Ms Angela Parker:
Welcome everybody to today's webinar on eRequesting, delivered as part of the RACGP Practice Essentials Webinar Series.
My name is Angela Parker and I'm a Project Officer from the RACGP Practice Technology and Management team. I'll be your host for today.
I'm joined by Dr Rob Hosking; a GP based in Melbourne who will deliver the presentation for you today.
Dr Rob Hosking has been interested in eHealth since commencing practice in Bacchus Marsh in Victoria in 1990. He gained his graduate certificate in Health Informatics from Monash University in 2000.
Rob has worked on a number of eHealth-related committees at NPS MedicineWise and the Royal College of Pathologists of Australasia.
Rob has been involved with the RACGP eHealth committee since 2008 and is currently the Chair of the RACGP Expert Committee, Practice Technology and Management.
Rob, welcome to the webinar.
Dr Rob Hosking:
Thanks Angela. Let's hope we can entertain people and give them some interesting ideas of what to take back to their practices today.
Ms Angela Parker:
Yes, thanks Rob. And thank you to everyone for attending and taking time out of your busy schedules to join this session.
Before we begin our webinar, I'd like to acknowledge the traditional owners of the land from where each of us is joining this webinar, and I wish to pay my respects to Elders past, present and emerging.
This activity is delivered by the RACGP in partnership with the Australian Digital Health Agency.
This is an on-demand webinar and you can pause rewind or fast forward at any point. If you need to stop, you can close the webinar and return at a later time.
This education activity is accredited for two points under the RACGP 2020-22 CPD triennium which you can quick log from the RACGP website where you accessed this webinar. To collect these points, you will need to watch the whole webinar.
Resources referred to in this webinar have been collated in a webinar resources pack that is also linked on the RACGP website where you accessed this webinar.
If, after the webinar, you have any questions, please do not hesitate to contact the team by email at firstname.lastname@example.org.
Now I'd like to hand over to Rob to begin the presentation. Thank you, Rob.
Dr Rob Hosking:
For the agenda today, what we're going to be covering is; what eRequesting is, how it works, how to set up your practice for eRequesting, the benefits of eRequesting, how your request will work with My Health Record and how you can view the reports within My Health Record and even download them into your own system. And we’ll also discuss patient consent to upload to the My Health Record.
What is eRequesting? eRequesting - or electronic requesting - enables pathology and diagnostic imaging requests to translate from your general practice clinical information systems so medical Director or This practice or they've made or others directly to the pathology or imaging provider company via secure electronic communication.
To start using eRequesting, your local clinical information system will need to be set up and patients will need to be referred to the providers who can receive the requests.
As we'll discuss later in the presentation, eRequesting enables some results to be uploaded to My Health Record. some labs However, it cannot upload pathology reports to My Health Record unless you've had a request enabled and the same with imaging.
How does eRequesting work?
When you create a pathology or diagnostic imaging request from person record within your clinical information system, a request will automatically be sent to your nominated provider if you've made the connections.
We’ll discuss in the next slide the steps you need to take to set up eRequesting between your system and your preferred providers paper request form is also a printed, at the same time as the request it has a bar code on it, which can be scanned by the provider much the same as your electronic transfer of prescriptions with the barcode on prescriptions paper on paper prescriptions. This allows your patients to choose a different provider if they wish, so they can take the paper to another provider, but it won't be in a request.
At present, not all general practice clinical information systems are able to generate a request, and not all pathology and diagnostic imaging providers can accept a request.
Currently, an individual eRequest can only be sent to one provider, however your clinical information system can be connected to multiple providers and you can choose a different pathology provider for each separate request. You just have to select it from the drop-down list at the top of the pathology requesting system in your clinical information system.
The Australian Digital Health Agency website has a list of general practice clinical information systems and providers of pathology and imaging that are able to participate in a requesting, and we've included the link in the webinar resources.
Setting up your practice.
To set up your practice for eRequesting, you first need to ensure that you are using a compatible clinical information system, and that your preferred providers can receive eRequests from your software. And that probably involves your practice manager or somebody calling up the pathology or imaging company to see if they're able to receive them.
Once you've confirmed this, you need to contact your preferred providers to organise eRequesting set-up between your two systems. This will usually involve downloading an application form from the provider, which will connect to your clinical information system to use the existing patient data to generate requests. Once the functionality has been turned on, eRequesting then happens automatically with every request.
So, what are the benefits of eRequesting?
eRequesting is intended to speed up the delivery of reports back to GPs and other requesters, as well as streamlining the patient experience with less waiting and lower chance of transcription errors which improve patient safety. I think the transcription errors is a particularly important part here.
When reports are uploaded to My Health Record, patients have better access to their own healthcare information which they can access anytime and share with other healthcare providers as required.
It also allows patients to keep track of their results and monitor their results themselves over time.
