verifiable
clinical information about the chronic conditions
of that individual, that really might be
quite useful from an effectiveness
point of view so you can tailor
your intervention to make sure you get
the biggest bang for buck from a service delivery
point of view, but it’s also efficient
because you have that verifiable clinical information readily available to you. It can also contain
event summaries. I’ll come back
to event summaries because event summaries are a catch-all
essentially for information that’s not captured as part
of discharge summaries, specialist letters, pathology, dispense records or prescription
records or e-referrals. You can provide an event summary
if you want to provide that information
to the person’s My Health Record because you and the patient
believe that information or that intervention
that you delivered might be useful
for somebody else. One of the key components
to the My Health Record that’s going to be
really valuable from a pharmacy point of view is discharge summaries. I think we’ve all had
circumstances potentially in our pharmacies where somebody is discharged
from a hospital on a Friday afternoon. They’re not quite sure
what’s happened in hospital, they’re not quite sure of what
medicines they’re meant to take now that
they’ve been discharged, you might be providing them
with a dose administration aid. Now wouldn’t it be useful if you
could go into the person’s My Health Record
and see that discharge summary which clearly outlines
what occurred in hospital, what the diagnosis was,
what the interventions were and what the follow-up
needs to be and what the discharge
medicines are. You can really again deliver more effective
and efficient care if you have those
discharge summaries. Specialist letters,
they can be provided to the My Health Record system
as well from a specialist. Again one of the most
valuable components I think we’re going
to see in the future is pathology information. You might be concerned of
an elderly patient’s renal function, you might be able to check
just to verify your concerns or in fact confirm that you
think the dose is appropriate for that person’s level
of renal function, so pathology information is going to be
really valuable and again it’s going to be
valuable for people doing potentially home
medication reviews or residential medication
management reviews as well. What we also see is prescription
and dispense records within the
My Health Record system. This is where pharmacies’
contribution, so not pharmacies using
the My Health Record or viewing
the My Health Record system, but pharmacies
dispensing records going to the
My Health Record system is so valuable for other
health care providers, valuable for the GP because they can see what
the person has had dispensed, valuable for
the hospital pharmacist when they’re trying to do
a medicines reconciliation, valuable for the emergency
department clinicians when they’re trying to see
what was dispensed, whether there was
any new medicines. So, those dispense records are
our contribution in the care of that individual
to the My Health Record system. The other thing is eReferrals,
so you can provide an eReferral. This is from
a general practitioner to the My Health Record
system as well. The My Health Record system is
definitely not meant to replace direct communication
with a health care provider. It’s meant to be
a repository of sorts for significant
or key information which may be useful
for other health care providers in the delivery of patient care. What other type of information? We’ve just talked broadly
in that slide before and talked about the
information from providers. I’ll also talk about some of
the administrative information, the Medicare information,
the first being Medicare claims. Medicare claims are provided
to the My Health Record system and PBS information, so your PBS dispense records go to the My Health Record
system as well, organ donor decisions and also
immunisations through the AIR provided to the
My Health Record system. Also an individual, so the
patient or the consumer can provide information to
the My Health Record system, so they can upload
event care plans, their advance care custodians
can do that as well. They can upload their personal
health summary information which pharmacists can view
and their other health care providers can view,
personal health notes and also emergency
contact details. There’s a question from Olivia. She said, “Are the discharge summaries
likely to be uploaded?” Just in response
to that question Olivia, I can talk about the experience that I have in Tasmania
where I’m based. All of the three major
hospitals in Tasmania are automatically uploading
discharge summaries on discharge for the patients. We know that some hospitals vary
when discharge summaries can be completed but some hospitals
certainly are when patients are being discharged
uploading them automatically. There’s a number
of circumstances where they can be really useful at that point of care. I’m just going to talk about
some of the digital health foundations. For some of you
who are registered for the My Health Record you will be familiar
with some of these things and for others
you might be less familiar but I’ll just run through them. I’ll start off on the
left-hand side here. Every AHPRA registered
health care professional has what we call and HPI-I, a health care provider
identifier for the individual. That’s so the
My Health Record system can track who interacts with the
My Health Record system. So, if you view a record
or you upload a record we know where that comes from. On the right-hand we’ve got
who received the service, so every individual patient has what we call
an individual health care identifier or an IHI, so that individual health care identifier
allows us to make sure that we match the service
with the right person so that we’re not
getting records that are going to the
wrong person’s My Health Record, so the individual health
care identifier is important. The other thing that’s important
is just at the bottom here, the HPI-O which is
the health care provider identifier for the organisation. That’s so we know
who provided the service, who received the service but also where the service
was provided from. I’m going to hand
over to Danny now. Danny is just going to take us
through a few slides just to talk about privacy and security of
the My Health Record system. Can I hand over to you, Danny? DANNY: Thanks very much, Shane,
and good evening everyone. Thanks for attending
on a Monday evening. Just a quick question we have
from Vee, the question is, “For the individual
is it an opt-in or an opt-out system
for the My Health Record?” Vee, at the moment
the system is opt-in but, as we will discuss later
in the webinar, the expansion of the My Health
Record will lead to opt-out. Shane will discuss that
in a little bit more detail. One of the main questions
that we do get asked, and I believe one of
the main questions our patients will ask us
in the pharmacy, is around the privacy and security
of the My Health Record system. As you can see
from this diagram, the security of the system
is quite multi-faceted. Firstly, all of those
previous identifiers that Shane mentioned on the previous slide
are 16 digits long. What this means is that the
encryption behind the system is extremely strong,
not only that, but the My Health Record
has its own cyber security team which looks for any signs
of security tampering. An example of this could be
a user logging in from overseas, a user logging in
from multiple devices and those types of instances. The system also has
strong firewalls as well as secure login
and authentication mechanisms, so for anyone who has used MyGov
before or any banking type apps know they will have
to add an SMS code for entry. As Shane mentioned earlier,
the patient is also able to add control access pin codes to their whole record or to specific documents for
