9977.1209 PIP eHealth Incentive Guidelines

IntroductionThe Practice Incentives Program (PIP) is aimed atsupporting general practice activities that encouragecontinuing improvements and quality care, enhancecapacity and improve access and health outcomesfor patients.To be eligible to participate in the PIP, a practice mustbe accredited, or registered for accreditation, againstthe Royal Australian College of General Practitioners’(RACGP) Standards for general practices. Practices mustobtain full accreditation within 12 months of joining thePIP. Practices must maintain full accreditation to continueto be eligible for the PIP.For more information on the incentives that the PIPoffers and PIP overall eligibility, go to the PIP guidelinesat humanservices.gov.au/healthprofessionals thenIncentives and Allowances > Practice IncentivesProgram > Forms and guidelines.The PIP is administered by Australian GovernmentDepartment of Human Services (Human Services) onbehalf of the Department of Health and Ageing.Definition of a GPFor the purposes of the PIP, GPs include generalpractitioners and/or non-specialist medical practitioners,known as other medical practitioners, who providenon-referred services but are not GPs. GPs includeFellows of the RACGP and the Australian College of Ruraland Remote Medicine (ACRRM), vocationally registeredgeneral practitioners and medical practitionersundertaking approved training.Payments and eligibility requirementsTo be eligible for the PIP eHealth Incentive, practices must:• participate in the PIP; and• meet each of the five requirements described below forthe entire quarter prior to the payment month exceptas qualified in Requirements Two and Five.Eligible practices can receive a maximum payment of$12,500 per quarter, based on $6.50 per StandardisedWhole Patient Equivalent (SWPE) per year.Practices need to keep their eligibility for the entirepreceding PIP payment quarter, including the ‘point intime’ date to be eligible for the quarterly payment. The‘point in time’ date is the last day of the month before thenext payment quarter. For example, to be eligible for theNovember payment, practices must keep their eligibilityfrom 1 August up to and including the ‘point in time’ dateof 31 October.Please note that, practices with additional practicebranches will have to meet these requirements at eachindividual site except where the organisationalstructure only requires a single HPI-O and/or PCEHRparticipation agreement.For more information on how the incentive is paid,go to the PIP guidelines athumanservices.gov.au/healthprofessionals thenIncentives and allowances > Practice IncentivesProgram > Forms and guidelines.The PIP eHealth IncentiveThe PIP eHealth Incentive aims to encourage generalpractices to keep up to date with the latest developmentsin eHealth and adopt new eHealth technology as itbecomes available. It aims to help practices improveadministration processes and patient care.To be eligible for the PIP eHealth Incentive, practicesmust be registered in the PIP and meet each of the fiverequirements defined below.The requirements for this incentive support thedirection of the Australian Government’s NationaleHealth Strategy. These Guidelines take effect from1 February 2013.2 Practice Incentives Program eHealth Incentive guidelines—February 2013

Eligibility requirementsFor guidance on how to meet these requirements, pleaserefer to the Implementation Overview documents foreach requirement available at nehta.gov.au/pipRequirement 1—Integrating HealthcareIdentifiers into Electronic Practice RecordsThe practice must:(i) apply to Human Services to obtain a Healthcare ProviderIdentifier–Organisation (HPI–O) for the practice, andstore the HPI–O in a compliant clinical software system(ii) ensure that each general practitioner within the practicehas their Healthcare Provider Identifier–Individual (HPI–I)stored in a compliant clinical software system, and(iii) use a compliant clinical software system to access,retrieve and store verified Individual HealthcareIdentifiers (IHI) for presenting patients.The intent of this requirement is to make HealthcareIdentifiers (HI’s) available for Secure Message Deliveryand for use in the personally controlled electronic healthrecord (eHealth) record system.Practices can apply for a HPI–Othrough the Human Services website athumanservices.gov.au/healthprofessionals thenHealthcare Identifiers Service and should retainevidence of their application.HPI–Is can be obtained from the Australian HealthPractitioner Regulation Agency (AHPRA) or by contactingthe HI Service Operator on 1300 361 457*.Note: all medical practitioners registered through AHPRAhave been allocated their HPI–I.The practice must ensure that its HPI–O (once obtained)and the HPI–I for each general practitioner is recorded intheir compliant clinical software system. The PIP eHealthProduct Register for Healthcare Identifiers lists compliantsoftware systems and is available at nehta.gov.au/pipPractices can use their compliant clinical softwaresystem to electronically access verified IHIs fromthe HI Service Operator, Human Services. Furtherinformation on how to access the HI Servicecan be found on the Human Services website athumanservices.gov.au/healthprofessionals thenHealthcare Identifiers Service.Practices should ensure their implementation anduse of HIs complies, where relevant, with instructionsprovided by the practice management system productsupplier and the HI Service Operator, Human Services,at humanservices.gov.au/healthprofessionals thenHealthcare Identifiers Service.For further information please refer to the NationalE-Health Transition Authority (NEHTA) document,Implementation Overview for Healthcare Identifiers,available at nehta.gov.au/pipRequirement 2—Secure Messaging CapabilityThe practice must have a standards-compliant securemessaging capability to electronically transmit and receiveclinical messages to and from other healthcare providers,use it where feasible, and have a written policy to encourageits use in place.To meet this Requirement a practice must have appliedfor an approved organisation authentication credential(digital certificate) for secure messaging.To meet the installation and configuration aspectof this requirement (see below), practices must havetheir HPI-O (Requirement 1) and digital certificate forsecure messaging.Where a practice has applied for but not obtained theirHPI–O (requirement 1) or digital certificate, they mustmeet the remainder of requirement 2 within four weeksof having received both.To meet this requirement, practices must have astandards-compliant product with a secure messagingcapability to both send and receive messages. The PIPeHealth Product Register for Secure Message Delivery listssoftware systems and is available at nehta.gov.au/pipPractices must also be able to verify that the product hasbeen installed and configured so as to be interoperablewith other standards-compliant products, in linewith the Commissioning Requirements for SecureMessage Delivery available on the NEHTA websitenehta.gov.au/pipThe procedures for verification are specified in theCommissioning Requirements and may be undertaken bya third party.For further information please refer to the NEHTAdocument, Implementation Overview for Secure Messaging,available at nehta.gov.au/pipThe requirement to use secure messaging ‘wherefeasible’ means where the sender and receiver havecompatible standards-compliant software, hold theappropriate authentication credentials, and where thereis a clinical need to convey information.Practice Incentives Program eHealth Incentive guidelines—February 20133