When healthcare providers have access to previous results in My Health Record, it can also reduce unnecessary duplicate testing and potentially improve healthcare outcomes. By checking My Health Record, you might find that the test you're about to request has already been done recently.
How do eRequests work with My Health Record?
It's important to note pathology or diagnostic imaging reports you have requested - either using a requesting or traditional paper request - will always be sent directly to you using the existing processes in your practice. And that's usually by secure electronic transfer from the pathology company directly to your system, so that will continue.
Providers participating in eRequesting can also have the results uploaded of your patients into the My Health Record when requested.
The reports will be available immediately to you and other healthcare providers accessing the patient’s My Health Record, but your patients can only view their results after seven days after the report is uploaded.
This gives you time to review the report and contact your patient to discuss the results before they are available in My Health Record. Obviously we don't want patients finding out alarming news or news that’s hard to interpret before they've had a chance to discuss it with their GP.
The only exception to this seven day rule is COVID-19 pathology reports which are available to patients after 24 hours, if they’ve been uploaded to My Health Record. Not all COVID-19 pathology results are uploaded to My Health Record, unfortunately.
Viewing pathology and diagnostic imaging reports in My Health Record.
To view them, you can access them through your clinical information system if it has My Health Record functionality, or through the National Provider Portal.
Very few people access it through the National Provider Portal, but you may wish to do that if you're away from your clinical information system (and that's using PRODA login or another login that is being phased out).
When accessing My Health Record through your clinical information system, you can view the pathology and diagnostic imaging reports in two ways.
There's an overview that groups the same types of reports and test results together to better support clinical decision making, whereas the list view displays reports in a full list, not grouped together, but they're in chronological order.
The Australian Digital Health Agency website has more information about how to view reports in My Health Record and the link is included in the website resources pack that we mentioned earlier.
If your clinical information system is not set up to access My Health Record, you can access your patient records through the National Provider Portal. As I said, information on how to access the National Provider Portal is also available on the Australian Digital Health Agency website.
Most metropolitan and regional public hospitals around Australia, although it is variable from state to state, are uploading pathology and diagnostic imaging reports to My Health Record where GPs are able to view the reports. In the case of imaging, you're not able to view the films, you’re only able to review the reports.
The number of private pathology providers and diagnostic imaging providers uploading to My Health Record is continuing to increase over time.
What if your patient doesn't want their report uploaded to My Health Record?
Firstly, they may not have My Health Record. In which case, it's not going to be uploaded if they haven’t opted out. But if they don't want their report uploaded, they can let you know in a number of ways. They can communicate this to you as the requesting GP, or directly to the pathology or diagnostic imaging provider. The requesting GP and provider must comply with this request; you can’t override their request for them to not have it in the My Health Record.
If your clinical information system has been updated to include a ‘do not send reports to My Health Record’ tick box, you'll be able to communicate this within the request.
The Australia Digital Health Agency website has a full list of the clinical information systems that have this functionality and we've included the link in the resources pack.
It's worth noting; if the request is made to ‘not send the report to the patient’s My Health Record’, this will apply to all tests that are included in that eRequest. You can selectively request some pathology results to be excluded.
If your clinical information system does not have this functionality, there is a tick box on the paper request form that the patient can tick that requests that the report is not uploaded. Or the patient can simply write on the paper form not to upload the report.
There may be some instances where your patient’s test results could be considered sensitive and you may wish to discuss this with your patient, whether they would like to upload the report or not.
Test results will not be uploaded to My Health Record where existing state or territory legislation prohibits the disclosure of sensitive information without the express consent of the patient. This includes HIV status in some jurisdictions.
If your patient wants to remove a report that has already been uploaded, they can do this by accessing their My Health Record online or by calling the My Health Record support line which will be provided in the resources pack.
Patients can also choose to restrict access to the report, but still leave it there, or they can put access controls on their entire records. Once again, we’ll include information on access and controls in the webinar resources pack.
The Australian Digital Health Agency has a range of resources to support general practice with eRequesting, and the topics include pathology diagnostic image reporting in My Health Record, a list of the providers uploading to My Health Record, online training for My Health Record, and clinical software simulations and demonstrations specific to your clinical information system.
The Agency also runs regular webinars and events tailored specifically to GPs and general practice staff and the links to the Agency website and resources have been put in the webinar resources pack.
That brings us to the end of the webinar and thank you for joining us.
I’ll now hand back to Angela.
Ms Angela Parker:
Rob, thank you for delivering today's webinar. And thank you to all of our attendees for viewing.
If you have any questions, please email the RACGP Practice Technology and Management unit at email@example.com. The team will get back to you within two business days.
The webinar resources pack is available to download from the RACGP website where you joined this webinar.
You can also stay up to date by subscribing to the monthly RACGP Practice Technology and Management newsletter; we've included the subscribe link in the webinar resources pack.
We hope you found this webinar informative. Thanks for attending, and we hope you'll join us for future webinars in our Practice Essentials Webinar Series.
Thank you and goodbye.