that extra bit of peace of mind. Lastly, the patient can also
view access logs or audit logs which list all the organisations
that have accessed their record and the documents
that they viewed. Let’s have a little bit
of a look at the consent associated with the system. If a patient is under your care, a provider such as us
as pharmacists, he’s authorised both by law and through the standing
consent of registration to view a person’s
My Health Record and also to upload
clinical documents to that person’s
My Health Record. Therefore, there is
no requirement for us to obtain consent
on each occasion prior to uploading
a clinical document. You can imagine the workflow if
we had to get consent with each and every dispense that we did
for a patient it wouldn’t work so that’s why that
standing consent is there. However, if a patient requests
that a clinical document is not uploaded a provider is
obliged to follow that request. In a pharmacy for example if you’ve already
dispensed the medication and it’s gone up to the
My Health Record you can edit that dispense within
your own dispensing system to take it down. This might happen if the patient
requests that it isn’t uploaded during counselling for example. In some States and Territories
some Category 5 conditions such as those conditions
such as HIV or AIDS require the express or written
consent of the patient, so to see if this relates
to where you practise, in the States and Territories
where you practise, My Health Record guidelines
which were released by the PSA a couple of weeks ago have
a really good reference table and the documents that you can
then search within that table. I highly recommend everyone have
a bit of a look for that one. Also later in the webinar
we will discuss the times when the My Health Record will be beneficial
to reference for pharmacists. One the questions
we do get a lot is around medico-legal
type concerns, so just remember
that all pharmacies and pharmacists
are under existing professional legal obligations to protect their patients’
health information. This is regardless
of their participation in the My Health Record. Just because we might
be able to access more people’s
medical information doesn’t mean we grasp
that opportunity, we’re only legally able to view
a person’s My Health Record if they are in our care and remember patients are able
to see those organisations who have accessed their
information through audit logs. To prevent any of this from
happening there are penalties in place for organisations as well as health care
providers themselves. These penalties range
from $126,000 up to $630,000 for organisations and depending on
the misuse of the system there could possibly be
gaol time as well. The last point around
uploading of information just like our
everyday obligations to dispense accurately, we do need to ensure
to take reasonable steps to upload accurate information to a person’s My Health Record. Just a quick question
here from Kenneth, “Does the system alert the user
or the health care provider if there’s information that the
patient has chosen to withhold?” Kenneth, with regard to that no, it doesn’t actually
have like a blank entry or anything like that in there. If the document is removed
by the patient then it is removed from the My Health Record
both viewable to the patient as well as the health
care provider. Let’s talk about
the My Health Record and its association
with children. From zero to 14 years of age
an authorised representative for that child such as
their parent or legal guardian will have control
of that child’s record. Of course there are exceptions
to this and the agency does have contingency
measures in place for children who could be in a domestic
violence background, from those types of things, so there are measures in place for those exceptions
to that above rule. After 14 years a child
can actually take full control of their record. However, if they choose
not to their authorised rep, so their parent
or legal guardian will manage their record
until they are 18. The important point is
the third point there. If that 14 to 17-year-old doesn’t take control
of their record then no new Medicare
information, so no new MBS or PBS information
will flow to that record. One example I like to give
when I do face to face sessions would be say
a 16-year-old female who has chosen to go
visit her GP to get on the pill and she doesn’t want
her parents to know that she’s taking the pill. From that point there will be
no MBS from the consultation with the GP and there will be no PBS
as long as that script is on the PBS information
going to the My Health Record. I think it’s important then for
the GP to ask that young woman if she would like that
prescription record to go to her My Health Record and then in the pharmacy
I think it would be important for the pharmacist
to recognise that and ask the same thing
for the dispense record. This slide I guess
is more of a summary, but starting from
the left side there, a patient can actually choose
to decline access to specific documents which are in the
My Health Record. They can do this by either
removing certain documents remembering that a patient
can’t actually edit a document or they can also apply
access codes to their whole My Health Record or certain documents
within their record. This means that organisations
who are accessing that person’s record
for the first time would need to enter a pin
to gain access. Just to note that at the moment
there’s only around .2% of individuals with their record who have actually put codes
on their My Health Record. It’s not something you might see
in practice a lot but that percentage
will probably increase when we do the expansion process
or program later on this year. A patient can also be alerted
by SMS or email if a provider uploads
a new clinical document such as a shared health summary
to their My Health Record and they can change these alerts within their personal
My Health Record themselves. Now in emergency, so for those
.2% of patients who have put access codes on
their My Health Record providers do have an opportunity to use
what’s called the “break glass” ability of the My Health Record to access that patient’s
My Health Record. It’s unlikely to really
occur in a pharmacy unless you have a patient
unconscious or something like that within your store but most likely used within
the emergency departments or especially in the future
when we get paramedics on board with the system I believe
they will be using the system or the emergency access
a little bit more often. Lastly, all instances of access
to a My Health Record are logged and can be monitored. Just a quick question
there from Peter, “How about private scripts,
can they be uploaded as well or just PBS?” Private scripts can be uploaded
to a person’s My Health Record. There’s a number of ways
that that can happen. It can happen through a
prescription record from the GP and also when we dispense
private scripts through our dispensing software that will also be uploaded
to the My Health Record as a dispense record. There will just be no PBS
information for that script because it is a private script. The last one I’d like to discuss
before passing back to Shane is the use of apps. There are a number of apps
available for use with the My Health Record
system at the moment. With such a high percentage
of people using a Smartphone, even the growing population
of older Australians, it allows easy access
to your own My Health Record especially at that point of care if that provider doesn’t have
their own access to the system. What we can see with these
screenshots supplied here it just shows how clear and easily laid out
the information is to view and how much of a time
saver it could be. What I’ll do is
I’ll just pass on to Shane and try and get the frog
out of my throat and continue. SHANE: Thanks, Danny.
