Thursday, February 21, 2013

It Seems Peace Has Broken Out In E-Prescribing. A Good Thing I Reckon But There Is More To Do.

Lots of news in this area last week:
First we have.

ACCC agreement to boost e-prescribing

14 February, 2013 Nick O'Donoghue
The ACCC is set to authorise an agreement between two competing e-prescription systems that will allow them to talk to each other.
The body issued its draft determination yesterday, following the granting of interim approval for the deal, which will enable the Pharmacy Guild of Australia backed eRx system to “talk” to the MediSecure system.
The Department of Health and Ageing has also supported the move, which is expected to boost electronic prescription use.
Currently, the two systems are the only prescription exchange services in Australia, but their incompatibility to-date, has hampered the growth of e-prescribing, Dr Michael Schaper, ACCC deputy chair said.
More here:
Next we have.

E-scripts boost after software agreement

15 February, 2013 Paul Smith
Peace has broken out in the long-running war between Australia’s two rival e-prescribing software systems raising the prospect of a major boost in e-prescribing.
Over the past fives years, MediSecure system, backed by the RACGP, has been fighting it out with its bitter rival — prescribing system eRx Script Exchange, supported by the Pharmacy Guild of Australia.
Until this year, the systems did not speak with each other, undermining the hope that e-prescribing would reduce transcription errors.
It led to the situation where a script written by a GP using the MediSecure software could not be dispensed electronically by a pharmacy equipped with eRx.
It also meant GPs using systems different from pharmacists were not sent notifications that scripts had been dispensed.
More here:
Last we have:

Pharmacies lag in using electronic prescriptions

Most pharmacists still manually type original prescriptions into their dispensing software, even though electronic prescriptions are now compatible across nearly all GP and dispensing programs.
From mid- January, Australian GPs and pharmacists have been able to generate and dispense scripts across both electronic prescription exchange services (MediSecure Script Vault and eRx Script Exchange) following an ACCC-approved collaboration between the rival software companies to allow interoperability.
The two companies were allocated over $1.2 million for technical work to ensure the interoperability and will collect an estimated $8 million in transaction fees under the Fifth Community Pharmacy Agreement, signed off in 2010.
Electronic prescriptions are still delivered in paper format, but the information is sent directly from the doctor’s computer to a prescription exchange service.
A barcode is printed on the script to allow script data to be downloaded to any pharmacy’s dispensary software, reducing the risk of errors from re-typing.
But while electronic prescribing has been touted as a cornerstone to eHealth in Australia and the technology is now in place, pharmacists are not using a key component – scanning the script’s barcode to access data entered by GPs.
"We’re still seeing that less than five percent of original scripts are downloaded," MediSecure CEO Phillip Shepherd told eHealthspace yesterday.
More here:
We need to be clear here. What has been done, with both of these systems, is that we have printed prescriptions being made to have a common barcode system which the patient then has to take to a pharmacy and then wait for it to be dispensed. We do not have electronic transmission of prescriptions to the pharmacy of the patient’s choice so the medicine can be ready when you arrive to pick it up.
Until we get to this stage - over the nonsensical resistance of the Pharmacy Guild - we really can’t claim to be trying to be user / patient friendly.
Pretty sad really.


Anonymous said...

Personally, by pharmacy visiting practices are far too unpredictable for an electronic prescription to be dispensed before I arrive.

Every pharmacy being able to access my prescription (and repeat info) on demand when I show up and ask for a dispense... that's a different story.

Dr David More MB PhD FACHI said...

Most of us know where we want to pick most would like this approach.

Sure works in the US.


Anonymous said...

But if you don't have a piece of paper with a bar code on it (or a smart phone with a code/bar code), to identify the exact prescription paper, then you will need to say to the pharmacist - if you have more than one prescription lurking in the prescription hub (which if you are on more than 3 meds you may very well have)...

" not that one, I think it is the one for the pink pills, the one I take for my embarrassing rash...can't remember the name of it...can you look it up for me? Can we please go soemwhere private to talk...?"

Keith said...

Compatibility between the two prescription exchanges is an important and welcome step forward, but can anyone enlighten me on what conformance and compliance testing and accreditation has been done in this whole e-prescribing area? Are we just taking the word of eRx and Medisecure that everything is hunky-dory or is there a CCA process being followed? It's made more difficult by the lack of an accepted ETP standard. It's too important to be left to chance.

Bernard Robertson-Dunn said...

Reinforcing Keith's point that "Compatibility between the two prescription exchanges is an important and welcome step forward,"

Does a strategy for e-prescribing exist? One that covers more than the technology approach recommended by Deloitte?

Quote from the Deloitte National eHealth Strategy
"It is recommended that electronic prescribing should be addressed through the development of
a nationally integrated ‘store and forward’ e-prescribing network where once a prescription is
finalised by the practitioner the electronically signed prescription is transmitted, in secure
fashion, to a central e-prescribing hub."

As we've seen in the case of the PCEHR, there's more to an eHealth system than technology.

Keith said...

Bernard Robertson-Dunn 2/22/2013 10:32:00 AM said: "As we've seen in the case of the PCEHR, there's more to an eHealth system than technology."

Agreed, but there are still some pieces of technology to be completed. David points out in the blog that we don't yet have true electronic prescriptions with a digital signature. That requires each prescriber to have a "NASH" style personal signing certificate. Judging by how long it is taking for DHS to issue a few thousand organisation certificates we are unlikely to be in a position to even contemplate a move to electronic prescriptions much before the end of this year.