You humble scribe is easy to confuse but recently the level of confusion has really accelerated.
First we have the announcement I reported last week:
Government scraps e-prescribing project
by Jared Reed
The Federal government has abandoned an electronic prescribing project started last year, claiming that its health reform agenda has changed the course of the project.
The open tender call was launched in May 2009, one month before the National Health and Hospitals Reform Commission released its 123 reform recommendations, and called for advice in the creation of an “e-prescribing and dispensing of medicines benefits realisation and implementation plan”.
But in a letter sent to bidders seven months after the NHHRC report’s release, the government says the recommendations had “materially affected the department’s anticipated workplan” for the e-prescribing project.
Bidders for the contract were required to submit recommendations as to whether the system should be government-owned and operated, government-owned and controlled but industry operated, or wholly industry-owned and operated.
On his blog, health IT commentator Dr David More says the cancellation would annoy groups who had put in a huge amount of development work.
More here:
http://www.6minutes.com.au/articles/z1/view.asp?id=509249
Then following appeared a few days ago in Pharmacy News.
Pharmacists gain e-script incentive
14 January 2010
Community pharmacies will receive a financial incentive for every prescription they fill using an electronic prescribing system, under a new measure proposed in the Fifth Community Pharmacy Agreement.
New details of the agreement reveal that pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions".
Dispensing software vendors are also set to receive extra funding to help them implement e-script functions into their platforms.
The new payment, however, coincides with the abolition of the $0.40 PBS Online incentive payment.
More here:
http://www.pharmacynews.com.au/article/pharmacists-gain-e-script-incentive/509272.aspx
and here a similar report.
Govt agreement delivers new incentives to pharmacists
Elizabeth McIntosh - Thursday, 14 January 2010
PHARMACISTS will soon receive new incentives for patient medication management and harnessing new technology, as part of the Fifth Community Pharmacy Agreement.
The fifth agreement between the Pharmacy Guild and the Federal Government will set out community pharmacy funding until 2015, and though negotiations are not complete, the Government has announced ambitions to cut up to $1 billion from the agreement.
According to industry e-newsletter Pharmacy Daily, while details of specific programs have not been released, a new Pharmacy Practice Incentive has been created which will be linked to defined outcomes in patient medication management.
A new Prescription Commitment has been created, which will require provision of consumer medication information and checking patient compliance with chronic disease medications.
Last year pharmacists came under fire from Federal Health Minister Nicola Roxon for a lack of consistency in providing medication information and advice to consumers, despite receiving incentive payments for the service (MO, 27 November 2009).
More here:
http://www.medicalobserver.com.au/News/0,1734,5777,14201001.aspx
We also discover that there are some other changes.
Agreement ushers in new dispensing charter
14 January 2010 | by Mark Gertskis
A nationwide system of medication information and compliance will be implemented in every pharmacy under the Fifth Community Pharmacy Agreement negotiated by the Pharmacy Guild with the Federal Government.
According to new details of the agreement released yesterday, a new Prescription Commitment will compel pharmacies to issue every patient filling a prescription with a leaflet tailored to the patient and the drug dispensed.
The leaflet will include consumer medicine information (CMI) for that drug, information on premium free products and a patient's compliance score for chronic disease medications derived via dispensary systems.
"We will be the first country in the world to implement a nationwide charter for a dispensing services in a community pharmacy," Guild national president Kos Sclavos told Pharmacy News.
More here:
http://www.pharmacynews.com.au/article/agreement-ushers-in-new-dispensing-charter/509268.aspx
The only detail available from the DoHA is this:
Agreement to Deliver Certainty for Community Pharmacy and Government
24 December 2009
The Australian Government and the Pharmacy Guild of Australia have reached agreement on the major components of the Fifth Community Pharmacy Agreement, which will commence on 1 July 2010.
The current agreement ends 30 June 2010.
The agreement is being negotiated in a very tight fiscal environment, in which the Government has to carefully consider its expenditure in all areas. This is especially the case given the Government’s significant health reform agenda.
Consumers can be assured that the Australia-wide network of community pharmacies will remain viable and at the front line of health care, delivering access to vital medicines to the community and delivering professional services such as medicines counselling and health advice.
The Government will make $15.1 billion available to community pharmacy over the life of the agreement, ensuring a viable community pharmacy network.
At the same time, through working closely with the Guild, the Government will make a saving of $1 billion on the forecast spending for community pharmacy, helping to maintain a sustainable health system and making other health reforms more affordable to Government.
