Paper scripts will still have currency
After the massive windfall for eHealth in the 2017-18 federal budget, when the My Health Record expansion program was funded to the tune of $375 million over two years, there were comparatively slim pickings in this year's budget, although it did hold a little surprise or two.
There was a bit of money to go towards the long-term project to replace the Medicare and aged care payments systems, and another bit for My Aged Care. Apparently there was also $5 million over two years to help the National Children’s Digital Health Collaborative to develop a national digital baby book, although we missed that in all the excitement over massive tax cuts that look unlikely to eventuate. We still can't track this announcement down in the voluminous budget papers so would welcome anyone kindly showing us the way.
The big surprise was a tidy little sum for the Department of Health and the Department of Human Services to begin the regulatory moves necessary to allow electronic prescriptions to become the legal form. We got an inkling that progress was being made on this front late last week, when the government released its response to the King review into the pharmacy sector and announced that national requirements for eScripts had been agreed with the states and territories in September last year through an electronic prescribing working group.
That was our most popular story for the week until the surprise announcement on budget night that ePrescribing will be in action by October next year. We made a few calls and discovered we weren't the only ones to be surprised that things are moving more quickly than expected, especially considering the absolute car crash that is the national roll-out of real-time prescription monitoring.
Just this week, the Canberra Times reported that the ACT was finally introducing legislation to allow RTPM, but things are looking bleak in NSW, where the chief pharmacist was quoted by the Sydney Morning Herald as saying that the country's most populous state still had no timeline for the introduction of an RTPM system. Considering it has been on the cards for over six years, this is simply not good enough.
That debacle aside, it seems ePrescribing will have an easier route. Paper will of course be around for some years to come, as the federal changes only apply to PBS scripts. It's up to doctors what they do with private scripts and after hours GPs will probably still need to handwrite scripts for the foreseeable future. We also think GPs will still be asked by many patients to print out a copy.
We imagine the move will be met with relief from hospital doctors, who won't have to sign both the medication order and the copy for the PBS, and by GPs, who will no longer be haunted by patients whose dog ate their prescription. It should also boost the use of prescription exchange services such as eRx and MediSecure as well as barcode and Q-code scanning in pharmacies, a move which can't come soon enough for those of us still hankering after PBS data to be cleaned up.
Overall, health IT did well enough out of the federal budget, although that's unlikely to be the case as the states and territories follow suit. Besides the windfall for the Parkville precinct in Victoria – rumblings about which continue to erupt – there probably won't be much elsewhere. NSW and the NT announced an absolute bonanza last year, but this year WA has offered up just $10m for essential health IT. That state is still in dire budgetary straits so we don't imagine much will be happening there for a while bar the announcement of the winner of its medical imaging platform tender, which has already been budgeted for.
So spare a thought for New Zealand. Just this week, HiNZ found that the DHBs were underspending on health IT compared to the rest of the world, but that's not likely to change when the coalition government hands down its first budget next Thursday. Labour went to the 2017 election promising big things for mental health and will have to deliver, but it probably didn't expect to discover upon gaining government that there has been significant underfunding of the DHBs themselves over the last nine years and they are all now clamouring for money.
The Northern Region EMR, which would have linked secondary and primary care in Auckland and Northland and was proposed in association with Epic, seems to have been put on the back burner, and not much has been heard about the national EHR either. A decision on moving to the next stage of the business case process is still pending cabinet approval, but that has been the case since last December.
As the Ministry of Health warns in its latest update on progress, momentum on the EHR may be lost if the detailed business case stage is delayed. For the government though, its priority is the national bowel cancer screening program, which has been hit by IT problems. MoH says a preferred supplier for the National Screening Solution has been agreed and signed off, and not a moment too soon. If anyone knows who that supplier is, feel free to give us a tip.
NZ had a few problems rolling out its ePrescription service, known as NZePS, but it began to gather a bit of steam last year. We'll see how we go in Australia, where we do like to stuff things up now and then. That brings us to our poll for this week: Do you think ePrescribing will be ready to roll by October 2019?
To vote in our weekly polls, sign up for our weekend edition or leave your comments below.
Last week we asked whether you thought the MyHR could be re-platformed. Most did: 67.5 per cent said yes, although 32.5 per cent were not so sure.