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WWW (Who, What, Where) and
E-Vents
This
edition demonstrates how really busy the Community of Pharmacy really
is, and how versatile pharmacists must be to herald in all the change
that is demanded for future development and survival.
Rollo Manning is hoping that you will all take a little time out and document
your good work so that it can be measured. In fact, if anyone is interested
in sending in some of their successful interventions, we would be happy
to publish for the benefit of all and create space on our website for
permanent reference.
The article on Future Medicine is worth taking in.
While we know new genetically engineered drugs are being patented in their
thousands and will force pharmacists to continually update knowledge,
what we were not aware of is that the entire structure of medicine is
going to change, leaning to a "Not Quite Alternate Model".
Read this with interest and note that these futuristic developments are
only a few years away.
Education is beginning to feature more strongly in our publication as
we move to a climate of mandatory continuing education and Practice Certificates.
The problems that this will bring in terms of education delivery, recency
of practice issues and Pharmacy Board controls may be just too much for
some pharmacists considering retirement and being a locum.
Consultant pharmacy appears to be progressing well in Britain, and perhaps
the Australian model could pick up a bit of speed here.
We also highlight some beneficial interactions between complementary medicines
and drugs, which may be able to be utilised in your own pharmacies.
So many developments are occurring in the e-commerce arena, it is difficult
to keep up. We report on an Australia Post initiative that is worth keeping
in mind.
Leigh Kibby is back with some Men's Issues and how to use mentors to build
a staff resource, and our final column is devoted to Rural and Remote
issues and we look at some issues surrounding the Guild and Aboriginal
Health.
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to Top
From Rollo Manning
National
Competition Policy has almost been and gone but the extension of time
to the year 2002 should not be a sign for complacency. The two reviews
of pharmacy regulation, ownership/location and registration and the Poisons
Acts are comprehensive and with many challenges. Leaders will face these
and implement programs to prove pharmacy value to health care. The value
of pharmacy to health care has to be defined.
PROOF OF VALUE IMPORTANT FOR NEXT FIVE YEARS
Changes
to legislation following the review of pharmacy ownership under National
Competition Policy are needed by mid 2002. This should see amendments
to the ownership provisions which will allow company’s to own pharmacies,
so long as the Company meets the requirements of only family and very
close friends as directors.
This is the South Australian model.
The review recommended the "pharmacist only" provision to be "on balance"
in the public interest, and that this outweighed opening the provisions
to outside parties.
A significant recommendation was that in the ACT and the NT there was
no need to change the laws, even though they were unclear on who can own
a pharmacy.
This is some concession and could provide scope for innovation.
The rest of the Australian States have still to decide what to do.
It is likely that the status quo will be maintained with a review period
drawing in the Third Agreement plan for development, and the time to be
set in the Poisons Acts review to be published shortly.
The Rhonda Galbally review of poisons regulations is still being concluded
but will propose that a review be conducted by mid 2003 on the success
of measurements to value added services provided in the sale of Scheduled
medicines.
And here is the crunch.
Are there any studies, which quantify the value which pharmacy adds to
quality health care?
This is an "open" question to all readers and interested parties.
Faced with a budget of say $5 million to pay for health service, try putting
down priorities of spending. There will be functions such as primary care,
acute care, chronic illnesses, health promotion, and so on.
The question is how does pharmacy rate in importance of spending against
these well-researched and proven value areas. Current practice and history
will show that pharmacy does not rate well at all. It is at the bottom
of the list with a lot of "you beaut" statements on what it could do if
it had the money.
There is little data to show the worth to health gains of pharmacy activity.
This is a rather hackneyed plea through these columns, but one which crops
up all the time when trying to argue a case for more pharmacy funding.
Imagine drugs being supplied by technology on doctors or nurses orders.
No pharmacists in sight.
Would anyone miss them?
Sure there will be the advocates for the profession that says they will
be missed. But what proof is there that staying around will make anyone
healthier?
All pharmacists should adopt a motto to collect some data, even just a
little, on how many people this week they were responsible for getting
off medication. That act will save the system money. That money can be
used on other activities like preventing ten people from getting diabetes
for the rest of their life.
These are the challenges to leaders of the profession.
Get out there and DO IT, not just talk. The next five years from 2005-2010
may be too late.
Ends
The
comments and views expressed in the above article are those of the author
and no other. The author welcomes any comment and interaction that may
result from this and future articles. The editor would be pleased to publish
any responses.
