Urgent action needed on real-time drug monitoring system

AMA Victoria is calling on the Victorian government to implement the Electronic Recording and Reporting of Controlled Drugs (ERRCD) system, which the federal Department of Health says is operational and ready for all states and territories to use.

AMA Victoria has joined other state bodies in urging the jurisdictions to act, asking for an allocation of $55 million over four years to implement the system as part of its 2014-15 pre-budget submission.

AMA South Australia wrote to SA health minister Jack Snelling in September last year, urging him to implement the system “without delay”, citing recent deaths from fentanyl misuse as an example of the urgency.

Both AMA branches say implementation of the ERRCD system will provide doctors and pharmacists with the ability to access previous dispensing information in real time and help prevent deaths from prescription drugs.

They are also urging the respective governments to facilitate the legislative changes required to replace the manual, paper-based reporting of controlled drugs with the new electronic system and to permit prescribers and pharmacists to access the records.

“This system would enable doctors and pharmacists to know if a person has received prescriptions from other places,” AMA Victoria president Stephen Parnis said. “It will reduce the risk of doctor shopping, it will reduce the harms that occur from these drugs and it will save many lives. We call on the government to act now so that in their May 2014 budget, real funds are allocated in this important area.”

A spokeswoman for the federal Department of Health said ERRCD, which is based on a system called DORA first developed in Tasmania, is available to states and territories to begin implementing. The federal government purchased licences for the system on behalf of the states in February 2012.

“The Electronic Recording and Reporting of Controlled Drugs (ERRCD) system is currently installed on a secure host server and is operational, waiting for each state and territory to commence utilisation,” the DoH spokeswoman said.

“Regulating the prescribing and dispensing of controlled drugs is the responsibility of the states and territories.

“The ERRCD system has been handed over to states and territories for their use via complimentary software licence agreements.

“Advice on progress with implementing the ERRCD system should be obtained from the relevant state health departments.”

A spokesperson for the NSW Ministry of Health said it was supportive of a national ERRCD system and “recognises that it will potentially provide numerous benefits to prescribers, pharmacists, regulators, and the general community, including a reduction in the harms brought about by the misuse of controlled drugs”.

“The NSW Ministry of Health is continuing to work through the financial and practical implications of implementation of the ERRCD system,” the spokesperson said. “Full roll out is likely to take three years.

“There may need to be changes to legislation to require the provision of pharmacy dispensing records of controlled drugs and to enable access to records by medical practitioners and pharmacists. These factors will be considered as the Ministry of Health progresses the implementation.”

The spokesperson said any government plans to provide financial assistance to GPs and pharmacists to use the new system “will be considered in detailed implementation plans when these are developed”.

The ERRCD system was first developed by the Tasmanian Department of Health and Human Services (DHHS) and built by Hobart-based software firm XVT Solutions.

It includes a nationally consistent Controlled Drug Electronic Register (CDER), an electronic system to collect and report data relating to the dispensing of controlled drugs, and real-time access for prescribers and pharmacists to current information on dispensing events for controlled drugs.

Currently, prescriptions for schedule 8 drugs must be registered on dangerous drugs registers, or DD books, in each state and territory. Details of the quantity, strength and balance of each controlled drug, the patient name and address and prescriber details as well as date of supply and prescription number must be recorded by the pharmacist.

In most jurisdictions, copies of the prescriptions are sent by fax or mail to state and territory health departments at regular intervals and they must be available for inspection by health departments and the police. However, the data is often analysed up to six to eight weeks after a dispensing event, meaning doctor-shoppers and fraudsters can escape notice.

DHHS developed DORA with funding from the Commonwealth's Health Connect program. Money for a national system was then negotiated by the federal Department of Health with the Pharmacy Guild under the Fifth Community Pharmacy Agreement (5CPA).

It is expected that in addition to changing legislation in each state, interfaces to pharmacy and GP software systems will also take some time to implement.

In its pre-budget submission, AMA Victoria is asking for $10 million in the first year, with an extra $15 million per year over the next three years to implement the system.

Posted in Australian eHealth

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