Quote Of The Year

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

or

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

Sunday, March 13, 2022

Is It Likely That The Pharmacist Shared Medicines List For The #myHealthRecord Will Make A Difference To Patient Medication Safety?

This release appeared last week:

7 Mar 2022 9:04 am AEDT

Royal Victorian Eye and Ear Hospital leads efforts to reduce medicine related mishaps

Australian Digital Health Agency

The Royal Victorian Eye and Ear Hospital (Eye and Ear) is the first hospital in Australia to implement the Pharmacist Shared Medicines List (PSML) medicine safety initiative.

PSML is a clinical document produced only by pharmacists and uploaded to My Health Record. It is a consolidated list that includes information about prescription and non-prescription medicines such as over-the-counter and complementary medicines, including vitamins and herbal remedies. It also includes the health practitioner’s reasons for prescribing each medicine and how and when patients should take them.

The PSML helps patients and healthcare providers manage medicines safely throughout a patient’s healthcare journey, including when they are discharged from hospital and go home or into a residential aged care facility.

When this information is available in My Health Record it can help patients and healthcare providers avoid medicine-related mishaps and ensure continuity of care. According to Australian research by the Quality Use of Medicines and Pharmacy Research Centre, UniSA, an estimated 250,000 hospital admissions are medicine-related and two-thirds are potentially preventable.

The Australian Digital Health Agency (Agency) and the Victorian Department of Health have worked closely with The Royal Victorian Eye and Ear Hospital in East Melbourne to deliver PSML at the hospital.

Director of Pharmacy at Eye and Ear, Catherine Rokahr, explained that pharmacists highlight changes to a patient’s regular medicines made during a hospital stay.

“This is detailed in the discharge medicines’ list uploaded to My Health Record which becomes part of the PSML and shows GPs and community pharmacists any medicines that have been stopped, directions and doses that have changed, new prescriptions, and the reasons for each medicine use and medication changes,” she said.

Jeanette Anderson, the Director of Digital Health at Eye and Ear added “PSML is part of the hospital’s commitment to an outstanding patient experience and there is real interest in adopting this medicine safety initiative across the state’s health system”.

Agency CEO, Amanda Cattermole, said “The Victorian Department of Health and the Royal Victorian Eye and Ear Hospital are to be commended for their support for the Pharmacist Shared Medicines List initiative.”

“Now this Victorian hospital has led the way in implementing this initiative, the Agency and the Department are working to extend PSML to other health services in Victoria.”

Chief Digital Health Officer at the Victorian Department of Health, Neville Board, said Victoria’s digital health roadmap centred on the secure sharing of critical health information between clinical settings, making each patient’s care journey safer.

“I thank all the staff at the Eye and Ear for taking the lead and getting essential patient medicines information into My Health Record” Mr Board said.

Background on the Pharmacist Shared Medicines List

A Pharmacist Shared Medicines List (PSML) contains information about the medicines a patient was known to be taking at the time the list was created.

The list includes medicines that have been prescribed to the patient by their doctors and other non-prescription medicines that they may be taking (such as paracetamol) and other known over the-counter medicines.

A Pharmacist Shared Medicines List could be created by:

  • a pharmacist after completing an in-pharmacy medicine review
  • a pharmacist in preparing a dose administration aid
  • a hospital pharmacy for patients when they are discharged.

A Pharmacist Shared Medicines List can benefit patients with a complex condition or chronic disease and who are taking multiple medications.

Here is the link to the release:

https://www.miragenews.com/royal-victorian-eye-and-ear-hospital-leads-737668/

Here is how the PSML is described by the ADHA.

Pharmacist Shared Medicines List

There’s a new way for you and your healthcare providers to securely access a list of medicines you take uploaded by your pharmacist. The Pharmacist Shared Medicines List. Helping reduce medicine-related problems in Australia.

What is the Pharmacist Shared Medicines List? 

Soon your pharmacist will have the software to connect to and be able to upload a document called the Pharmacist Shared Medicines List (PSML) to your My Health Record.

The Pharmacist Shared Medicines List is a list of medicines that may include those prescribed by your doctor, non-prescription medicines including over-the-counter or complementary medicines (such as vitamins or herbal medicines) you may take. This list will include details on how and when you take your medicines at the time the list was created. 