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FUTURE MEDICINE
The
delivery of medical services, drugs and equipment is being re-engineered
from the ground up.
This is no fanciful dream, it is a reality being produced in research
laboratories on a global scale.
People are going to be empowered to monitor their own health and take
giant strides towards choosing their own forms of treatment.
Not Quite Alternate Therapy
This
week, a new initiative is being launched through the Media Lab division
of world renowned Massachusetts Institute of Technology (MIT).
It will share some of the values of the Alternate Therapy World in that
a new model for a medical system is being unveiled, drawing from both
systems.
It is being developed in acknowledgment that the traditional medicine
model has become obsolete, and that it needs to be replaced with a entirely
new system where people take responsibility for themselves, but most importantly,
are given the tools to do so.
In other words, the development of a wellness system to halt the progression
to illness, which is where the traditional system picks up.
Nothing new in that, you may say, but few patients would agree that they
have been empowered to this point. The sharply increased attendances at
alternate practitioner clinics has generated the awareness of health consumer
preferred needs.
Developers of the new Media Lab program propose that people in the new
millennium will no longer want or be able to afford "the kind of trauma-triage
treatments that are now the bread and butter of the medical industry".
Thinking is built around ageing populations, and that elderly are going
to need a higher level of care, with insufficient people to provide the
care, and insufficient working taxpayers to fund the care.
The solution?
Provide the tools and let people care for themselves.
What sort of tools?
Well most will be built around nanotechnology and biomems (bio-micro-electromechanical
systems) designed to deliver drugs, supplements and therapies to specific
sites in the body with the ability to extend dosage over weeks, months
or years. Already a system exists for a device to replace insulin injections
with a one-time implantation of tiny silicon capsules beneath the skin.
Another type of tool involves wearable technology, building monitoring
devices into items such as shoes, watches, underwear etc designed to provide
information about the body when it is not functioning as it should, at
a stage when it can be corrected or better managed. Known as biomonitors
they will have Internet connectivity to provide some, or all, of the information
needed for you to basically be your own doctor. Monitoring of blood chemistry,
body odour, breath odour and analysis of trace chemicals to determine
the progression of a problem.
This
closely follows the alternate medicine procedure of documenting such things
as "nutritional body language", looking for sub-clinical symptoms and
signs to see if an illness is in progress.
Because of the Internet link, privacy will be an ongoing major concern.
It is also possible that with detailed information on their health, some
patients may become obsessively concerned (hypochondriacs), but this is
not seen as a deterrent.
Associated with Media Lab is the University of Rochester and their Centre
for Future Health. The Centre is a multidisciplinary research laboratory
where physicians, engineers and scientists from both academic and industrial
pursuits, create advanced medical technology on a personal scale.
Researchers at the centre develop new concepts for consumer priced, home
based, non-intrusive devices and systems that maintain health and promote
wellness. The Centre's industrial partners produce and market the concepts
for child development, care of the elderly and preventive health monitoring.
The focus is specifically on the individual, in a home-based setting using
affordable technology.
This revolutionary approach is set to alter the structure of healthcare
worldwide, and will give the individual complete ownership over their
own health.
Technology is the first step to converting a health system from an institutional
model to an individual model.
The second step is to create a knowledge transfer about that individual's
health.
The
University of Rochester is proving an ideal setting for this new development
and it has been able to harness cooperative efforts from their School
of Medicine and Dentistry, the departments of Computer Science, Optics
and the School of Engineering and Applied Sciences in this collaboration.
Combined with MIT's Media Lab, the alliance is set to establish an entirely
new medical industry which will create opportunities for pharmacy as well,
particularly in the marketing of biomonitors and the provision of quality
advice.
Given the rate of change and the current launch date of the project, expect
gradual changes to occur in Australia within two years.
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EDUCATION
Continuing
education is emerging as a major issue in pharmacy, because one of the
recommendations of the CoAG Review was that a Practice Certificate be
put in place. This requires "recency of practice" plus some form of formalised
continuing education. With the spectre of globalisation driving a whole
host of parallel issues, it is quite possible that pharmacist qualifications
will eventually be recognised in a range of countries, hence the need
for some form of measurement. While these comments are pitched into the
immediate future, we look at some of the trends in Internet education
in the engineering profession, and their moves towards a global professional
accreditation. This must be inevitable for pharmacy, and there are signs
of an Internet stirring within the pharmacy academic community. Comment
is also made on the impact of a practice certificate and the retired (or
about to be) pharmacist.