There’s a couple of questions. Jenny, I’ll answer your question
a little bit later on. There’s a question by Jeremy
around discharge summaries and will they be uploaded
retrospectively once we go to the opt-out process. They won’t be uploaded
retrospectively. In answer to your other question Jeremy around outpatient
episodes, essentially care needs
to be delivered through a care setting, so if a person
is an out-patient, they’re still associated
with hospital care and they’re still being treated
by a care practitioner, so the consent process
is the same. Most people give,
or the overwhelming majority, give standing consent to access
their My Health Record. What I’ll talk about now briefly
is just the My Health Record opt-out participation trials and, as Danny
just mentioned before, at some stage later this year
at the date to be announced every Australian
will be communicated with and offered to have a My Health
Record allocated to them unless they essentially
opt out of the process. That’s being based on
two large trials that were conducted
in two areas, one in Far North Queensland and the second area being
the Nepean Blue Mountains area. What they found out
through that process is that less than 2% of the
population in those trial areas actually opted out of having
a My Health Record allocated for them. I know a number of pharmacists
who worked in those regions who found the number of people having a My Health Record
in their area being great and immense and when their hospitals were
uploading discharge summaries they knew if their patient
went to hospital they would have
a My Health Record and because their hospital
was uploading discharge summaries that they could go in and they could see
what occurred in hospital and allow them to deliver
effective patient care. Those two trials have
really set the scene for the opt-out program that
will happen later this year. Just to reiterate
a couple of key points, it is about setting
the foundations for the future and making sure that the information
that health care providers need about patients
is available to them to deliver high level care, that it’s safe and secure. As Danny outlined in one of
those previous slides, it certainly is a safe
and secure mechanism but also not only
with safety and security you need to make sure that the patients have control
of their health care. It is a personally controlled
electronic health record and that people can opt out
should they choose to. There’s been significant
investment made to ensure that everyone has
a My Health Record unless they choose not to.
They can opt out. That opt-out model
will be rolled and dates will be available with regards to
the communication that will occur with the
My Health Record system. There’s a question that’s
come through from Vee around dispensing
software capability. We’ll answer that
question pretty soon that we want
to increase pathology and diagnostic imaging reports because we saw that 17%
of pathology and diagnostic imaging
reports are duplicated. We also need to make sure
that medicines reconciliation, that medicines
information and accuracy of somebody’s medication record is available to all people with relevance
in the person’s care. This is quite positive to see. Whilst we’re going to
an opt-out system we actually have quite
a significant amount of people who already have
a My Health Record. We nearly have
six million patients who have a My Health Record and quite a large number
across population groups and large numbers across
different States as well. When I go down
to the blue section which is the health care
providers registered, we see that there’s a large
number of general practices, we see that there’s probably
a little bit over maybe approaching 30%
of community pharmacies, we see a small number
of private hospitals and that answers
one of the questions that was given before
around private hospitals. We see that there are
private hospitals registered with
the My Health Record so they would be able
to provide information and to access
the My Health Record, only a small number
of aged care services, smallish number of pathology
services, but that’s increasing as well. I want to take you over
to the green section here which is the information
that’s in the My Health Record. From a pharmacy perspective this is where we have
great opportunity to utilise the information that’s in the My Health Record
for better care. I think a lot of us
in community pharmacy, and I say this a lot, we often
work in an information vacuum. All you have available to you
perhaps is the information that the patient provides
you which sometimes may or may not be accurate based on what they perhaps
know about their health and the person’s
dispensing history and those two pieces of
information combined together isn’t a complete
overview of the person. What we actually have here is
the opportunity to have more information which allows us to be more
efficient in the information gathering component
of what we do so history taking, things like that, but it
allows us to be more effective, so instead of second guessing
sometimes what might be going on with a person’s care we
actually know what’s happening. You will have
discharge summaries. Again if I go back
to the meds check example around a shared health summary, having those listed,
verifiable chronic conditions, allows you to deliver
better care to the patient. I think what that also
enables us to do is to deliver the services that will take pharmacy
into the future, so expanded services that
deliver care to the patients and have pharmacy taking
more responsibility and accountability
for patient care. I often think about,
and some of you may know, but some of the work
that is being done in Canada by pharmacists
where they’re able to modify prescription doses and things like that I think
what this provides us with is an opportunity to understand
more about patients and be able to deliver more
accountable and effective care for the patients that we’re
seeing in our pharmacies. As I’ve talked about before,
this really is about us using the information to be able
to deliver the services that we do within
the pharmacy setting. We’ve got meds check services,
diabetes meds check, HMR. What that enables us to have
is to have more information to deliver those
services effectively. It also allows us when
we’re helping our dose administration aid patients who might come in
and out of hospital like I said to have access
to discharge summaries. We also might have
more information about their OTC medicines. If we’ve got patients
who come to the pharmacy who might be from other areas we can see what they might
have had or understand what might be going on
with their care, coordinate the care for people
with chronic conditions and also see patients’
immunisation status. That’s also important when
we’re providing our immunisation records to the Australian
Immunisation Register but also the ability
to be able to see whether vaccinations
are necessary or not. These are a couple of examples
of shared health summaries. You can see here
on the left-hand side this is an example
of a shared health summary. It shows you the adverse
reactions of the individual, so you can make sure
if necessary that that information
is within your system. You can see the medications
that are provided or that the GP believes
that the person is taking and also their medical history. There have been a couple
of questions that I’ve noticed
