Only three software vendors sign up to e-health identifier tests

Healthcare identifier testing environment goes unutilised over contract disagreements and lack of final specifications

Minister for Health and Ageing, Nicola Roxon, has announced amendments to the Healthcare Identifier Bill, which is expected to be passed before Parliament later this month.

Minister for Health and Ageing, Nicola Roxon, has announced amendments to the Healthcare Identifier Bill, which is expected to be passed before Parliament later this month.

A total of three software vendors have signed a developer agreement to take part in the National eHealth Transition Authority's (NeHTA) software testing environment for the proposed national healthcare identifier (HI) service.

The figure was announced in Senate budget estimates by a spokesperson for the Department of Health and Ageing, after a raft of berating questions from senators on the committee about e-health spending, and whether the healthcare identifier service would be able to meet its initial 1 July deadline.

One of the department's spokespeople, Raelene Thompson, assured that Medicare Australia continued consultation with the industry over the healthcare identifiers, but said it is yet to begin live testing of the system.

The testing facility was launched in March by Medicare Australia to "assist early adopters in the commercial software market to build and test connection with the national HI Service ahead of legislation".

At the time, the environment supported the initial release specification for the HI service, with two additional releases planned for April and the end of June.

However, according to the president of the Medical Software Industry Association, Geoffrey Sayer, the fact that NeHTA is yet to release final specifications for the identifier service is holding software vendors back form committing to implementing the system.

"Because [the specifications] depend on the legislation, you technically cannot have signed-off for testing because the specifications do not exist yet," Sayer told Computerworld Australia.

The MSIA opposed the initial developer agreement for the testing environment in March due to multiple clauses, including one which placed the onus on the software companies to make necessary changes if specifications were altered by NeHTA or Medicare Australia. MSIA has since been in negotiations with Medicare Australia regarding an amended agreement, but at time of writing the parties had not come to a conclusion.

Sayer said he was surprised that even three vendors had signed the agreement.

"We're led to believe you would be looking at in the order of 150 to 200 software companies would have to interact with the HI service at some stage," he said.

Computerworld Australia contacted NeHTA for comment, but did not receive a reply at time of writing.

It remains uncertain as to when the healthcare identifier service will actually become available. A breakdown sheet accompanying a consultation paper on unique health identifiers released by NeHTA states that the identifier numbers will be allocated "from mid 2010" rather than the 1 July deadline initially set.

NeHTA expects the HI service to be fully operational within 18 months.

Legislation is still to be passed through Parliament, with health minister, Nicola Roxon, recently announcing that the Government would introduce some amendments to the bill as proposed by the Opposition and through public consultation.

A spokesperson for the department confirmed at the budget estimates hearing that Medicare Australia wouldn't conduct live testing of the system until legislation had been passed, after which a final contract between NeHTA and Medicare Australia would also be signed.

"I'm confident that Medicare Australia won't press the button to allocate the numbers until they're confident it is safe and secure," they said.

The spokesperson also noted that state governments may be faced with additional costs of up to $286 million in order to connect existing healthcare provider systems into the national healthcare identifier database.

Sayer said the lack of final specifications for integrating healthcare identifiers into software or compliant software vendors wouldn't prevent Medicare Australia from implementing a database and allocating numbers to Australian citizens. However, the lack of a secure method of transmitting those numbers to healthcare providers via software would defeat the purpose of such a system.

"There's a big difference between having a HI service that has a number in it - and you can ring up Medicare if you want and find out what the number is - and having a technical solution with software sitting on doctors' desks that electronically connects to the HI service in a reliable and secure manner."

According to implementation papers released by NeHTA, healthcare providers would ultimately be able to connect to the HI Service through a "secure business-to-business web service", a web portal or by telephone. However, the same paper concedes that developing the secure business-to-business connection would only be possible when providers' "systems are able to support them and if they see value in making the change".

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Tags e-healthNEHTAMSIAMedicare Australiaunique health identifier

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