Communication with end users
At the moment, uptake is being driven by financial incentives (for GPs through e-Health Practice Incentive Program payments) but there is not a high level of understanding in the sector as to why they should use the HI Service once they are registered and what benefits it will ultimately deliver. To date much of the communication that has occurred has focused on technical capability and requirements of the HI Service. Feedback from clinicians indicates that communication would be more effective if messages about the HI Service were integrated with information about the applications and clinical business processes that will utilise the Service.
There is a very variable level of knowledge of the current status of the HI Service functionality, uses and policies, and how the HI Service relates to other services (e.g. the relationship between HI Service and PCEHR system registration). It is important that accurate information be provided from a single source to promote a common understanding of the Service.
As the use of the HI Service expands beyond projects that NEHTA manages, there will need to be agreement on who is responsible for ensuring all stakeholders are included in relevant communication.
Communication between delivery organisations
An agreed and widely disseminated responsibility matrix would clarify the functions of each organisation involved in development and delivery and promote the consistency of information. This will be essential as the HI Service integrates with more programs, and therefore more organisations. As the environment becomes more complex, simplifying the pathways for support and access to information, and ensuring the consistency of information, will become even more important to assist users.
Stakeholders, particularly in the jurisdictions, have noted a significant reduction in their level of involvement in the HI Service and engagement with NEHTA since deployment of the Service. Stakeholder engagement and consultation continues to be NEHTA’s role, but this function has suffered due to the loss of a number of key staff and the redirection of resources to other programs still under development. A robust stakeholder engagement process will continue to be vital to ensure that the Service meets the requirements of clinicians, both for the development of new functionality and to address issues that will inevitably occur as the Healthcare Identifiers system becomes more actively used by a range of other systems. The more programs that utilise the Service, the more critical it will become that design impacts on all stakeholders are understood and that there is input from the jurisdictions and primary care to inform priorities and dependencies.
Extensive communication materials have been produced for Healthcare Identifiers, aimed at vendors, providers and consumers. Core documentation required to integrate and use the HI Service and other e-Health systems is held on three different websites (DHS for HPI-O application forms and support, PKI and HPD consent, NEHTA for confirmation of compliant software, AHPRA and DHS for HPI-Is), as well as via the websites of professional associations such as the Australian Medical Association and Australian Practice Managers Association). There has been an effort by NEHTA, DHS and groups like the Australian Medical Association to develop checklists for GPs to simplify the navigation through these information sources. There has been a significant improvement in consolidating the information required by vendors for the HI Service (e.g. specifications, testing information) onto a single website. However, healthcare providers aiming to participate in the HI Service and the PCEHR system report that it is still difficult to navigate the many sources of information and that a “one stop shop” for all related information, guides and forms would be beneficial (even if this just provided links to all relevant sources of information). DHS has initiated work to simplify the range of forms currently required to register for HPI-Os, HPI-Is, PKI, NASH etc. and to create a single form. A single explanatory booklet that provides a guide to the whole end to end process would also assist.
The appropriateness of guidelines and other communication materials has to be reviewed to ensure that they are appropriate for all types of healthcare organisations. The requirements and nature of interactions between the HI Service and different types of health services are likely to vary considerably and documents should reflect this.