In 2006 the Council of Australian Governments (COAG) agreed to a national approach to developing and implementing Healthcare Identifiers (HI) for individuals and providers. The implementation of the Healthcare Identifiers Service (HI Service) is the first step in a transformational e-Health reform program. When fully implemented this program will help drive improved quality and safety of care, increase efficiency, support integration and enhanced communication between disparate health services and providers, and reduce duplication of services, assisting with the long term sustainability of the health system in Australia. Implementation of the Personally Controlled Electronic Health Record (PCEHR) system, secure messaging and other programs cannot be achieved without a reliable and accurate means of identifying healthcare recipients, healthcare providers and healthcare services.
The National Partnership Agreement on e-Health (NPA) was signed by COAG in 2009, formalising the commitment to Healthcare Identifiers by all jurisdictions but without requiring a specific timeline for this to occur. The NPA lapsed in June 2012 and is proposed to be replaced by a Memorandum of Understanding on developing a national e-Health capability. This Memorandum of Understanding is currently in the process of being ratified by all jurisdictions.
The Healthcare Identifiers Bill 2010 was introduced to Parliament on 10 February 2010. The Healthcare Identifiers Bill 2010 was passed by Federal Parliament and received Royal Assent on 28 June 2010. The then Chief Executive Officer of Medicare Australia commenced operations as the Healthcare Identifiers Service Operator (HI Service Operator) on 1 July 2010. There have subsequently been Regulations made under the Healthcare Identifiers Act 2010 (HI Act) on 20 October 2010. The Act anticipates that a State or Territory may make its own Healthcare Identifiers legislation to cover public bodies of that jurisdiction. It is noted that Healthcare Identifiers are regulated under existing legislation in some jurisdictions, such as Health Privacy Principle 12 in the NSW Health Records and Information Privacy Act 2002.
Section 35(1) of the HI Act requires that an independent review is undertaken of the legislation and the Service after two years of operation. The aim of the Review is to ensure that the Act provides the regulatory support to enable the HI Service to operate efficiently and effectively and support the sharing of clinical information in practice.
The objective of the Review was to consider:
- The HI Act and Regulations made under the Act
- Amendments to the HI Act proposed in the Personally Controlled Electronic Health Record (Consequential Amendments) Act 2012 (PCEHR (Consequential Amendments) Act)
- The implementation, operation, performance and governance of:
- The HI Service
- The HI Service Operator (SO).
The Review considered any legislative or administrative barriers that may be impacting the Act achieving its objectives and makes recommendations on changes that may be made to improve performance against the objectives of the HI Act. This report presents the findings of the Review. The Terms of Reference for the Review are provided in Appendix 1.
The findings were informed through a review of documents relating to the HI Service, interviews with key stakeholders and written submissions.
The full list of documents reviewed, interviews and written submissions is included in Appendix 2-4.
In total the consultation involved interviews with 86 stakeholders from the Department of Human Services (DHS), the National E-Health Transition Authority (NEHTA), the Department of Health and Ageing (DOHA), the Australian Health Practitioner Regulation Agency (AHPRA), the Office of the Australian Information Commissioner (OAIC), jurisdictions, Medicare Locals, clinicians, vendors, and professional and consumer groups over the period November 2012 to January 2013.
Twenty two organisations were also given the opportunity to provide written submissions. Written submissions have been received from seven organisations:
- NPS Medicinewise
- Consumers Health Forum
- Royal Australasian College of Physicians
- Office of the Australian Information Commissioner
- Australian Privacy Foundation
- Australian Medical Association
- Healthdirect Australia.