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

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.

PCEHR-An untapped database of patient medication history?

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 Australia: An incomplete picture

Imagine an E-Health system where any GP, specialist or pharmacist could view the complete medical history of a patient. A system where they could find anything and everything from a patient’s history including current medications, medical conditions, immunisation records, allergies, past test results and doctors referrals.  A system where a medical practitioner can get a comprehensive view of someone’s health and therefore provide them with the best possible health care. Unfortunately, Australia’s E-Health system will not appear quite like this. Instead, patients will be able to pick and choose what appears on their Personally Controlled Electronic Health Record (PCEHR), that is, if they even decide to have one all.

I understand that healthcare can be a very personal topic for many people. And I get that people do have conditions that they wouldn’t necessarily want to share.  But how can a treating medical practitioner get the full picture of somebody’s health when things can so easily be omitted? What may be considered insignificant or embarrassing to a patient may just be the piece of the puzzle a doctor needs to get answers.

The worrying thing to me is that if people are able to select which things they wish to exclude, treating doctors could easily miss vital clues for diagnosis, or worse still prescribe medications that interfere seriously with previously diagnosed conditions. Pharmacists could unwittingly dispense medications that patients are allergic to or have had reactions to in the past. If all the information is present, things are much clearer and it is easier for medical professionals to provide better and safer treatment.

True, there probably are certain things could be excluded without implications on future healthcare, but where do we draw the line on what is needed and what is not? It’s not as if the health records are there for anyone and everyone to read, they are for treating healthcare professionals.

What is your view on Australia’s take on E-Health? Do you agree that patients should have full control of their E-Health record?

Let me know what you think!