Internet Mobility and
a Look at Other Professions
Providers of education are gearing their resources to provide formal courses
in a myriad of subjects, and deliver the bulk of the content via the Internet.
Education is rapidly globalising in this fashion and is set to become
an export earner for those countries able to provide a quality product.
The success of the various education initiatives will be dependant in
part, on whether recognition will be given in other countries.
An accreditation process for the purpose of skill measurement has emerged
as an urgent issue for those countries wishing to become global players.
In an interesting development this month, the Minister for Education,
Training and Youth Affairs launched a new publication aimed at improving
the recognition of professional engineering qualifications.
Entitled the "APEC Engineer", it was launched at a forum of APEC countries
and engineering professionals in Parliament House.
The publication is an initiative to increase mutual recognition of overseas
qualifications and professional mobility for engineers in APEC participating
economies, which include Australia, Canada, Hong Kong, China, Japan, Korea,
Malaysia and New Zealand, with the Phillipines, Thailand, the United States
and Vietnam likely to join next year.
Because barriers will be removed for professionals seeking to practice
in an APEC country, it provides an opportunity to boost trade and is seen
as vital for Australia's economic future.
All eligible APEC engineers seeking to practice in a participating economy,
will be given partial or total exemption from assessment for licencing
or registration.
Exports of engineering services increased 11 percent in 1998-99, which
amounted to $24 million dollars over the previous year.
It also opens the door for Australian higher education exports, estimated
to be around $2 billion currently.
The APEC Engineer was developed by APEC Human Resources Development Working
Group and is a joint initiative of the Institute of Engineers and the
Department of Education, Training and Youth Affairs (DETYA). A register
of successful applicants will be maintained by each APEC country with
the Internet being utilised to publish the information to be available
to regulatory and licencing authorities in other countries.
The initiative has been widely acclaimed as an outstanding example of
promoting professional mobility and economic growth.
Management
consultants in Australia, have for some years been able to register for
international accreditation through the Institute of Management Consultants.
The writer of this article has such an accreditation (designated CMC-Certified
Management Consultant), and as such, can practice in most developed economies
throughout the world.
Online
education is still in its infancy in Australia and much of the existing
material has just been repackaged, rather than re-engineered for the Internet
and provide a totally new learning experience, by integrating as many
of the new technologies as is possible. Educational products need to be
aimed at different segments of the education market. Currently, no Australian
University is offering a virtual degree. but with universities being short
of cash, online higher education is an attractive option.
The difficulty is that online courses are suitable as "add-ons" and face-to-face
teaching is needed for the core elements of a subject.
Private companies such as e-cademy are selling short courses, seminars
and staff training to corporate clients, claiming to provide cost effective
e-learning. With material available 24 hours per day and participants
able to work at their own pace, hours are not lost by staff having to
travel to formal face-to-face courses.
Engineers can currently update their skills with this type of delivery.
Online education is considered to be suitable for technical training and
the transfer of information, but seems to founder in the "soft" skills
such as values and strategic thinking.
Australian rural universities seem to be leading the development of the
"e-university" and recently the University of Southern Queensland (USQ)
and the University of Wollongong jointly shared the "University of the
Year Award" in a special ceremony held at Parliament House.
Prime Minister John Howard said that the award "recognised leadership
in developing the e-university where students learn and are supported
through the innovative and strategic use of web-based technologies that
encourage e-world expertise."
At the ceremony, Professor Peter Swannell, vice-chancellor of USQ said:
"Rural and regional communities can be as effective in the 'e-world' as
bigger cities. The e-world has brought with it what I like to call 'the
Regional Advantage' whereby people and organisations can live the advantages
of regional life and work and compete in the global marketplace."
"There is no such thing as THE best University! However, it is particularly
satisfying to be recognised by the Good Universities Guides as joint Australian
University of the Year. USQ is a dynamic University that has established
its place in a first class, diverse university system and the recognition
afforded to us by receipt of this Award is a wonderful incentive for us
to keep on improving."
"We are in a time of total e-volution!
USQ is a clear example of this.
Based in Toowoomba in Queensland, it has systematically and strategically
implemented information and communications technologies with a view to
providing the best possible opportunities for students, no matter where
they live and study."
