ScriptX – Just What is it and Where is This Heading?

The following press release appeared a day or so ago, along with an ASX announcement under the symbol COO.

Corum Health joint venture pioneers e-prescriptions

27/03/2008

Corum Health Services is pleased to announce the joint venture to develop the first widely available system for electronically transmitting prescriptions between doctors and pharmacies. Endorsed by the Pharmacy Guild of Australia, ScriptX has the potential to dramatically improve patient care by improving the safety and efficiency of prescribing, while protecting patient privacy and choice of pharmacy.

Our joint venture partners, Health Communication Network Limited and Fred Health, have worked with us to:

• Enable doctors to securely electronically send prescriptions to an encrypted hub for retrieval at a patient’s pharmacy of choice

• Provide a universal standard, so that all doctors, medical facilities and pharmacies throughout Australia can access ScriptX, no matter what software they use

• Preserve patient choice, rather than directing scripts to a particular pharmacy

• Observe all privacy laws and regulations

• Increase efficiency and reduce errors in transcribing handwritten prescriptions

• Provide secure access codes for doctors and pharmacies

• Improve the handling of owing scripts and retrieval of repeat scripts

“We are delighted to be providing electronic prescriptions to all doctors and pharmacies, while maintaining the highest standards of patient privacy. This industry-wide solution is a significant breakthrough in the interaction between Doctors, pharmacies and ultimately the customers.” said Mark Winnett, Managing Director, Corum Group.

“For doctors, this will be a vital milestone in supporting patients with overall medication management, including seeing that patients are getting the medication that they need. This is an important step on the e-health journey towards improved health care for patients,” said John Frost, CEO, Health Communication Network.

“Anything that aids the safety of patients is well worthwhile, and a national electronic prescribing system could provide the basis for real improvements in public health and community care. ScriptX is a major breakthrough, backed by substantial industry leadership and commitment towards improved patient health outcomes, through ongoing innovations designed to streamline and safeguard prescribing,” said Bill Scott, Chairman, Fred Health.

“The Guild is pleased to endorse and support plans for the national electronic prescribing system ScriptX, which will improve the safety and efficiency of prescribing in Australia, with the aim of more effective medicine management and better health outcomes for patients,” said Kos Sclavos, National President of the Pharmacy Guild.

The Pharmacy Guild of Australia has pre-purchased 10 million transactions on the ScriptX gateway for Guild members to use at no charge. The ScriptX gateway is due to be launched Australia-wide by March 2009.

About Corum Health Services
Corum Health Services is a leading provider of pharmacy software solutions, enhancing the point-of-sale, dispensing and business operations of more than 2,300 Australian pharmacies. Brands include Corum, Amfac and Pharmasol.

For more information please contact: Mark Winnett, Managing Director, Corum Group Limited, 02 9289 4699

The press release can be found at the following URL:

http://corumhealth.com.au/news-detail.aspx?cid=1&navid=-1&newsid=24

Media Release: End of Paper Prescriptions Nearer?

The Pharmacy Guild of Australia is assisting in driving innovation in the health sector by announcing its endorsement and support for a national electronic prescribing system ScriptX where prescriptions are sent in a secure encrypted gateway from doctors to an “electronic mailbox” and later retrieved by the patient at the pharmacy of choice.

“ScriptX will improve the safety and efficiency of prescribing in Australia, with the aim of more effective medicine management and better health outcomes for patients. It also maintains patient choice and privacy, while streamlining the prescription process, “ said Kos Sclavos, National President of the Pharmacy Guild.

ScriptX does not store information on patients or any prescription details and information held while waiting for the prescription to be filled is held in a fully encrypted form to ensure privacy and it is prohibited for details to be sent to third parties other than with the full consent of the patient.

ScriptX and the Guild have entered into a historical agreement to allow patients to elect for limited information to be sent via ScriptX to the Guild’s new Medication Care Pharmacy Programs such as MedsIndex, which assist patients with dosages, medication management and compliance.

Initially, paper prescriptions will be issued alongside the e-prescription until the Guild and other health professionals are confident that the system is working. At that stage an approach will be made to Government to plan the phasing out of paper based prescribing. The Guild has worked with the Federal Government on many successful health IT initiatives.

ScriptX is a joint venture between the three leading primary health IT vendors in Australia including the Health Communication Network, Corum Health and Fred Health. All medical and pharmacy software vendors will be able to use the gateway.

The Guild has entered into a commercial arrangement where it will purchase 10 million transactions for its Guild pharmacies for first stage implementation. The system is based on a pharmacy user pay system although Federal Government support will be sought following phase I implementation. In addition the ScriptX system is free for doctors to use.

For further media enquiries contact Michael Pittman, Media Manager of the Pharmacy Guild of Australia on 02 6270 1888; John Frost, CEO of Health Communication Network on 0402 383 658; Mark Winnett, Managing Director of Corum Group on 0434 658 800; or Paul Naismith, CEO of Fred Health on 0417 341 899.

