Complete health identifier service still months away

Software vendors to come online in Q1 2011 as NeHTA rolls out "evolutionary process"

Despite efforts to have the healthcare identifier (HI) service up and running by 1 July, the National eHealth Transition Authority (NeHTA) believes the service could take years to fully implement.

A spokesperson for the authority behind the implementation of the identifier service told Computerworld Australia that the system required additional software vendors, live testing and education for healthcare providers before the system was rolled out nationwide.

Recent amendments made to the Healthcare Identifiers Bill - the legislation that will enable the service to be implemented - has pushed back its reintroduction into Parliament to 17 June, and potentially pushed back the service's starting date back from its original July timeframe.

However, the spokesperson said that, even if the service was ready to go by the intended date, it would only be at reduced capacity.

"The timelines are starting to look a little tight, but if all that happens by 1 July, the numbers will be populated into the system in or around 1 July," the spokesperson said. Once populated, the numbers would be cross-checked by Medicare Australia and subsequently be made for use by both the public and healthcare providers.

The HI service is eventually intended to serve unique identifiers for patients through three different portals; by telephone, through a web portal or through business-to-business connections via clinical software. The most basic method - by telephone - will likely be available once identifier numbers are assigned but, with no secure method for healthcare providers to store those numbers, this is designed a backup channel rather than an e-health solution.

Numbers will also be available through the same Health Professionals Online Services (HPOS) web portal already in use by Medicare Australia to distribute Medicare numbers to providers. The spokesperson said functionality is currently being locked down for the HI portion of HPOS, and is intended to be made available shortly after the identifiers are released.

However, a business-to-business web service integrated into existing clinical software is at least six months away. Though believed to be the optimal solution for a fully operational identifier service, the Department of Health and Ageing (DOHA) recently revealed at a Senate budget estimates hearing that only three software vendors had signed the developer agreements required to test the identifier specifications with their software in a operational environment opened in March. Geoffrey Sayer, president of the vendor representative body Medical Software Industry Association, said that 150 to 200 vendors would ultimately be required to sign up for a fully functional service.

"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," Sayer said.

According to the NeHTA spokesperson, the authority always expected a small number of vendors to sign up initially.

"We weren't expecting the majority of vendors to come on board until at least the first quarter of next year. It would be a major risk to roll it out live to 200 vendors and have them all integrating on 1 July.

"The plan is that it's going to be an early adopter process, communities that are interested in those jurisdictions that are ready to go will test various components of the HI service," the spokesperson said.

Instead, NeHTA and Medicare Australia are believed to be phasing the deployment of the identifier service, a little known timeframe that led Senators to question the lack of live testing on Medicare Australia's behalf at the recent budget estimates hearing.

Apart from the process of upgrading capable software at healthcare providers, the implementation also includes an education process for both providers and the public, which NeHTA carefully set out in papers released last week.

"All of the software could be built and fit for purpose and nobody uses it because they don't know how to use it," the spokesperson said.

Implementation papers released by NeHTA concede that implementing a secure business-to-business connection through existing clinical software 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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