Duncan, Thinus, Oliver and Colleagues,
Here is the text of the Medicare referral standards:
Notice of Information Technology (IT) Standards under the
Electronic Transactions Act 1999 for Electronic and Paper:
Referrals to Consultant Physicians or specialists
Requests and Confirmations of Requests for Pathology Services to
Approved Pathology Practitioners
Requests for Diagnostic Imaging Services
This Notice specifies the IT standards the Health Insurance Commission
(‘HIC’)
requires for the electronic transmission, scanning, and storage of:
Referrals to consultant physicians or specialists pursuant to ss20BA
and 133(2) of
the Health Insurance Act 1973 (‘the Act’) .
Requests for, and confirmation of requests for, pathology services to
approved
pathology practitioners pursuant to ss16A and 23DK(1) of the Act, Reg,9A,
Health Insurance Regulations (the regulations) and the Health Insurance
(Pathology Services) Regulations (the HI(PS) regulations);
Requests for diagnostic imaging services pursuant to ss23DR and 23DS
of the Act
and Reg.19 of the regulations.
In this Notice:
Any reference to a ‘request’ for a pathology service includes a
Confirmation of
the Request.
‘HIC PKI Standards’ means the standards for PKI, Certificate
recognition, and
EDI formats set out at www.hic.gov.au, Professional Stream under
‘e-business’.
Non-digital images such as microfilm, are not supported as IT standards.
These IT standards address:
1. Fully electronic Referrals or Requests
2. Scanning of paper Referrals or Requests for electronic storage
3. Storage of Referrals or Requests (wholly electronic or scanned)
1. Fully electronic Referrals or Requests
1.1 Where a medical practitioner:
Refers a patient to a specialist or consultant physician: or
Requests a pathology service; or
Requests a diagnostic imaging service,
by electronic means, HIC requires that the referral or requests:
a) Consist of either a standard e-mail message* , or a recognised EDI
format,
that is transmitted using HIC’s PKI standards;
b) Meet all the requirements for a Referral or Request provided in the
Act, the
regulations and the HI(PS) regulations; and
c) Be digitally signed by the referring/requesting practitioner using an
individual
private key for which there is a current public key certificate
recognised by the
HIC (in accordance with HIC’s PKI standards), to allow a specialist,
consultant physician, or Approved Pathology Practitioner or medical
practitioner to verify the authenticity of the Referral or Request upon
receipt.
2. Scanning of paper Referrals or Requests for electronic storage
2.1 Where an image of a paper Referral or Request is scanned for
electronic storage,
HIC requires that:
a) The scanned image be unaltered and unalterable from the moment
scanning is
finished, including confirmed as completed at batch or individual level:
b) The image have appended to it, or associated with it, by the system,
a unique
reference number (reference number)
c) Consecutively created images have consecutive reference numbers;
d) The date and time the image was converted to digital form be recorded;
e) The whole digital image, including the reference number, date and time as
requested in 2(b) and 2(c), is digitally signed as a true copy under
HIC’s PKI
Standards by a person independent of the referring specialist or consultant
physician, the rendering Approved Pathology Practitioner or medical
practitioner;
and
f) In cases where a group of images are digitally signed simultaneously,
the digital
representation of all images in the group be able to be produced in full
along with
the individual requested image, so as to permit verification of the
digital signature.
Acceptable image formats include those in common use on Web sites and
popular
scanning software.
2.2 Where an image of a paper Referral or Request is scanned for
electronic storage,
HIC permits:
a) De-speckling, de-skewing, and minor cropping to the extent that this
does not
compromise the image;
b) Superimposition of the sequential number and date/time on the scanned
image
provided the original details are not concealed by the superimposition. The
c) digital signature required by 2.1(e) is to be applied after all such
operations are
completed.
*For text or e-mail referrals, any text format in common use on
English-language Web sites is
acceptable, including plain text, Hypertext Markup language (HTML),
Microsoft Word (DOC), Rich
Text Format (RTF), and Portable Document File (PDF).
3. Storage of Referrals or Requests (wholly electronic or scanned)
3.1 Where an image of a paper Referral or Request is stored
electronically, HIC
requires that:
a) a stored Referral or Request be retrievable in a legible form that:
i. provides a complete, accurate and legible paper reproduction copy of the
Referral or Request at its original size, and
ii. contains, where a signature was required on the original Referral, a
complete
and accurate representation of the original signature/s on the original
Referral;
3.2 Any system that electronically retains and stores Referrals or
Requests must not
permit any loss, improper disclosure, destruction, addition, or
alteration of the
electronically scanned image of the Referral or Request, nor any
compromise of
stored information affecting the verification of any digital signatures.
3.3 (a) Specialists, consultant physicians, Approved Pathology
Practitioners and
medical practitioners using electronic storage must ensure the adequacy of:
i. physical security;
ii. logical information security;
iii. information security and record retention policies;
iv. information privacy, confidentiality and release policies;
v. back-up and recovery policies, procedures and practices covering data,
software and essential equipment;
vi. archiving processes;
vii. redundancy, recovery and auditability of systems (including ability
to trace
activities and events), and
viii. business continuity strategies.
(b) A back-up copy of the digitally signed scanned image and electronically
received Referrals or Requests, are to be electronically stored in a
physically
separate secure location.
(c) Electronic Referrals or Requests, and scanned images of paper
Referrals or
Requests must be retained unencrypted with the authors’ digital
signatures intact
and verifiable.
(d) In satisfying the requirements set out in 3.3(a), HIC requires that
documentation
and records demonstrating compliance be made available promptly to HIC on
request.
(e) The storage system must enable all electronically stored Referrals
or Requests for
a particular
i. Period, including a particular date; or
ii. Requestor of a medical service
To be identified and produced to the HIC on request.
God bless, even you pagans like me.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
PRIVATE & CONFIDENTIAL
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