This appeared last week:
Rosemary wants to be the 'Uber' of electronic scripts
Carrie LaFrenz Senior Reporter
Jul 8, 2019 — 12.00am
The former managing director of Dropbox Australia, a Microsoft Health executive and an early Atlassian employee are among the seed investors in Rosemary, a start-up that has created an app to help the millions of Australians struggling to manage their medications.
Better management of medicines can improve their efficacy and reduce waste. The app could also help the 5660-plus community-based pharmacies around Australia to compete better with giant chains such as Chemist Warehouse, not to mention US-giant Amazon which entered the US pharmacy market in 2018, and has grand ambitions in the sector.
Rosemary has raised nearly $1 million from investors including Microsoft director of Health and Social Services, Asia, Gabe Rijpma, ex-Dropbox Australia MD and entrepreneur Charlie Wood, and California-based Justen Stepka (who sold his software security business to Atlassian in 2006).
Other investors include those working in private equity and several discreetly wealthy Australians.
Romain Bonjean is co-founder and CEO of Rosemary, which has a trial under way and aims to go live in early August, ahead of the federal government's planned introduction of a new national digital drug script platform in October.
The French-native was previously involved with healthcare start-up Tyde, which is no longer operating after a backflip by the government's Digital Health Agency, which ended up denying third-party developers such as Tyde access to personal data.
Mr Bonjean said the Rosemary app is about bringing the community pharmacy into the 21st century by "putting it into your pocket".
“How do we make them more relevant? It's similar to Uber eats – they don’t provide the kitchen, but they provide a service to locals for restaurant food in a more convenient fashion," he told The Australian Financial Review.
“The convenience of getting medications delivered and keeping track of adherence are two critical ways to ensure better clinical outcomes."
Mr Bonjean pointed to US-based Capsule as his inspiration for Rosemary, which has gained the backing of the powerful Australian Pharmacy Guild.
…….
How it works
Rosemary will make money by charging the pharmacist a small fee on each script processed using the system, while the patient may be charged a small delivery fee depending on the value of the therapeutic.
“There is profitability on every transaction for both Rosemary and the pharmacy," Mr Bonjean said.
"But the goal is to improve convenience and adherence for people managing ongoing medication. Improving adherence will potentially help reduce waste in the PBS. It is estimated one-third of all medicines prescribed for ongoing medical conditions are not taken as recommended, or wasted."
Rosemary is connected to the national Prescription Exchange Service (PES) – a storage system for ePrescriptions that have been prescribed and are waiting to be dispensed by the pharmacy.
There are currently two PES systems operating in Australia – eRx Script Exchange and MediSecure.
Read the full article here:
Seems like a great idea to have the patient have an app which directs the script to their selected pharmacist who then dispenses and arranges delivery of the medicine. Has to be pretty convenient and has the advantage of being largely private sector and not likely to be closed down by the ADHA – as apparently Tyde was.
You can read more details about how the system / app works here:
Will be interesting to see how it goes…
David.
More patient data being given to more people not involved in direct healthcare. WCGR?
ReplyDeleteExactly - What Could Go Wrong?
ReplyDeleteMore importantly - who pays when it does go wrong, which it surely will?
ReplyDelete@10:03 AM - the investors will pay. How many fast-hyped start-ups fail - most. Do any of these fast talkers understand the hugely complex health space - no.
ReplyDeleteInvestors will pay when the privacy of one or more patients is breached?
ReplyDeleteI hope someone tells them of this risk. Governments can afford to ignore this risk - they are big enough to brave it out.
What this does highlight for me is how the PCEHR MyHR has distorted governments role and independence. What should be happening is policy setting that enables an equal, fair and open playing field where business and consumer are looked after within a policy setting and framework.
ReplyDeleteThe Federal department is now a played in the market and looking to be a dominate one. This means it is in conflict with what government is suppose to do. This dial a script has bolted out of the stable with no restrains and little regulatory thinking.
If you hint that there is a role for MyHR in this the Department heads go weak at the knees
Is this the way of the future for healthcare?
ReplyDeleteOverload GPs with two health record systems (their own clinical system plus myhr) so that they have less time to spend with patients.
Rope in pharmacists to ease the load, thus fragmenting care and further increasing the load on GPs who have to work out what a pharmacist has prescribed or recommended.
