Pharmacies with FRED Dispense ready for eHealth

Huge news for those Pharmacies who use Fred Dispense!

The Fred IT group has released a new PCEHR enabled version of their software. . This will hopefully encourage other pharmacies to sign up as the useful software will now be available for their use.

McDonald (2013) explains that this update provides Fred equipped Pharmacies with the ability to send information through the eRx and the National Prescription and Dispense Repository (NPDR), which is due to do live this week. Further, the NPDR and the PCEHR are estimated to be able to talk to each other before the end of the month which is great news for those Pharmacies who are currently registered for the PCEHR. What a huge step toward paperless prescriptions and something that most people do not think about, a huge step forward for the environmentally-friendliness of this Profession! 

We can hope that this will encourage Pharamcists to begin promoting ehealth to their customers and patients and advising them to sign themselves, or even receive help from the Pharmacist to be signed up for their own PCEHR. Pharmacists will be integral to the uptake and application of this program as they can identify and counsel those who would most benefit from having an ehealth record, such as parents of small children, the elderly and those with chronic illnesses about the benefits, also provide a helping hand in signing up for the program. It would be great to see a greater uptake of PCEHR when the NPDR and PCEHR are both live and able to communicate with one another. 

These are exciting times for ehealth in Australia and one can only hope that these new software updates provide a platform in which Pharmacists can lead the way in promoting eHealth in Australia to ensure a more cohesive 21st Century healthcare system.

 

REFERNCE

McDonald, K., (2013) Pharmacies ready for NPDR as PCEHR v3 nears. PusleITMagazine. accessed from http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1420:pharmacies-ready-for-npdr-as-pcehr-v3-nears&catid=16:australian-ehealth&Itemid=327 on 09/05/13

Are financial incentives they key to get the E-Health ball rolling?

When I was checking out E-Health systems from around the world, one of the things I liked about what the United States has done, was the fact that they are providing financial incentives so that the healthcare sector will be more inclined to implement the system.

I have just found an article on Pulse+IT which suggests that this could be what is missing from our own system, particularly in relation to the aged care sector.

Financial support the missing link for aged care PCEHR uptake:

http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1416:financial-support-the-missing-link-for-aged-care-pcehr-uptake&catid=67:aged-care&Itemid=332

According to the article, the Aged Care Industry Information Technology Council (ACIITC) is urging the government to consider financial incentives so that they can be PCEHR-ready, claiming that lack of important software has forced a slow uptake in the aged care sector.

Aged care is one of the areas that I believe would gain the most from the E-Health system- so this is something that I believe should be considered. Patients in this sector are often on countless medications, see several healthcare practitioners and are in and out of nursing homes and hospitals. I know I would struggle to keep up with all this information if this were me. PCEHR would make things a lot easier but if the aged care industry does not have the key software- everyone cannot get involved and the system won’t work as effectively as it could. Funding for this could help with the uptake of the system.

ACIITC chair Suri Ramanathan claims that because pharmacists receive a PBS dispense fee for dispensing medications- they should be receiving incentives too. He says that they are one of the largest industries in the country and “facilities operate on a paper-thin margin, so for them to adopt the change, they need a little bit of a hand.”

Mr Ramanathan said that financial help is the “missing link” for E-Health to really get moving in the aged care industry. However, why stop at aged care? Surely many areas in the healthcare industry could use some financial help to get E-Health up and going.

From a pharmacist’s perspective, the more people healthcare industries that get involved in E-Health, the better. Like I have said previously, PCEHR is meant to provide a whole picture of a patient’s health and the key to this happening is getting all areas of the healthcare industry involved. If funding will inspire more to get on-board, then I believe it is something to really think about.

Do you think funding would encourage more healthcare professionals to implement E-Health?

Tips for Maintaining Privacy with Ehealth

New developments and programs bring the need for new privacy laws and regulations. This is the case with eHealth in Australia.

From the 12th March 2014 the privacy laws and guidelines in Australia will be receiving a sort of make over and upgrade. Bigger changes than have previously been made to the Privacy Act (1988) will be implemented. The changes include the creation of 13 Australian Privacy Principles which will replace the current National Privacy Principles (for the private sector) and Information Privacy Principles (for the public sector).

These new principals include new regulations to encompass eHealth, such as the PCEHR Act 2012.

Information that is important for the public about their privacy and eHealth records can be sourced from the new Office of the Australian information Commissioner (OAIC) Website under Pubications and Resources. Factsheets number 13,14 and 15 are explicitly related to ehealth privacy, two sheets for healthcare professionals and the public. http://www.oaic.gov.au/ is a good place to start!

