Sunday, July 30, 2017

I Wonder Will This Get To Operational This Time? There Seem To Have Been A Few False Starts.

This press release appeared a few days ago.

National approach to prescription drug misuse

The Australian Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
Page last updated: 28 July 2017
28 July 2017
The Turnbull Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
The Real Time Prescription Monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines.
This system will save lives and protect the community. This is something of absolute national importance.
Real time monitoring has been called for by the Australian Medical Association, Pharmacy Guild and by many families across the country who have been devastated by the loss of a loved one to misuse of prescription medicine.
We have listened to these calls and today we are taking action.
With this injection of funding – and close collaboration with states and territories – we have the means to provide a nationally consistent, mandated system for real time monitoring of controlled drugs.
I look forward to continuing our work with all states and territories to make this national approach a reality.
This issue of misuse of prescription medicine is a growing trend in our community, and although it is not the only response required, it is a very important step.
Real time reporting will assist doctors and pharmacists to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines, and patients who are diverting these medicines.
This can happen if a patient has developed a dependency on controlled medicines, or is selling these medicines to others, including for the purposes of manufacturing other illegal drugs.
Controlled medicines include morphine, oxycodone, dexamphetamine and alprazolam.
The Australian Government first funded the development of the Electronic Reporting and Recording of Controlled Drugs system to assist state and territory governments to improve their monitoring and regulation of controlled medicines in 2013.
This project was initiated with $5 million allocated under the Fifth Community Pharmacy Agreement (2010-15).
It is an important public health and medicine safety measure, providing regulators, doctors and pharmacists with information regarding supply of controlled medicines and other medicines with potential for misuse.
(ENDS)
Here is the link:
This article provides a clearer outline of the history!

Govt commits $16m to national prescription tracking system

By Justin Hendry on Jul 28, 2017 12:35PM

To prevent doctor shopping.

The federal government will spend more than $16 million on a national real-time prescription monitoring system to target the misuse of certain prescription drugs.
The system will be used to instantly alert pharmacists and doctors if patients receive multiple supplies of prescription-only medicines that contain morphine, oxycodone, dexamphetamine and alprazolam.
The introduction of real-time prescription monitoring has long been called for by the Australian Medical Association and Pharmacy Guild.
While a large-scale pilot of real-time monitoring of over-the-counter sales of medicines containing codeine has already been conducted, implementation of the national electronic reporting and recording of controlled drugs (ERRCD) system - first funded by government in 2010 - to monitor all prescribing and dispensing has been patchy.
Tasmania remains the only state to have successfully introduced the medication tracking system.
New South Wales is in the process of implementation, as is Victoria, which allocated $29.5 million in the 2016-17 state budget for the effort and will roll out the centralised tracking system next year.
More here:
There is also more coverage here:
28 July 2017

Hunt pledges real-time prescription monitoring

Posted  by Julie Lambert
Federal Health Minister Greg Hunt has promised to roll out national real-time prescription monitoring by next year and support a further expansion of pharmacists’ scope of practice.
Mr Hunt also pledged to dump a sunset clause on store location rules which protect pharmacies from undue competition, saying the sector needed certainty to stay viable.
The minister announced the commitments at the Pharmaceutical Society of Australia’s annual conference in Sydney today.
He said it was utterly unacceptable that 600 Australians a year died from the misuse of prescription drugs such as morphine.
“We will now move immediately to real-time monitoring.”
A system to track dispensing records across state borders would mean a pharmacist asked to fill an Endone script in Albury, for example,  could find out immediately if the patient had had the drug dispensed over the border in Wondonga an hour or a day before, he said.
“The fact that we don’t have that in Australia is a legacy and an error which we will address.”
He said the commonwealth would contribute $16 million to the scheme.
RACGP President Dr Bastian Seidel welcomed the commitment to real-time prescription monitoring, noting accidental overdoses of pharmaceutical prescription opioids now killed more Australians than heroin overdoses.
Lots more here:
The bottom line here is that we have had a pretty fragmented approach to all this since 2010 and it is long past due for the various jurisdictions and interests to just stop it and get this going.
The will tell if it is 3rd (or is it 4th) time lucky!
In passing I can’t help wondering just where the ADHA is in all this and where it will fit as a project to be sponsored by the national strategy?
David.

