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Friday, March 20, 2009

E-Prescribing Wars Break Out in Australia!

Well it seems we are to have a little competition for the eRx program announced a week or two ago and commented on in detail here:

http://aushealthit.blogspot.com/2009/03/e-prescribing-comes-around-again-in.html

Well now we have a new competitor.

RACGP supports MediSecure e-scrip solution

March 20, 2009:A contender for the secure electronic transmission of prescriptions (ETP) from doctors to pharmacists has gained the support of The Royal Australian College of General Practitioners (RACGP).

Created jointly by ArgusConnect, PSLnet and Medseed, the MediSecure e-prescription solution promises a standards-compliant solution that is open to all clinical and dispensing IT systems and is working now.

MediSecure is a response to initiatives taken by COAG and the Commonwealth Government which placed electronic transmission of prescriptions (ETP) and secure individual electronic health records (SIEHRs) at the top of the national E-Health agenda.

“The MediSecure e-prescription solution is committed to implementing Australian standards; Open interface specifications; Interconnectivity and equity of access with all IT vendors in medical practice and pharmacy; privacy protection and market contestability in relation to any e-prescribing exchange” said Ross Davey CEO of Argusconnect.

MediSecure uses technology developed for the eHealthNT trial of Electronic Transfer of Prescriptions, which was implemented by General Practice Network NT (GPNNT), a leading division of general practice. This trial adopted current and emerging standards, open design principles and open participation, as well as implementing the most recentHL7 Prescription Message standard. MediSecure incorporates HL7 and the emerging IT14 standards.

MediSecure Chairman, Paul Montgomery said “MediSecure is confident its working technology meets all the prevailing standards including best practice privacy requirements, it has in place a process to adapt to evolving standards fromNeHTA and others, and includes the HeSA PKI which provides for message encryption, digital signing and authentication. Overall, we believe we have carefully positioned our offer to meet the current and future requirements for a standards-compliant contestable market solution that is acceptable to government and the standards setters in medical practice.”

Much more here:

http://www.idm.net.au/story.asp?id=16699

More coverage is found here:

Pharmacists & GPs back rival e-script projects

Simone Roberts

A direct competitor to the Guild backed eRx Script Exchange entered the market yesterday with the support of doctors.

MediSecure announced the release of the MediSecure e-prescription solution, created jointly by ArgusConnect, PSLnet and Medseed. According to MediSecure, ArgusConnect currently connects over 8,000 health care practitioners, while PSLnet is a secure trading exchange with the capacity to electronically connect every pharmacy in Australia.

A statement from the company said pharmacists would pay 25 cents per script while there would be no cost to doctors.

The initiative has received the backing of the Royal Australian College of General Practitioners (RACGP). RACGP president Dr Chris Mitchell said pharmacists would save time and money in the dispensing process and looked forward to their enthusiasm in supporting the development.

Guild president Kos Sclavos said Dr Mitchell's comments were the "typical approach of doctors".

More here:

http://www.pharmacynews.com.au/articles/Pharmacists-GPs-back-rival-e-script-projects_z473932.htm

There is a web site here:

http://www.medisecure.com.au/index.html

We also have more eRx related news:

Simple Retail joins eRx rollout

THE majority of pharmacies across Australia are tipped to start using the fi rst national electronic prescription platform by the middle of the year after Simple Retail joined the rollout of the software.

The dispensing specialist will join main developers Fred Health and medical software specialist Best Practice in rolling out the eRx Script Exchange system to pharmacies.

Pharmacies in New South Wales and Victoria have already started trialing the system with a nationwide launch expected in July.

Pharmacy Guild of Australia national president Kos Sclavos expected eRx Script Exchange to be available in 60 per cent of Australian pharmacies by July.

More here:

http://www.pharmacynews.com.au/articles/Simple-Retail-joins-eRx-rollout_z473798.htm

All I can say it is starting to get exciting.

However, the time has really come for DoHA and NEHTA to step in, make it clear we are going to have one National System – which is consistent with all the other secure messaging initiatives which are in train (and which is consistent with the National E-Health Strategy) – and put the parties on notice that this is a key policy issue which the Government will address in a sensible way which conforms to the national interest.

To let all involved just spend money and effort – without policy and regulatory clarity – is just absurd.

Minister Roxon are you listening?

David.

23 comments:

Anonymous said...

Wait on - are pharmacists happy with that? They get 40 cents for sending each script claim off to Medicare/PBS, but they would have to spend 25 cents per script to receive the script electronically from the precription hub, where it has been lodged by the GP - at no cost to the GP (and in fact the GP gets a PIP payment for contemplating sending a script to the hub). With the ?160 million scripts annually, that's about ?$40 million to be made by the prescription hub services (at 25 cents per script). Maybe its a good idea to have multiple hubs - leading to competition, and cheaper transaction costs? Maybe the PIP payment should focus instead on ensuring that doctors use software that is capable of integrating (using national standards) with a standards-compliant hub. Does it matter that there are mutiple hub systems, as long as they are standards compliant? The standards would need to include messaging and data standards for the payload of the secure prescription messages (including the Australian Medicines Terminology where relevant), and can build on the messaging standards work completed for medication messaging through Standards Australia.

