Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, March 14, 2018

It Looks Like We Have A Little Way To Go On Real-Time Prescription Monitoring Just Yet.

This appeared last week:

Looming workload headache? Fears over national script-monitoring system

It will be less than seamless compared with Victoria's system, say pharmacists
8th March 2018
The Federal Government’s real-time script-monitoring system to tackle opioid misuse will not be integrated with GP software, raising fears it will become a workload headache.
The system is being rolled out this year and aims to give all doctors access to information on S8 drugs prescribed and dispensed.
However, it will be based on the Tasmania system — known as DORA — where doctors have to log in to a state government website and view a record of what a patient has been prescribed.
Concerns about the proposals were raised in a TGA consultation on curbing opioid misuse.
In a submission, the Pharmacy Guild of Australia said there were also concerns about whether a nationwide system would be able to cope with tracking details of 25 million patients, given the DORA software was designed for just 500,000 Tasmanians.
“I’m not here to criticise [the Tasmanian system] in any form, but for larger populations, the query is scalability,” the president of the guild's Victorian branch, Anthony Tassone, said.
The guild said the Federal Government should look to adopt the real-time prescribing system developed for Victoria — SafeScript.
SafeScript is due to come online this year.
More here:
There is more detail about the Guild’s preferred system here (from their submission):


Victoria is much further progressed with implementation than any other mainland state and has thoroughly investigated what is required to implement a high performing system on a Victorian and national scale. A feasibility study commission by the Victorian Government revealed a better alternative to address the limitations of the Commonwealth software which in its current state will not meet the needs of clinicians, nor will its interface with clinical systems encourage high uptake. As a result, Victoria has made the decision to develop SafeScript, based on contemporary technology. It will source data from Prescription Exchange Services (PES) - technology that is already used in the majority of pharmacies and medical clinicsto facilitate electronic transfer of prescriptions. This approach will have significant advantages. SafeScript will be high performing from the outset, and as it will be developed using modern cloud-based architecture, it will be scalable to an increasing volume of prescriptions.
By comparison, significant redevelopment work would have been necessary before the Tasmanian software could have supported Victoria's prescription volume, let alone at a national level. Most importantly, SafeScript will be designed around clinicians' needs and will offer a better user experience and cause minimal disruption to clinical workflow. Clinicians will receive pop - up notifications from their desktops within seconds after a prescription has been issued or dispensed which will prompt clinicians if a review of the records in SafeScript is necessary. The notification will also provide a direct link to the patient's record. The Commonwealth software does not provide these workflow features for clinicians.
Here is the link to the submission:
If indeed the SafeScript system is more scaleable and provides better work-flow support then I suspect the Guild has a reasonable case assuming there are no buried commercial nasties.
We really do need to get this system in place ASAP.


Bernard Robertson-Dunn said...

OMG. If this is true, it is madness built on stupidity. IMHO.

Many (most? All?) GPs have clinical systems which support what they do. Such systems automate old fashioned paper records (a good thing) and they give a more complete perspective of a GP/Patient interaction (another good thing).

However, if not implemented and used carefully they can be a two edged sword - there's quite a bit of evidence that they have value but come at a cost - monetary and in terms of negative impact of GP/Patient interaction quality and time.

So what is the government trying to do? Add to a GP's workload with a second, summary health record system (not a good thing) and an additional prescription monitoring system (not a good thing).

And what about other people who can prescribe medicines - Dentists, Hospitals etc? What about their workflows.

If either or both of these systems are made mandatory, then it will be interesting to see GP reactions. If they are not mandatory it will be equally interesting to see the uptake by people who will get little value and bear a lot of cost.

Anonymous said...

It is another example a quick win mindset. I just have to deliver a letter, who cares about the impact or if it is the right letter in the right order or even if it adds value to the alphabet. Everything is done in a reactive manner these days.

Anonymous said...

"Everything is done in a reactive manner these days." and without any understanding of the current health care system. It was and is all about technology. These days by people who don't even understand technology but who have drunk the Kool-Aid.

Anonymous said...

I am sure the ADHA will turn a corner, by the sounds of things they have a few organisational issues in middle management. They probably need to sort that out as I know a few people that are not willing to contemplate working there. It is not something Tim can afford. The ADHA needs to compete with the states, territories other agencies and the private sector, all of which are far more attractive. Extract the poison from they well and they may start attracting the right people rather than loosing more and more.