After choosing to blog on this particular topic of issues around eHealth for Pharmacists, I decided to do a little investigating. I wanted to know what this PERSONALLY controlled electronic health record system was all about. Signing up for the eHealth record was quite easy, all you really need is your medicare card and to have some knowledge of your own personal details…seems reasonable. Once I had registered and looked at my own yet to be populated eHealth record, I was struck by how this system could make the entire healthcare process so much more integrated and efficient, as long as it is widely adopted. The second thing that struck me was a little sidebar of information running down the left side of the record. As the eHealth record seems to be largely administered by Medicare, all of my doctors visits and PBS prescriptions that had been dispensed over the past 3 or so years were there. I believe this to be an untapped resource.
One problem that we still have in our society is a dependence and in some cases an addiction to certain medications. The people who are addicted to these medications sometimes do drastic things to ‘beat’ the system to get them. This includes seeing multiple doctors to get prescriptions for the same items, and having these dispensed at different pharmacies so as not to be detected. Further, at a Pharmacy we only have the medication history of a patient to the extent of the medication that they have had dispensed at our pharmacy. This can prove problematic at times when we do not receive the whole medicinal history of our patients. How does this tie in to electronic health records you may ask?
The information that is collected by Medicare regarding dispensed prescriptions is already providing us with an avenue to cut down the level of medication misuse and abuse, and to gain a more complete medical history of our patients to cater more efficiently to their needs. Currently this information it is not used in this manner by Medicare. All PBS prescriptions which have been dispensed show up on that particular individuals eHealth record. A record that, if widely or universally adopted in Australia would lead to a greater benefit to society as a whole, which would provide pharmacists and other health professionals with an extra tool in their ability to treat patients effectively and provide other forms of therapy if needed.
But now we come back to the main issue for pharmacists and the Ehealth initiative. If the system is purely based on personal choice to opt-in, how will better health outcomes for patients to be reached? Can a system where compliance is not mandatory in an area as pivotal to our society as healthcare truly achieve better outcomes without a complete framework and information database to work with?
Alternatively, is an integrated Electronic Prescription Database (independent of the eHealth initiative at this time), with mandatory membership of all pharmacies a more reasonable answer at this time? The ETP is somewhat attempting to create this with efficient flow of paper-less prescriptions from doctors to pharmacies planned for the future, but is this really integrating our dispensing systems enough? An all encompassing national database would contain the information already collected through medicare and all of the patient records within individual pharmacies which would work together to help strengthen the foundations of conscientious dispensing within this country. We have the technology so why not the initiative? An inter-connected database and transfer of prescription information between all pharmacies nationally is really not all that far-fetched as an idea.
E-Health Blog 2013 