Tips for maintaining privacy with your Personally Controlled Electronic Health Records include:

• You are in charge of how much influence you have over the information that can be accessed by specific healthcare providers.
• Decide upon what access settings you would like as soon as you sign up, and regularly check and update these. Keep up to date with who is on your ‘access list’.
• You can organise an access code to further restrict access to your record by certain healthcare providers, or even restrict access to particular  documents if  you do not want them to be accessed. This access code would ensure that only healthcare professionals that you approve of can access your eHealth record.
• It is recommended that those who sign up or are thinking of signing up read the eHealth record System Operators privacy notices and policies to further their understanding about how their information will be handled.
• If you do not want certain information or a certain document uploaded to your eHealth record by a particular healthcare professional, you should let them know. If it has already been uploaded and they refuse to take it down you can organise for the documents removal through medicare.
• Always be sure to think it through and decide upon the importance of a document before removing or requesting its removal, as once it is removed from you eHealth record, it will not be available during an emergency.
• Remain vigilant about checking to make sure no unauthorised access to your eHealth record has occurred.
• Check your record frequently to be sure that information held on the record is up to date, correct and complete.
• One of the most important aspects of keeping your health information secure and private is by making sure you protect your record with a strong password.
• The new system is protected by the PCEHR Act (2012) which limits how information may be collected, used and disclosed. If information is not collected within these regulations then this is an interference with privacy.
• You may opt-out at any time.

Important privacy information tips for Healthcare providers include:

• Heathcare providers need to know what is expected of them under the PCEHR Act as there are serious penalties for non-compliance, (information can be collected, used and disclosed to provide healthcare to the patient)
• Develop robust practices for using the PCEHR system and be sure all staff are adequately trained
• Inform patients of any information that you will be adding, do not add information that you have not previously discussed with them.
• Do not collect more information from someone’s Ehealth record than is necessary
• Be professional and practice responsibly when collecting, using and disclosing information from a patients eHealth record.
• Understand how an eHealth record can be used in the case of an emergency

It is important that all parties involved know what their role is in maintaining privacy when it comes to eHealth records. It really is a situation where patients are just as crucial to the maintenance of their private health information as healthcare providers. One of the interesting aspects of the system where the patient seems to have the majority share of power.

Pharmacists need to be sure that they are completely up to date with current privacy laws surrounding eHealth, and understand the new changes coming in to force next year. Maintaining the integrity of our patients privacy is always paramount, and thus this new age of IT and Health collaboration means that Pharmacists need to ensure a complete understanding of their role when it comes to privacy and patient health. Pharmacists remain the middle man between doctors and patients (especially when it comes to medications), therefore they will have to learn to balance their information share between collection for healthcare reasons and collecting/ accessing more than is required.

These are interesting  times in which we do live!

eHealth and the Elderly

I have previously blogged on my own experiences with signing up for an PCEHR, and as a young relatively healthy young person I can see how this record and overall program can be beneficial for me.

However, I believe that on a much larger scale, those who really need this program to get up and running are the elderly. Having worked on community pharmacy for quite a few years now, I have come to appreciate that along with all the other joys of ageing, one of the main things that older people have to deal with is taking in some cases more than 10 prescription items (and some probably more than that). In a time when we are living longer due to medical advancements, we are more likely to need more medications to maintain more medical conditions, both chronic and acute.

Thus, this demographic are much more likely to see multiple doctors and other healthcare professionals, have multiple hospital visits and take many medications. They may not be up to scratch with how this whole ‘internet’ thing works, but they are absolutely among those who are most likely to receive great benefit from the wide uptake and implementation of eHealth in Australia.

Greater collaboration between doctors, pharmacists and allied health professionals is invaluable to creating better health outcomes for our elderly and aging population.

This collaboration could lead to less adverse reactions and accidental over/underdosing of medications by the elderly and therefore less avoidable hospital admissions. More mutual understanding between medical professionals leads to much better health outcomes for patients.

Pharmacists play a central role in maintaining eHealth records, especially for the elderly, as they are the medication experts. Pharmacists would be able to counsel patients about their health in general and specific medications with a more rounded view of the patient history than what is provided in the dispensing databases.

More than this, pharmacists can play an active role in encouraging and even helping older people sign up for a PCEHR.

Further, clinical services provided by Pharmacists to these patients could be easily recorded and uploaded on to their eHealth record, for this information to be shared with other health professionals. Transferring of information about services provided can also be easily transferred to Guildcare for reimbursement from the government.