Anonymous said...

Government is looking down the barrel of the guild’s big guns. At 160 million scripts dispensed each year anything from 25 cents to $1.0 per script is very attractive. If Medicare can pays us 40 cents per script to use PBS online why can’t they pay us 40 cents for escripts, then we could afford to pay Medisceure and eRx Script Exchange and whoever else wants to jump in the pond the 25 cents they are asking - for starters that is BEFORE they get serious and jack their transaction fees northwards.

Anonymous said...

Why should we pharmacists have to pay 25 cents per script and not the doctors? Why shouldn’t it be split 50/50? The patient should be made to pay if they want their script sent electronically or better still Medicare should be. At $1.0 per script we can all share the revenue, 25 cents for us, 25 cents for the doctors, 25 cents for the carrier and 25 cents for the software companies.

Anonymous said...

When the 5th Guild-Government negotiations get underway you can be sure the Guild will be pushing to be the banker over all funds related to escripts.

Anonymous said...

Banker indeed. The guild is the banker to everything else of any relevance in pharmacy. Those of us who aren't allowed to be members of the guild watch in utter amazement at how government rolls over every time the guild says 'boo hoo' and cy into our tea leaves at the impotence and ineptitude of the PSA in not being able to stand up to the guild and be seen by government as a worthy partner. Perhaps if we got some of the funding that government throws at the guild we could level the playing field and provide better outcomes not just for pharmacy but for the whole-of-health. That it should ever come to pass - we live in hope.

Anonymous said...

Government is impotent here. Market forces will prevail and someone will pay dearly for what should be a public-owned infrastructure facility. These commercial exchanges which both have deep rooted associations with the Pharmacy Guild are intent on securing a solid footprint before government wakes up to the fact it is too late to do anything except roll over. This will be followed by Medicare talking about outsourcing to one or another of the commercial players and paying dearly for the privilege. Of course the Guild won’t really mind which way it goes because it has its tentacles deeply entrenched in both camps.

Anonymous said...

Multiple hubs are one option but they won't fix the real problem of interoperability between hubs until NEHTA gets off its proverbial and there is little chance that will happen in time to make a difference.

Anyway, regardless of what Nehta or government do the pharmacists and maybe the doctors too, if they're quick, will snatch the opportunity away from government and if they can find a way they will use these exchanges as leverage for more money. Government is blind and incapable of doing much about it. And the Minister, indeed all politicians, are scared of the chemists' lobby. Maybe what's needed is some white knight to ride along over the top of them all.

Anonymous said...

Can't help wondering why HCN's MD John Frost pulled out of the ScriptX project. At the time he was reported as saying the reason was because the business model didn't stack! Most odd given there are now two exchanges which think there is plenty of juicy business o be done.

Could there have been some other reason? As doctors we are his constituents not the pharmacists. Did he fear we might have turned on him through the College if he was seen to be playing into the pharmacists hands?

Anonymous said...

Who owns the Intellectual Property behind Medisecure?

If it is based on the "eHealthNT trial of Electronic Transfer of Prescriptions, which was implemented by General Practice Network NT (GPNNT)", developed with federal government funding where lies the IP? Does DOHA have any interest in this? Has our President been conned in the rush to be seen to be competing with the Guild? Does he know who owns the IP? And while he’s at it can he make a statement to clarify no secret commissions are being paid or have been negotiated and that the RACGP is not receiving backhanders of some kind at its members expense?

Anonymous said...

If the RACGP has locked itself up with ArgusConnect and Medisecure what does this mean for Healthlink which many of us use and what does it mean for some of the other messaging suppliers?

Anonymous said...

Is the RACGP saying that Argus Connect is the way to go for all doctors? What cut of the action is being backhanded to the RACGP for enticing us all into this Medisecure exchange? How about paying the doctors rather than the RACGP.

Anonymous said...

Hold everything. Who creates the data in the first place? We do - the doctors not the pharmacists.

We write the prescription. We should be remunerated for sending the script to the exchange. At the moment it looks totally one way to me - make us do the work to create the data and pay us nothing while charging the pharmacists for using our data!! Hello!! HELLO!! Is anyone home?

Anonymous said...

Surely to goodness it is time the AGPN, RACGP and AMA started looking after our interests before the horses have well and truly bolted. It looks like we are about to get rolled, robbed, raped and pillaged by the pharmacists whichever way you look at it - eRx, Mediscure, PGA. The CEO of Medisecure is the same as the CEO of PSLnet! Guild members and friends of the guild everywhere!

http://www.pslnet.com.au/pslpeople.htm
http://www.medisecure.com.au/contactus.html
http://www.mpsnet.net.au/contacts.html

Is there any room left in this Trojan horse? Will we be overrun at night and murdered in our sleep.

Anonymous said...

John Frost could see the writing on the wall. Withdrawing from ScriptX had nothing to do with business models as someone said. John understood that the doctors were his constituents and he refused to be drawn into something that could be turned against his company. Whether or not Frank Pyefinch sees the light remains to be seen, but he may soon find he won’t get much support from the College or from a lot of us if he insists on supping with the devil.