"With
75% of USQ students studying off-campus in more than sixty countries,
the University’s global presence is been made possible by an organisational
commitment to technical innovation supported by superb staff and teaching."
Judges of the Award and co-authors of The Good Universities Guides, Dean
Ashenden and Sandra Milligan, congratulated USQ on its achievement.
"USQ is making the most of its 25 years experience as a distance education
provider to develop ground-breaking commercial partnerships and cutting-edge
technologies to pursue its vision of an e-university," they said.
In
the e-world of Australian Pharmacy, we are yet to see credible Internet
offerings for professional development. In edition #14 of this newsletter,
we highlighted a program being launched at Nottingham University in the
U.K which did lead to a formal degree qualification.
However, I have just received a survey form from the School of Pharmacy
at the University of Queensland, asking me to provide answers to questions
concerning the type of training I might like (re-entry training, updating
current knowledge and skills, contact and discussion with accredited pharmacists),
what areas do I need the most training in and what times would best suit
to achieve my requirements.
Included was a choice for flexible delivery....correspondence and/or Internet.
So it seems at least one Australian pharmacy school is preparing to provide
online material, which may include a Graduate Diploma, Masters Degree
or a Doctorate qualification.
Simultaneously, I received an invitation from the Faculty of Pharmacy
at Sydney University to attend a course on medication reviews, lasting
over a week.
Being located at Australia's best address (the rural town of Alstonville,
not far from Byron Bay, in the state of NSW...but ten hours drive from
Sydney), I was wishing that an Internet version might have been available.
Perhaps next year.
The above events only serve to reinforce the comments made in edition
#14 which, although personal, I am sure they relate to many pharmacists.
Those comments are re-stated:
"So it seems that if I am going to be able to renew my practice certificate
in the future, I will need an educational delivery system that is flexible
in content, easily accessed, economical in cost, provides recognition
for work completed, and which further builds to a formal qualification
that is preferably globally recognised. It is inevitable that such a system
would have to be totally web-based. Given that vast distances exist in
Australia between individual pharmacists and generally major or regional
city-based educational establishments, education will have to flow to
the individual, and not in the reverse manner. This is achievable via
the Internet. Educational material would have to be delivered in "bite-sized"
pieces to enable absorption,say,over a lunch hour, or at home after the
evening meal. This can also be achieved via the Internet. Material would
have to be diverse, because "one size does not fit all". If I have the
right to choose which material I study, and from a network of global education
providers, then I begin to feel quite enthusiastic."
These
comments are made in light of the fact that many pharmacists will be retiring
over the next three to five years, which is part of the reason for pharmacy
human resource shortage now.
If the renewal of a Practice Certificate is not organised in a convenient
fashion, then many of these pharmacists ,who may have returned as locums,
will simply vanish.
The human resource problem will then exacerbate further.
Also, if periods of physical attendance are required to attend university
classes, those restful holidays begin to disappear, and extra stresses
result if a pharmacy proprietor requires a locum, who may be non-existent
at that time.
To complicate matters further, Pharmacy Boards are moving to establish
the concept of "recency of practice" coupled with the idea of a practice
certificate lasting say, for three years, rather than an annual roll fee.
The Pharmacy Board of Queensland is known to be considering this concept
in legislation going through parliament now.
The problem is that the legislation is broad and non-specific and allows
the Board itself to determine what is too long a period to be out of practice
and what inputs are required for a practice certificate
It also suggests that change will be more rapid in the future as the Board
will be able to change the rules without the need of enabling legislation.
One of the CoAG recommendations was to reduce powers of Pharmacy Boards
to operate in this fashion.
In this instance, it appears that events are moving against CoAG recommendations,
and that the general pharmacy population may not be fully informed as
to the content of proposed legislation.
Is this happening in your state?
Better find out quickly before it is too late!
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CONSULTANT PHARMACY
Consultant pharmacy is moving at a constrained rate within Australia.
On the one hand it is controlled by the two major forces within pharmacy
(The Pharmacy Guild and the Pharmacy Society) giving the strength and
resources required for its establishment.
On the other hand, the limited input that individual practitioners are
able to contribute, needs to be increased so that practising consultants
can be elected to the board of management.
British developments, particularly in the area of prescribing, may allow
an equivalent Australian model to be developed, with the ability for more
say in the outcome.