around the extra time. Nobody is suggesting that
a My Health Record system needs to be accessed every time
that a care consultation or a prescription is being provided within a community
pharmacy setting. This is just another
additional information source that might be useful to you in delivering services
to that person. Nobody is saying that that needs
to be accessed every time you dispense a medicine and I certainly
wouldn’t be suggesting that that needs to be done. It’s just another information
source that is available to you. Again, if you had somebody
who came in to your pharmacy who had been discharged
from hospital understanding what happened
in hospital would save you, and I can say this has certainly
happened to me in my pharmacy, saved me certainly a little bit
of angst down the track in knowing what’s happened
within the hospital setting. I’m just going to hand
back to Danny because Danny is going to talk
about the registration process within the pharmacy and also
talk about some of the software. I know there have been
a couple of questions asked about software. DANNY: Thanks very much, Shane. We also had a couple
of questions around how a pharmacy is going
to be reimbursed or compensated
for the extra time with the registration
of the system etc. Unfortunately there
are no intentions for reimbursements for pharmacy. We have however as
I will soon show, streamlined the
registration process and we also do have the PHN so that your local
primary health network is also there
to support pharmacists with the registration process as well as with
the training of your staff. There’s another question
around should we dispense over the counter medications
for our patients. I think it would be a good idea
for our DAA patients, that’s just an everyday patient
who comes into our store, I don’t think it’s necessary,
but what you can do is recommend that they put that information
into their My Health Record themselves through
their personal health summary. Moving forward,
as Shane mentioned, we’ll start talking about
the registration process and obviously we need
to register our pharmacies for access to the
My Health Record. First of all, I just wanted
to have a bit of side note around some of the work
that the agency is doing. We are involved with a number
of the big banner groups around Australia to help facilitate
the registration process and we do this through
their head office. For some of you who are under
Terry White, Chemmart or a Chemist Warehouse
for example we have started
this process already. You may have been
delivered a PDF with pre-filled information
within your inbox and hopefully signed it
and sent it back. We’ve also started initial
conversations with API and Sigma Healthcare group too. As the last point says though,
this does not preclude you from registering yourself
in the meantime. As we’ll see in this next slide
with the registration form it is extremely streamlined and
can be filled in very quickly. I had a session in Perth
not too long ago and by the end we were able
to get everyone signed up which was nice and quick. As of a couple of months ago this is the new streamlined
registration form and it is specific to pharmacy. Although there was
no intention we did ensure that the registration
process would not take long. This form was introduced
after working collaboratively with the Department
of Human Services and the editable PDF version can be found on our
digital health website. For those who remember
the old of PCHR days of 2012 might still have nightmares
around the registration process because admittedly it was large and there were probably around
30 pages of documents that needed to be filled in. This document is pretty much
what you see on the screen. It’s one and a half pages long
and generally the information that’s required is readily available
for the pharmacist owner or the pharmacist manager
who’s filling the document in. There’s one field
that may cause an issue and that’s the second field. You may not be able to see it
clearly on your screen. That’s the Medicare PKI
certificate RA number. What this number is is
it’s associated with the security system. It’s the security certificate
between your pharmacy and the Medicare
online claiming. So, how do we find this number?
I’ll go through a step which is on the next slide
to discuss that. There is just a note
and this goes once again back to the earlier
days of the PCHR. For those pharmacists who are
using Fred Dispense or Aquarius we recommend, you do need
to sign up to the health care provider directory
or the PHD. This used to be –
I remember doing it, it was a four page form
that we needed to fill in. These days it’s that
simple phone number and follow the prompts for each pharmacist
within your store to verify their gender details and then to sign themselves up to the health care
provider directory. You need to sign up because
when you do validate yourself within your dispensing software,
in Fred and Aquarius software, you do need to find
your name within that HPD. How to find our RA number,
there is a number of ways. I’m not sure if you have seen
that disc on the left there. For some, so for those
who are organised amongst us it will be in the safe, for others it will probably
in the back of a long-forgotten drawer and then for others it still
might be in CD drive because we don’t really
use CDs any more. As we can see the RA number
is found on the Medicare PKI disc itself. It’s also found on the letter
that that disc came in. Because this number is
publicly available there is a site which is Certificates
Australia website can also be used
to find that RA number but if you do have difficulty
you can contact us at the agency or even contact your local PHN
and we’ll assist you further. Just looking at some time frames
around the registration process the duration side
it’s actually a lot less than that for a lot
of those fields. I’ll discuss that
when I get to them. As you can see with that
registration form, the streamlined form, it’s really not going to
take that long to fill in. It’s things you know already
like your approval number, ABN, those types of things, so it will take generally
around 10 to 15 minutes maximum
to fill in. When it comes to
the registration form as well I just wanted
to take a note. We’ll go through conformant
software in a second but even if your software
is not yet conformant we do recommend using this form and to register
as soon as possible. By the end of June
there could be a change with the registration process and that form could be replaced. We’re really unsure
if that process will be a bit more
difficult in future, so we do definitely recommend
that people do use this form while we have the
opportunity to do it. Once that form has been sent to
the Department of Human Services as we can see unfortunately there is a wait
of around six weeks for the issuance
of the NASH certificate. That’s something that we do
not have control of from the agency perspective. What that NASH certificate
will do will be the security certificate between your pharmacy
and the My Health Record system. Yes, it does take a long time,
say six weeks, but looking at it from a glass
half full sort of perspective it does provide you
the opportunity to conduct staff training as well as update
pharmacy policies and procedures etc. The third step which I mentioned
on the previous slide is the Fred and Aquarius users or pharmacists to contact HPD to sign up to that directory. It will generally take
