The Healthcare Provider Directory (HPD) has a number of constraints that are impacting the potential of the directory to fulfil its objectives, and are causing significant frustration with stakeholders. The major issues are outlined below.
The opt in basis for participation was raised as the major concern with the utility of the HPD and was seen as a significant barrier to a number of programs, in particular to the implementation and effectiveness of Secure Message Delivery and NASH. (See section 3.2) The opt in rate is currently very low. This is partly a result of a lack of understanding about the purpose of the directory, partly a lack of awareness about the existence of directory, or the need to actively consent, and partly functional issues impacting the process. While there is a web service that allows people to consent online and maintain their details this is not being routinely used at this point. Low participation rates impacts confidence in the quality of the HPD as most searches do not return a result.
The lack of data in the HPD is causing a lot of frustration with users as manual workarounds are needed to ensure messages are being correctly routed. Other functional limitations also affect adoption, particularly the lack of functionality to download provider details from the directory to update local Patient Administration Systems. The inability to download provider information has resulted in many health services implementing their own directories, causing duplication that a national directory should reduce. This functionality is critical for efficient workflow. The HPD needs to support referral and other clinical projects, but should also be able to be used for the PCEHR system to manage consumer access choices.
There appears to be duplication in the infrastructure and content of the HPD and the National Health Call Centre directory (National Health Services Directory (NHSD)). Maintaining more than one directory, containing similar data, but involving different maintenance processes and structures will increase costs, increase the maintenance effort and potentially reduce the utility as users need to navigate between multiple directories. The requirement and value of maintaining multiple directories needs to be reassessed as the burden maintaining multiple directories will be considerable and the value of this is questionable. The HPD is only accessible by healthcare providers. The NHSD supports secure sections that are only accessible to providers as well as public areas for consumer access. HPI-Is have been added to the restricted section of the NHSD to enable discharge summaries to be sent.
There is potential to rationalise national healthcare provider directories through integration between the NHSD and the HI Service as the source of truth for the data relating to the identifiers. In this model selected information relating to HPI-Os and HPI-Is (e.g. the identifiers, the status of these, Seed/Responsible Officer/Organisation Maintenance Officer registration information) would be managed by the HI Service and would be read only in the NHSD. Other information that is more appropriate to be managed by providers could be editable in the NHSD, where the provider information supports multiple functions. Integration between directories would require changes to the HI Act and to the functionality of the NHSD.
Recommendation 19 – Directory infrastructure
It is recommended that a concept of operations for directory infrastructure be developed to identify options to rationalise directories, increase use and decrease maintenance cost and effort. This should consider the feasibility of integration between the National Health Services Directory and the Healthcare Provider Directory to reduce duplication and rationalise the national directory infrastructure.