If your pharmacist has uploaded a Pharmacist Shared Medicines List, you can find it in the ‘Documents’ section in your My Health Record.

What is the difference between the Pharmacist Shared Medicines List and the Medicines Information view?

If you have a Pharmacist Shared Medicines List in your My Health Record, your healthcare providers will be able to quickly access your most up-to-date information. 

This document can only be added to your My Health Record by your pharmacist. 

You will find the Pharmacist Shared Medicines List in the ‘Documents’ section in your My Health Record. 

The Medicines Information view can quickly look for, sort and display your most important health information in your record in date or by medicine name.

Rather than opening every document available in your My Health Record, the information in the Medicines Information view can be gathered from your most recent prescription and dispense records, your most recent shared health summary or hospital discharge summary prepared by your healthcare providers, or if you’ve added any medications or any allergies or adverse reactions.

You will find the Medicines Information view in the ‘Documents’ section in your My Health Record.

Here is the link:

https://www.myhealthrecord.gov.au/for-you-your-family/howtos/pharmacist-shared-medicines-list

You can read the technical specs. Here:

https://developer.digitalhealth.gov.au/specifications/clinical-documents/ep-2924-2020

Note the current version is dated March 2020 – 2 years ago!

So after 2 years the first hospital in the country is actually implemented…..

Looking at the PSML system is seems to be an application that has been created for professional pharmacists who have a huge amount of time on their hands and an inclination to spend that time filling is PSML’s. I don’t know many of those! I note there is no mention of payment for doing the work!

My only comment to that is in the immortal words of  Darryl Kerrigan in The Castle …. “Tell them they are dreamin’”

I really wonder just what sort of technocrat would think such a system was sensible in the real world!

It is interesting that the ADHA provides no individual statistics on how many PSMLs have been crated – just as they don’t on Shared Medical Summaries created by doctors.

See here:

https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/statistics

I believe this is a totally ill thought out, overly complex and user hostile system which will hardly, if ever, be used.

What do you think?

David.

 

9 comments:

Anonymous said...

It will probably be as useful and successful as Health's national COVID-19 vaccine roll-out booking solution and CovidSafe which seem to have quietly and noiselessly sunk without trace. Unnoticed and unloved.

Anonymous said...

"A Pharmacist Shared Medicines List (PSML) contains information about the medicines a patient was known to be taking at the time the list was created."

1. How useless is that list 12 to 18 months later? It isn't.
2. Is it a real-time interactive list? No.
3. How is it kept current? It isn't.
4. Can it be relied upon and trusted? No.
5. Is one medically liable if one relies upon the list? Yes.
6. Would health practitioners rely on the list? No.
7. What value is the list? No value.
8. How stupid are the people quoted? Immeasurably.

Anonymous said...

I think you mean:

How uselful is that list 12 to 18 months later? It isn't.

Anonymous said...

@4:49pm. Correct. Thanks.

Anonymous said...

It's not easy building a successful business. 9 out of 10 startups fail. Public sector driven initiatives are no different. PSML will fail because it is an ill-conceived pin-point piece of a huge highly-complex system where the kernel of the technology needed to drive and viably sustain it has not yet been developed.

Anonymous said...

"Rather than opening every document available in your My Health Record, the information in the Medicines Information view can be gathered from your most recent prescription and dispense records, your most recent shared health summary or hospital discharge summary prepared by your healthcare providers, or if you’ve added any medications or any allergies or adverse reactions."

So it's just a co9llection of all the medication data? There's certainly going to be duplication, so trying to make sense of it all will be time consuming and unreliable.

The only thing worse than not enough data is too much data. The real problem is that of curating the data to make sure it represents what is current, in real-time. Which, of course, is an impossible task.

Rule number one in healthcare is - make sure the data is current and valid.

The reality of healthcare is that this cannot be achieved. Old and incorrect data can kill.

Clara Ward said...

Maybe the department heads can get together with the PM&C and design a new logo for the MyHR and ADHA

Anonymous said...

Fabulous suggestion Clara; fabulous.

Anonymous said...

"... a new logo for the MyHR and ADHA"

How about a picture of a couple of public servants throwing large amounts of money on a fire?