a few minutes to do and if you do call the number, there’s a few
pharmacists present you can always just
hand over the phone to each pharmacist
if they’re in the store. After you’ve received your NASH
certificate you do need to contact your software vendor
to set it up for configuration. I believe I’ve written 30
to 45 minutes on the slide. It generally doesn’t
take that long. It will take 10 to 15 minutes
and that’s all you’d need to do. That’s that part. The next two involve the
training and education of staff. As I’ve said, this is something
you can do in between the sending
in of your registration form and the issuance
of the certificate. It could be
a simple staff meeting. PHNs have offered their
assistance for staff training but also the Digital
Health Agency has a number of modules
on our website which are CPD accredited
to pharmacists but they’re suitable for all
pharmacy staff to complete. Also the PSA and
the Pharmacy Guild will or have already released
CPD accredited modules too. The last point around
pharmacy policies there is a new
security access policy which the PSA has released
around the My Health Record and I’ll discuss
that in a second. The question around
locum pharmacists, with locum pharmacists
if you’re using say Minfos software you
just need to validate your HPI-I within the Minfos
software itself and that’s just a simple task
of hitting a validate button. If you’ve put your name
in the system and you’ve got your
PHA number in there it will just be a simple
matter of validating. If you’re using Fred and you’ve
already signed up for the HPD you can search for your name
through the Fred software as well but you’ll need to ensure
that the locum pharmacist has signed up
for the HPD previously. How far back is the history
of a patient being recorded? There’s a couple of facets
to that question Suzanne. The first is that
any clinical documents such as uploaded by a GP or a pharmacist that will start
as soon as the person has registered
for the My Health Record. It starts roughly like
a new bank account. It starts off with zero. However, when people at
the moment who are registering for the My Health Record they do have the opportunity
to include up to two years
of Medicare information, so there will be up to two years
of MBS or PBS information being added already to
their My Health Record. Looking at it from a team
approach I just wanted to spend a little bit of time
on this slide just to discuss a couple
of important roles that a pharmacist who is using
the My Health Record system would need to delegate. The first in the top middle
there is the RO or the Responsible Officer and 100% of the time I would recommend
the pharmacy owner who is known to Medicare
to always be the RO. That’s because you want your RO as a stable person
within that pharmacy. A pharmacist or a pharmacist
manager they can always pack up and leave in which case
you would need to change the RO. Pharmacists or pharmacist
managers would be perfect for what’s called the OMO or the Organisational
Maintenance Officer. It could be, as I mentioned,
pharmacist managers or pharmacists. I believe it’s important
to delegate a number of OMOs within your pharmacy to ensure that there’s an OMO
or an RO present at all times. This is because the system
operator can only and will only talk
to an RO or an OMO with regards
to the My Health Record system within your pharmacy. Lastly just a quick point
talking about the bottom fields. Just on the right we can see
that there’s the pharmacist, and the pharmacist because
we’re AHPRA registered, we do have a HPI-I
and we are able to view and upload to a person’s
My Health Record. Unfortunately, dispensary
technicians who are sometimes doing all the dispensing are unable to as they do
not have that HPI-I number. However, what you can do
within your pharmacy is provide them with viewing capabilities to assist the pharmacist
in the dispensing process. This would obviously need to be
reflected within the security and access policy which
I’ll discuss in the next slide. This policy with
the assistance of the PSA was released a couple
of months ago and it is found on the PSA’s
Digital Health Hub. There’s a lot of really good
resources and information on that hub including
the My Health Record guidelines which I mentioned earlier. As stated, under the My Health
Record rules all HPI-Is, all organisations
need to develop and maintain a security
and access policy. What we’ve done here is ensured
that there’s an easy document for pharmacists to fill in. It’s a matter of simply
assigning roles and responsibilities surrounding the My Health Record
system within this policy document itself
within the template. Within that which you can’t
quite clearly see there are a number
of explanatory notes provided just to ensure that you can accurately
fill in the information. The patients’ demographics
and linking patients’ identifiers with
the My Health Record system, for your dispensing
software to link or to validate a patient’s IHI you do need five key fields
or pieces of information. Firstly, you’ve got
the Medicare card or DVA card. You also need first
name and surname and then the last two,
date of birth and gender. The first three would be
readily obtained in the pharmacy but to correctly complete
that linking we do require date of birth
and gender to be filled in. It’s obviously something that we
don’t normally do in pharmacy, I’m not sure why but
we’ve never really obtained a person’s date of birth
unless it was on an S8 script or a child’s script or something like that, but it is something
that we do need to do. One way that it’s worked
in some pharmacies could be by including a cardboard note, just like you would have
a note for a fridge or a product in the fridge, you’d put that note within
the patient’s script box and then when that script
goes out you do ensure that that date
of birth is obtained by whoever is taking
the script out. Then it’s updated within
the dispensing system itself. The second step I guess
with regards to making the My Health Record work is our dispensing software so looking at what is conformant or should we be using
the provider portal. I’ll just make a quick note here and I’ll repeat myself
later I’m sure, but with the streamlined
process the way it is, registration process and the fact as we can see
that all major software vendors will be conformant this year, I highly recommend using
that streamlined form rather than registering
for the provider portal and then updating
at a later time. I’ll go through that
a little bit later on. As we can see
on the left-hand side the conformant software
we have Fred and Simple which have been conformant
for a number of years. Minfos, RxOne, Dispense Works as well as Merlin
in the hospital setting and then those in progress. These have all signed
contracts in the process of becoming conformant. Z Dispense will probably
be the next one which will be piloting
in the next month or two. MyScript from Chemist
Warehouse had a schedule so that one will actually be
in the next month or two as well and Corum should be
by September if not sooner. As you can see that’s probably
99.9% of you will be conformant
by September this year. If we take in the six weeks issuance of the NASH
certificate by DHS we do highly recommend you using that streamlined
registration form. What I’ll do is pass
back to Shane to discuss
how the My Health Record is used within certain
dispensing systems. SHANE: Thanks, Danny.
