Budget 2014: paperless claiming for PBS meds in hospitals

The federal government has allocated $16.5 million over five years in the budget to allow the supply and claiming of PBS medicines from medication charts in all public and private hospitals.

Similar to a scheme being rolled out in residential aged care facilities, the initiative will mean that the medication chart can serve as a prescription for most medications, meaning pharmacists can supply and claim PBS medicines with the chart itself as the record of supply.

In RACFs, doctors will only need to complete the medication chart and will no longer have to write a separate PBS form, except for certain medications such as schedule 8 drugs. Nursing staff are also able to administer medications directly from the chart.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) has been developing the National Residential Medications Chart (NRMC) for several years and started rolling it out in pilot trials in association with the Department of Health and aged care facilities last year.

It follows work co-ordinated by the commission and the jurisdictions on creating standardised medication charts, including the National Inpatient Medication Chart. Software vendors are working to add them to their clinical information systems.

These charts can be both paper-based or electronic, but by acting as the prescription or the record of supply, the aim is to reduce workflow burdens on doctors, nurses and pharmacists, as well as increase patient safety by reducing the risk of dispensing errors during the transcription of data from medication charts.

The roll-out will take some time as state legislation must be amended to allow for this manner of prescribing and dispensing. According to the budget papers, the measure is expected to deliver at least $40 million per year worth of red tape reductions.

“This initiative will deliver medication safety benefits to patients, improving the quality use of medicines and health outcomes through reductions in transcription errors,” the budget paper says. “It will both complement and harness the useability of the eHealth record in the primary and acute care setting.”

Also announced in the budget, the government has provided $2.1 million over two years to the Pharmacy Guild to administer the payment functions of professional pharmacy programs under the Fifth Community Pharmacy Agreement (5CPA), which were previously administered by the Department of Human Services.

The Guild said the funding was directed towards the cost of establishing and implementing online registration and claiming of a range of 5CPA programs.

These include the Home Medicines Review Program, Residential Medication Management Review Program, Diabetes Medication Management Service, Medicines Use Review, Rural Pharmacy Maintenance Allowance, Section 100 Support Allowance, and the Pharmacy Practice Incentives Program. The 5CPA expires in July next year.

As widely reported, co-payments for the PBS have risen in this year's budget, by $5 for general patients and 80c for concessional patients. PBS safety net thresholds will also increase each year for four years from next January.

This is in addition to the existing annual indexation of co-payments and safety net thresholds in line with the Consumer Price Index. The measure is expected to save $1.3 billion over four years.

In a statement, the Guild said is disappointed that despite these savings, the government had not seen fit to ameliorate any of the pre-election changes to price disclosure, which it said were announced without consultation and in breach of the 5CPA.

“The Guild will continue its fight for this unfair impost to be redressed, including in the negotiation of the next Community Pharmacy Agreement,” it said.

Posted in Allied Health

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