This appeared last week:
Deadline looms for sign-up to centralised prescribing
The Department of Health and Aged Care is urging practices that have not registered for the national Prescription Delivery Service to do so.
17 Aug 2023
More than 150 million e-prescriptions have been issued since May 2020.
Reimbursement
for an e-prescription SMS will stop from 30 September unless prescribers have
signed up to the new national Prescription Delivery Service (PDS), the
Department of Health and Aged Care (DoH) has warned.
It said practice owners and managers should check whether they have registered
and if their software providers advise any necessary updates.
The centralised PDS, run by eRx
Script Exchange, is designed to streamline prescription delivery and
dispensing, according
to the DoH.
A $99.6
million deal was signed this May, with eRx Script Exchange contracted to
provide the PDS from 1 July this year until 30 June 2027.
According to
Services Australia, clinicians and pharmacies need to connect to the PDS by
the end of next month to continue prescribing or dispensing eligible
medications.
Reimbursements for e-prescription tokens are currently paid by the Australian
Digital Health Agency (ADHA), an arrangement that had
been extended several times while DoH officials considered a permanent
solution.
The Government-funded prescription exchange will continue to cover SMS fees but
only for practices that have signed up to the new PDS.
The DoH says the move to the new system will simplify the prescribing process,
as well as give ‘long-term funding certainty to enable innovation and
efficiency … clearer governance … and enhanced capacity for patient-centred
support and care’.
The DoH says other policy reforms, including the mandated use of e-prescribing
for high risk and high-cost medicines, ‘are on the horizon’.
The move to a model directly contracted by the Federal Government was announced
as part of the 7th Community Pharmacy Agreement, with the tender going out in
June last year.
The majority of practices are believed to have signed up to eRx Script Exchange
already, and do not need to take further action.
Set up in April 2009, the prescription exchange service is a subsidiary of the
Fred IT Group, which is part owned by the Pharmacy Guild.
The other software vendor that runs a prescription exchange service,
MediSecure, will continue providing private prescriptions, which will remain
free to send by SMS or email after the transition period according
to a statement on the company’s website.
The ADHA states there have now been more
than 150 million e-prescriptions issued since May 2020, with the pandemic
proving a significant catalyst.
More here:
https://www1.racgp.org.au/newsgp/professional/deadline-looms-for-sign-up-to-centralised-prescrib
It seems we have just set up a small partial national monopoly here with the Pharmacy Guild at least somewhat involved. At least it is not the total monopoly I am sure they would have liked!
It is certainly a good thing all this will not we stable and can be bedded in to provide what will become an essential service I am sure.
I guess we will just have to wait and see how well the arrangements work in the longer term, but it is good to have a national e-prescribing service in place!
David.
11 comments:
Who owns the technology, software and patents etc, of the Prescription Delivery Service (PDS)? The posting implies that it's a monopoly, but whose?
Is the DoHA opening itself up to coercion etc?
I am not sure but knowing Government I am sure they have obtained ultimate ownership and control of the system.
Can anyone at the ADHA clarify?
David.
Can anyone at the ADHA clarify?
You have lost none of you humour Dr More.
David, eRx is the key beneficiary. Telstra and PGA own Fred 50/50 and Fred owns eRx. I'm pretty sure that's the current state of play.
If so, Telstra and PGA are the real beneficiaries. This new set up pretty well renders Medisecure irrelevant and Government beholden to Telstra and PGA.
"More than 150 million e-prescriptions have been issued since May 2020".
39 months and 150 million e-prescriptions equates to 961,000 each week. Assuming 8,000 medical practices with an average of 3 doctors per practice that means each practice transmits an average of 120 scripts each week or 40 scripts per doctor each week.
@9:50 PM With 30,000 Full-Time Equivalent GPs that equals 32 escripts per FTEGP each week, or approx. 6 scripts per day. Clearly the government is hoping to see this number increase substantially by mandating that doctors use the National Prescription Delivery Service (PDS) after September.
With the government reimbursing eRx Script Exchange (via ADHA) $100M over 4 years the subsidy per script equates to 50 cents which is 3.3 times the current sms token.
The 7th Community Pharmacy Agreement should specify who owns the IP (if the PGA knew what it was doing) and who has ultimate ownership and control of the system; my guess is the Guild has run rings around the bureaucrats once again!
However! The key is who has patented the PDS business processes - the Guild, the Government, or neither!
Average of <1in6 Rx are eScripts for the 3 years. That's assuming we are counting the same things which I'm not sure of. >300 million PBS Rx/yr, >100M below threshold (fully paid by patients), >200M with PBS subsidy. I don't know how many private scripts nor whether eScripts would apply to them as well.
It would be good to hear a policy statement from the ADHA on this against their promise of interoperability as a market opener and consumer benefit. Appreciate someone has to run the infrastructure- however on the surface this does not appear to be ‘public infrastructure’ rather a public funded private monopoly.
The details behind those figures are irrelevant to ADoHA. It’s all about big number volume, quantity over quality, meaningless use over secondary use. The My Health Record and ADHA version of digital health is a Ponzi scheme.
Technically, I believe it's worth noting that in the Australian solution there is only a single drug per e-script. In contrast, scripts generated from the NZ e-Prescription Service can contain one, or many items (drugs).
I thought it quite promising when the REQUEST FOR TENDER contemplated "the appointment of a single PDS provider OR MULTIPLE PROVIDERS with a view to selecting ONE OR MORE PDS providers and A SINGLE ASLR provider".
"Oh, what a tangled web we weave, when first we practice to deceive!" (Sir Walter Scott, 1808)
Clearly everyone was blind-sided by the Department's duplicity. But has the Department been too clever by half?
The Department will ferociously exercise their intention to force into place a monopoly over the transmission of electronic prescriptions come hell or high water. It is the only way they can salvage the ADHAs reputation by pushing the $2.5 billion failed MHR into the background and replacing it with some highly credible successful alternative digital health solutions which they can use to promote a tsunamic-wave of positive media coverage from which to claim some great successes [PDS, ASLR and RTPM] thereby hoping to achieve much kudos.
In my opinion MediSecure offers Australian doctors, pharmacists, consumers and vendors, a much needed clear and welcome alternative choice in the use of a PDS. Sadly, the Department seeks to remove the option for doctors and pharmacists to choose, and in so doing eliminate any market competition, through the establishment of a monopoly; one only PDS.
In time the Government will mandate all private scripts pass through the government-controlled PDS.
Notwithstanding the huge risks and high likelihood of massive market disruption, which could quite conceivably set digital health in Australia back by a decade or more, Australian citizens are being done a grave disservice by this bureaucratic shortsightedness and the Department's preference to establish a monopoly in the electronic prescription ecosystem.
According to Alan Fels, Former ACCC Chair, Government (hence the Department) is exempt from any ruling by the ACCC on Fred IT Groups Application of 9 May 2023 to the ACCC.
The 14 June 2023 submission to the ACCC, by Department of Health and Aged Care, is dismissive of the ACCC in stating that "Irrespective of the outcome of this application (both the interim and final determination), the Commonwealth's decision will not be reversed."
https://www.accc.gov.au/public-registers/authorisations-and-notifications-registers/authorisations-register/fred-it-group-pty-ltd-and-ors
The ACCCs Draft Determination was published 14 Sept 2023.
https://www.accc.gov.au/system/files/public-registers/documents/Draft%20Determination%20%26%20Interim%20-%20PR%20-%2014.09.23%20-%20AA1000641%20Fred%20IT%20Group%20and%20Ors.pdf
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