British Pharmacists Gain Prescribing Rights
At
the British Pharmaceutical Conference held in Birmingham on September
12th, pharmacists were addressed by Lord Hunt, the Parliamentary Under-Secretary
of State for Health).
In his detailed speech, he outlined a five year plan for British pharmacists,
and to their surprise, it contained most of the items on their "wish list"
which had been accumulating for some time.
Included were medication management, electronic prescriptions, extended
prescribing rights, money for clinical governance, repeat dispensing,
inclusion in NHS Direct, electronic pharmacy, contracts with individual
pharmacists, more pre-registration places in hospitals and an approval
for an upgraded disciplinary mechanism.
Many of the details contained in the plan had been announced previously.
The profession had been asking for a national strategy for a number of
years, and although many details are yet to be negotiated, British Pharmacy
is engaging a new era of progress.
The nearest mechanism approaching the above process in Australia is the
Guild/Government agreement, so in some respects, Australia would seem
to be ahead. However, professional development in Britain seems to be
advancing at a faster rate than in Australia, and the most significant
of the above initiatives is that of extended prescribing rights for pharmacists.
Certain groups of pharmacists (equating to consultant pharmacists in Australia)
will soon be enabled by legislation to prescribe under the NHS.
Initially, pharmacists will be given a supplementary prescribing role
where pharmacists will be responsible for the continuing care of patients
who have been clinically assessed by an independent prescriber.
Depending on the success of this process, pharmacists could proceed to
the role of independent prescriber.
The government wishes to ensure that patient care is not affected by the
rigid demarcations that currently exist between the professions.
The possibility of hospital pharmacists prescribing discharge medications
is also being explored. Currently, as in Australia, this function is performed
mainly by resident doctors. Discharge medication prescriptions tend to
arrive at the pharmacy only minutes before the patient is due to be discharged,
resulting in minimal patient education by pharmacists and a higher level
of "rebound" patients due to non-compliance.
The process is inefficient and only partially fulfils the duty of care
this process is supposed to represent, before the patient obtains continuity
of care in the community. Pharmacists are well placed to provide this
function in a cost efficient manner, allowing for a streamlining of dispensing
procedures, higher levels of patient communication and liaison with the
patient's community pharmacist, so as to provide seamless care.
The savings to the hospital system would be considerable.
Lord Hunt acknowledged the fact that clinical pharmacy services have become
an established component of hospital health care, and there is realisation
that more can be done to ensure a quality use of medicines in hospitals.
A medicines management performance framework specific to hospitals is
to be announced later this year by the National Health Service Executive's
regional offices. With regard to electronic prescribing, this process
is set to be routine in hospitals and in the community by 2004.
Electronic prescriptions will have the same legal force as prescriptions
signed in writing. This will eliminate a continuing pharmacy hazard, that
of illegible and incomplete prescriptions (provided the right buttons
are pushed!).
Pharmacist training and recruitment is to be given a boost, and NHS payments
will be modernised to recognise clinical and management streams.
Pharmacy support staff are also singled out in the Government plan, stating
that:
"The Government believes that the time is right for a more focused debate
on the respective roles and responsibilities of pharmacists and their
staff, so that the talent and skills of pharmacy technicians and other
support workers are fully utilised."
This
process has already begun in Australia and it is obvious that most of
the dispensing and dispensary management functions will eventually be
absorbed by this group, possibly leading to a medication management role
in the areas of S2 and S3 medications sales, by value adding with information
( and preserving these schedules for pharmacy).
Rollo Manning's article in newsletter edition#15, touched on why an initiative
should be commenced for Australian pharmacists to gain prescribing rights.
With the British model about to be rolled out, there can be no excuse
for consultant pharmacist representatives not to begin lobbying for similar
legislation in Australia.
Coupled
with the global development of universal professional credentials as outlined
in the previous article, we could be set for an accelerated ride into
the future as international pharmacy health practitioners.
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COMPLEMENTARY
MEDICINE
A
number of herbal/drug interactions have been published in recent months,
with the herb St John's Wort taking centre stage,and shown to have some
serious interactions with a wide range of drugs. Opponents of complementary
therapy will enlarge upon this finding for some time to come. However,
unlike drugs there can be positive and beneficial interactions when complementary
medicine are used in conjunction with orthodox medicine. Some recent discoveries
follow.
Beneficial Supplement/Drug
Interactions Metformin, Vitamin B12 and Calcium
Metformin, used in the treatment of Type 2 adult onset diabetes, belongs
to the biguanide family of drugs.
