s Disgraceful – discuss | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2009         Volume. 1 No. 2   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July edition of i2P, and of course, the first week of the new financial year.

Note that we are developing a new range of categories for you to follow e.g. health politics, hospital news, an expanded IT offer and we will be developing the category of anti-ageing medicine

Also, out of interest, could I refer you to the e-publications category located immediately below our columnists. If you click on the link contained there, you will find a range of e-publications that are recommended reading.

The first publication noted is the Pharmacist Activist written by Dr Daniel A. Hussar of the faculty of the Philadelphia College of Pharmacy at the University of the Sciences in Philadelphia. He is a pharmacy advocate.

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Recent Comments

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I’ve seen the future…….and I’m not happy, Jan!

Chris Wright

The ubiquitous Mrs Wright, in her quest to unearth a new erotic shopping experience, ushered this writer to a new Coles store located at the all very nice and leafy suburb of Ivanhoe in Melbourne recently.
This is contemporary retailing at its best, no doubt influenced by the gurus at Westfarmers and the rapidly changing retail climate in Australia, which of course involves the future of Pharmacy in some way….but more about Pharmacy later.

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Pharmacists losing their mojo

Neil Retallick

I read some market research recently that ought to concern community pharmacists across the country, as well as the Pharmacy Guild of Australia.
Groups of average Australians were brought together for a series of focus groups to discuss the community pharmacy landscape as they see it.
Some of the feedback was disconcerting.

Comments: 3

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Has the horse bolted?

Ken Stafford

Some twenty years ago uneasy tremors were running through hospital pharmacy here in Perth. Hospital management had suggested to one of my fellow Chief Pharmacists that the hospital needed a total parenteral and intravenous additive service (IVAS) .
When it was pointed out that this would be very labour intensive and the pharmacy did not have sufficient staff to provide it, the comment was that “nurses would be happy to run such a service”.

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Independent Pharmacist Practitioners

James Ellerson

In the region where I practice, GP’s are reluctant to comply with a patient request for a Home Medication Review.
The stock standard phrase is “I can do that for you” and so in frustration a patient will turn to me, in a professional, or quite commonly in a social setting, and asks if it is possible for me to perform a review without the doctor’s involvement.

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Disgraceful – discuss

Pat Gallagher

Disgraceful – discuss
The newspapers have been chock-a-block the past few days with dire tales but true about the black hole we are about to enter with the insane policy to re-regulate the ‘workplace’ to suit the union paymaster cliques.
While I never voted for Keating I did admire him a little bit this morning when I read a quote of his from the bad old days.
He said to some union goose: “you are carrying the jobs of (100,000) dead men around your shoulders”.
Giving a dead hand to this union unfettered power play will ensure that the nation will soon look like NSW; where the government is actually the plaything of a few loosely combined public ‘service’ union mugs.
Depending on how large your pharmacy is, in terms of overall staffing, you will soon be touched by the coming dead hand of the new/old order.

Comments: 3

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UK Dispensing Errors Under Review

Staff Writer

The recent furore in the UK over pharmacist Elizabeth Lee receiving a conviction for a criminal offence and subsequently a suspended jail sentence, has really lit a fire under the imbalances that exist when a pharmacy dispensing error is made.
The dispensing pharmacist or the supervising pharmacist under current UK legislation, has been made to bear the brunt of legal responsibility, with pharmacy owners escaping with little pain.
According to an article in PJ Online "In many cases, all that the employer needs to establish is that he had standard operating procedures in place and that the employee or locum had simply not complied with them. In these cases, the employer can walk away leaving the employee or locum to face the, often damaging, consequences".
There is now a rush in the UK to have current legislation amended to reflect a more proportionate responsibility for all parties involved.

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A New Ministery - Indigenous, Rural and Regional Health

Staff Writer

The appointment for the first time of a Minister for Indigenous, Rural and Regional Health and Regional Service Delivery is an important strategic recognition of the special needs and circumstances facing people in Australia's rural and remote communities.
People in the bush will expect this position to be part of a permanent increase in the Government's commitment to rural communities.
In welcoming Minister Warren Snowdon to the new position, Dr Jenny May, Chairperson of the National Rural Health Alliance (NRHA), said the appointment will be important both for substantive policy reasons and to boost the place of rural issues on the political agenda.

