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Healthcare Identifiers Service – Frequently Asked Questions

The following documents provide responses to Frequently Asked Questions about the Healthcare Identifiers Service

Healthcare Identifiers Service Frequently Asked Questions (PDF 49 KB)
If you have any difficulty in accessing the PDFs, please contact eHealthweb@health.gov.au for an alternate version to be sent to you.

Frequently Asked Questions

What do healthcare identifiers mean for consumers?

Q1. Why do we need healthcare identifiers?

Communication of health information is a vital part of effective healthcare. The accurate identification of individuals is critical in all health communication. Mismatching of patients with their records and results is a documented problem for the health system and a clear link has been established between avoidable harm to patients and poor medical records management.

Using an Individual Healthcare Identifier (IHI) provides a way for healthcare providers to more accurately match the right records to the person they are treating and improve accuracy when communicating information with other healthcare providers. This will help to avoid medical mix-ups or one person’s information being recorded on another patient’s file.

Q2. What does the Healthcare Identifiers Service mean for Australians?

The Healthcare Identifiers (HI) Service is a national system for uniquely identifying healthcare providers and individuals. The healthcare identifiers will help ensure individuals and providers can have confidence the right information is associated with the right individual at the point of care.

As part of the Service, every Australian resident is allocated a unique 16 digit IHI number. You don’t need to remember or do anything with your IHI. It has been created to be used by healthcare providers to improve the security and efficient management of your personal health information.

The HI Service allocates three types of healthcare identifiers:

• Individual Healthcare Identifier (IHI) – for individuals receiving healthcare services;
• Healthcare Provider Identifier – Individual (HPI-I) – for healthcare professionals involved in providing patient care; and
• Healthcare Provider Identifier – Organisation (HPI-O) – for organisations that deliver healthcare (such as hospitals or general practices).

Healthcare identifiers are an important building block to enable the personally controlled electronic health record (PCEHR) system.

Development of the personally controlled electronic health record (PCEHR) system is part of National Health Reform. The PCEHR system will enable people who would like to participate – and the health provider they choose – to access their key health information online. People will control what is stored on their health records and will decide which health professionals can view or add to their files.
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The PCEHR will use healthcare identifiers to provide greater certainty that your information is being correctly attributed to your electronic record. It will ensure accurate communication of your health information.

Q3. Who operates the HI Service?

Medicare Australia is the operator of the HI Service. As a trusted government authority, Medicare Australia has the national infrastructure, as well as the industry and community relationships needed to securely deliver and maintain the healthcare identifiers.

The HI Service is a separate and new Medicare Australia function, not linked to its funding or claims for payment functions. The HI Service, including Medicare Australia’s role as the HI Service Operator, will be reviewed two years after commencement taking into account any further eHealth developments.

Q4.Why not use existing Medicare numbers?

A Medicare number is not unique. Some people have more than one Medicare number because they are members of more than one family and may be on multiple cards. Also, some Australian residents and visitors do not have a Medicare number.

Q5. How do I get an IHI?

There is nothing a person needs to do to get an IHI. If a person is enrolled with Medicare or holds a DVA treatment card, they have automatically been allocated an IHI. If not, a temporary IHI number may be provided when a person next seeks healthcare.

Q6. Does this mean I need to get a new card or remember another number?

No. You don’t need to do anything. When required, your healthcare provider will access your IHI number using your Medicare or Department of Veterans’ Affairs (DVA) number, or from the HI Service Operator via phone or a secure online system. If you are not enrolled in Medicare, your healthcare provider may issue a temporary IHI at the time you attend.

Q7. Do I need an IHI to receive healthcare or claim Medicare Benefits?

No. If a healthcare provider can’t get your IHI number from the HI Service, or the IHI is not available for any reason, you will not be refused treatment. You will still need to use your Medicare number to make claims.

Q8. How is my personal information protected?

The HI Service protects individual privacy through legislation and technical security and access controls.
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Only healthcare providers who are identified with an individual HPI-I or an authorised employee or contracted service provider can access the HI Service to obtain the IHI of a patient being treated.

The system design does not allow ‘browsing’ of identifiers. A request by an authorised healthcare provider for a patient’s identifier will only reveal an IHI when there is an exact match with patient information provided by the healthcare provider. Each time a person’s healthcare identifier is accessed, the details of who requested the identifier is recorded.

The Healthcare Identifiers Act 2010 (the Act) specifies that the identifiers are to be used for healthcare and related management purposes, with penalties in place for misuse. Healthcare identifiers cannot be used for other purposes including for insurance and employment purposes, unless the use is for the purpose of healthcare delivery to an individual.

For example, it is expected that some private health insurance companies will use identifiers to provide healthcare-related services to their customers, such as chronic disease management programs.

Penalties for the intentional misuse of healthcare identifiers, such as inappropriate disclosure of information by Medicare Australia, or users of the Service are also set out in legislation and current privacy laws apply.

The Federal Privacy Commissioner monitors the operation of the HI Service by Medicare Australia and handles complaints relating to the HI Service.

Q9. What type of information is attached to the IHI?