I would like to thank the Guild, and in particular its President, Mr Kos Sclavos, for working so constructively with Government in the interests of the Australian community.
Release is here:
So what we have here is a payment for e-prescribing being introduced and the consultation required to determine how e-prescribing would be best done being canned in pretty much the same week.
Can I say I smell a rat!
What is more the doctors have lost the Easyclaim incentive and the pharmacists are being incentivised for providing a service which relies on Doctors doing electronic prescription transmission for which they are not being paid.
It also can’t be in a Standardised way as the standards have not yet been finalised so how is it being done and what is the measure on which payment will be made? More important, who counts?
Pity the actual agreement still seems to be secret, despite copious leaking from the Pharmacy Guild.
This is heading towards a huge mess in my view!
David.
9 comments:
You have headed your blog "It looks like The Pharmacists Have Just Gazumped the Docs."
David, "looks like" is a gross understatement. The fact is the doctors HAVE BEEN WELL AND TRULY GAZZUMPED. In fact it's far worse than that if one reads between the lines. The Guild has snookered the doctors and torpedoed Medisecure below the waterline, simultaneously and there is not much they can do about it. The Guild is at the negotiating table daily over its 5th Community Pharmacy Agreement and it's at the table that deals are cut.
If Doctors think they have been "gazumped" which I think is not quite the right term but I understand the context, Doctors should do what political parties do, form coalitions of convenience to achieve objectives.
Further they should make sure second preferences fall their way - be pragmatic. Avoid treating Pharmacy as an adversary and work together to wring better outcomes from the purse holder.
The purse holder is expert at holding parties at arms length to suit their objective(s). A review and a fresh approach may be needed by the profession's leaders. Remember SWOT. "O" is for opportunity and sometimes its only knocks once when deals are being done.
I don’t think “gazumped” is the right term either. The doctors and the pharmacists wrestle with each other at the political level all the time but in the end they have to work together in the interest of their patients.
We shouldn’t get too distracted by the Guild’s posturings. It is under a lot of pressure at present to get the best deal for its members in the community pharmacy agreement negotiations which will cover the next 5 years. The purse-holder has a responsibility to extract maximum mileage for our dollars [which we give it to spend on our behalf] and it needs the doctors to provide input and guidance on that front to ensure a proper balance is achieved.
I think this is where the real ‘O’pportunity lies, not so much in which technology gets what funding [albeit very important, as government subsidies are required to offset some of the business risk because in the final wash up the purse-holder stands to benefit enormously from the efficiency gains involved] but more, in how to get the consumer to fall in behind the drive to get escripts working to the purse holder’s satisfaction. If we can get the consumer and the patient to create the demand it will have sufficient political pull-through to overcome whatever barriers are put in the way of progressing ehealth to everyone’s benefit.
The doctors would seem to be are the logical starting point on that score because they create the medescript which then has to find its way to the pharmacist.
I don't have a lot of confidence about this. ".... pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions" and "Dispensing software vendors are also set to receive extra funding to help them implement e-script functions into their platforms." So far so good but then "The new payment, however, coincides with the abolition of the $0.40 PBS Online incentive payment." Can anyone tell me "when will these new incetives be aboloshished?" One, year, two years?
The Docs can always refuse to bear the cost of setting up eprescription at their end. If there are no eprescriptions going in then there is no money coming out the other end for the pharmacies.
There is still room for a deal to be cut here particularly if the benefits accrue largely for pharmacies.
I doubt consumers will be clamouring for it anyway - would you care as a consumer?
As a consumer I wouldn't care one iota. There needs to be a consumer driven demand created to pull escripts through the system.
It won't make any difference if "The docs can always refuse to bear the cost of setting up eprescriptions at their end" or not. Why is this so? Because the pharmacists with government funded assistance will cause the public to pressure the docs and the docs will oblige.
Well it really depends on whether the docs can control the high ground or whether the Guild can dominate the battlefield and win the hearts and minds of consumers with the support of government. There are no half way houses - it's all or nothing.
I'd bet my money on the Guild for three reasons:
(i) they speak with one voice unlike the docs which seem to have many spokespeople / bodies
(ii) they are politiclly astute and incredibly well organised as a lobby group
(iii) they can access virtually everyone in the community through their netwrok of 5,000 pharmacies
So I reckon they probably control "the high ground" as you describe it.
Post a Comment