This time it will be nurses, not GPs, left in the lurch.
PBS-subsidised registered nurse prescribing is set to kick off in less than a month, but the Medical Software Industry Association has a long list of questions it says need to be answered before the technical implementation can proceed.
This marks the second time in less than six months that the medical software industry has warned the Department of Health, Disability and Ageing that it requires deeper consultation and partnership before pushing out a substantial change.
From 1 October, RNs who have undergone additional training will – theoretically – be able to start writing authorised PBS prescriptions for certain Schedule 4 and Schedule 8 medicines.
They will not be able to do so independently, however. Like nurse practitioners prior to 2024, RN prescribers must have an active prescribing agreement with an authorised health practitioner setting out their agreed roles, the medicines they are allowed to prescribe, and what medical conditions they can prescribe for.
MSIA convened a meeting between industry representatives, Services Australia, the Australian Digital Health Australia, and the nursing union on 25 August – at which point there were just 25 working days until the 1 October go-live date.
“It’s a marvellous policy – absolutely tremendous – it increases the access and equity of PBS drugs, and that’s a great thing,” MSIA CEO Emma Hossack told The Medical Republic.
“Everyone in our industry is 100% behind the minister with his policies … but the problem we’re having is not with the policies.
“It’s with the lack of engagement on implementation. These things need to be addressed with the implementation partners – which is industry – because it’s industry which is responsible for electronic prescribing delivery.”
It was unclear, for instance, how vendors were meant to identify and validate eligible RN prescribers, enforce restrictions on the drugs they were allowed to prescribe and whether any conformance changes were needed for ePrescribing and MyHealthRecord integration.
Over the 30-minute meeting, Ms Hossack said more than 70 different questions from vendors came through.
While some had since been answered, more had sprung up.
“It’s basically whack-a-mole, because you send one question and it comes back and that raises others,” she said.
“It’s not a good way to deliver policy.”
Related
GPs found themselves in a similar position in June, when it suddenly became clear that planned assignment of benefit changes would not be ready to implement on the go-live date.
The DoHDA ultimately decided to delay the changes by one year – but it didn’t make that call until just eight working days from the intended start date.
Ms Hossack said the current situation was potentially “even worse” than assignment of benefit.
“[If we had been where we are now] 12 months ago, then no problem at all. It could happen easily on 1 October,” she said.
“But with so many unknowns? I can’t get a time from industry until I’ve got enough specs for them to go ‘okay, this is what we have to deliver, and this is how long it’ll take’.
“They can’t commit to a time until they’ve got all of the information, because there’s development and there has to be testing, and it appears that there is going to be some changes to the business rules and logic for prescribing software, which is quite significant. And if that is the case, there would need to be conformance testing.”
She stressed that any delay to RN prescribing would not be down to a lack of enthusiasm or lack of cooperation within the medical software industry.
“What I get really anxious about with this is that [people will say] ‘industry is not ready’, and that’s just not true,” the MSIA CEO said.
“The department and agencies … did not advise industry what they needed.
“… Well, who would be ready when they still don’t have the pattern to develop to, now [just] days out?”
