The question was:
Does It Make Any Sense For the NEHRS / PCEHR To Have Three Different Unsynchronised Sources Of Medication Information?
It’s Perfectly OK 12% (6)
Might Not Be Totally Sensible 6% (3)
Is Clearly Not Sensible 12% (6)
It Violates Basic Principles Of Information Management 69% (35)
I Have No Idea 2% (1)
Total votes: 51
Most readers think this is purely bad information management practice. That is because it is.
Again, many thanks to those that voted!
David.
Three different sources and three different contexts and purposes, all brought together into a different context and for a different purpose. Not safe.
ReplyDeleteThe PBS data is not clinical data, but rather just reflects what a pharmacist has claimed against the PBS for dispensing (it is part of their income). It may not even reflect everything that was dispensed for a patient – just those items that have been claimed. (Some items are cheaper or the same price purchased over the counter). Furthermore, the data may be out of date, or in some cases completely wrong, as was outlined in a recent PulseIT article. See the article and the comments (http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1424:incorrect-pbs-data-added-to-pcehr&catid=16:australian-ehealth&Itemid=328).
The checks for Pharmacists to ensure that they are claiming using the correct medicare number for claiming a dispense fee against the Commonwealth are simply not enabled or rigorous enough for this data to be used in a clinical or a patient record context. The PBS claiming data probably has an error level which is OK for the original purpose for which it was collected. But picking it up out of context and plonking it into a clinical record changes all of that. Even doctors, who voiced their concerns about including this data and may not even consider looking at it in a patient’s record, may be surprised at how inaccurate and out of date the data is likely to be. Patients and carers will, if they see wrong data in their record, likely lose confidence in the system altogether, despite any rigour around the other components. A huge risk to the whole PCEHR program. Best thing is for the Commonwealth to pull the plug on the PBS data feed until it has better quality data available, or improves the processes for quality and safety of the PBS data. That level of honesty and action might allow for the public to trust the record. Pretending there is not a problem will not end well.
If I were in charge of the PBS I would require that the PBS Claim be tied to the PBS eScript and that the claim be submitted to the PBS via the script exchange.
ReplyDeleteThat makes a lot of sense. It means that only claims for electronic scripts which have been dispensed will be paid. Whilst scripts which have been dispensed manually will continue to be claimed under the old system which will or should eventually whither away to nothing.
ReplyDelete