> -----Original Message-----
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] Behalf Of Greg Twyford
> Sent: Monday, 27 February 2006 11:52 AM

> Duncan Guy wrote:
> > 
> > Question - if Doctor A writes in the progress notes - refer 
> to Dr B is that a valid referral?
> > 
> > Each Dr has their own unique logon - every entry into the EMR is 
> > labelled, dated and time as being entered by that Dr.

Greg Twyford replied:
 
> Either it's a written-on-paper, signed-in-ink, referral or if it's 
> electronic it has to be signed electronically with the referring 
> doctor's HeSA supplied-Medicare Australia approved individual signing 
> key, the famous, but least-used piece of technology in the health 
> sector, the RAINBOW iKey [dongle].

Greg, I think that if we looked at what is actually happening around Australia, 
many GPs and specialists are simply politely ignoring Medicare Australia's wish 
for electronic referrals to be signed with individual digital certificates, and 
are just getting on the with the job of caring for patients, as Duncan's group 
is doing.  A local specialist told me just the other day that his group is 
doing exactly this - they are accepting referrals without digital signatures 
and using them for Medicare benefits purposes.

It sounds to me that the system used by Duncan's group of specialists provides 
reasonable evidence that a referral was made.  I believe that Medicare 
Australia would not and will not dare to try to prosecute any specialist who 
used such a referral to issue an account which can be used by the patient for 
the higher Medicare benefits payable for a referred service, because it would 
be howled down in public by the whole profession as obstructing the delivery of 
health care with inappropriate and unworkable bureaucratic rules.  It's a bit 
like the Berlin wall - suddenly, just by a kind of mass civil disobedience the 
whole thing (in this case, digital signing) is seen as irrelevant and 
unnecessary and everybody just gets on with doing the job that needs to be done.


Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens
South Australia 5086
Ph. 08 8261 1355  Fax 08 8266 5149
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