Wednesday, May 09, 2018

Does Anyone Know What This Is About? It Seems Pretty Obscure To Me.

This appears at Page 36 of the Health Department Budget Papers.
Improving Access to Medicines - e-prescribing for safer medicines
Department of Health






Administered expenses
4.3
4,018
13,720
2,844
400
-
Department of Human Services





Departmental expenses

-
1,669
2,555
591
594
Departmental capital

-
-
1,793
-
-
Total

4,018
15,389
7,192
991
594

This is the only mention of e-prescribing in the 400+ pages! (2 mentions of electronic prescribing)
This seems to be a description (Item 3):

6 things the Budget means for pharmacists

New fees to open a pharmacy or transfer ownership
9th May 2018
Pharmacists wanting to open a new PBS pharmacy will face increased costs from July 2019 as a result of new fees announced in the federal Budget.
……
Here are six key Budget measures:
  • New fees for pharmacy approvals. From 1 July 2019, pharmacists will pay an application fee when they seek to supply PBS medicines from new or relocated premises. A change-of-ownership fee will also apply.
  • Decreased up-front costs for pharmacies for high-cost medicines. This is one of the government’s most important responses to the King review and was flagged at APP last week. From 1 July, some of the revenue rebates manufacturers pay to the government will be reduced for some high-cost medicines. This will be followed by a trial of special pricing arrangements from July 2019.
  • $28 million over five years to upgrade electronic prescribing software systems and deliver a fully electronic prescription alternative to paper-based scripts.
  • $5 million over three years to continue the awareness campaign aimed at increasing the use of generics and biosimilars.
  • Funding for the National Prescribing Service and the Return of Unwanted Medicines will be cut by $40 million — about 25% — over four years. The funding cut is in return for a new four-year funding agreement. The savings have been promised for other health policy priorities.
  • The $20,000 tax offset for small businesses has been extended for another year.
Full article is here:

I can only guess it refers to this – but why are the funds not in the ADHA allocation and I wonder what it really means?

“Commence policy work with the Department of Health to enable digital paper-free options for all medication management in Australia, which would allow individuals to request their medications online, and all prescribers and pharmacists to have access to electronic prescribing and dispensing.”

Anyone know what the Department and the ADHA are cooking up? Seems like a lot of money for bit of policy work? Any other comments on the ADHA Budget?

David.

6 comments:

Anonymous said...

"The Government will provide $28.2 million over five years from 2017-18 to upgrade the e-prescribing software system used by clinicians to prescribe medicines. This measure supports a national electronic prescribing system that will contribute to Pharmaceutical Benefits Scheme efficiency, compliance, drug safety and data collection.

The upgrades will make the system more user-friendly and enable prescribers to better identify prescribing options that best meet the needs of their patients, with doctors to retain the final say in advising patients on which medicines to use."

Funding allocation gives an idea of timeframes at least - 13mil to DoH in 18-19 then 5mil to DHS in 19-20, so designed and built this year, rolled out the next.

Bernard Robertson-Dunn said...

David,

It's money that has gone to the Department of Health and Aged Care. It is not clear who is going to implement the initiative.

https://www.humanservices.gov.au/organisations/about-us/budget/budget-2018-19/health-and-aged-care

Improving Access to Medicines — e-prescribing for safer medicines

This measure introduces a national electronic prescribing system for the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) from 10 October 2019.

It will enable prescribers to use clinical prescribing software to issue an electronic PBS prescription as a legal form of prescription. Currently all prescriptions are paper based.

This measure gives prescribers and consumers the option of a full digital experience. Their prescription will be able to be electronically transmitted from the prescriber to the pharmacy, reducing the reliance on paper and manual processing.

Who is eligible?

Patients, prescribers and pharmacies.

The date this will start and finish

The measure will start on 10 October 2019 and is ongoing.

Oliver Frank said...

"doctors to retain the final say in advising patients on which medicines to use."

How generous. Is the corollary of this statement an implication that one or more other parties are going to have their say initially or at some other point(s) in the prescribing process about which medicine the patient should use? Is there going to be a debate in which the doctor will participate before the doctor is allowed to have the "final say"?

Bernard Robertson-Dunn said...

Some thoughts:

A national electronic prescribing system cannot be part of the myhr system because people can opt out of myhr therefore it will not have complete, national coverage.

This means it is yet another application GPs will need to work with, further distracting from patient care.

The $15million will only become available after 1 July so they will have just 15 months to ramp up, develop and implement the system, and train GPs and Pharmacists

A little optimistic, I would suggest.

Anonymous said...

http://dilbert.com/strip/2018-05-07
http://dilbert.com/strip/2018-05-08
http://dilbert.com/strip/2018-05-09

Bernard Robertson-Dunn said...

There's a report in the SMH that sys:

"Health authorities have no timeline for the introduction of a real-time prescription monitoring service to stop doctor shopping in NSW, an inquest into opiate deaths has heard.

NSW Chief Pharmacist, Dr Judith Mackson, told Deputy State Coroner Harriet Grahame that, despite government commitments to rolling out the service, the potentially lifesaving system was still far from being realised.

The Health Council of the Council of Australian Governments last month determined that a national model for real-time prescription monitoring would be created, with states feeding the data from their own systems into a federal one."

https://www.smh.com.au/national/nsw/no-timeline-to-roll-out-service-to-end-doctor-shopping-court-told-20180510-p4zel0.html

The ADHA "strategy" vaguely says:

"4. Better availability and access to prescriptions and medicines information.

Patients and providers in Australia want safe and convenient digital management of medicines. By the end of 2018, all patients and their providers will have access to comprehensive views of their prescribed and dispensed medications through the My Health Record system. This will reduce the incidence of medication errors and adverse drug events – minimising harm to patients and creating significant cost savings.

By 2022, there will be digitally enabled paper-free options for all medication management in Australia. People will be able to request their medications online, and all prescribers and pharmacists will have access to electronic prescribing and dispensing, improving the safety of our systems."

I say vaguely because there are no firm plans or other details in the "strategy".

Furthermore the statement "By the end of 2018, all patients and their providers will have access to comprehensive views of their prescribed and dispensed medications through the My Health Record system." is a patent exaggeration. The only thing that might happen is that in addition to those who already have been registered, a large number will have been registered without their consent. It is doubtful that the government will have uploaded all the PBS data, and few people will have completed their registration.

Getting back to the strategy it has this:

'Prescription medication abuse and overdose is also a growing public health issue, with coroners calling for real-time electronic monitoring of controlled drugs. The Australian Medical Association has described prescription drug abuse as a "national emergency”'

The project that David has identified is e-prescribing "a fully electronic prescription alternative to paper-based scripts", which is hardly a transformation of health care - more of a mundane e-business application. It certainly goes no way to address the national emergency of drug abuse.

ADHA may think it has a strategy, but the rest of the health care industry and governments don't appear to be engaged in it.

Confusion reigns.