Hi Greg,
This all depends on what problem you want to solve.
As you are probably aware (from my blog) - my main concern is the quality, reliability etc of the prescribing system and the quality of its decision support etc. I would like to see systems being used that give consistent up to date decision support that is really useful.
In terms paper prescriptions with a 2D barcode working it does...you loose prescription etc - we are all used to the consequences - have been doing it for years.
As far as doctor shopping - you use the medicare claims data for the PBS to id those doing it if you really want to..and then send a monthly report that the pharmacist's system reads / downloads to alert which drugs are being overused by which patients from his site.
2D barcodes would be a good interim step till we figure out the best fully networked way and fund and prove it up.
I told the government - with a business case - this was a good idea in 1996 at their request - so you can see how urgently they are responding!
Cheers
David
---- Dr David G More MB, PhD, FACHI Phone +61-2-9438-2851 Fax +61-2-9906-7038 Skype Username : davidgmore E-mail: [EMAIL PROTECTED] HealthIT Blog - www.aushealthit.blogspot.com On Thu, 03 Aug 2006 13:58:08 +1000, Greg Twyford wrote:
> David More wrote:
>> Hi Greg,
>>
>> As I understand it the concept they are attempting to patent is that of a shared patient record - which was at the base of Medi/Health Connect.
>>
>
> Yep.
>
>> It seems to me one only needs to look at the plans that were implemented for Community Health Information Networks in the mid 90's and at places like
>> Reigenstrief to realise there is a heap of 'prior art' - given this was filed in October 2002.
>>
>
> I'm sure you're right but patent law sees under a cloud at the moment.
>
>> An attempt to enforce it would fail badly I believe, despite not being a lawyer.
>>
>
> Ther amy be great value for the pharmacy Guild in just having it, untested, in their pocket, for negotiations with government. Certainly Rob Wooding knew
> about it in 20004 at the GPCG Annual Forum, and while appearing unfazed, I'm sure he would be just as cool confronting a charging elephant.
>
>> It is also probably moot - since we know Healthconnect is very unlikely to ever be developed in that form and once they realise the complexity of e-
>> prescribing (if they do what the pharmacists want - i.e. choice of dispensing pharmacy) it will need a big network they (the government) will be hesitant
>> to pay for.
>>
>
> Yep, Rob was the guy who said in December 2004 that HealthConnect, in its envisaged form, would cost the government "many billions of dollars" to implement.
> I reckoned it was dead once I heard this.
>
>> Much better to use a 2D barcode printed on the prescription and have the pharmacists scan the paper in. Just as quick as pulling it down from a network and
>> all the needed details fit easily with that technology and no change in business practices.
>>
>
> It would overcome the problem of security and transmission, and the patient potentially having no idea what to ask for at the pharmacy. Elderly patients
> would be a minefield. However, it may not help with doctor shopping so much.
>
> Also, inherent in the proposal is that all prescriptions would be produced 'electronically' even if it was only the text and the bar code, but it would mean
> that still significant numbers of players would have to catch up. We have 72% GPs using prescribing software. Michael Kidd's recent sample was 90%.
>
> The reality is somewhere in the middle in all probability. Most of our non-electronic prescribing GPs are either old and counting-down to retirement, too
> tight/stupid to invest in their businesses, part-time females, computer-phobics or a combination of these factors.
>
> As with the indemnity changes in 2004, lots of 'marginal' providers bailed out, because of the extra overheads. At a time of growing GP shortage, with no
> solution in sight, that can't be a good thing, unless some other measures are put in place.
>
>> Simple, cheap and works.
>>
> Up to a point. For this to be of any use though, wouldn't the pharmacy need access to an online database then to reveal doctor-shopping, etc? Plus lost and
> repeated scripts, scripts used for non-Medicare card holding family and friends, etc. Or will the 'Access' card fix all that, in which case why this too?
>
> Greg
> --
> Greg Twyford
> Information Management & Technology Program Officer
> Canterbury Division of General Practice
> E-mail: [EMAIL PROTECTED]
> Ph.: 02 9787 9033
> Fax: 02 9787 9200
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