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NZ fish killed by water quality

Staff Writer

The following news item was recently published in Science Alert. It would seem that the pristine environment of New Zealand is under attack. The reasons are similar to those findings in Australia surrounding the protection of the Great Barrier Reef.

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New theory for global diabetes epidemic

Staff Writer

A new "fertility first" hypothesis published this week by a group of international experts in the American Journal of Human Biology, proposes that the global epidemic of Type 2 diabetes has its origins in the struggle, over millennia, to sustain human fertility in environments defined by famine.
A surprising and important implication for us in the modern world is that this hypothesis gives cause for optimism that the modern epidemics of diabetes and cardiovascular disease will diminish.
Source: Sydney University

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Immune system key discovered

Staff Writer

A team of Monash University researchers has discovered the importance of a protein, which could improve the way the drug interferon is used to strengthen the human immune system.
Published online in the prestigious journal Immunity, the findings show that the protein promyelocytic leukemia zinc finger (PLZF) is a key player in the body's immune response to disease, increasing our understanding of the function of the immune system.(Source: Science Alert )

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Political suspicions raised as China cracks down on bogus online health info

Staff Writer

China is notable for its authoritarian approach to the Internet and other forms of media communications.
Restrictions on Internet activity may have some long-term implications for Australia, particularly as these restrictions are intruding into the health arena.
Source: Tech.Blorge

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Senior Pharmacists - A Valuable Resource

Staff Writer

Little thought seems to have occurred in maintaining and supporting mature aged pharmacists in the workplace.
Given that this group of pharmacists is the one with the "corporate memory" of the profession, with many having started life as compounding pharmacists and counter-prescribers, there is a wealth of untapped intellectual resource that could be internally utilised in mentoring or even training pharmacists in how to sell a professional service.
This group of pharmacists is concerned with the development of retail clinics proposing to do almost exactly what they were successfully doing 30-40 years ago.
What went wrong?

Well, there is plenty of evidence to illustrate that the process of commoditising medicines is the primary reason for this loss, because if you strip everything out of a process to sell at the cheapest possible price, you get a barren professional offering
Source: Science Alert

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Terry White Makes a Move

Staff Writer

Introduction:

It is clear that the Terry White pharmacy group is on the move with the recent purchase of Pharmacy Direct and a restructure of its own management. Terry has had a distinguished pharmacy career and his stewardship will see possibly the strongest pharmacy group in Australia emerge He is opening up the opportunity for equity for senior members of his management team.
The following excerpt extracted from pharmacy media reports explains the process.

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Disgraceful – discuss

Pat Gallagher

articles by this author...

Patrick Gallagher is well known in Information Technology circles. He has a vital interest in e-health, particularly in the area of shared records and e-prescriptions, also supply chain issues. He maintains a very clear vision of what ought to be, but he and many others in the IT field, are frustrated by government agencies full of experts who have never actually worked in a professional health setting. So we see ongoing wastage, astronomical spends and "top down" systems that are never going to work. Patrick needs to be listened to.

Disgraceful – discuss
The newspapers have been chock-a-block the past few days with dire tales but true about the black hole we are about to enter with the insane policy to re-regulate the ‘workplace’ to suit the union paymaster cliques.
While I never voted for Keating I did admire him a little bit this morning when I read a quote of his from the bad old days.
He said to some union goose: “you are carrying the jobs of (100,000) dead men around your shoulders”.
Giving a dead hand to this union unfettered power play will ensure that the nation will soon look like NSW; where the government is actually the plaything of a few loosely combined public ‘service’ union mugs.
Depending on how large your pharmacy is, in terms of overall staffing, you will soon be touched by the coming dead hand of the new/old order.

open this article full screen

Discuss.

Why I am on this bent on politics in a paper centred on IT? Simple. Today’s newspapers also report that COAG is meeting in Darwin today to discuss, amongst other things, e-health. As and as an aside I am beginning to wonder if the ‘e’ stands for eternal rather than electronic.