I notice there’s a few questions which unfortunately
it doesn’t look like we’ll probably get time
to address a lot of the questions
that are coming through, but what I would hope
we would do is we’ll collate those questions so for those of you
who have registered we will be able
to provide feedback to those questions
that are coming through. This is what My Health Record
looks like in some of the software that you might see within
the pharmacy setting. As you can see here in
the middle of the page you’ve got the area for an IHI. This is where if you’ve got
the person’s surname, first name, their gender, their Medicare
number and their date of birth you can request – essentially download
the person’s IHI. When you download
that individual’s IHI it means that you can
communicate with the My Health Record system. For those of you who are
familiar with the Fred system you can see
in the back page there – I won’t use the laser pointer because I’m afraid
I’ll draw everywhere – but you can see the fourth icon
from the left is a greyed out
My Health Record symbol. When somebody has got
a My Health Record that illuminates with
a green background. You need those five parameters
that Danny talked about before, the surname, first name,
gender, date of birth and the person’s Medicare number to be able to review
the person’s My Health Record. Just a couple of brief questions
that have come through and I’ll very briefly
answer those. Yes, you can access
the My Health Record if you’re
an accredited pharmacist and you can do that through
the provider portal that Danny will talk about
a little bit later on and yes there are delays
in RPBS and PBS claims. It’s generally about six weeks before they go through
to the My Health Record system. What happens, if you click
on that greyed out button if it was green then
this button comes up and you can press okay to access
the person’s My Health Record. What you can see here is that you can do a search
for information. For example, if somebody again
has been admitted to hospital you might specifically be
looking for a discharge summary. You generally go there if you’re
looking for information because you’re concerned. A couple of questions before
were raised about liability about accessing the person’s
My Health Record so if there was a problem
that you should have detected and you didn’t access
the person’s My Health Record one of the things I’ll say
just read the PSA standards and guidelines on access
to My Health Record. There’s a key component there
on access to the My Health Record’s viewing records
on p.16 of the guidelines. It really does succinctly
outline what you should do and it’s just an extra
information source. You can see that this
is a person, Frank Harding, who actually has
a My Health Record. You can see there that
if you’ve got the information within your dispense system,
the person’s IHI, it will tell you if they’ve got
a My Health Record or not, so you can click on that. You can see information
like prescription and dispense records
and other records like I talked about,
discharge summaries etc. You can view that person’s
discharge summary. You can click on that. You can see the current
medicines on discharge. For those of you who have
or haven’t seen discharge summaries, for those of you
who have you will know that they can be
quite comprehensive. They’ll have medicines
on admission, medicines on discharge, what happened in the hospital
and any follow-up. Some can be briefer and some
mightn’t include necessarily the information that you
might desire but discharge summaries from our hospital
colleagues generally are improving
in quality which is good. I think having access from
a community perspective to these records will shine
a light on those things. This is what the My Health
Record system looks like within Minfos. You can see here that it’s got
the My Health Record icon. It says here that there’s
an active My Health Record. For those that have you can see
on the top line it says the person has an active
My Health Record and on the bottom it says
My Health Record not found. You can see the different
systems access My Health Record differently but essentially they show you
whether the person has got a My Health Record
available for you to access and to access that information
to deliver care. They all have similar
displays like this. You can see what’s called a
prescription and dispense view. The prescribing
and the dispensing is actually collated and expands should you wish it to expand
when you click on the record. You can see here that this is
for an example of Simvastaten, Perindopril and Indapamide as well for the person
that’s listed here. You can see that perhaps that
person is going to another pharmacy and you might need
to monitor adherence or somebody may well be
prescribed a medicine and not have that
medicine dispensed. That prescription dispense view is just one way of
linking up the systems. Again in the Minfos system you
can see here in the third column the document type along
with the dates that are listed in the far
left-hand column, discharge summaries,
event summaries etc. That just again allows you to be
able to easily check for relevant document
types in an accessible way so that you can again check whether there’s any
extra information that you need
to ensure the safety and appropriateness
of the medicines that are being dispensed. Again this is what the shared
health summaries and discharge summaries look like in Minfos, very similar to the display
within the Fred system so that’s useful from
a consistency point of view. This is a really useful
innovation for all health care providers in the management of people
on multiple medicines. The My Health Record a little
while ago had a few updates and incorporated what’s called
this Combined Medicines View. This is really fantastic
in delivering medicines reconciliation services or when you’re trying to do
a home medicines review or a meds check
service for example. What it does is it brings all of
the medicines information available about the person
into one area, so all of the medicines
information that might be in
a discharge summary or a shared health summary
or a prescription record or a dispense record
in the one place and uses a sort of computer
generated sort of algorithm to put everything together. It somewhat does a medicines
reconciliation by the My Health Record system which presents
information to you so that you as their clinician can then ensure that that
information is accurate or not. That Combined Medicines View is
a great innovation in collating all of the medicines information available for that individual. Like I said, if you sit down
to do a meds check within your pharmacy having that information
available to you will allow you to deliver
a really efficient service. The other things that are
within the My Health Record are those PBS records. Sometimes medicines
fall through the gaps, and what I mean by falling
through the gaps, is that there’s some information where somebody
might have a medicine dispensed in the pharmacy
and the pharmacy is not connected
to the My Health Record system, it still means that that PBS
and RPBS information will go to the
My Health Record system but it might be a bit delayed. It’s often delayed
by about four to six weeks, but it’s still within
that environment so that you can still see what medicines that person
is having dispensed. That information is still within
that My Health Record system. On the slide it doesn’t
contain directions because it’s just the PBS record and won’t include S3 items
or private prescriptions. The difference as you
can see here when you look at the
prescription dispense records that the prescription
record says it’s been prescribed and the dispense record
says it’s been dispensed. The advantage is that they’re
linked when you see the record within the
My Health Record system, so you can track the dispensing of an original
prescribed prescription to see whether all of those
medicines have been dispensed at least from a My Health Record
registered pharmacy. I’m just going to hand back
to Danny to briefly talk about the provider portal and then I’ll wrap up
just briefly after him. DANNY: Thanks, Shane.