The release is found at the following URL:

http://www.guild.org.au/content.asp?id=1742

Also worth reviewing is a Q & A found at

http://www.guild.org.au/uploadedfiles/National/Public/News_and_Events/Media_Release_Archive/Q%20and%20A%20ScriptX(1).pdf

Background is also available here (as well as an explanation of MedsIndex):

Scores help patients keep pace with prescriptions

Adam Cresswell, Health editor | March 29, 2008

PATIENTS will be scored on how closely they follow their doctor's orders in taking their prescribed medications, in a move designed to lift adherence rates and improve outcomes for people with chronic conditions.

The scores will be expressed as a "mark" out of 100, and will be colour-coded to indicate increasing levels of concern as scores get lower. Pharmacists will be encouraged to help patients whose scores are slipping into the red, by packing multiple medicines into blister packs that make it easier to see which drugs are due to be swallowed at particular times.

For more difficult cases, patients may be asked to see their GP for a home medication review, which is designed to simplify a patient's drug regimen.

However, the scores are not designed to imply fault or blame, and no penalties or sanctions will apply to people with low scores.

The new scheme will work by comparing the time it takes patients to return to a pharmacy to have a repeat script filled, with the time it would have taken them had they taken all the previous doses at the appointed times. It was launched by Parliamentary Secretary for Health Jan McLucas at a pharmacy conference this week.

The MedsIndex scheme has been devised by the Pharmacy Guild, which has already run it as a successful four-month pilot, mainly in Victoria and Queensland.

Pharmacy Guild president Kos Sclavos said research showed patients' adherence to dosing schedules plunged rapidly in line with the number of daily medicines they were supposed to take.

Among patients taking one pill per day, compliance was about 80 per cent, but fell to 72 per cent for those taking two pills -- and to just 64 per cent among patients taking three pills every day.

Sclavos said even an 80 per cent compliance raised concerns, as "drug manufacturers don't confirm their drugs remain efficacious if you are missing one dose in five".

More at:

http://www.theaustralian.news.com.au/story/0,25197,23442127-23289,00.html

There are a few comments that need to be made about all this:

First it is important to be aware of the following:

“The number of prescriptions dispensed in 2005-06 subsidised under the PBS was 168 million. This compared with 170 million in 2004-05.”

When we add private prescriptions to this number the total will be well over 200 million annually. The 10 million free is all of a free 3-4 week introductory offer!

Second with 200 million transactions per year even a 20 cent user pay for the pharmacists per transaction can rack up $40 million per year. A nice little earner for what will amount to operating a few secure servers, paying for some internet bandwidth and running some software which once developed would be almost cost free! I wonder who is hoping to profit from all this.

Third this has the feel to me of an attempt to establish what amounts to a commercial private monopoly on e-prescribing in Australia with the objective of entrenching the market power of the three participants. I am by no means sure this is the way to go and would prefer to see Scriptx as an entity which is at arm’s length from the joint venture partners and which is both not for profit and able to be joined by other interested entities (e.g. other practice management system providers).

Additionally I am not sure I think, what will become a crucial part of the e-health infrastructure in Australia if the venture succeeds, should be held in private hands. If there is a case for Medicare Australia to be providing identity services for the health sector I think there could also be a case for Medicare to operate the e-prescribing gateway. Certainly, given the need for data security and operational continuity, the option needs to be carefully considered before this all goes too far. Frankly this is a service Medicare should have been providing for the last five years!

Fourth I note that, while HCN is part of a major ASX listed corporation (Primary Healthcare), Corum is a worryingly small entity with a share price that was $4.00 in 1998 and which is now only 8 cents. The company’s revenue has actually declined since 2003/4 to now be only $17million p.a. Not, at first review, the ideal partner in a critical national e-health infrastructure service.

Fred Health is privately held and from its web site seems to be involved with, among other things, data mining of prescription data for the pharmaceutical industry among others.

See:

http://www.pcanu.com.au/prnetwork.html

Not an activity I am all that keen on I must say. This is hardly re-assuring.

“In conjunction with some of the world’s largest research companies, PRN also provides pharmacy data for use in research, usage reporting as well as scan data from retail activities. PRN adheres to the strict legislative requirements of privacy and confidentiality to ensure that all data protects both the interests of the participating pharmacist and their patients. The program requires that pharmacies intending to take part give formal consent before they begin.”

I wonder do patients know this is going on and I wonder how much the pharmacist is paid?

Last I wonder just how standards compliant what is proposed is. For successful interoperation nationally a high level of standards compliance is vital. I wonder what input, if any, Standards Australia work and NEHTA have had in making sure the gateway is genuinely open and interoperable.

There is a good deal of water to go under the bridge on this I suspect.

We can all watch and see how things play out. Right now, while keen to see progress, I am not quite sure this is quite the progress I want.

Time will tell.

David.

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Note: News will appear tomorrow.

D.