EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (Quality Assurance Activity – Emergency Medicine Events Register (EMER)) Declaration 2025
Authority
Subsection 124X(l) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by legislative instrument, declare a quality assurance activity described in a declaration to be a quality assurance activity to which Part VC of the Act applies.
The Health Insurance (Quality Assurance Activity- Emergency Medicine Events Register (EMER)) Declaration 2025 (the Declaration) declares the Emergency Medicine Events Register (EMER) (the Activity) to be quality assurance activity to which Part VC of the Act applies.
Purpose and operation
Part VC of the Act creates a scheme to encourage efficient quality assurance activities in connection with the provision of health services. Those activities help to ensure the quality of health services that are funded by the Government, including through Medicare benefits and public hospital services. The scheme encourages participation in such activities by protecting certain information from disclosure, and by providing some protection from civil liability to certain persons engaged in those activities in good faith.
The purpose of the Declaration is to declare the Activity to be a quality assurance activity to which Part VC of the Act applies.
The Activity is conducted by the Australasian College for Emergency Medicine (ACEM). The Activity applies only to health services provided in Australia. The Activity consists of an online incident reporting platform for emergency medicine practitioners, including emergency medicine trainees practising in Australia and New Zealand, to report adverse events or 'near-miss' events that occur during their practice. Other allied health care professionals and health care consumers can also access the platform to report an event.
Users may report incidents across a spectrum of incident severity, ranging from 'near misses' to severe harm, by using an online portal (www.emer.org.au). Users are asked to respond to close-ended and open-ended questions and provide information about each incident in free-text fields. At the completion of each reported incident, a brief summary of the incident is provided to the reporter. An incident identification number is provided for reporters that are health professionals, to use to record continuing professional development points. No information that may identify a person is contained in the summary or incident identification number.
Any information that may identify a particular site, individual or individuals either expressly or implicitly is removed within 72 hours of each incident reported by an appropriately qualified designated EMER data custodian appointed by ACEM. As this process de-identifies the data and removes any personal information, users will not be required to consent to their personal information being used for the purpose of the quality assurance activity.
ACEM personnel categorise each incident according to patient safety issues, human contributory factors, system resilience, and how far downstream an error travels before it is detected.
Persons who request access to EMER data must obtain low risk ethics approvals from relevant institutional human research ethics committees and ACEM. Once all approvals are obtained, ACEM data personnel extract the data from the EMER database and check that all potentially identifiable information has been removed before the data is released to the person and used for further analysis. The data is then securely released to the data requester.
ACEM has the following security measures in place to ensure safe and secure storage, protection and access to the data:
- The EMER will be on a dedicated virtual server hosted on Amazon Web Services (AWS). AWS is an Australian Signals Directorate Cloud Certified Provider. In this context, "dedicated" means the server would not host any other website.
- It will implement a web application firewall to mitigate against un-authorised access and other attacks.
ACEM will only ever release de-identified, aggregated data from the EMER to produce reports for journal publications, newsletters, peer reviewed publications, and for presentations at safety and quality related conferences, professional development and learning programs and workshops. Data will only be released where there is a minimum cluster of at least five similar cases.
Data from EMER that is used for quality assurance activities will be securely held and retained for seven years from the date of the last data entry, and then securely destroyed using a double deletion process. The deletion process will be double audited to ensure that all artefact data and back up data are securely removed from the AWS dedicated virtual server.
Commencement
This Declaration commences on the day after registration of the instrument on the Federal Register of Legislation.
Consultation
ACEM, as the applicant for declaring the Activity, was consulted in relation to the content of the Declaration. No concerns were raised with the proposed content Wider consultation was not considered necessary as the quality assurance activity only relates to the gathering of information for the Activity, as conducted by ACEM. The declaration of the Activity will not result in any direct or substantial indirect effect on business.
General
This Declaration is a disallowable legislative instrument for the purposes of the Legislation Act 2003.
Details of the Declaration are set out in Attachment A.