The UK's NHS is in such dire straits that they are shunting off patients to pharmacists for "minor" issues.
https://www.dailymail.co.uk/health/article-7273161/People-sore-throats-headaches-sent-pharmacists-instead-doctors.html
The claim is that "Pharmacists are experts in medicine". That's good, but would it not be better to have someone who is an expert in clinical health care?
This move to utilise pharmacists is starting to happen in Australia but is being driven by pharmacists and supported by the ADHA that is desperate to get something back from the $2B spent on a largely unused myhr.
IMHO, technology and Digital Health is becoming a danger to healthcare, to patients, to doctors and to those who fund healthcare.
The irony is that myhr, which was supposed to reduce data fragmentation is heading towards a fragmentation of the healthcare system.
The idea that patients should or can "take control of their health" is a simplistic, unjustified hope.
You are absolutely correct Bernard when you say "The irony is that myhr, which was supposed to reduce data fragmentation is heading towards a fragmentation of the healthcare system."
ReplyDeleteThis increasing fragmentation of the health service delivery model can only lead to an increase in adverse events.
Thank you Ian.
ReplyDeleteI wonder if those politicians and bureaucrats pushing myhr think they are in the Dunning-Kuger Club? Probably not.
And I doubt that this would change their minds
https://tincture.io/our-dunning-kruger-healthcare-system-e4d74d8400bf
When it appears they take advise from Freddy Kruger Consultancy I doubt they are aware of what effects their actions and inactions have
ReplyDeleteIs this also the way of the future?
ReplyDeletehttps://www.reddit.com/r/canberra/comments/cgctd4/let_down_by_our_healthcare_system/
The healthcare system can't help, the government has given you a health record, you can see a pharmacist, now it's over to you.
What more do you want? To be cured? Do you think we are made of money?
@10:23 AM What I find most disturbing is that "This increasing fragmentation of the health service delivery model can only lead to an increase in adverse events."
ReplyDeleteThe central justification for the MyHR has been that it will greatly decrease the prevalence of adverse events and help overcome the problem of fragmentation lead to better integrated and more cohesive health system.
It seems that all the Health Ministers and the government have been blindsided by hype and political rhetoric - ie. they have been misled and lied to.
They've also been told it will lead to significantly fewer tests. There is absolutely no evidence that this is a valid claim.
ReplyDeleteIt is a claim that can be validated. Have tests decreased at a rate reflective of the adoption on GovHR
ReplyDeleteWhat adoption?
ReplyDeleteIf you exclude all those registrations that were foisted upon unsuspecting people when the system first launched and the registrations that were offered in the maternity ward for all newborns and their mum and the registrations that were driven by GPs wanting ePIP and the registrations from the opt-out trial and the registrations after the opt-out period ended hardly anyone has actively adopted the system.
And if you mean how many people and doctors are actually using it to access and/or download useful data, there is no evidence that this is happening and delivering meaningful value.
So it's likely that the number of tests have decreased at a rate reflective of the adoption on GovHR. The problem for the government is that the rate of both is approximately zero.
Well I was thinking the same numbers as used to promote the system, so that is a cool 90% of the population. I don’t provide the numbers, just think we should compare lemons for lemons.
ReplyDeleteThe system has been in operation long enough to be able to see a reduction. Not much to ask to see evidence
The first thing to know would be the number of un-necessary tests over some period?
ReplyDeleteI bet nobody has any idea what that number is. It's another one of these "it sounds like a plausible reason to spend billions but we don't really know." PR stunts.
Minister Hunt will not as he cannot reduce testing in Australia. The MyHR and the need to believe it has a role is bound to the support of the various peak bodies and colleges. If he (Hunt) was willing and/or able he would be crawling back that $175 million a year that pathology companies make from Medicare claims. This figure is estimated based on efficiencies in the process brought about by automation
ReplyDeleteIf the MyHR is supposed to be some sort of help for patients so they can take control of their health, then one does wonder why the peak bodies and colleges support it so much - apart from the bribes and stuff.
ReplyDeleteHas anyone stopped to ask - do patient's really want to take control of their health?
If they did, all they have to do is stop eating junk food and go for a walk.