A healthcare identifier is not a health record. The information held by the HI Service Operator, Medicare Australia, is limited to identifying information such as your name, date of birth and sex needed to uniquely identify you and your healthcare providers. In some circumstances more information may be required to ensure unique allocation such as your address, birth plurality, birth order or aliases.

Q10. Can I opt out of having an IHI?

No. Under the the Act the HI Service Operator has automatically assigned an IHI to individuals who are enrolled for Medicare benefits or have a DVA treatment card. The legislation does not provide for an individual to choose not to be assigned an IHI.

People who are not already registered with Medicare or DVA can be assigned a temporary identifier by the HI Service when the person seeks healthcare. The healthcare identifiers will help ensure individuals and providers can have confidence the right information is associated with the right individual at the point of care.
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Q11. Can I access the information that the HI Service holds about me or a person under my care?

Yes. Individuals and their authorised representatives can access the information held by Medicare Australia as part of the HI Service.

Individuals can view their IHI history by registering for Medicare Australia’s Online Services at www.medicareaustralia.gov.au or at any Medicare Australia Office. Once registered, they can simply log on to the Medicare Australia website and look up their IHI history.

The HI Service uses Medicare Australia’s existing flexible processes which support carers or advocates acting for a person with impaired decision-making abilities. Information on these processes can be obtained by contacting Medicare Australia on 1300 361 457 or healthcareidentifiers@medicareaustralia.gov.au.

Q12. How can I be sure about who has accessed my IHI?

You can access your IHI history using Medicare Online Services. To access Medicare Online Services you must provide details such as your Medicare card number, date of birth and a password. To verify your identity you must then answer two secret questions and enter your suburb and postcode. The Medicare Online Services page provides information about the last time you accessed online services, including to get to your IHI history page.

Your IHI history page provides a record of requests made by healthcare providers to the HI Service to disclose your IHI, in keeping with the healthcare identifiers legislation.

Q13. Why does my IHI history on the HI Service web pages show that a healthcare provider has accessed my IHI multiple times, even when I haven’t received healthcare at those times?

The Healthcare Identifiers (HI) Act specifies that healthcare identifiers can be used for healthcare and related management purposes, with penalties in place for misuse.

Under the HI legislation, the HI Service must keep an up-to-date record of who has requested your healthcare identifier, each time it is accessed. You have a right to access this information.

Your IHI history may show that a healthcare provider’s administrative system has accessed your IHI a number of times depending on the way the system software is developed to retrieve your healthcare identifier. In addition, provider systems may also access your IHI for management purposes, such as testing or maintenance activities to monitor or improve the quality and effectiveness of the way their system interacts with the HI Service.
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If you have a query about your IHI history, you can contact Medicare Australia on
1300 361 457.

If you have a query about privacy matters, you can contact the Office of the Australian Information Commissioner on 1300 361 457.

Q14. Can I receive healthcare anonymously?

Healthcare identifiers do not change the way that anonymous healthcare services are provided. Individuals can still seek treatment and services on an anonymous basis. In these instances, an IHI would not be used by the healthcare provider.

In certain circumstances a person may want to access healthcare services using a pseudonym. The HI Service allows for a person to have an IHI allocated to a name other than their legal identity.

This process is separate from Medicare claiming processes and requirements for making a claim under Medicare remain unchanged. A Medicare claim can only be made using the name on your Medicare card.

Q15. What do healthcare identifiers mean for providers

A HPI is a number that can be assigned to eligible healthcare providers and organisations to support their unique identification.

HPIs are referred to as:

• Healthcare Provider Identifier – Individual (HPI-I) for healthcare professionals involved in patient care; and
• Healthcare Provider Identifier – Organisation (HPI-O) for organisations such as the hospital or healthcare practices where care is provided.

Q16. Who issues HPI-Is and when?

Medicare Australia, through its HI Service, allocates and maintains healthcare identifiers.

The Australian Health Practitioner Regulation Agency (AHPRA) issues HPI-Is automatically to its registrants. Health professionals not covered by AHPRA can register for an HPI-I directly with Medicare Australia.

AHPRA began allocating HPI-Is from mid 2010.

Q17. I received a letter from AHPRA which included my HPI-I, what do I need to do?

You don't need to do anything; AHPRA has issued you with your HPI-I as the first step toward you using unique identification as part of electronically communicating health information.

For more information about the HI Service please go to www.medicareaustralia.gov.au.

Q18. How will I know when AHPRA has provided Medicare Australia with my details and I can begin to use this service?

If you have received your HPI-I from AHPRA you can contact Medicare Australia on 1300 361 457 to find out about using the HPI-I.

Q19. Who will be eligible for a HPI-I?

Healthcare providers, including those in primary care and allied health, may be issued with a HPI-I. To be eligible for a HPI-I, a healthcare provider must provide a ‘health service’ as defined in the legislation.

There are two classes of healthcare providers who will be eligible for a HPI-I:

• healthcare providers registered under a state or territory law which relates to the registration of a particular healthcare profession or healthcare providers registered under the national law with AHPRA; or
• healthcare providers who are members of a professional association that meets certain criteria.

