This appeared last week:
Extension to subsidised SMS e-scripts ‘needs long-term plan’
The SMS fees will continue to be reimbursed until September, but some GPs are concerned about the uncertainty once the current extension expires.
01 Jun 2022
On 18 May, the Department of Health (DoH) sent a letter to healthcare providers to inform them that reimbursements of electronic prescription tokens sent via SMS will be extended until ‘at least’ 30 September 2022.
This is a further extension to the announcement in August last year, and includes reimbursement for both original electronic prescription tokens and the cost of repeat tokens, as well as the 15 cents electronic prescription fee to be maintained until the Request for Tender process is finalised.
The RACGP supports the further extension and states it will continue to work with the DoH and the Australian Digital Health Agency (ADHA) to advocate for an ongoing funding model that supports uptake and provision of electronic prescriptions.
But while also supportive of the extension, Dr David Adam, RACGP Expert Committee – Practice Technology and Management member, is frustrated with the ongoing uncertainty.
‘We just need some clarity and some idea about what the long-term plan is,’ he told newsGP.
It’s just a repeated extension, but then GPs don’t know what to expect.’
Dr Adam is concerned about what will happen once the current three-month extension is up, saying that practice owners may not know whether they’re going to be billed after 30 September.
‘There’s lack of a clear plan … and [for practice owners], it’s pretty difficult to make a plan,’ he said.
‘I imagine the [Federal] Government is waiting until the Active Script List [ASL] system is implemented, but that’s been on the cooker now for more than 18 months, so I don’t know if that’s going to happen.’
Currently rolling out to pharmacies with compatible software across Australia, the ASL is expected to become available more broadly throughout 2022 and will ‘make life easier’ for patients, prescribers and dispensers, Dr Adam previously said.
The college supports implementation of the ASL as a permanent feature of electronic prescribing to improve the way patients and GPs manage multiple electronic prescriptions without incurring SMS fees.
While the latest extension to the subsidised arrangement means there is currently no cost to a practice for sending a prescription token via SMS, Dr Adam estimated that without the SMS subsidy, practices could foot a bill of around $1000 per year.
‘The numbers we’re talking about are not massive … but it’s the principle,’ he said.
‘Whatever arrangement is made needs to be sustainable in the long term.’
The interim agreement is expected to continue while the Request for Tender process is underway, and will continue to support electronic prescribing which has seen a substantial uptake.
According to the ADHA, as of February 2022, more than 37 million electronic prescriptions have been issued since May 2020 by more than 31,000 prescribers.
More here:
https://www1.racgp.org.au/newsgp/professional/extension-to-subsidised-sms-e-scripts-needs-long-t
It seems to me that what we are seeing is a situation where the perfect is being the enemy of the good, with the Department wanting the perfect system in place – but taking a long time to get there, while many are perfectly happy to press on as they are with a reasonably working system.
If the ASL is finally set up and working well then the older system will wither and eventually pass on.
In the mean time why not just make the small financial commitment and give everyone certainty?
Have I got this wrong or are there good reasons for this minor bit of bureaucratic ‘penny pinching’.
Let us all know!
David.
It's all about control by 'who'.
ReplyDelete"According to the ADHA, as of February 2022, more than 37 million electronic prescriptions have been issued since May 2020 by more than 31,000 prescribers."
ReplyDeleteWell, that does sound like a lot. Doesn't it?
From May 2020 to February 2022 [22 months max] 31,000 prescribers have issued an average of 54 scripts per month!
ie. an average of 1,193 scripts per prescriber over 22 months!
ie. an average of 54 scripts per prescriber per month!
ie. an average of 15 scripts per prescriber per week!
ie. an average of 3 scripts per prescriber each weekday!
Well, that doesn't sound like many, does it?
Surely, after all the time, money and resources expended to-date on electronic prescribing we must now be asking:-
Why is it the uptake and utilisation of electronic prescriptions so low?
There are 31,000 general practitioners registered in Australia. A significant proportion of them do not issue prescriptions electronically. My question therefore is what is the breakdown of prescribers who do issue prescriptions electronically:
ReplyDelete(a) GPs
(b) Specialists
(c) Dentists
(d) Pharmacists
(e) Others
213.6 million Rx in 2020-21 PBS subsidised, compared to 208.5 million for the 2019-20 financial year.
