A day or so ago eRx released its most recent newsletter.
The Newsletter can be found here:
http://www.guild.org.au/uploadedfiles/National/Public/Guild_Initiatives/eRx%20June%20News.pdf
The key bits of information contained in the 2 page newsletter are:
1. NEWS FLASH - 150,000 scripts transmitted since launch in April, and more than 1500 contracted pharmacies and GPs to date.
2. COMING SOON - From July, eRx Script Exchange will also provide a more efficient process for managing new and owing prescriptions, with the owing script and new script request functions. This will provide messaging capability between GPs and Pharmacies of new or owing scripts required, therefore removing the need for sending requests by fax or telephone.
3 PARTNERS LIST – The whole of page 2 is a collection of logos from all sorts of commercial parties who are involved with the plan.
It is interesting to note that there are only 2 prescribing systems currently listed as partners and that Medical Director and Genie are not.
If you are curious to know what is being done visit here:
http://www.erx.com.au/Demos/eRxInAction.aspx
In its present form I am not at all happy with the way this is evolving – recognising, of course, that this would only be happening if there was not substantial frustration with the progress NEHTA and DoHA have made in the e-Prescribing space.
I have written on the plan and a proposed competitor here:
http://aushealthit.blogspot.com/2009/03/e-prescribing-wars-break-out-in.html
This also provides a backwards link to another set of comments specifically on eRx.
This is here:
http://aushealthit.blogspot.com/2009/03/e-prescribing-comes-around-again-in.html
Why is control being lost? For a start the DoHA commissioned consultancy to advise Government how to proceed is not due to report until 34 weeks after somewhere in May, 2009 when a contract to do the work should have been signed. This simply means all this is happening in the total absence of any Government leadership and direction – never a good thing until well into 2010. Government is meant to provide frameworks and guidance to assist things like e-Health develop in ways that are valuable for the community – but right now they are just absent the field.
We also have eRx saying they are not actually planning to use the relevant Australian Standards (SNOMED CT etc) See the FAQ:
“What messaging standards will eRx adopt?
eRx will adopt messaging standards when possible. eRx will however not let standards, or a lack of standards, further slow the implementation of this vital piece of the e-health infrastructure.”
Note a competitor Medisecure is planning a standards based approach. See here:
http://www.medisecure.com.au/index.html
This then brings up the question of, if this actually goes ahead and develops substantial scale, just what relevance does the work the volunteers at Standards Australia have and what relevant does NEHTA’s standards setting role have.
I would also bet the eRx infrastructure is not compliant with Series 2 Architecture Blueprints which we learned NEHTA is developing last week.
See here:
http://aushealthit.blogspot.com/2009/06/nehta-is-simply-not-ready-for-any.html
If I were involved in this work, volunteer or paid, I would be less than impressed that the whole thing is allowed to go ahead – and would be unlikely to get involved in future projects unless assured there was some point to putting in the effort!
There is also a real issue about what professional responsibilities pharmacists have to ensure the information being used for dispensing is utterly trustworthy. Scanning a barcode does have a (very low) error rate (ask Woolies and Coles) but just one wrong prescription being downloaded and dispensed would be one too many!
Last, I am sure we really don’t need anyone ‘clipping the ticket’ of e-Prescribing. There were 237 million prescriptions filled in 2006 – (Australia’s Health 2008) so even at $.25 per script we are talking a service costing near enough to $60 million per annum. Blowed if I can see that being a good deal for the public or the pharmacies (sounds pretty good for eRx however) – remember once the core infrastructure is bought / developed to actual cost per transaction is almost certain to be less than 1-2 cents each!
It is also important to see all this in the context of the upcoming Pharmacy Framework Agreement.
Pharmacists lobby for $1 billion federal funding
Elizabeth McIntosh - Friday, 10 July 2009
PHARMACISTS will be pushing for $1 billion in federal funding for pharmacy programs and services when negotiations for the Fifth Community Pharmacy Agreement commence later this year, though their requests may face stiff opposition from Health Minister Nicola Roxon.
Under the current agreement, pharmacists received $500 million over five years to provide services such as home medication reviews. However, Pharmaceutical Society of Australia (PSA) vice-president Dr Shane Jackson (PhD) said funding needed to double if pharmacists were to be adequately paid for their work.
“If we can establish [these activities] are improving outcomes for consumers and reducing doctors’ visits, [pharmacists] should be remunerated,” he said.
Pharmacy Guild president Kos Sclavos was reluctant to put a figure on negotiations but suggested newly launched electronic prescriptions would save the Government billions over the life of the next agreement, which could be used to expand the PBS.
More here (registration required)
http://www.medicalobserver.com.au/News/0,1734,4849,10200907.aspx
Someone needs to tell the Pharmacy Guild that the benefits of e-prescribing come from getting prescribing right at the medical end and providing an accurate easy to read prescription to the pharmacist. The benefits of the actual electronic transmission accrue to the pharmacist as efficiencies (why else would they be prepared to pay for each script?). The government would see very little benefit with a new system as they have most of it already.
The bottom line here is that unless this is all reigned in, and soon, there will be a lot of people who will have had their volunteer time wasted and a system which may, or may not, be in the national interest will come into place.
The merits and frameworks for a critical public good, as this will be, need to be decided by Government and no-one else in the context of the National E-Health Strategy. With this done industry can then go ahead and compete for space and profit within an appropriate national framework.
Get on with it Ms Roxon, and provide the policy leadership you were elected to provide.
David.
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