Healthcare providers not registered under a state, territory or national law can obtain their HPI-I by applying directly to the HI Service (www.medicareaustralia.gov.au).
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Q20. Why do individual healthcare providers need a HPI-I? Will it always be the same number?

When information is sent to other providers to support a patient’s ongoing healthcare, the HPI-I, in combination with secure authentication mechanisms, will provide greater certainty about who the information is from.

A provider’s HPI-I is unique. A provider will only need one HPI-I regardless of the number of qualifications attained or healthcare organisations worked for.

Q21. Which organisations can get a HPI-O?

All organisations that provide healthcare services can apply for a HPI-O from Medicare Australia.

An organisation must provide evidence to the HI Service that it is a legal entity and that it employs or contracts one or more individual healthcare providers. Sole traders who provide health services can also be assigned a HPI-O.

Q22. How does the introduction of healthcare identifiers affect current IT systems?

The HPI-I will provide an accurate and secure foundation for sending and receiving messages and information to and from other providers electronically.

In order to participate in the HI Service, a healthcare provider business requires IT systems that incorporate minimum standards and security features necessary to access the HI Service. Healthcare providers are able to access the HI Service via Medicare Australia’s Health Professional Online Service (HPOS) and Business to Business (B2B) web interface. This access enables healthcare providers with the ability to, for example, manage and update information associated with provider identifiers.

The Service Operator also provides some services over the phone.

Software developed to access the HI Service will be assessed to ensure it meets appropriate standards of quality and safety. By purchasing conformant software, healthcare providers will ensure their systems use healthcare identifiers in a manner that supports clinical safety, privacy and information security.

Q23. What is the benefit for providers?

The costs associated with inadequate patient identification are significant. It is estimated that 10 per cent of hospital admissions are due to adverse drug events and that up to 18 per cent of medical errors are due to inadequate availability of patient information.

The use of healthcare identifiers contributes to immediate improvements in existing methods of communication between healthcare providers and will help prepare providers to participate in future eHealth developments.

An additional benefit of the HI Service is the availability of a Provider Directory Service. The provider directory allows GPs to locate other providers (such as specialists) in a timely manner, and facilitate communication with other providers when referring patients or making decisions about the patient’s care needs.
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Q24. Is there a cost to business?

Healthcare providers will bear some start-up costs associated with staff time required for considering information supplied to them about how healthcare identifiers should be implemented and for responding to patient enquires on how the new healthcare identifiers can and cannot be used.

Healthcare providers will be provided with appropriate resources to refer consumers to for more information.

Q25. What are the next steps?

The National E-Health Transition Authority (NEHTA), Medicare Australia and all jurisdictions in consultation with stakeholders, have jointly developed Implementation and Communications strategies to support the HI Service.

A final Implementation Approach and a Communications plan were released by NEHTA. The roll out of healthcare identifiers is being undertaken in a staged approach to ensure that identifiers are integrated into clinical systems in a way that enhances patient safety.

Early adopter projects in the jurisdictions and PCEHR eHealth Sites are making it one of their first steps to implement identifiers. These projects are an opportunity to provide experience and lessons learned that will assist other users to adopt identifiers in the future.

At this stage, implementation planning and testing activities are underway in a number of projects and implementation of identifiers into live clinical systems is expected to take place in June 2011.

Q26. What are the processes for reviewing the HI Service?

As the HI Service Operator, Medicare Australia will report on its activities, finances and operations at the end of each financial year and provide the report to the Ministerial Council and the Minister. The report will be tabled in Parliament.

Legislation requires the Minister to appoint an individual to review the operation of the Act and prepare a report on the review by 30 June 2013. A copy of the report must be made available to the Ministerial Council and tabled in Parliament.

Consultation

Q27. What has been the consultation process to date?

On 13 July 2009, a discussion paper was released seeking comments on legislative proposals to support the establishment and implementation of unique identifiers for healthcare purposes and the privacy of health information. As part of this consultation, two stakeholder forums were held to allow detailed discussion of the proposals.

Consultation closed on 14 August 2009. Over ninety submissions were received from stakeholders.

Further consultation, including the release of exposure draft legislation was undertaken from 20 November 2009 to 7 January 2010. Fifty-five submissions were received. Stakeholder feedback was taken into account in finalising the legislation.

On 12 March 2010, Exposure Draft Regulations were released for public comment. Consultation closed on 9 April 2010 and fifty-two submissions were received.

NEHTA released a draft HI Service Implementation Approach and a draft HI Service Communications Plan for public comment for a period of 4 weeks, closing on 28 June 2010. The final documents were released on the NEHTA website on 7 October 2010.

More information about the public consultation process is available on the Department’s website www.health.gov.au/eHealth/consultation.

Q28. Who has been involved in the design and development of healthcare identifiers?

The Australian Government and state and territory governments, in conjunction with NEHTA are collaborating with representative groups drawn from the healthcare sector, as well as health leaders, consumer groups, software vendors, information managers and standards experts to develop the foundations for eHealth.

The Office of the Privacy Commissioner has also participated in the consultation processes.
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