The next part we will discuss, the provider portal and,
as I mentioned before, with all those software vendors either being conformant
or about to be, we do recommend using that
streamlined registration form. It is a lot easier
in registering for the provider portal which is via the digital
online forms on our website. However, as the earlier
questions sort of asked if you are
an accredited pharmacist and you’re not working within
a pharmacy or a GP clinic and you’re your own
organisation, registering for
the provider portal allows you access
to the My Health Record. That’s why we will sort
of briefly discuss it here. There is a note though. Access via the provider
portal is viewing only so you can’t upload
any documents to the provider portal itself. Just a couple of prerequisites
as listed here, as we can see the first
is the HPI-I. As a pharmacist we already
have that, so that’s a tick. Secondly, by the registration
process via the digital online forms you will be issued
with a NASH certificate. This is a NASH certificate
for an individual. What you’d get by using
the streamlined form would be a NASH certificate
for an organisation. Instead of a disc you will
receive a USB or a smart card as 10 years or so, PRODA. That’s going to be your security
between your organisation, be it just a single
person organisation, and the My Health Record system. Next you would need to ensure
that that HPI-I is linked to the organisation or organisations
using the HPI-O. Just down the bottom
there there is a link on the My Health Record site which does provide some
really good information on how to register for
the provider portal itself. Accessing the system
is via recent versions of most of the most
common website browsers, Internet Explorer,
Google Chrome and Firefox. Then we also have the portal
login there for users. Just like conformant software
we do need those five key fields to validate that patient’s IHI or to access that patient’s
My Health Record. As you can see you can’t see
his first name there because it’s scrolled up
but there’s first name and last name, there’s date of birth,
there’s sex and then there’s the identifier. If you know the patient’s
IHI you can put that in there, otherwise you can put Medicare
card number or the DVA number. As we can see because
it is a web based system it is quite pretty looking, so once we’ve gained access
you can see the provider portal and the navigation panels there
make it quite easy to navigate. If you wanted to see a certain
clinical document it’s a matter of just clicking
on that clinical document and the appropriate tab and then you just click
on the document that you actually
want to look at. The next step is similar to
what Shane was discussing with the medicines preview. Within the provider portal
it’s under medicine record. Otherwise everything else
will be the same. As you can see in the middle
of the screen how it’s using adverse reactions
which is highlighted. Those four tabs there are what’s
called the navigation panel. As Shane mentioned,
just like medicines preview this pulls all
the relevant allergies and adverse reactions
for that patient and this is the example
of the medicines preview within
the provider portal itself. On the left it has
the source document, so you can actually click
on that source document, date which you can filter
if you wanted to or you can put, you know, the medication, then the medicine brand
as well as directions. It’s extremely helpful
when you really want to get that snapshot
of that patient especially if they’re
new to your pharmacy. I won’t go through these
next couple of slides because just like
conformant software the provider portal documents will all look the same, so they’re all called
what’s called a CDA format. It will just ensure that
there is that continuity between the provider portal as
well as any conformant software. What I’ll do is
I’ll pass back to Shane to just discuss
those final steps and then summarise
tonight’s webinar. Thanks, Shane. SHANE: Thanks, Danny. Hopefully you’ve seen from
the information available what we can do from a pharmacy
perspective with access to that information. It really is about
the foundation for us as a profession in delivering
better medication management, leveraging off the digital
health innovations that have been made
available to us, so it’s really for us
as a profession to embrace that and to make sure that we do utilise
the My Health Record system to be able to help us do our job in a way that we can because we have access
to that extra information. It is a safe system
and it’s a secure system. It is a system that
the individual has control of, so they can say
who has access quite rightly and they can say what is
available quite rightly. They can choose to opt out
of the My Health Record system if they desire to do so. Really what we would like you
to do is to register. Those of you who are
in community pharmacy get registered for
the My Health Record. If you’re the manager,
if you’re the owner, if you’re the key decision
maker within your pharmacy, make sure that you talk
to colleagues around how you’re going
to register the pharmacy and make sure that you do that. If you’re an independent
practitioner, so an accredited pharmacist, you can still access
the My Health Record, so you can still go through
the same process to do that, you register for
the provider portal. For those of you
in community pharmacy you ask your software vendors once you receive the appropriate
certificate to assist you with the connectivity
to the My Health Record system. Danny has talked about this,
I’ve talked about this, there’s the PSA
My Health Record guidelines. There’s also policies
and procedures available from the digital
health resource hub and the society that can
help you within your pharmacy. Also make sure that you avail
yourselves of the education that’s available also through
the PSA resource hub. There’s also education available from the Australian
Digital Health Agency which is accredited
that goes through in detail some of those components
that we perhaps haven’t had time
to go through it. The first port of all I would
suggest for anybody who wants to have any
further information is to read the PSA
standards and guidelines and if there are any questions
then you can direct them either to the agency
or through the PSA where we can get some answers or provide some answers
should that be necessary. Like I said, there’s education
and CPD opportunities, there’s face to face
education sessions. The PSA has been doing them,
the Pharmacy Guild, Sigma Hospital pharmacists and also the primary
health networks. The primary health networks,
if you’re trying to register the primary health networks
are your first port of all to be able to assist you in navigating any of
the difficulties that you might come up against from
a registration point of view but also from a use point
of view as well. There’s CPD modules
as I talked about on the digital health website. There’s webinars
that you’ve done. There’s modules also available
from the guild and the society. There’s also some frequently
asked questions specifically for pharmacy
