This appeared last week:
Last week a GP wrote Australia's first ever e-script: Here's what doctors can expect
It's been decades in the making but the
health system's long-awaited e-prescribing adventure has begun
13th May 2020
Meet Dr David Corbet, who has just earned a
very unique place in Australian health care history.
Last Tuesday, the GP from Anglesea, on
Victoria’s Surf Coast, wrote the first ever legal electronic prescription which
was successfully dispensed by a pharmacy.
OK, no moon-landing but in terms of
the struggle involved in bringing 21st Century technology to bare on
an act that occurs literally hundreds of millions of times a year, it is
probably close.
“It was very simple,” Dr Corbet says of
the first e-prescription (which was for an asthma medication).
“The user interface on the practice software
is essentially the same you would normally use for writing a script, except
that it has an e-script button and you can select which way you want to send
it.”
By
pressing that button, Dr Corbet activated the Federal Government’s
e-prescribing system, sending a unique web link via SMS to his patient’s phone.
The
link, known as a ‘token’, could also have been emailed to the patient or
printed out as a QR code, which, when scanned, opens up the details about the
script.
Dr
Corbet’s patient then forwarded the token to the pharmacy for dispensing.
“And you can resend the SMS if someone loses it. You can also
cancel scripts at any time from within the software.
“There’s
also a nice way to authenticate S8 scripts where the doctor re-inputs
their password to make the prescription valid.”
Dr
Corbet’s practice was selected to beta test e-prescribing because it’s in the
unique position of being the only practice in a town that has just one
pharmacy.
He
says both himself and the pharmacist Jason Bratuskins have a keen interest in
IT.
Following
the successful test, Dr Corbet estimates around 50% of scripts in his practice
are electronic. E-scripts and are becoming “more and more regular”, he tells Australian Doctor.
“There
have been no problems and it is going well.”
But
he says time is still needed to allow patients to adapt to the latest change,
with some turning down the offer of an e-script because they “won’t know what
to do with it”.
The
practice is also holding off offering the electronic scripts to patients who
may find the token system too complex.
“For most of our 90-year-olds, it’s not quite so straight forward.”
More here:
I guess the journey of a thousand miles
begins with a single step. One has to think it will be a good while before we
see significant use of the system, especially as I understand the Pharmacy
Guild does not like the way EP is being implemented.
See here:
‘Token’ model to cause chaos?
The “rushed” introduction of electronic prescriptions is set to cause unnecessary chaos, warns the Pharmacy Guild
The Guild has said in a statement that the planned fast-tracking of electronic prescriptions will cause unnecessary chaos and be a backward step for patient care at exactly the wrong time.
The imminent fast-tracking of the electronic prescriptions (FTEP) is part of the Government’s COVID-19 National Health Plan.
The Guild says that on behalf of the community pharmacists working in thousands of pharmacies across Australia, it cannot support the introduction of a measure which it says will impose further significant disruption at a time when community pharmacies are already under intense pressures to support their patients during COVID-19.
The proposed fast-track introduction of the “token” model for electronic prescriptions is the wrong move at a time when the system and pharmacy network is clearly not ready and experiencing unprecedented challenges, the Guild says.
The “untested” system, under which prescriptions would be conveyed by “tokens” sent to patients by text or email, presents unnecessary risks to patient care, says the organisation.
This system will impose unwarranted disruption to the administrative and clinical workflow of both prescribers and community pharmacies already having to adjust to new arrangements in support of the COVID-19 National Health Plan, it says.
…..
“This is why the Guild has recommended, through the Electronic Prescribing National Change and Adoption Working Group, that the alternative model known as the Active-Script List (ASL) be prioritised as it best supports a patient’s access to their medicines via electronic prescribing and best enables the community pharmacy to support this access.”
The Guild says that under the ASL system, the patient’s “active” prescriptions can be authorised for access by the patient’s chosen community pharmacy without the need for a token or multiple tokens to be self-managed by the patient.
“While the Guild will continue to be a strong supporter and contributor to the national electronic prescriptions project, it recommends the FTEP (Token) be removed from the COVID-19 National Health Plan in favour of the ASL model, and that maintaining patient access to medicines during COVID-19 is achievable by the appropriate resourcing and funding of the current COVID-19 measures,” it says.
I think it would be sensible to
stand back and see how this plays out. As we all know if the Guild is not on
side things may move very slowly!
David.
16 comments:
Has the second scrip been written and dispensed yet?
There are a few barriers to adopting electronic data interchange but health certainly seeks them out and where there is a gap they invent one. Push the time between the 1948 Berlin airlift and the start of the seventies to one side, the worl started doing this 50 years ago. Using that as a starting point the second transmission should be late next year.
