> -----Original Message-----
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] On Behalf Of Greg Twyford
> Sent: Tuesday, 25 July 2006 2:50 PM

> The recent discussions re the appropriate standards for electronic 
> transmission of clinical data, electronic referrals under Medicare and

> faxed referrals are informed by the attached AMA newsletter.
> 
> Obviously the AMA is trying to make it simpler and recognises that the

> HeSA PKI is a bit of a showstopper, as is the requirement to follow-up

> faxed referrals with the original.

Greg,

Two things are being confused here.  The AMA newsletter says:

"IT Standards for referrals

Doctors are reminded that under the Electronic Transactions Act 1999
electronic referrals, pathology or diagnostic imaging orders must comply
with Medicare Australia Public Key Infrastructure (PKI) Standards. PKI
is the only approved encryption standard for these transmissions. One of
the problems of course is that the person to whom the transmission is
sent must also have PKI in order to read the message.

Following member queries in relation to faxed referrals or requests, the
AMA has confirmed that at present the original signed document must
subsequently be forwarded. Following AMA representations Medicare
Australia is seeking advice as to whether a fax copy can be considered
compliant with the legislation and thus potentially allow the
elimination of one more bit of red tape."

In the first paragraph, "electronic referrals" refers to emailed
referral messages or letters.

The second paragraph then jumps to talking about whether faxed referrals
(presumably those that contain a handwritten signature) will fulfill the
Medicare requirements or whether the original document must be posted or
otherwise delivered to the recipient, who presumably has to store that
original for possible audit by Medicare.  Apparently, despite thousands
if not millions of referrals having been faxed over the past few years,
Medicare still has not decided whether they fulfill the requirements for
Medicare benefits purposes.

The first paragraph skipped over the issue of electronic referrals (that
is, those sent by email) being able to be signed by the sender with his
or her digital individual certificate, which serves as a legally valid
signature, which means that no other document needs to be sent. 

Clear now?  I thought not.  I suggest that we just all go on sending
good referrals by whatever means and in whatever format we find most
efficient and helpful for patients' care.


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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