This group of medications is known to deplete body stores of Vitamin B12,
potentially contributing to side effects, which include impaired mental
function, nerve problems and anaemia.
Thus, supplementation with Vitamin B12 will minimise these effects.
In a recent study published in Diabetes Care, researchers have discovered
that calcium supplementation at a dose of 1.2 g daily restored Vitamin
B12 absorption.
Verification that metformin impairs Vitamin B12 absorption was also confirmed.
It is postulated that the mechanism for Vitamin B12 absorption is calcium
dependant and that metformin inhibits this mechanism. Supplements of both
Vitamin B12 and calcium would be beneficial in minimising any long term
effects of metformin.
Tamoxifen, Vitamin E and
Vitamin C
In
an Indian study, researchers found that women taking tamoxifen for breast
cancer may minimise any adverse events through supplementation with Vitamin
E and Vitamin C.
Tamoxifen opposes oestrogen in the body.
Oestrogen is the promoter substance that stimulates a mutated cell to
become cancer. Although tamoxifen is quite effective in cancer prevention,
it increases triglyceride levels, increasing the risk of heart disease
and stroke.
Researchers discovered that by supplementing 500 mg of Vitamin C plus
400 mg of Vitamin E daily, triglyceride and cholesterol levels reduced,
with an improved ratio of HDL to LDL cholesterol.
This was not a double-blind placebo trial, and more evidence is required
to support the findings
References
1. Bauman WA, Shaw S, Jayatilleke E, et al. Increased intake of calcium
reverses vitamin B12 malabsorption induced by metformin. Diabetes Care.
2000;23:1227–1231.
2. Babu JR, Sundravel S, Arumugam G, et al. Salubrious effect of vitamin
C and vitamin E on tamoxifen-treated women in breast cancer with reference
to plasma lipid and lipoprotein levels. Cancer Lett. 2000;151:1–5.
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E-COMMERCE
The
rate of introduction of online retailing in Australia lags behind that
of America, UK and Europe. Australia Post is set to give the process a
nudge by setting up some infrastructure nationally, which also offers
a human face to the ultimate consumer.
The Pharmacy Guild has an opportunity to enhance its own e-commerce site
through these developments and is in a position to negotiate price for
individual members.
And in a separate B2B venture, the Big Four Banks appear to be tempting
fate with the ACCC in a proposed merger of their wholesale products division
online, possibly locking out all smaller banks from the marketplace.
Australia Post Extends
its E-Commerce Backup
As part of its e-commerce strategy, Australia Post has announced that
it will offer warehousing, fulfilment, payment, billing and delivery services,
for both businesses and consumers.
Targeting e-retailers and their customers, Australia Post has already
established warehouse facilities in Sydney and Melbourne to provide management
of products, delivery, billing and payment services (at local post offices
offline or online at a central website).
The services are being marketed to prospective clients either as a total
integrated solution (called PosteDeliver), or in four modules.
* PosteLogistics for warehousing
*
PosteParcels for delivery and tracking
*
Postbillpay for paying bills online
*
Pay-it-at-Post where customers can visit a post office to pay for goods
already ordered online.
The
total investment amounts to $34 million and represents a scale of efficiencies
that e-pharmacies might find attractive. Payment technology was supplied
by CheckFree and the e-commerce platform by Interworld.
All 80,000 square metres of warehousing facilities are fully secured.
While not expecting a rush, Australia Post is confident that its services
will be providing good revenues within three to five years.
Australia Post has 4600 outlets throughout Australia, which is a remarkably
similar number to that of community pharmacies, and appears to be ahead
of the market in the proposed services on offer.
It is also looking to secure some of the B2B market and has CorProcure
in mind for this purpose (Corprocure is an e-commerce hub set up by 14
of the largest companies in Australia to procure goods and services online).
Coles main customers include Telstra, Coles Direct, SmartBuy and Bluemanna.
The
Pharmacy Guild is currently involved in developing a storefront website
in partnership with Medweb, for a proposed launch in February 2001.
It is ideally placed to negotiate a bulk service price with Australia
Post, to assist pharmacists in the e-commerce areas they are deficient,
and perhaps integrate Australia Post services with the Medweb site.
Apart from the Pharmacy Guild and Medweb, a third partner in the form
of ANZ Bank is noted, and that its contribution to the development is
$3 million.