There's either multiple hidden agendas or massive incompetence. Or both.
apart from the bribes and stuff.
ReplyDeleteI think that is pretty much sums up the drivers
(Dr Bartone's) speech, (at the Press Club today) titled Time For Action, will call on the federal government to outline a clear agenda after taking few health policies to the May election.
ReplyDelete"The government now has clear air, it’s had its term of reviews, it’s collated the information – it’s got three years now to actually implement,"
He said the nation’s health system needed better coordination as "many parts all come together haphazardly at the moment".
"There are bottlenecks, there are barriers, at times there are unnecessary delays for treatment... we need to be more coordinated and more seamless."
It's just as well we've got My Health Record - that will fix everything.
Could someone tell me why the nation's health system needs better co-ordination?
ReplyDeleteHealthcare is a state responsibility. Why waste money trying to co-ordinate state systems when the real problems are at the state level? Let each state sort its own problems first then consider a national approach, it it is deemed of value - which currently it probably isn't.
The health industry is in a mess, something must be done, this (fill in the gap, eg My Health Record, RTPM, Digital Health Strategy, etc) is something, let's do it.
Our dearly beloved leaders either confuse activity with progress or are being cynical.
My bet is confusion.
How about pharmacists get their own house in order before messing about with healthcare.
ReplyDeletePharmacists, grieving mum call for medication law reform after boy's death
https://www.abc.net.au/news/2019-07-25/medication-errors-lead-to-pharmacy-call-for-health-law-reform/11340998
"After an investigation they discovered that there was a substitution error made [at the pharmacy] and the wrong medication was put in his liquid.
...
This was in Canada only three years ago, and Ms Sheldrick is now pushing for law reform across the world to stop the sort of mistake that led to her son's death.
Her campaign has brought her to Australia this week, where health experts are warning our system could lead to similar tragic cases."
The My health Record will help prevent this. How?
The My health Record will help prevent this. How?
ReplyDeleteMy understanding is the My Health Record is to resolve the fire hazard that come from faxing. That seem to be the general message - faz-bad, MyHR-good
It does make you wonder if anyone at ADHA actually understands the basic building blocks of transformation. Because if they do they hide it well.
ReplyDeleteIt is a human imperative that we bring to a closure the ADHA, move the MyHR into operational expenditures within DHS. We can then create a new body seperate from any health department but funded by them and work on the hard bits of clinical interoperability. And ADHA, by hard I do not mean getting animations into slide decks or integrating yammer and twitter.
Interesting research report that shows that even the "leading digital health companies have not yet demonstrated substantial impact on disease burden or cost in the US health care system"
ReplyDeleteAnd the ADHA expects us and the Australian government to believe they can do better? And that myhr is a "high-impact product"?
"Impact On High-Burden, High-Cost Conditions"
Abstract
"Digital health companies hold promise to address major health care challenges, though little has been published on their impact. We identified the twenty top-funded private US-based digital health companies to analyze their products and services, related peer-reviewed evidence, and the potential for impact on patients with high-burden conditions. Data analytics (including artificial intelligence and big data) was the most common company type.
Companies producing biosensors had the greatest funding. Publications were concentrated among a small number of companies. Healthy volunteers were most commonly studied.
Few studies enrolled high-burden populations, and few measured their impact in terms of outcomes, cost, or access to care. These data suggest that leading digital health companies have not yet demonstrated substantial impact on disease burden or cost in the US health care system.
Our findings indicate the importance of fostering an environment, with regard to policy and the consumer market, that encourages the development of evidence-based, high-impact products."
The conclusion is also worth looking at. This is the first part:
ReplyDelete"Conclusion
Digital health represents a new and expanding field with substantial promise to address major health care challenges in high-cost, high-burden patient populations. In this cross-sectional observational study of top-funded digital health companies, we found that few companies studied their products and services in high-cost, high-burden populations or measured their impact in terms of key health metrics such as outcomes, costs, or access. Most studies were of healthy patients, congruous with the direct-to consumer approach that many digital health companies have taken to bring their products to market."
Apart from the obligatory "promise" it seems that there is no evidence that Digital Health is having much impact on high-cost or high-burden populations.
Like myhr these products are being marketed to healthy people and their impact is not being measured in terms of key health metrics such as outcomes, costs, or access.