Yesterday a daily newspaper reported that we need to spend $1 billion to $2 billion to implement a universal EHR system. This is nine years after the original announcement was made and three after NeHTA’s took the reins to deliver electronic health records for all.

Now it seems we are starting, yet again, down a yellow brick road to another dreamtime event. For heaven’s sake, this is blood boiling stuff.

There are over 200 people working for NeHTA and they have already chewed though hundreds of millions of dollars and delivered what? I believe in the theory of a transition authority but I despair at the results.

Discuss.

Then there was an article on the weekend making the (not) surprising observation that inventions and technologies, that raise productivity, are good for the community, work for the common good and are just plain sensible, often take a long time to become accepted.

Take faxes, bar codes, mobile phones, even desk top PCs, they all had a slow flat update trend and boom, overnight almost everyone had one.

Whereas with all the bits and bobs of e-health we are taking an eternal age to be still flat-lining to nowhere. Why is that?

Discuss.

Want to know what I think? Well if you have read this far, just keep going.

The first factor is the dead hand of regulation and the top down belief that ‘they’ know better than the workplace "proles" as to what is good of them; like the United Handbraking Union.

Secondly, like most union leaders, straight from university to a quasi political job, these imposters have never actually done the work they are supposedly going to improve.

Thirdly, they all love a big bang. Not for them the one step at a time, boring bit. No "sirree" (or should that be no "personree"). Their only way is the big way. Which means, as is displayed every living day, the big way is usually - no way. Nothing gets done.

Discuss.

Let’s take the 200+ souls beavering away in the transition authority’s employ to make e-health happen. Then let’s look at the tasks as a three dimensional model: a) policy and strategy, b) enablement and c) implementation. Or a) intellect and power, b) skills and knowledge and b) common sense and the sweat

Level 1: As far as we can see all 300 are engaged fully at Level 1, doing the top down ‘work’. What do we see for all this effort? Well, not much, because among many other barriers all their minutes and other progress records are marked ‘commercial-in-confidence’. Because the authority is a Pty Ltd company.

Shameful and confusing therefore that they all have an email address that includes ‘@gov.au’. This ‘@ government’ indicates that they are public servants. As a member of the public I want to be served and I want to know.

Not funny is it?

In fact it is just as disingenuous, as is and was, the union campaign based on ‘your rights at work’. When actually it was really about ‘our power over your work situation”.

Discuss

Level 2: the enablement level is really all about technology. Choosing the right technology that works, integrating the technologies into a seamless and interoperable platform and putting it in place in a measured and planned manner, so as to introduce change gradually and effectively.

This is so important yet so simple that hardly anyone understands (it) that it is complex only by the nature of trying to do ‘it’ in one big bang.

Whereas if ‘it’ is broken down and introduced ‘one step at a time’, then it becomes many simple milestones that eventually will arrive at, and will deliver the desired change based benefits.

But oh no. That is not what is happening. What is happening is of course not much, if not nothing at all, based on an impossible big bang approach.

Jeepers my mind just wandered off to the proposed NBN; the national broadband network. I digress I know, but this is the same disaster waiting to happen, as ‘e-health’. Can only end in tears.

Anyway, back to the subject of disgraceful conduct.

Then we have level 3: which in my opinion is where the answer lies. There is no time or space in these pages to set the scene, debate the facts and then conclude all points of view to a logical and balanced outcome.

On the other hand there is precious little balance in the Level 1 world so why change the playing field just for this observation.

My point is that we should re-visit the working lives of the 300 souls beavering away at Level 1. They should be re-directed to work in a completely upside-down model.

For example, to make e-scripts ‘work’ these people should be seconded to work alongside GPs and Pharmacists as they endeavour to learn the facts on which they then produce their matching Level I plans.

To make EHR work is to realise that a patient health record is made up by capturing data at the source by the many and very different specialist source workforce. They is no one, big bang, one size fits all answer to the workplace scenarios.

Let’s embed the 300 alongside all these specialist workers, in hospital admissions, in pharmacy, in pathology, in the wards, in records, everywhere; so that a heavy dose of reality shapes their Level 1 policy work with a heavy influence of effectiveness and convenience ahead of any vapourish big bang dreams.