Anonymous said...

If the RACGP has locked itself up with ArgusConnect and Medisecure what does this mean for our messaging supplier Healthlink and other messaging suppliers for that matter? Has the RACGP said Argus Connect is the way to go for all doctors? I think the RACGP and ArgusConnect need to made an unequivocal statement about this immediately and it would be even better if it was combined statement with the AMA and AGPN as well.

Anonymous said...

We write the prescription so we should be remunerated for sending the script to the exchange. At the moment it looks all one way to me. Let us do all the work to create the data and pay us nothing while charging the pharmacists for using our data. It's time the AGPN and RACGP and AMA started looking after our interests before the horses have bolted.

Anonymous said...

Electronic Transfer of Prescriptions, as “implemented by General Practice Network NT (GPNNT)", was developed with federal government funding. Who owns the IP? Does DOHA have any interest in this?

Aus HIT Man said...

Argus was initially developed under a DoHA contract that as part of the contract has the source code made open-source and freely usable. Since then it has been evolved by Argus.

Details at www.argusconnect.com.au.

David.

Anonymous said...

Guild president Kos Sclavos said Dr Mitchell's comments were the "typical approach of doctors".

The kindest thing one can say is that the comment in itself is so consistently typical of the Guild and perfectly befitting of self opinionated arrogance and superciliousness well suited to a petty small minded president.

Anonymous said...

It was almost a year ago, on the 10th of April that Kos uttered this dire warning to his pharmacist colleagues:

“Electronic prescribing poses many threats to our profession; get the structure wrong and community pharmacy could be on the path to destruction. We have only one chance to influence the way this new phenomenon is established - and that chance is now.”

Influence! I think he meant ‘control’ but couldn’t bring himself to use the word.

Anonymous said...

In Greece, around 460 BC, on the island of Kos - Hippocrates was born.

He became the founder of medicine and was regarded as the greatest physician of his time. He founded a medical school on the island of Kos and began teaching his ideas. He died in 377 BC. Today Hippocrates is known as the "Father of Medicine".

Kos is the sacred home of medicine.

Nothing to do with the pharmacy guild or its president who seems hell bent on a land grab.

Ross Davey said...

"If the RACGP has locked itself up with ArgusConnect and Medisecure what does this mean for our messaging supplier Healthlink and other messaging suppliers for that matter? Has the RACGP said Argus Connect is the way to go for all doctors? I think the RACGP and ArgusConnect need to made an unequivocal statement about this immediately and it would be even better if it was combined statement with the AMA and AGPN as well"

The statement is unequivocal. Although Argus is a participant, from day one of our involvement we have made it plain that MediSecure must interface will all clinical messaging providers - not just Argus. We are committed to open interface Standards as well as all other relevant Standards and evolving Standards development. Hence yes, HealthLink is encouraged to come forward as a messaging communication mechanism and they will be asked to interface according to the standard interfaces developed. Likewise all others including but not exclusive to: MO, AllTalk, ReferralNet, 2Hippo.

We are similarly committed to carry prescription messages from any clinical systems vendor and deliver these to any/all dispensing systems. Some will be harder than others to engage, but we will not turn any away. As you can see from the Media Release we are committed to standards with IT14 and HL7, as well as web services and will implement all standards as soon as promulgated by NeHTA and other standards authorities. RACGP is committed to openness and we have given them assurance we will commercialise on this basis.

Likewise, we believe that it is inevitable that prescription messaging exchanges will need to intercommunicate if everyone is to achieve the full benefits that such a technology can deliver, and on this basis Medisecure is committed to this and to keeping channels open to make this happen.

kind regards
Ross

___________________________________________

Ross Davey
CEO, ArgusConnect

Russell Beattie, Marketing Director, MediSecure said...

Neither RACGP nor MediSecure are locked into Argus and RACGP is firm in their insistence the system be open to all members. Medisecure wrote to the MSIA recently as follows

"There are sectors of the industry/profession that are casting e-prescribing in turf/ownership terms, which is not helpful. We initiated MediSecure with the active support of RACGP but are convinced that on the journey to true interoperability there will be any number of "exchanges" and our Secure Script Vault is just one. We are committed to dialogue and if we can achieve a commercial solution with other e-prescribing solutions we will foster interconnectivity.

We are similarly committed to carry prescription messages from any clinical systems vendor and deliver these to any/all dispensing systems. As you can see from the Media Release we are committed to standards with IT14 and HL7, as well as web services and will implement all standards as soon as promulgated by NeHTA and other standards authorities. RACGP is committed to openness and we have given them assurance we will commercialise on this basis.

Although ArgusConnect is a MediSecure participant, from day one of their involvement Ross Davey has made it plain that MediSecure should interface will all clinical messaging providers - not just Argus. We have already been approached by ReferralNet and the dialogue has been fruitful. We are keen to foster the same with HealthLink, Medical Objects as well as all pharmacy dispense system vendors.

It would be most helpful if you could provide this advice to the MSIA membership. We would welcome their queries."

In relation to questions around IP, MediSecure owns all its own IP and has the necessary licenses to deliver on its charter.

Kind regards
Russell Beattie