What is not yet clear is what amount of capital the Guild has committed
its members to, in this project.
Would it have been cheaper to give support to an already established (and
apparently identical service), such as Online Pharmacy in Queensland (which
purports to have 600 pharmacies signed up)?
The Guild system therefore appears to be fragmented at the start, because
of the existence of alternative functional sites.
An alliance with one or more existing sites would have made more sense,
as the cost to all concerned will now be much higher, in competition with
each other.
There
is no argument that such a project is necessary, but whether it is the
right type for Guild members remains to be seen, as costing, design and
scope have not been transparent to Guild members.
As the launch date is next February, do you know what your initial and
ongoing costs are through Guild expenditure on this project?
The Medweb site is initially being constructed to service doctors, with
the pharmacy site being spliced in to create communication between pharmacists
and doctors.
But this segment is also being hotly contested.
Promedicus, an e-health group, has already launched its Promedicus.net
secure e-mail system which enable the transmission of encrypted patient
details. The system has already been installed by over 1500 doctors and
diagnostic practices across Australia. This was prompted, in part, by
the Federal Government's $64 million Practice Incentive Program, designed
to provide better managed patient information and referrals, through technology.
There are approximately 67 million diagnostic services being carried out
annually through doctors, all requiring written reports and courier systems.
The costs involved here reduce dramatically through Internet management.
Promedicus.net Secure E-Mail system offers a doctor the advantage of being
able to connect to his or her own Internet Service Provider, and in the
instance of downloading pathology results, only one dial-in suffices for
the multiplicity of laboratories.
While Medweb will offer some distinct advantages to the medical/pharmacy
marketplace, it will need to remain innovative to stave off competitors
that are appearing from all over.
Merged Portal for Big
Four Banks
The
thought that Australia has a competitive and open banking system has already
lost its charm, with the ACCC already taking action against banks for
colluding on fees and charges on credit cards, and unconscionable conduct
in respect of behaviour surrounding some housing loans.
Now the ANZ, National Australia Bank, Westpac and Commonwealth Banks have
announced that they would form an electronic portal, titled AusMarkets.com,
to distribute wholesale financial products and services online.
The ACCC has immediately jumped in and expressed "concern" that action
may have to be taken if the smaller banks are locked out of the system.
The system is to be operated by an independent company and the electronic
platform would provide corporate clients with a single access point to
use financial market products offered by any of the banks. The portal
launch date is early in 2001 and will focus on money market and debt securities,
with interest rate derivatives and foreign exchange products.
Aimed initially at local markets it will rapidly expand to a global position
within 12 months.
Meanwhile, the ACCC is still seeking answers to some of its questions
relating to the merger, as it has the potential to lock all non-participating
banks out of the system totally.
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MEN'S
ISSUES
Leigh Kibby runs a successful business coaching and mentoring service
to a range of organisations. While it is proposed that a mentoring program
may be useful in developing all staff, it is almost essential if pharmacies
begin a conscious process of balancing their workplace by introducing
more male assistants. As it has been pointed out previously, there is
a big market out there if you can reach into those "caves" where men live.
Business Mentors - Building
Success and Business Community
........from Leigh Kibby
Mentoring is evolving into one of the most powerful and cost-effective
tools for Australian business.
Whilst bordering on being one of the "soft skills", it is fast becoming
one of the hard realities that makes a real difference.
The pressures of business today mean we have to work smarter and better
to be successful.
We also have to work together and establish a sense of community within
business. A well run Business Mentor program provides the edge to be more
successful whilst also building the web of connections and trust that
foster community. A Mentor is a cross between a consultant and a counsellor
with none of the cost of the former and all of the caring of the latter
whilst retaining a sense of the bottom-line and the importance of financial
realities.
The Mentor also brings a rich history of experience and wisdom learnt
in the school of life - an invaluable asset that can reveal hidden opportunities
and help avoid pitfalls and mistakes.
There are two key aspects to a Business Mentor program:
Bridges - a system for making contacts; and Modelling -
a process for acquiring critical skills. The themes and process that ensure
success are A.I.M.S. and T.R.U.S.T.
Attitude - the attitude of the Mentor and the way to communicate
an appropriate attitude.
Investment - the relationship is the investment not the outcomes.
Mutuality - sharing a common style or reciprocal feelings. Story - the
message and how it is told.
Truth
- honesty must be the first priority, it is the core for building trust.