The Declaration is compatible with the rights and freedoms recognised or declared under section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. A full statement of compatibility with human rights is set out in Attachment B
ATTACHMENT A
Health Insurance (Quality Assurance Activity – Emergency Medicine Events Register (EMER)) Declaration 2025
Part 1—Preliminary
Section 1 – Name
This section provides that the name of the Declaration is the Health Insurance (Quality Assurance Activity – Emergency Medicine Events Register (EMER)) Declaration 2025.
Section 2 – Commencement
This section provides that the Declaration commences on the day after it is registered on the Federal Register of Legislation.
Section 3 – Authority
This section provides that the Declaration is made under subsection 124X(1) of the Health Insurance Act 1973.
Section 4 – Repeal
This section provides that the Declaration will be repealed when it ceases to be in force in accordance with subsection 124X(4) of the Health Insurance Act 1973.
Subsection 124X(4) of the Health Insurance Act 1973 provides that a declaration of a quality assurance activity ceases to be in force at the end of 5 years after it is signed, unless sooner revoked.
Section 5 – Schedule
This section provides that the Activity described in the Schedule is declared to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 applies.
Schedule 1 – Description of quality assurance activity
Item 1 – Name of activity
Item 1 of Schedule 1 provides that the name of the Activity is ‘Emergency Medicine Events Register (EMER)’.
Item 2 – Description of activity
Item 2 of Schedule 1 describes the quality assurance activity as a registry of emergency medical events, including the reporting of adverse events and near-misses. The EMER is a clinical incident reporting system that captures information via a secure online website hosted at www.emer.org.au. The system allows emergency medical practitioners, emergency medicine trainees and allied health professionals practicing in Australia, as well as health care consumers including· patients, their families, and carers, to voluntarily and anonymously report incidents that resulted in an adverse outcome or near-miss event.
Users provide information in response to close-ended and open-ended questions. The data is recorded in a database managed by ACEM, which conducts the Activity
All data is de-identified by a designated data custodian appointed by ACEM. The de-identified and aggregated data is analysed to inform improvements in emergency medicine practice and patient safety. This includes:
- Releasing de-identified, aggregated information to members of the emergency medicine profession for quality assurance research;
- presenting findings at state, national, and international conferences, workshops, and webinars focused on emergency medicine, patient safety, and quality;
- promoting EMER and sharing learnings and corrective strategies at relevant events;
- publishing findings on the ACEM website, in member newsletters, and in peer-reviewed scientific journals; and
- informing updates to ACEM's emergency medicine training curricula, clinical practice policies, and standards,
The Activity aims to analyse national-level data to support the development of educational resources, improve clinical practice and enhance patient safety in emergency medicine.
ATTACHMENT B
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance (Quality Assurance Activity – Emergency Medicine Events Register (EMER)) Declaration 2025
The Health Insurance (Quality Assurance Activity - Emergency Medicine Events Register (EMER)) Declaration 2025 (the Declaration) is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Overview of the legislative instrument
The Declaration declares the Emergency Medicine Events Register (EMER) (the Activity), conducted by the Australasian College for Emergency Medicine (ACEM), to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 (the Act) applies.
Information known solely as a result of the Activity, or documents created solely for the purposes of the Activity, will be covered by qualified privilege.
Human rights implications
This Declaration engages with the right to health as set out in Article 12 of the International Covenant on Economic, Social and Cultural Rights by assisting with the progressive realisation by all appropriate means of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
The Qualified Privilege Scheme established by Part VC of the Act is aimed at encouraging participation in quality assurance activities that help to ensure that the highest possible health care standards are maintained. The quality assurance activity described in this Declaration will provide participants with a greater degree of confidence and security that their participation is solely for the benefit of improving clinical practice and patient safety
This Declaration also engages, but does not limit, the right to privacy as contained in Article 17 of the International Covenant on Civil and Political Rights by involving the collection, storage, security, use, disclosure or publication of personal information. While some personal information may be initially collected, it will be promptly de-identified by a designated data custodian to ensure that no individual is identifiable. The de-identified data is then securely stored, analysed, and disclosed only in aggregated form to appropriate data requesters for the purposes of quality improvement in emergency medicine.
Conclusion
This Declaration is compatible with human rights as it promotes the right to health and does not limit the right to privacy.
Professor Michael Kidd AO
Chief Medical Officer
Department of Health, Disability and Ageing