Too many steps, too many clicks

A promised online solution for obtaining authority scripts proves to be a nightmare

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Medicare’s new PBS authority service went live on 1 July promising an “online solution” for doctors to get approval for most authority PBS medications, as well as increased quantities and repeats.

But the lack of an interface with medical desktop software makes for a slow and clunky experience, leading early users to say they’ll stick to the phone.

“We’ve been asking for 15 years for an authority system that links with clinical software, but that is apparently not what they are delivering,” Dr Nathan Pinskier, chair of the RACGP’s eHealth and Practice Systems committee, told The Medical Republic.

It appears the Department of Human Services expects medical software vendors to sort out the many problems with the online service.

“The system allows prescribers to get a PBS authority approval online using either the Health Professionals Online Services (HPOS) or an upgraded version of their existing prescribing software that integrates web services,” DHS General Manager Hank Jongen said in a statement to TMR last week.

“A small number of prescribers have started using HPOS to request PBS authority approvals, and we expect the rollout of upgraded prescribing software in coming months to prompt a significant shift to the online channel.”

For now, the lack of an interface with clinical software means doctors need to pick their way through 20 steps online for each application for authority approval.

“There are a number of steps which are really quite annoying,” Sydney GP Dr Brian Morton, one of the few GPs to take part in the trial, said.

Dr Morton said he did not mind having to register for a Provider Digital Access Account (PRODA), but there were many instances of red tape and legalistic language that were not doctor or patient friendly.

He was most frustrated by a lack of clarity about drug restrictions, and difficulty in cutting and pasting Medicare and Authority numbers.  A number of steps appeared to be simply redundant, he said.

“Online authority prescribing is cumbersome and unlikely to be widely used unless it is integrated in desktop clinical management software,” Dr Morton said.

Dr Pinskier said the data-transfer problems merely opened the door to error, recalling the chaos that hit the aged-care sector when DHS launched the bug-ridden My Aged Care portal.

“It’s too many clicks and too many steps, and if you can’t transfer data seamlessly, the likelihood of success is low,” he said.

“You run the risk of transcription error taking data across from one system to another.  It introduces new risk, new headache, new complication.”

Medical software vendors said they were in discussions about incorporating the new function in future versions of their products.