of which I think we can update some of those
frequently asked questions from some of the questions
that have come through tonight as well and communicate
those back to the participants. All those things
are available to answer any of the questions
that you might have. I’m not necessarily going to go
through the case studies. What I’m going to do
is just leave the opportunity in the last five minutes to answer any of the
specific questions that have come through. I don’t know, Danny,
you might be able to answer specifically any of the ones
that you’ve been looking at maybe while
I’ve been wrapping up. We also give the opportunity
in these last five minutes to see if there’s
any additional questions that have come through. It’s over to you Danny first. DANNY: Thanks, Shane. There just were a couple
of questions that came through while you were speaking. Nerida, with
the PBS information yes, the PBS information will go
to a patient’s My Health Record even if they said
that they didn’t want your dispense record to go up. Now what they can do
within their My Health Record is actually turn that off
if they wanted to. They can also remove
that document within their My Health Record too
if they wanted to. We’ve got no control
over the PBS records going up to the
My Health Record, only dispense records
that we’re putting up. Fiona had a question around
registering back in the good old days
of 2012 and 2013. Fiona, what would happen
in your case most likely is that your NASH certificate, so that security certificate would most likely have expired. My recommendation would be
either to contact us at the agency
or contact your PHN and we will put you
in the best way to get that NASH certificate back in order. Therese had a question around
what the My Health Record card looks like. There is no card
per se, Therese. The way that pharmacists
will get a patient’s IHI, so their identifier, will be by validating them
through our systems, our conformant software
or by using the provider portal. That’s why we need
those five key fields to validate that IHI number. Lastly before Shane probably
answers some questions, Olivia asked about when
it’s going to be compulsory for a pharmacy to be registered
and using the My Health Record. Olivia, at the moment
it is an opt in for health care providers
including pharmacy. There is no idea that
that’s going to be changing any time soon, but one thing I do say when I do
these education sessions is that the system
is controlled by the consumer. If you imagine a couple of years
down the track when using My Health Record is the norm a patient is going to be
look at their record and thinking well, I’ve got my GP information
going up to the record, I’ve got this other pharmacy
down the road information going to the record but this pharmacy, my regular
pharmacy, isn’t uploading. It will be a patient push
or your customers will push you to probably register in due course
to the My Health Record, but if you don’t want to at this
stage that’s totally up to you. One example I do have
is a GP conference I went to a few months ago, what happened was this GP he
actually registered his clinic just because his one patient said he had registered for
the My Health Record himself and he wanted his GP
to start uploading information. That’s going to be something
which will happen in the future
in pharmacy too. SHANE: Thanks, Danny. There have been a couple
of questions additionally, is the AHPRA registration
number the HPI-I. When you login, for example, when you login
to the AHPRA website to pay your registration fee you’ll see your HPI-I
at the top of the page that outlines
what your HPI-I actually is. There have been a couple
of comments and I think from an individual there’s perhaps somebody who doesn’t work within
a community pharmacy setting who has
struggled to register. Can I say I think there has
been some recognition that the processing of
applications for the HPI-O for those people
who aren’t necessarily attached to a traditional community
pharmacy hasn’t been ideal. That individual I’ll take to
provide feedback to the agency and get in contact with you
so that that can be improved because we’ve had
a bit of feedback that that hasn’t been ideal. For those of you who are
accredited pharmacists who aren’t attached to
a traditional community pharmacy who have struggled all I can say
is contact the agency help desk. They are trying to address
some of those anomalies with the processing
of those applications. A question here is when
it becomes opt out will patients be signed up
to register for the record. When it becomes opt out
every person will be allocated a record unless they opt out and there will be
a number of accessible ways that patients will be
able to opt out. It is provided to people
in a number of ways. That won’t be done
within a pharmacy setting. That is 8 o’clock. Heather, I’m thinking I’ll hand
back to you just to wrap up or did you want me to wrap up? HEATHER: You can wrap up Shane but I would just like
to thank everybody. Now you’ve got
the help centre number. If any of you are having
problems ring this number. It’s the agency help centre. They’ll either direct you
towards the DHS help centre or try to help you
with this number. Give this one a go first but
do ring your PHN as Shane said. Thanks everybody
and I’ll just pass back to you Shane to wrap up. SHANE: Thanks, Heather. The other thing is
if you are having difficulty and you don’t feel that you’re
getting the right outcomes again please email me
and I’ll give you my email address which is shane.
[email protected] If there are challenges
and you just don’t think that you’re receiving
the appropriate advice then please do that. The other thing is
I’d like to really thank Heather for opening,
Danny who’s the pharmacy expert within the digital
health agency. Again he’s a key person who can
help navigate what’s necessary. Danny is well on top
of what’s necessary here but equally I would like to
thank everybody for dialling in, for being engaged
in the My Health Record. The My Health Record is
an enabler of the services that can be delivered
by pharmacists and it’s just a matter of us
embracing that technology and embracing the use of it. It will be baby steps
to start with. There will be some challenges because we do have access
to that extra information but we shouldn’t be scared
and we should embrace that because it will allow us
to do our job better. The other thing is that I’d like
to note that the CPD questions for this event
are on the PSA portal, on the PSA digital resource hub so if you would like
to access your group two points on this event you can access
that via the portal. I would like to thank
everybody for dialling in. Thank you very much. All I can say is we’d
like you to register. We’d like you to use
the My Health Record and we would like you
to contribute those vital dispense records so that other people
can use them in the health care system as well. Thank you very much for
dialling in and I’ll sign off and thank you from the
digital health agency and also thank you from
the pharmaceutical society. Thank you very much.

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