Rapport - using listening skills effectively. Unearthing - revealing
ALL issues and options.
Strategies
- considering options using the "seventh hat."
Tactics
- action steps. By using AIMS and TRUST, you can develop a strong Mentornetwork
that will benefit business, the community and build a real business community.
The
comments and views expressed in the above article are those of the author
and no other. The author(s) welcomes any comment and interaction that
may result from this and future articles, and can be contacted directly
by e-mail at kinematic@bigpond.com.
Alternatively, the editor would be pleased to publish any responses directed
to neilj@computachem.com.au
.
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RURAL
AND REMOTE
A regular column devoted to Rural and Isolated Health Issues Roundup
(Written by Guest Columnists)
Editor's
Note:
Following the Roundup article in edition#15, the Pharmacy Guild forwarded
a comment, which is published below. Details of the article in question
may be viewed in Newsletter Edition #15 .
Readers should form their own opinion after perusing all published material.
"The Rural and Remote Health Issues information posted in item 8 of the
in the latest E-newsletter is incorrect.
Money has NOT been set aside for Aboriginal Health Services to 'upskill'
as pharmacy technicians.
The funding is for community pharmacists to assist them in providing a
quality use of medicines services to remote Aboriginal Health Services
who are operating under section 100 supply arrangements. The funding is
for pharmacists to provide services such as:
* Providing assistance to the AHS in developing an implementation plan
for section 100 arrangements;
*
Providing assistance in the implementation of appropriate procedures and
protocols for managing section 100 arrangements, including the development
of a medication store;
*
Providing continuing education to AHS staff in aspects of medication management
or stock control;
*
Assisting clinical staff in the AHS with any clinical inquiries;
*
Assisting the AHS staff with stock control and medication management procedures;
* Implementing agreed measures which aim to enhance the quality use of
medicines.
Details of the scheme are currently being refined by the Guild, some key
remote area pharmacists, the Department of Health and the National Aboriginal
Community
Controlled
Health Organisation.
Pharmacists eligible for the allowance will be informed of the remuneration
mechanism within the next few months. The posting of incorrect information
on the E-Newsletter is not helpful to pharmacists who may use your newsletter
as a source of information, and I ask that you check your sources in the
future, and inform recipients of this error.
Regards,
Lance Emerson
Director Rural and Professional Services
The Pharmacy Guild of Australia "
The
columnist responds.....
The
Pharmacy Guild has given a detailed list of features, which will be funded
from the Section 100 supply scheme for Aboriginal Medical Services from
the Pharmacy Development Program.
This implies a comprehensive program.
It assumes there will be pharmacists out there to do the work.
The remuneration system for this program is worth visiting to see just
how attractive it is as a business proposition. $1-14 is the current fee
per item supplied and has been since July 1999.
It has not gone up with any indexed movement.
In fact it did go down in January 2000 when the co-payment increased,
but the ready prepared (RP) fee did not.
The fee calculation was based on the difference between these two figures.
The Guild must have done some fancy talking and had the "handling fee"
stated at the July 1, 2000 level of $1-14.
But what of the future?
The RP fee is predicted to be at $4-74 in 2005 in accordance with the
Third Agreement. The co-payment will move with CPI and may be up to $4-20.
The difference 54 cents!
Maybe the Guild would like to let us in on how the future fee will be
determined.
This will show if it will be worthwhile being in the program at all, let
alone provide "quality" services under the Third Agreement money.
ends
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THE NATIONAL RURAL HEALTH ALLIANCE
Want
to subscribe to another interesting newsletter?
The National Rural Health Alliance has a publication dedicated to news
and reviews of all aspects of rural health. You can subscribe on the website
at http://www.ruralhealth.org.au
or you can contact the independent editor, Jim Groves, at grovesc@winshop.com.au
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*
Don't forget to advise of any change in your e-mail address so that your
subscription may be continued without interruption.
* Letters to the editor are encouraged, or if you have material you would
like published, please forward to the editor.
* You are invited to visit the Computachem web site at http://www.computachem.com.au
.
* Any interested persons who would like to receive this free newsletter
on their desktop each fortnight, please send a single word e-mail "Subscribe"
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.
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Why not try (and bookmark) the Computachem
Interweb Directory , for an easily accessed range of medical and pharmacy
links, plus a host of pharmacy relevant links.
The directory also contains a very fast search engine for Internet enquiries
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