Pharmaceutical Benefits Scheme electronic Chemotherapy Medication Chart project

The Pharmaceutical Benefits Scheme electronic chemotherapy medication chart (PBS eCMC) (when enabled via conformant oncology systems) will support electronic prescribing, supply and administration of chemotherapy infusions and other supportive medicines.

The electronic chemotherapy medication chart is not like a standardised paper medication chart. Instead, it is a list of information requirements (data entry fields) that must be available within oncology systems to support electronic prescribing as part of the conformance requirements set by the Australian Digital Health Agency. (See ADHA conformance framework). Business analysts turn information requirements into functional and technical specifications for an information system.  Information requirement examples include, ‘patient name’, ‘medicine name,’ ‘protocol name or ID’. An information requirement does not specify the data that will be entered into the data entry field. The PBS eCMC represents the minimum information requirements recommended to support electronic chemotherapy medication management.

The proposed PBS eCMC information requirements will support efficiencies in the clinical workflow with the aim of improving safety and quality of chemotherapy medication management. It is expected that information will only need to be collected once in the appropriate system. Information collected in other systems may need to be shared with the PBS eCMC medication management system to support clinical workflows.

The PBS eCMC will integrate with the broader electronic prescribing ecosystem ensuring that all the information required to electronically prescribe and claim a PBS chemotherapy medicine is electronically documented and 'shared' through system interoperability. The goal of interoperability in Australian healthcare is to give consumers and providers access to health information from disparate sources, ensuring the right information is available to appropriate people at the right time to provide improved care.

• https://www.digitalhealth.gov.au/newsroom/blogs/interoperability-better-connections-for-better-care

This is outside the scope of this project. This will be available through other national initiatives being undertaken by the Australian Digital Health Agency including electronic prescriptions. 

• https://www.digitalhealth.gov.au/initiatives-and-programs/electronic-prescriptions

This is outside the scope of this project. The current project is focused on the information requirements only. 

The PBS eCMC information requirements have been developed to support a legislative requirement for an ‘electronic chart’ for electronic prescribing. In practice, this means that existing oncology systems will need to incorporate the information requirements specified in the legislative instrument once finalised. If the oncology system you currently use already includes all of the information requirements specified in the legislation you may not ‘see’ any change when you view your system.

The PBS eCMC will not replace a paper-based medication chart. Information requirements specified for a PBS eCMC have not been validated nor configured for use on paper. A human factors analysis has not been conducted to ensure safety and quality on paper and in the clinical context.

Defining the information requirements for a PBS eCMC is the first phase of a multistage project by the Australian Government Department of Health (Department) to support electronic prescribing of chemotherapy and supportive medicines in hospitals and other care settings. The timing of the next stages of the project will be determined by the Department and their coordinating partners.

Once the PBS eCMC information requirements have been legislated, the Electronic Prescribing Conformance Profile (an Australian Digital Health Agency (ADHA) document) will need to incorporate the required changes. Following this, software vendors will be able to work toward achieving a conformant system. The ADHA will issue a conformance identifier to the software vendor once conformance has been achieved. Conformant systems are then permitted to utilise electronic prescribing functionality.

Many of the current chemotherapy medication management systems being used today may be ADHA conformant in the future. Your software vendor will be able to inform you as to whether they will be working toward an ADHA conformant system to support electronic prescribing.

In part, yes. The ADHA conformance framework also supports the application of these requirements.

The PBS eCMC contains the minimum number of information requirements for chemotherapy medication management. While it is anticipated that information will ultimately and ideally be pulled from organisations’ other systems to support safety and streamlining, completing all information requirements may also be dependent on regulatory and policy requirements at jurisdictional and organisational levels.

The Department engaged the Commission to develop an electronic medication chart prescription form to support chemotherapy medication management in hospitals and other care settings. A paper medication chart will not be developed as part of this project.