Thank you to NTML for running the following scenarios through NeHTA & DoHA, and sharing their responses.
Children under the age of 14 years
• Can health professionals view and add information to the PCEHR without the parent present (i.e. child comes in with someone who is not their parent)?
• Can health professionals view and add information to the PCEHR without the authorised representative present?
Response from DOHA:
Yes as long as a healthcare provider has access permission they can add records to a consumers record when an authorised representative is in place. The same principles apply regarding consent to access and upload information when an authorised representative is in place as when the consumer is in control of their own record.
Standing consent has been provided, as part of the application for the registration with the PCEHR system, for the consumers health information being uploaded to the PCEHR System by registered healthcare provider organisations involved in care, subject to any advice expressly given to the healthcare provider not to upload: (a) a particular record; (b) a specified class of records; or (c) any records.
An organisation may choose to have a one-off conversation with the consumer or their authorised representative to reach an agreement on how the organisation will handle records for the consumer’s PCEHR. Alternatively an organisation may choose to discuss consent for uploading documents during each consultation – this continues to be a best practice approach and provides the opportunity for a consumer and their authorised representative to be kept informed about the nature of the records being uploaded to their PCEHR. It is up to the organisation to determine their policy on this matter which best reflects the organisation and its operational needs.
Legislative Policy section | eHealth Strategy and Policy Branch | eHealth Division | Department of Health and Ageing
Further commentary from NEHTA:
The implication from the response is that the organisation uploading the document does not have a responsibility to specifically ascertain whether the person in the room at the time is an authorised representative for PCEHR purposes (noting that there may well be a general obligation for a provider to be satisfied that if a person without capacity presents to receive treatment, that the person they come with and makes any decision on their behalf has that right). For PCEHR purposes, given the standing consent applies, the provider can upload information as they would for a person without an authorised representative.
I suppose where it could be more complex is when the person asks the provider not to upload a document – the provider may not be able to immediately determine whether the person who is accompanying the subject of care has the right to request information not be shared into a PCEHR. As per the advice from DoHA, the organisation should make a call on how such scenarios are dealt with should be determined locally, based on their existing processes for managing similar matters.