Our elderly population is growing and eHealth, along with pharmacy clinical services are just some of the benefits that this group in the population can enjoy if eHealth gets off the ground.

Here’s hoping.

New Software leading the way for Ehealth to really get going.

A report in the last week states that ‘Best Practice Software’- A GP desktop software vendor has released their latest piece of software that allows GP’s to finally upload documents onto the PCEHR’s of their patients (McDonald, 2013). This is a huge step forward for the eHealth initiative, and a much needed boost for things to really get rolling. All of the other software vendors involved in the National e-Health Transition Authority’s (NEHTA) have also released their versions of this software which spells a win for the possibility of a viable e-Health system.

Further McDonald (2013) states that the government will now finally begin its advertising campaign around PCEHRs and the eHealth initiative in Australia, including television commercials. Some (including this blogger) might say this is a long overdue step in the right direction given that the level of those signed up for a PCEHR is still disparagingly low, at about 160,000 (Wong, 2013). Given that we are now a country of 23 Million, this is not comforting. The beginning of an effective advertising campaign and the implementation of this software in doctor’s officies, hospitals, allied healthcare offices and of course pharmacies can only be a good combination for furthering this cause. The sooner we get to see the real landscape of eHealth in Australia and all of its possibilities, the more effective it can become as a truly integrating and game changing practice. Something that we as training health professionals will be able to look forward to being a part of in the future.

References

McDonald, K. (2013) PCEHR- enabled Best Practive now available. Pulse+It Magazine. Retrieved from http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1400:pcehr-enabled-best-practice-now-available&catid=16:australian-ehealth&Itemid=327 on 27/04/13

Wong, M. (2013) Potential for big data through PCEHR. Pulse+It Magazine. Retrieved from http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1393:potential-for-big-data-through-the-pcehr&catid=16:australian-ehealth&Itemid=327 on 27/04/13

E-Health: The Australian Context

The development and introduction of an eHealth Initiative in Australia provides a new and exciting topic for discussion, thus this initial blog is an attempt to provide an outline to the topic for further investigation.

The eHealth Record in the Australian context refers to a Personally Controlled Electronic Health Record (PCEHR) System. This system comprises of an interconnected database of patient health records, providing authorised healthcare professionals access to critical patient information with relative ease and in a much less time consuming manner than is currently available. The eHealth initiative in Australia is centered around the idea of being consumer friendly with the public having to ‘opt-in’ to having an eHealth  record, and also having decision making abilities around which specific heath information can be viewed by particular health professionals. The ability to sign up for a PCEHR in Australia began in July 2012, about eight months ago, therefore at this stage the program remains in its infancy and the full potential is yet to be realised.

Some of the main components of the eHealth initiative in Australia include:

• Personally Controlled Electronic Health Record (PCEHR): The cornerstone of the eHealth program in Australia. This record will consolidate the many separate health and dispensing records that are currently held for the patient with their GP, Specialist, Pharmacy and from previous Hospital visits. More information about PCEHR for consumers and healthcare professionals can be found at http://publiclearning.ehealth.gov.au/
• Opt-in and Opt Out Function: This component applies to both patients and healthcare providers. Patients and Healthcare providers are required to voluntarily sign up to be a part of the eHealth record system. In the instance of patients they also have the power to decide to opt-out of the system if they no longer want to keep their eHealth record.
• Electronic Transfer of Prescriptions (ETP): currently being rolled out and is currently used in the majority of Australian pharmacies in the form of bar coded eRx paper prescriptions. The continuation and roll out of this initiative is a component of the 5th Community Pharmacy Agreement negotiated between the Australian Government and the Pharmacy Guild of Australia. The purpose of ETP is to make the process of dispensing medications more precise and to eliminate dispensing errors. In its full implementation, the system will do away with the need for paper prescriptions. The patients prescription details will be uploaded on to their secure eHealth record at the time of prescribing. The patient may then choose to have their initial dispensing (and all subsequent repeats) filled at any community pharmacy of their choice in Australia. All prescription transfer of information will take place over the electronic prescription exchange which is in turn linked to the individual patient record, allowing a more holistic view of medication, prescribing and dispensing history. This program will eventually deal with the problem of lost prescriptions and cut down the industries impact on the environment through the excessive need for paper. For more information about ETP check out the following interactive link http://prezi.com/vwz-csacweld/v2-etp-education-program/

There are many issues and benefits for Pharmacists that are set to arise with the rolling out of this program, hopefully we will be able to delve into some of these within this forum.

More information about the eHealth initiative and ETP can be found at http://www.ehealth.gov.au and http://www.5cpa.com.au