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

Wednesday, June 05, 2019

Is The ADHA Setting Us All Up For The Mother Of All Confusion On Medication Lists?

The release from the ADHA came out a few days ago:

Engaging pharmacists to enhance medicines safety

30 May 2019: The Pharmacist Shared Medicines List is a new feature coming to My Health Record that provides a complete view of a consumer’s medicines, including non-prescription and over the counter products.
The Pharmaceutical Society of Australia’s report Medicine Safety: Take Care cites some sobering statistics on medicines safety in Australia: 250,000 hospital admissions annually as a result of medication-related problems, at an annual cost of $1.4 billion. The good news is that half of these problems are thought to be preventable, and the Agency is developing tools to assist in this endeavour.
“Proactive engagement of pharmacists has the potential to significantly reduce the number of medication-related hospital admissions and adverse medication events in Australia due to their place in the healthcare system, the frequency with which they have patient contact, developments in health infrastructure, including My Health Record, and the availability of digital tools to support medication management.” [Medicine Safety: Take Care, p. 20]

Facilitating comprehensive medicines reconciliation

Hospital discharge summaries, and prescription and dispense records are already captured by My Health Record, and their medicines information is usefully collated in the medicines information view. However, these records will not include over counter (OTC) products and other non-prescription medicines that may be relevant to medicines reconciliation.
This is where the new Pharmacist Shared Medicines List (PSML) can help. This is a pharmacist-curated list of a consumer’s medicines, developed in collaboration with the consumer or their care providers, as appropriate. This collaboration enables the pharmacist to confirm and discuss the complete list of medicines being taken by the consumer, including complementary and OTC products. The resulting list can then be uploaded to the consumer’s My Health Record, providing an excellent foundation for medicines reconciliation by care providers, especially during episodes of transitions of care.
The addition of the PSML to the My Health Record system will significantly enhance the completeness of the information in the medicines information view, further increasing the utility of this tool. Moreover, when PSMLs are developed in a community setting, the personal collaboration between pharmacists and consumers represents a golden opportunity to discuss a consumer’s medicines and any related issues.

How should I prepare for the PSML?

The PSML will be included in the next update to My Health Record for use by early adoption sites. Revised professional guidelines will soon provide guidance to pharmacists on generating and uploading a PSML, and other health professionals and consumers will be further informed about what a PSML is and how it is best used to support patient care and enhance medicines safety.
Here is the link:
What seem to be the plan as far as medication lists is that there are now planned to be 3 different sources of medication information.
The first is the addition from last year that curates information from the PBS and the Dispense records to generate a medication list.
The second is the medication list contained in the Shared Health Summary.
The third is the new one described above.
Are myHR users meant to look at all 3 sources? Will they all be displayed on the same screen? If there are differences (as there will be) which one is to be believed?
Truly this is just nonsense working to make potentially confusing data even less trustworthy.
A giant own-goal I reckon and plain dumb!
David.

4 comments:

Bernard Robertson-Dunn said...

Prescription data can be spread over multiple sources - more than three, including Patient Health Summary

myhr has a consolidated view of medicines, allergies and reactions that it can find in all the uploaded documents.

At the top of the "Medicines Preview" page there is warning box which says:

"To assist you to find medicines related information in this My Health Record, previews are provided of medicines related information in documents (where available) with links to the source documents where more detailed information can be obtained.

Important: Some documents do not allow for a preview of medicines or allergies and adverse reactions information and should be opened by the links provided. This view should not be wholly relied upon as a complete record of medicines or allergies and adverse reactions information."

So much for completeness.

I assume that data from the PSML will be included in this Medicines Preview.

Note that it only has dispense data in this view.

My Medicines Preview has six entries, only one of which am I still taking.

If I go to the Prescription and Dispense Records section where it says "This is a list of medicines that have been prescribed and dispensed" it tells me the medications that have been prescribed and dispensed in the past two years.

Unfortunately it is empty apart from two entries in September 2017 and even then the data on First Dispense Last Dispense Dispensed says "unavailable"

The section "Prescription information - PBS & RPBS" does have data on what has been prescribed and dispensed 5 rows at a time out of a total of 43.

Of course, prescribed and dispensed data does not mean that the medication has been taken. I have had hip replacement surgery and I my surgeon is quite insistent that I have 2Grams of antibiotics if I see a dentist and there is a chance of bleeding.

A script lasts for a year and the medicines can last longer than that. So the prescribed and dispensed dates will have no correlation at all with taken date (if I ever do take them).

So much for not having to remember anything about my medication.

About as useful as a chocolate teapot.

Dr Ian Colclough said...

There is something so very wrong in all of this. That the Health Ministers do not seem to even want to understand and acknowledge there is anything amiss is very very troubling.

Anonymous said...

I agree having so many different lists and views of medicines in the My Health Record is confusing, especially if items appear on one list/view and not in the others.

The concept of having a pharmacist curated list seems good and probably is way closer to what the patient is actually taking than the other views/lists (depending on when it was generated of course). However it does rely on pharmacists having the time and resources to generate the list each time the medicines for a patient change. If this only happens for some patients, but not all patients taking meds, then it may make things worse. In the absence of a recently curated list for a consumer, we would need to fall back to the inconsistent & incomplete lists.

Anonymous said...

A Rhetoric, a wannabe UX expert, a lame public servant and an Irishman walk into a digital health agency ........ the punch line is still being implemented and it does not look funny and it sure ain’t clever.