PCEHR Declaration of Conformity

Clinical Information System (CIS) / Contracted Service Provider (CSP) System

(In accordance with AS ISO/IEC 17050.1-2005)

Organisation details

Organisation name:

Address:

Website:

Name of contact: Telephone: ()

Email:

Software system(more than one component may be listed)

Name: Version:

Name: Version:

Name: Version:

Description of the software system:

Type of software system

Clinical Information System / CSP System

Does the software systemupload prescription and dispense records directly to the National Prescription and Dispense Repository (NPDR)?

No
Yes
The software system supports the following use cases to access the NPDR:
UC.CIS.201 – Upload a clinical document
UC.CIS.202 – Supersede a clinical document
UC.CIS.203 – Remove a clinical document
The software system uses the following web services to access the NPDR:
Ping_PortType_Ping_InputMessage
DocumentRepository_ProvideAndRegisterDocumentSetbRequest
removeDocumentRequest

Does the software systemdirectly access the PCEHR Repository?

No
Yes
The software system supports the following use cases and associated web services to directly access the PCEHR Repository:
UC.CIS.001 – Check if an advertised PCEHR exists / doesPCEHRExist
UC.CIS.002 – Gain access to PCEHR / gainPCEHRAccess
UC.CIS.201 – Upload a clinical document / ITI – 41 Provide & Register Document Set - b
UC.CIS.202 – Supersede a clinical document / ITI – 41 Provide & Register Document Set – b
ITI – 18 Registry Stored Query
UC.CIS.203 – Remove a clinical document / RemoveDocument/DeregisterDocument
UC.CIS.204 – Download a clinical document / ITI – 43 Retrieve Document Set
ITI – 18 Registry Stored Query
getChangeHistoryView
UC.CIS.301 – Access a view service / ITI – 18 Registry Stored Query
getChangeHistoryView
getAuditView
getRepresentativeListView
getIndividualDetailsView
getView
UC.CIS.401 – Search for a template package / searchTemplate
UC.CIS.402 – Retrieve a template package / getTemplate
UC.CIS.403 – Store template metadata or a template package
UC.CIS.501 – Assisted PCEHR registration of an adult / RegisterPCEHR
UC.CIS.502 – Assisted PCEHR registration of a child / RegisterPCEHR
The software system uses the following web services to access the PCEHR Repository:
doesPCEHRExist / getChangeHistoryView
gainPCEHRAccess / getAuditView
ITI – 41 Provide & Register Document Set – b / getRepresentativeListView
RemoveDocument/DeregisterDocument / getIndividualDetailsView
ITI – 43 Retrieve Document Set / getView
ITI – 18 Registry Stored Query / searchTemplate
RegisterPCEHR / getTemplate

The organisationhas assessed the conformance of their software tothe mandatory and relevant conditional requirements in the above PCEHR CIS use cases specified in Clinical Information Systems Connecting to the PCEHR System –Conformance Requirements, version 1.5, 6 Sep 2012 and Amendment 1: Conformance Requirements for Assisted Registration, 6 Mar 2013.

Does the software system produce clinical documents in CDA format?

No
Yes
The software system produces clinical documents meeting the following requirements for conformance levels and clinical usability:
eReferral1A1B23A3B / Clinical usability
Discharge Summary1A1B23A3B / Clinical usability
Event Summary 3A 3B / Clinical usability
Shared Health Summary 3A 3B / Clinical usability
Specialist Letter1A1B23A3B / Clinical usability
PCEHR Prescription Record 3A3B / Clinical usability
PCEHR Dispense Record 3A3B / Clinical usability
The software system conforms to the mandatory and relevant conditional requirements for document producers listed in the following specifications:
PCEHR Conformance Profile for Electronic Referral Clinical Documents, v1.3
PCEHR Conformance Profile for Discharge Summary Clinical Documents, v1.4
PCEHR Conformance Profile for Event Summary Clinical Documents, v1.2
PCEHR Conformance Profile for Shared Health Summary Clinical Documents, v1.3
PCEHR Conformance Profile for Specialist Letter Clinical Documents, v1.3
PCEHR Conformance Profile for PCEHR Prescription Record and PCEHR Dispense Record, v1.1
PCEHR Clinical Usability Software Requirements, v1.0

Does the software systemaccess information in the PCEHR system?

No
Yes
The software system accesses the following PCEHR views:
Prescription and Dispense View / Medicare View
Observations View / Health Check Schedule View
The software system displays information according to the following specifications:
CDA Rendering Specification, v1.0
Prescription and Dispense View Presentation Guide, v1.0
PCEHR Clinical Usability Software Requirements, v1.0

Conformance assessment completion date:

(day/month/year)

Additional information:

Limitations on the validity of this declaration:

Do you want the software system listed in the Practice Incentives Program (PIP) eHealth Product Register?

(for information about PIP conformance requirements, refer to )

No
Yes
I agree with the Vendor Terms and Conditions on the PIP eHealth Product Register website

Do you want the software system listed in the eHealth Register of Conformity?

(for information about the eHealth Register of Conformity, refer to theNEHTA website)

No
Yes
Iagree with the Vendor Terms and Conditions on the eHealth Register of Conformity webpage.

By signing below, I certify that the information I have provided on this form is accurate, complete and uptodate. I am aware that NEHTA or any other observer does not perform conformity assessment and that I am responsible for the representations I make on this form.

Signed by:

Name of issuer or authorised representativeSignature

Role (day/month/year)

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