9 comments:

Anonymous said...

The ADHA should stay right out of it IMHO otherwise it will become over complicated and the only focus to get more stuff in the MyHR.

Anonymous said...

I'd like to know why it will cost $16 million. That can only mean that some big IT company is involved in fleecing folks in building something huge to track this stuff. Regardless, $16mill seems excessive - even by MyHR standards!

Anonymous said...

"He said the commonwealth would contribute $16 million to the scheme." means it will cost more than $16m. The states will need to add some more.

Anonymous said...

You would see a core administrative team creating a salary budget of some 6 Million, property and services say another million, additional contractors and consultancy another 4 million per year. So it adds up. Be interesting to see if the ADHA is involved, will they go into homes of families and addicts? Will we see stories from the streets? Or will it be big lunches with manufactures, distributors and dispensing houses?

Anonymous said...

7:50 AM Don't you worry about that. "Mr Kelsey has pledged to fix it. And that holds out the possibility that GP's could eventually use the system to monitor real-time prescribing and help deal with the doctor-shopper challenge." (Medical Observer 20 July 2017 Antony Scholefield).

More than likely ADHA's CEO envisages the ADHA building an accurate, all encompassing, secure, interoperable, centralised database of each individual's prescriptions (prescribed then dispensed) fully integrated into the My Health Record, thereby wresting control from the jurisdictions of state supervision and regulation of prescribed drugs (S8, S4), thus superseding attempts by the jurisdictions to develop and deploy their own state-based Real Time Prescription Monitoring system. Tim Kelsey and the Health Department would be delighted to see every doctor and pharmacist being obliged to check the ADHA's centralised database each time they prescribe or dispense a medication and update the My Health Record each step of the way.

It's fair to say that, as coroners everywhere have been enormously frustrated by a decade of filibustering from the states, Tim Kelsey should have little difficulty getting Coroners to embrace the ADHA's plans for a nation-wide RTPM system as an integral component of the My Health Record.

Bernard Robertson-Dunn said...

"A system to track dispensing records across state borders would mean a pharmacist asked to fill an Endone script in Albury, for example, could find out immediately if the patient had had the drug dispensed over the border in Wondonga an hour or a day before, he said."

and then what......?

There are many valid reasons why someone might want to have a drug dispensed again after only a short period of time (lost stolen, traveling and forgot to take the drugs with them, etc etc)

Is this a monitoring system or an enforcement system?

Is a pharmacist going to have the power to not dispense the drug? What if the patient subsequently dies or suffers harm?

and re: "RACGP President Dr Bastian Seidel welcomed the commitment to real-time prescription monitoring, noting accidental overdoses of pharmaceutical prescription opioids now killed more Australians than heroin overdoses."

How will monitoring prescription dispensing reduce overdoses? Are they going to track that people actually take the drugs as prescribed rather than save them up and then overdose?

And the idea of using MyHR as a RTPM system is just ludicrous - MyHR is opt-out and people can also cancel (suspend) their record. Or are they going to make it mandatory?

I do hope they have thought this through, but the evidence and their track record is that it's just another technology fix to a highly complex social problem.

Anonymous said...

11.02 AM Mandatory is probably the long term plan.

Anonymous said...

Seems another polical rather than policy driven brain fart from the fibre factory

Anonymous said...

11.02 AM Mandatory is probably the long term plan.
Maybe they will make it mandatory to see your GP at least once a month to update and confirm your MyHR. More frequently if you have a health incident or change the meds you take or if your weight changes or you go on a diet. And it will be illegal to lie about your health and you'll definitely have to put it on your MyHR if you take recreational drugs. Oh, what fun the health police will have.