Software Vendor Meeting - 20 March 2015

  • Time: 8.30am to 5pm
  • Venue: Rydges Sydney Airport, 8 Arrivals Court, Sydney International Airport

 

Agenda

  • 08:30 Arrival/set-up
  • 09:00 Welcome/introduction
  • 09:15 Review Action Items
  • 09:45 PBS XML Schema version 2.10
    • a) Hospital Medication Charts
    • b) Complex Authority Required
  • 10:30 Morning tea
  • 10:45 Community Access
  • 11:30 Post-Market Authority Review
    • a) Tranches
    • b) S100 harmonisation
    • c) Initial/Continuing Authorities
  • 12:30 Lunch
  • 13:30 PBS Enhancements
  • 14:30 AMT v3
  • 15:00 Afternoon tea
  • 15:30 PBS XML Schema version 3.0
  • 16:30 Other Business
    • a) Remote Area Services
    • b) Private scripts data collection
  • 17:00 Meeting closed

 

Documents

 

Minutes

Please note: These minutes should be read in conjunction with the Powerpoint slideshow that was presented at the forum.

Agenda Item 2 - Review Action Items

  • Start date changes have been in production as of the 1 February 2015 schedule data
  • Other action items are addressed through other agenda items

Agenda Item 3 – PBS XML schema version 2.10

  • Hospital medication chart data has been included into the PBS XML starting from the 1 March 2015 schedule data.
  • Written authority prescribing rules were not originally eligible for prescribing using a hospital medication chart.  This was changed recently and those newly eligible prescribing rules will be flagged appropriately starting in the 1 May 2015 PBS XML.
  • Test data for CAR drugs has not been made available.  Test data is to be generated based on the current schedule.  This data will also be distributed to DHS for testing purposes

Agenda Item 4 – Community access

  • Current Highly Specialised Drug arrangements include dispensing rules to define the appropriate fees and mark-ups.  Community pharmacies effectively claim against those dispensing rules by acting as an agent of the respective hospital
  • Question was posed whether vendors preferred replicating the existing dispensing rule model for the new arrangements or adding an explicit new dispensing rule for community pharmacies.  Decision was made that the new Community Access program will include explicit dispensing rule for community pharmacies (note that this is also distinct from the existing s90-cp dispensing rule).
  • Decision was made that this new dispensing rule would also be appropriate to apply to the existing HS and HB program and will be incorporated into test data.
  • Vendors raised some concern about the remuneration of the new arrangements.  This will be raised with the relevant policy area within Health.

Agenda Item 5 – Authority review

  • The first tranche of recommendations have started coming through in the PBS XML.  These appear amongst other regular restriction changes
  • Subsequent tranche include harmonising the business rules and listings for the public and private hospital highly specialised drug programmes.
  • The harmonisation would be achieved under a new programme code and listings would be moved onto the new programme over time.  New listings would be listed directly onto the community access program and/or the combined hospital programme.
  • The combined hospital program would not change the business rules associated with making a claim, or the appropriate reimbursement rates.  PBAC intent of this change is to avoid the patient having to keep returning to specialists/hospitals.
  • Third tranche is streamlining continuing treatment after the initial authority requirement was complex or in writing.
  • Some suggestions for implementing this included: transcribing approval numbers onto the physical script, incorporation of approvals into PCEHR, or a PBS online mechanism similar to ANS.
  • DHS online authority changes are independent of this proposal.  This was only announced recently and may have some interactions.

Agenda Item 6 – AMT v3

  • Health remains at phase 0 of the staged adoption proposal.
  • Additional tools have been put in place to reconcile some outstanding concepts to the last AMT v2 release.  Some reconciliation will have appeared in the PBS XML and will continue.
  • Phase 1 was on track for release in the August 2015 PBS XML.
  • Phase 1 will un-reconcile multi-component concepts at the MP level but remain reconciled at lower levels.
  • Some concerns about non-AMT concepts and their interoperability when using the same identifiers.  Health to investigate whether non-AMT concepts would be kept explicitly separate from AMT concepts using scheme attribute or remove the code and will produce test data for comment.
  • Note that the 2.10 schema includes the facility to identify the last AMT release which was used.  This will remain at the last AMT v2 release until we reach Phase 1
  • Health to investigate whether MPUU information could be included for ready prepared items.

Agenda Item 7 – PBS XML schema v3

  • Current major release cycles for PBS XML have been V1-V2 (~5 years), V2-V3 (~5 years)
  • Purpose number brings together all legally enforceable components of the restriction and should be more stable.  “Treatment of” entity captures the indication and treatment phase, which should be more stable again
  • Expect to have indication, treatment phase and individual parameters at a level of granularity that allows mapping to SNOMED concepts.
  • Current model has disjunction at restriction level, conjunction at criteria level and disjunction again at parameter level.  This has not proven to be flexible enough.  New model includes explicit connectives to allow different relationships.
  • Alternate text is still in use and previous agreement to remove it may need revisiting. 
  • Streamlined code as letters was generally agreed but some concern about length.  Needs to be case insensitive and character limited.  15 chars was proposed, as long as it was words rather than digits.  If it remains numbers, may need a check digit.  Needs further discussion
  • Complex assessments could use provision of actual data and results rather than granular binary answers.  This is similar in nature to the “date required” and “text required” flags from the ANS system.
  • There is a need to include temporal data for price changes, in addition to restriction changes or transition for new programs etc.  This would not cover repeats for items that have subsequently been deleted.  The data as it stands was effective for communicating listings from the perspective of prescribers but not necessarily dispensers.
  • Some concerns about file size, particularly if pricing data is needed.  Health to investigate potential magnitudes and potential alternative file distribution mechanisms.
  • Feedback required from vendors on utilization of changes list.
  • Teleconference and/or discussion forum posts to discuss options, with some analysis of impacts etc.

Meeting Close

Summary of decisions made from this meeting:

  • New dispensing rule will be created to explicitly describe remuneration for Community Pharmacy dispensing of Highly Specialised Drugs (including Community Access)
  • PBS XML v3 ontology does not require further granularity (e.g. type, subtype), rdf:resource is appropriate as is.

Summary of action items from this meeting