GPs tick real-time drug database

The Royal Australian College of General Practitioners (RACGP) has patted Health Minister Tanya Plibersek on the back for announcing a new $5 million e-health system to counter prescription-drug abuse.
Written by Suzanne Tindal, Contributor

The Royal Australian College of General Practitioners (RACGP) has patted Health Minister Tanya Plibersek on the back for announcing a new $5 million e-health system to counter prescription-drug abuse.

On the weekend, Plibersek announced that the Federal Government will fund an e-health database for doctors, pharmacists and state and territory health authorities, which will allow real-time monitoring of the prescription and consumption of addictive drugs. The database will be available from 1 July.

Health professionals will be able to access the database, which will contain prescription records, over a secure network, and detect whether a person suspected of trafficking painkillers, forging prescriptions or doctor shopping is seeking medication.

"The new records system will be able to flag patients in real time who have repeatedly sought controlled drugs, helping to prevent people from inappropriately using the drugs or selling them to others."

"While controlled drugs, such as oxycodone, morphine and codeine play an important clinical role in managing pain, abuse of these drugs can cause enormous harm, and is a growing problem in the community."

Currently, paper-based prescription records are often still in use, and electronic record systems are often siloed, so that only a group of pharmacies or only stores within a state are connected.

The minister's office said that privacy measures are being put into place to ensure that patient information isn't abused, but additional information had not been provided on these measures at the time of writing.

Health IT blogger David More has questioned the proposal, asking how it fits together with other roll-outs, such as the government's Personally Controlled Electronic Health Records (PCEHR), and private projects, like eRx. He said that these, too, look to improve information on patient medication. However, the PCEHR system is on an opt-in basis, while this database will be on an opt-out basis, to ensure that those who are abusing the system in order to obtain addictive medication for trafficking purposes are denied the chance to do so.

More also pointed to Project Stop, a web-based tool developed by the Queensland branch of the Pharmacy Guild of Australia, in consultation with Queensland Police and the state's Department of Health, to watch people who are abusing the prescription of pseudoephedrine products.

The project started in November 2005, and, in 2007, it was expanded to be a national project. The database, which Plibersek has announced has a wider scope than just pseudoephedrine products, will cover the medicines included in Schedule 8 of the Standard for the Uniform Scheduling of Medicines and Poisons.

ZDNet Australia asked whether the Project Stop database could be expanded, but had not received a response at the time of writing.

The RACGP said the database addressed issues that it had raised in its federal budget submission about medication safety.

"General practitioners (GPs) are often faced with managing patients who have been discharged from hospital into the community without timely communication of their hospital medication discharge plans. Often, GPs are unaware whether medications have been ceased on discharge, or if an exit plan to taper and cease the opioid prescription exists," Professor Claire Jackson, RAGCP president, said in a statement.

"The roll-out of initiatives such as [this one] provides health practitioners with an extremely effective tool in combating the consequences surrounding recurrent issues, such as doctor shopping, prescription and supply of drugs of addiction."

Budget requests

The RACGP also made recommendations about the government's introduction of PCEHR in its budget submissions, saying that the government needs to invest in GP software and hardware to make sure that they have the capability to support the implementation of the PCEHR. It also wants the government to provide an audit tool, so that general practices can evaluate their technical capabilities. It estimated that this would cost $5000 per practice, with an overall sum of $1 million to develop audit-tool guidelines.

To help with change management, the RACGP suggested that the government spend $0.5 million on education, training and support for the PCEHR, and $0.4 million on creating an e-health competency framework.

It also suggested that the government could provide incentives for general practices to dedicate human resources to data quality of the e-health summaries outside of the time spent in patient consultation.

Security received special attention. The RACGP said that another $0.5 million needs to be directed towards training in this area, and that the college's computer information-security standards should be applicable for all healthcare facilities that operate in an office-based environment.

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