Community Pharmacy Owners and the NZHIT Plan

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Presented by Anna Mickell …

Presented by Anna Mickell
School of Computing and Mathematical Sciences, Auckland University of Technology

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  • Unfortunately, some of the comments and findings in this presentation - and the related paper -
    are based on the incorrect premise that Patients First has an overall governance role in the NZ ePrescribing Service.
    This Service, and the Pharmacy Services Agreement, are governed by the eMedicines Programme -
    which is run by directly by the National Health IT Board and the Health Quality & Safety Commission - and not Patients First.
    Are you sure you want to
    Your message goes here
  • Unfortunately, some of the comments and findings in this presentation - and the related paper - are based on the incorrect premise that Patients First has an overall governance role in the NZ ePrescribing Service. This Service, and the Pharmacy Services Agreement, are governed by the eMedicines Programme - which is run by directly by the National Health IT Board and the Health Quality & Safety Commission - not Patients First.
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    Your message goes here
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  • 1. Community Pharmacy Owners and the NZHIT Plan Anna Mickell, David Parry, Dong Li and Xu Zhang School of Computing and Mathematical Science Auckland University of Technology
  • 2. Lead Researcher/Speaker  Anna Mickell – – – – Diploma of Nursing (1985), MBA (2013) General Manager ProPharma – Present Business Development MIMS NZ and AU (2002- 05) Developed NZ’s first consumer health info portal everybody in early 2000’s – Nurse in various hospitals, Mt Eden prison and Cancer Society
  • 3. Background      Just under 1000 privately owned community pharmacies in NZ Community pharmacy businesses holds individual DHB contracts (CPSA) for provision of all community clinical and medicine supply services Total medicine market size of just under $1 billion at last quarter (IMS Q3 2013) – Around $800 m from Government revenue – IT services must provide both inventory and clinical tools to support government and non government revenue Service revenue of $380 million (approx) Massive changes to pharmacy funding occurring – Capped service funding envelope introduced in 2012 – Declining revenue due to PHARMAC gross and net spend reductions ($50million in last financial year) – Desperate requirement to improve operating efficiency and/or grow revenue!
  • 4. Background – Work Stream 3  v NZ HEALTH IT BOARD, NZ IT PLAN 2010 Disclosure: Funding (>$400) for the survey and customer database were provided by ProPharma NZ HEALTH IT BOARD, NZ IT PLAN 2010 2010
  • 5. Background - Benefits of Work Stream 3  “benefits of this work steam (3) are that it: – Reduces adverse drug events – Improves the use of medicines to treat patients – Reduces pharmaceutical wastage – Reduces administrative overheads and manual handling” NZ HEALTH IT BOARD, NZ IT PLAN 2010
  • 6. Research Question 1 DO THEY KNOW ABOUT IT?  What is community pharmacy owner’s awareness of the aims of the Work Stream 3 of the National IT Health Plan
  • 7. Research Question 2 DO THEY THINK IT WILL WORK?  To what degree do community pharmacists believe that successful delivery of 3 key work stream projects are capable of achieving the stated 4 aims of the work stream? – NZULM – NZ Medicines Formulary – Community e-prescribing AIMS -Reduces adverse drug events -Improves the use of medicines -Reduces wastage -Reduces OPEX
  • 8. Method and Response  Random selection of 120 community pharmacies from a wholesalers database of 683  109 community pharmacy shareholders were identified that had a greater than 10% shareholding in the business and whose surname was closest to the letter A (where multiple shareholdings)  Email invitation sent inviting them to participate in confidential online survey  Likert Scale and Yes/No responses only  59 responded (54%) over a two week period in July 2013
  • 9. Results and Recommendations  64% of pharmacists don’t know of or are unsure about the NZHIT Plan Recommendation:  The NZHIT Board needs to re-evaluate it’s communication strategies with regard to the pharmacy sector  Amend ‘The Plan’ to include two other “key decision makers” - community pharmacy owners (and general practice owners) as those “directly affected” by the plan!
  • 10. Results and Recommendations  Only 12% of respondents had heard of Patient’s First (Primary Health Care IT Governance Group) Recommendation  Patients First’s poor level of sector awareness suggests that they have not achieved their core purpose and it’s role, management and/or memberships should be re-evaluated by the NZHIT Board.  Leading change requires stakeholders who are knowledgeable, urgent and powerful .... Memberships are full of “legitimate” office holders .... “The Board is actively supporting good governance at all levels and has created a strengthened implementation leadership and accountability model for the health sector”. NZHIT Plan 2010
  • 11. Results and Recommendations  92% had heard of the NZDF  12% had heard of the NZULM
  • 12. Results and Recommendations
  • 13. Results
  • 14. Results and Recommendations  Respondents somewhat more likely to see potential for OPEX reduction and improving the safe use of medicines  Overall respondents ambivalent or disbelieving in these ability of these initiatives to achieve their aims Recommendation:  NZHIT Board should focus on OPEX reduction in order to stimulate demand within the sector.  NZHIT Board should actively target those in sector who understand potential and use “jungle drums” to get word out (proven, effective channels for communicating with sector)
  • 15. Getting community pharmacy owner’s attention  Infrastructure that grows my business! – Help me attract more patient’s by servicing them faster and better – Help me looking after the self-care market better (cough, cold, allergies, weight loss etc) – Help me be eligible for more Government revenue than others (I’m in a capped funding environment) – Help me be the pharmacy of choice in my area for local doctors and nurses – Help me, and the funder, measure my effectiveness to prove my worth
  • 16. Research Question 3 WILL IT IMPROVE MY BUSINESS?  Do community pharmacists believe that successful delivery of 3 key work stream projects will improve their businesses by lifting revenue, maintaining revenue or mitigating risk?
  • 17. Getting community pharmacy owner’s attention
  • 18. Getting community pharmacy owner’s attention
  • 19. Getting community pharmacy owner’s attention
  • 20. Getting community pharmacy owner’s attention
  • 21. Getting community pharmacy owner’s attention
  • 22. Results and Recommendations  92% of respondents did not know or were unsure how community eprescribing will be funded  Majority of respondents prefer a funding model that allows them to determine who they will purchase e-prescribing services from than the directed approach being rolled out  98% of respondents did not know what governance structures were in place to support the roll out of e-prescribing
  • 23. Results and Recommendations Recommendation: Research would suggest …  Directed approach not going to work (is not working) – – – NZHIT Board should get out of software ownership/provision and get into setting standards and offering/suggesting incentives for performance NZHIT Board should re-think it’s investment in medicines data and get clear and urgent on data standards and incentives for performance NZHIT Board should facilitate informed, “powerful” and “urgent” community clinicians and service providers to provide the leadership and governance required to drive the change and lighten up on including “legitimate” office holders
  • 24. Update 2013/2014
  • 25. Thank you!