Requirement 5—Personally ControlledElectronic Health (eHealth) Record SystemThe practice must:(i) use compliant software for accessing the personallycontrolled electronic health (eHealth) record system, andcreating and posting shared health summaries and whenavailable, event summaries, and(ii) apply to participate in the eHealth record system uponobtaining a HPI–O.This requirement takes effect from 1 May 2013.From this date, where a practice has applied for, but notobtained their HPI-O in accordance with requirement 1,they must meet requirement 5 within four weeks ofreceiving their HPI–O.Practices must use software that is listed on the PIPeHealth Product Register for the Personally ControlledElectronic Health (eHealth) Record System available atnehta.gov.au/pip. The products listed on the registermay be updated from time to time. Practices will be givensix months notice, in writing, to comply with productlistings that are updated after 1 May 2013. This is onlyexpected to occur in the event of new functionalityembedded into GP desktop software as part of the usualupgrade cycle.Practices may need to work with their software or serviceprovider to ensure that the compliant product is set upcorrectly for accessing the eHealth record system.For further information please refer to the NEHTAdocument, Implementation Overview for the PersonallyControlled Electronic Health (eHealth) Record System,available at nehta.gov.au/pipTo apply to use the eHealth record system, completethe Participation Agreement relevant to your healthcareprovider organisation and the application to registeras a healthcare provider organisation available fromehealth.gov.auPractices should retain evidence of the submission oftheir completed Participation Agreement and applicationto register as a healthcare provider organisation.ApplyingPractices must reapply for the eHealth Incentive tokeep receiving payments and will be notified in writingof application arrangements under the new Guidelines.It is expected practices will need to reapply fromFebruary 2013.Assessment of eligibility for the eHealth Incentive willbe considered retrospectively for the payment quarter inwhich the application is received only.ObligationsThe practice must:• give information to us as part of the ongoingconfirmation statement and audit process to verify thatthe practice has met the PIP eligibility requirements• make sure information given to us is correct, and• tell us in writing, of any changes to practicearrangements by the relevant ‘point in time’ date orwithin 14 calendar days, whichever date is earlier.For more information, go to the PIP guidelines athumanservices.gov.au/healthprofessionals thenIncentives and Allowances > Practice IncentivesPrograms > Forms and guidelines.The practice must nominate an authorised contactperson(s), who will confirm, on the practice’s behalf, anychanges to information for PIP claims and payments.Appeals processThe PIP has an established appeals process. To ask fora review of a decision, the authorised contact personor the owners of the practice must write to us within28 days of the date on the notice of the decision. We willreview the decision and advise the practice in writing ofthe outcome.For more informationOnline humanservices.gov.au/healthprofessionalsthen Incentives and Allowances >Practice Incentives ProgramEmailCallpip@humanservices.gov.au1800 222 032** 8.30 am to 5.00 pm, Monday toFriday, Australian Central Standard Time*Call charges apply.** Call charges apply from mobile and pay phones only.DisclaimerThese guidelines are for information purposes only. Whileit is intended that the Australian Government will makepayments as set out in these guidelines, the makingof payments is at its sole discretion. The AustralianGovernment may alter arrangements for the PracticeIncentives Program at any time and without notice.The Australian Government does not accept any legalliability or responsibility for any injury, loss or damageincurred by the use of, reliance on, or interpretation ofthe information provided in these guidelines.9977.1209Practice Incentives Program eHealth Incentive guidelines—February 20135humanservices.gov.au