ReplyDeletehttps://www.pbs.gov.au/info/statistics/expenditure-prescriptions/pbs-expenditure-and-prescriptions-report-30-june-2021
"More than 55 million electronic prescriptions have been issued since May 2020, by more than 41,000 prescribers - GPs and nurse practitioners.
- May 2022"
https://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/electronic-prescribing/for-prescribers
At best it's about 10% for the total period. If it's accelerated then maybe now it's 30% of new scripts.
But I could be confused regarding the correct denominator of each source (MHR vs PBS): prescribed, claimed or dispensed.
According to the SMH Australia needs a national COVID-19 database
ReplyDeleteWouldn't it be a good idea for all Australians to have a health record that included accurate and up-to-date COVID and other key health information and which all healthcare providers could access?
Oh, wait a minute, don't we have one of those already ......?
Push for a national COVID-19 database
Melissa Cunningham
SMH
Some of Australia’s most respected infectious disease experts have warned that our systems for collecting information on coronavirus infections, hospitalisations and deaths are poor and fragmented, preventing the country from properly preparing for the next wave of disease.
They say the answer is a national data system that constantly updates and eliminates the differences that exist between each state and territory when collecting information about how many people are getting infected, who is being hospitalised and where the virus is spreading.
"We’ve got basically eight different systems operating," said infectious disease physician Professor Allen Cheng, a former Victorian deputy health chief officer.
Professor Sharon Lewin, head of Melbourne’s Peter Doherty Institute for Infection and Immunity, said that while Australia fared better than many countries during the pandemic, the way it collected coronavirus data was far behind comparable nations such as the UK and US.
"Our data systems are still really poor," Lewin said. "We really need better ways to understand who is being infected and how, who is being re-infected and who is in hospital, and who is dying in Australia."
Tens of thousands of Australians are being infected with coronavirus and dozens are dying daily. In Victoria alone, about 500 people are in hospital each day infected with COVID-19.
Lewin, who called for surveillance system on par with the UK, said upto-date national data was a gap in Australia’s pandemic response. The priority must be to ensure Australia enacts national policies to deal with future coronavirus outbreaks and to remove divisions between state responses, she said.
Cheng said there was a need for a national plan on how Australia monitors coronavirus into the future, as it faces its third Omicron wave – predicted to peak in late June – and as more contagious Omicron variants BA4 and BA5 are expected to push up infection levels.
"Information about how many people are getting infected, who is being hospitalised, where the virus is spreading ... can help us make forecasts," Cheng said.
With Australia transitioning to living with COVID, abandoning measures such as contact tracing and mandatory mask wearing, University of Melbourne epidemiologist Professor James McCaw said it was "as critical as ever" to understand how the virus was behaving.
"What we need is systems that allow us to infer or estimate how the virus is spreading in the community," the adviser to the federal government on its pandemic response said. "It is through well designed ... systems that you can anticipate what the impact will be in terms of clinical loads in hospitals and where you may have an opportunity to ... dampen outbreaks."
Prior to winning the federal election, the Labor Party committed to establishing an Australian Centre for Disease Control, promising the dedicated body would have capacity to monitor current and emerging threats and work with state governments and medical providers to prepare for the next crisis.
A spokesman for Federal Health Minister Mark Butler said the department continued to examine ways collection, storage and utility of data relating to COVID-19 and other diseases could be improved.
re:
ReplyDelete"They say the answer is a national data system that constantly updates and eliminates the differences that exist between each state and territory when collecting information about how many people are getting infected, who is being hospitalised and where the virus is spreading.
"We’ve got basically eight different systems operating," said infectious disease physician Professor Allen Cheng, a former Victorian deputy health chief officer."
If I could just point out, yet again, that the original architecture of the PCEHR was to connect up all the existing databases of healthdata - they were called repositories. The aim was to reduce data fragmentation.
What was built and what is now the My Health Record is nothing like its original architecture. MyHR is not connected to any databases, all its data is uploaded into a central database.
If the original architecture had been implemented it would be a relatively simple task to connect these "eight different systems", especially if they had been built from scratch to act as repositories to the MyHR.
The MyHR system as it exists now is totally unsuitable to be used as a national COVID-19 database. Or anything else of use to healthcare providers for that matter.
A shame those who designed it where exited, many in very nasty ways, many of those who pushed the current system sit in very comfortable spot or consult to those in comfortable spots blocking any hope for change.
ReplyDelete