I know this is good to see but it is also embarrassing to witness. What is needed is some sort of way to share resources interoperable, allow the flow of information between trusted parties that preserves the meaning and allows for data extraction and analysis based on open standards supported by policy and tools.
Well don’t look to ADHA and there circle of visionaries. They are only discovering SNOMEDCT-AU and it’s possible usefulness ( I joke not there was a thread last night on LinkedIn)
ADHA Staffer, are you referring to this thread ( I have extracted the first five comments). All leaders in the current iteration of digital health experts.
Interesting article in Pulse IT discussing the use of SNOMED-AU as a key component to gaining a deeper understanding of how our healthcare $ is consumed....is COVID-19 opening up the opportunity to improve (I don't want to say mandate) the use of SNOMED-AU?
…………..
A consistent, national clinical terminology is a good step forward.
……………..
Watching the 73rd WHO assembly last night I am also interested in the continued focus on global transparency, openness and information sharing as we learn lessons and strengthen systems.
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I agree that SNOMED-AU could add more definition to data. As important, are the mechanisms of data access and governance. Vital to get timely, updated and linkable data on health services use. Great opportunity to enable digital health in a stepwise fashion if policy makers embrace innovators to leverage health data. Need to think programatically, not old school project by project with long timelines to get outdated data.
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Any chance SNOMED-AU and MyHealthRecord could get together in the e-health paddock one day? Permissioning aside (or front and centre as it should always be) there may be an opportunity for patient sign off on key aspects of the visit, what goes on record, and the payment at the same time?
@Anon May 22, 2020 8:54 AM
After 8 years and $2b? Start again? With credibility shredded and a perceived track record of miserable failure? Trying to do the same old same old.
The government should get real and get out of the way.
Thinking in the rest of the world has moved on from pathetic attempts to automate manual health records to digital front doors.
https://sueschade.com/2020/05/knocking-on-the-digital-front-door/
This one woman has more innovation in her than the whole Australian government's bureaucratic machinery.
To mix a metaphor, with it's collective head in the sand, ADHA is hanging on by its fingertips to the past.
Wonder if ADHA has stumbled across AMT? Showed promise at one stage. How a once great opportunity fizzled out and now flaps about like a limp fish.
Who knows the fate of the Aust. Medicine Terminology (AMT). I had assumed the ADHA was still maintaining and delivering it?
It is an appalling waste of effort if it has been abandoned!
David.
re AMT. Seek and ye shall find:
https://developer.digitalhealth.gov.au/specifications/ehealth-foundations/EP-1995-2015
Bernard AMT is hosted elsewhere these days - https://www.healthterminologies.gov.au/
That said 9:52 does demonstrate the lost in knowledge as a result of Tim Kelsey and the ADHA. I doubt anyone other the Bettina even knows the problem it was solving or why. Certainly doubt any other than a few know it exists outside a repeating line item in the work plan and budget.
@Anon May 22, 2020 12:27 PM
Thanks.
What's the connection/relationship between
https://www.healthterminologies.gov.au/ and ADHA?
According to the logo the site is part of the ADHA. Someone will have more details about the size and so on of the terminology unit I am sure.
David.
This is a useful summary of the AMT:
Australian Medicines Terminology
The Australian Medicines Terminology (AMT) is the national terminology that delivers unique codes to unambiguously identify originator and generic brands of medicines commonly used in Australia. It also provides standard naming conventions and terminology to accurately describe medications.
The AMT covers all commonly used medicines in Australia, and was developed to be implemented in clinical information systems to support electronic medication management, including the following activities:
Prescribe;
Record;
Review;
Issue including dispense;
Administer; and
Transfer of information.
The AMT (a formal subset of SNOMED CT-AU), is updated every month to include changes and additions to the Pharmaceutical Benefits Scheme (PBS) and Australian Register of Therapeutic Goods (ARTG). It can be downloaded for free by registered license holders.
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David
Making AMT and SNOMED CT-AU available to the digital health arena in Australia is one of the unsung achievements of Nehta/ADHA.
It would be very surprising if the national My Health Record system did not make use of it...
"It would be very surprising if the national My Health Record system did not make use of it... "
Does anyone actually know???
David.
How little has changed, if anything is is more complicated than ever.
https://aushealthit.blogspot.com/2012/10/there-is-governance-management-chaos.html?m=1
The health department just can't win
They produce the MyHR and hardly anyone wants it, in spite of all that media blitz
They release COVIDSafe early, there's an initial uptake then people lose interest.
The government releases an update, which everyone needs to download but very few do, in-spite of the media blitz.
They permit telehealth and so many people want to use it the department gets worried, in case it's getting rorted.
Nothing works as planned or intended.
SNAFU.
It will be interesting to see how eprescriptions work out.
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