Discuss.

Frankly we are living through a disgraceful farce.

The department has outsourced e-health transition to a body pretending be a private company!

This private company pretends that all of its 300 people have more than enough experience and knowledge to devise and make work, say, a e-prescription system without ever working in a surgery, pharmacy or a dispensary.

Meanwhile lurking in the darkest shadows of the Yes Minister underworld is the re-run of the Australia card stuff-up.

What is disgraceful about this, is that the last campaign to introduce a universal card, was destroyed by a not dissimilar effort to push the half truths and untruths we heard about ‘working families’ and ‘your rights at work’. Same self-serving nonsense.

The current message is that discussion among the involved agencies are under way (code for it has now been over four years), to solve the individual identification system that is mandatory for e-anything to work.

Or, how to re-engineer and fashion the Medicare number system, that is in place and threatens no one, with a personal-linked number.

The tip, tip toeing around this issue is nauseous. All these people at Level 1 are engaged in various turf wars around their ideology and their prejudices using the blind path issues of security and privacy to waffle endlessly and deliver vapour.

I bet if you ran a one-week survey of every patient who picks up a script, as to whether or not they would be afraid of, or would object to, a individual ID system; the overwhelming response would be “NO”.

We aren’t afraid. We do not object. We, however, have never been asked because we are actually at Level 4. We are merely the patients and taxpayers. What we know, what we think and what do we want – is treated as very rhetorical question at Level 1.

Oldie but a "goodie" and it is not so far from the truth – “it would all work much better if we didn’t have to consider the patients”

Discuss.

No.

Don’t discuss.

Think about getting angry.

The strong belief I have is that the whole e-health fiasco will remain largely flawed until one huge factor is recognised, acted on and made to happen successfully.

That is to conduct a huge publicity campaign to tell all of us what ‘it’ is exactly that will be better when and if e-health is implemented.

When it will happen, regardless of whether it is five, ten or fifty years.

And most importantly to tell us that is ‘it’ going to cost $1 billion or $2 billion (‘coz then we will all, as the taxpayer, know it will actually cost three times that).

Once we know how much of our money they are going to spend, then we can all asked the sixty dollar question as to whether we do, or do not, accept a personal identifying system - as the key to obtaining these (I think wonderful) healthcare and health service delivery benefits.

This campaign to let us into the secret should be the antithesis of the phoney ‘your rights’ baloney; rather it must be like the Decimal Currency Conversion campaign, it should treat us all to information in an open and honest manner, so we can decide to accept or reject e-health as a national and common benefit.

Otherwise we will continue to discuss the present disgraceful situation for a long, long time.

 

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Submitted by Anon on Mon, 06/07/2009 - 16:41.

There is no demonstrable willingness at the highest levels to open the minds to a new way of thinking. Until that occurs nothing much of significance will be possible.

Submitted by Ian Colclough on Mon, 06/07/2009 - 16:32.

Of the many thoughtful points Pat Gallagher makes, one, in particular, is an absolute standout - the three dimensional model of what is so badly needed yet so rarely seen - namely, intellect, skills, and nous. These three elements together are fundamental to everything else and without them there will be no successful enablement.

Submitted by Neil Johnston on Sat, 04/07/2009 - 11:52.

I join in your exasperation and despair at the general state of Australian Health Information Technology.
The amount of money wasted over the past 10 years would have been sufficient for those small to medium innovators (actually working at the coalface within their health specialty) to have built up a world class IT infrastructure, that could be globally exported.

As we both know some of these innovators, it is indeed frustrating to see the rest of the world overtake the Australian efforts, simply because Oz initiatives remains unsupported.
Worse still, we see overseas systems imported for use in Australia that systematically destroy our local talent base.
The wastage of government funds is one issue that needs to be addressed because it is a national disgrace.
More importantly is the type and style of management, who is represented and how many "coalface people" are given a voice.
This is the more urgent issue, because it is apparent that the current mob of so-called administrators haven't the faintest idea of where they are going.
Keep up the good work.

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