Welcome to the current edition of i2P (Information to Pharmacists E-Magazine dated Monday 6 August 2018.
Have you heard of a new organisation called “Bridgebuilders”?
No?
Well it is a new, low-key organisation that had its genesis after a recent GP Conference (GP’s Down Under 18), that was held at the end of May 2018.
A small group of GP’s attending that conference found common ground in deciding that there was a need for collaboration in healthcare and a system for creating channels of communication between health profession leaders, rather than acrimonious or derogatory comment delivered in a destructive manner.

It puts patient benefit and focus as the central objective and collaboration between health professions as a key to enhancing that objective.
It is also designed to repair internal divisions within each separate health profession, given that there needs to be internally harmonised health professions before they can successfully collaborate
And it promotes its vision through an acronym based on the word “bridge”.

This has to be a “lightbulb” moment for all health professions and worthy of full support by all members of those various, very diverse health professions.
It is about building links for the future; connecting people, building trust and facilitating relationships – key components of successful collaboration – so that future leaders will be able to lead together.
And above all, ensures a confident and beneficial patient engagement – much to their relief!

The website, Twitter account and Facebook page communicate passionate messages supporting current and future leaders to get together, build relationships and networks – and hopefully lead together more often.

From their website:

“The project is in the start-up phase and is adopting an informal & different approach. 
Some of the things we want to do:

*Continue the conversation about more collaboration & breaking down silos in healthcare

*Find common ground and build relationships & trust between leaders

*Encourage working across organisational boundaries.

Building bridges requires patience, long-term commitment and encouragement – without judgement. 
We hope that the BridgeBuilders project will start conversations.

And maybe, just maybe, we can get our leaders together, face-to-face, to talk to each other more – but we will not set the agenda or advocate for specific issues; this already occurs in other places.

And, just to be clear, we will not become the next political group or organisation as that would defeat the purpose of bringing existing groups together.”

To work, Bridgebuilders needs your support.
So why not contribute a point of view after some considered thought processes and be part of a progressive solution?

The newsletter “Disruptors Handbook” has published a small article about the “My Health” online patient record system.
For reader interest, this item follows:

“Australians have just over a couple of months to opt out of the MyHealth record system.
And while there are many arguments for opting out, there appear to be few arguments for staying in.
And the major reason for the concern is the security risk associated with the data.The UK had to cancel its Care.data scheme because third parties such as drug and insurance companies were able to buy patient data.
And the Australian MyHealth system is based on the same system, and even managed by the same person.
The system is not just a risk for identity theft, it’s potentially a massive risk for personal privacy.
What is considered ‘private’ is constantly changing, and varies by culture and even within social groups.

And it’s certainly true that social media has changed our perception of what is private information.
But there is still general acknowledgement that some information should always be considered sensitive and personal, and that no security agencies, governments or corporations should have unbridled access to that data.
So how do you reconcile the convenience that can be derived from systematic sharing of personal data, with the maintenance of personal privacy?

The obvious option is liberal application of encryption systems, but is encryption enough?
Some commentators argue that the security risk problem is never going to be solved.
All data has a certain level of vulnerability, and instead of fixating totally on securing information, what we need is the right and ability to control information held about us – and the right to be forgotten. 

In an era where inclusion, agency and autonomy are so valued, it’s ironic (and depressing) that the systems we deploy for productivity may be compromising these values.
It may be as science fiction author, David Brin, once said – the issue of the information age is not privacy of information, but equity of exposure.”

So what are your thoughts and conclusions regarding the MyHealth system?
As we were compiling this item it was announced through national media that legislation was being changed to disallow police and other government agencies to access MyHealth without a warrant.
Will this reduce overall concerns sufficient to enable it to become a reality?
It certainly would be an assist for pharmacist independent prescribing.
Will you be staying in or opting out?
What will you be advising your patients?

The recent results of the fourth Australian Medical Association Aged Care Survey involving 608 general practitioners, consultant physicians, palliative care and geriatrician specialists has highlighted a serious problem in aged care services.
Among the 129 aged care doctors who responded to a question about intentions to visit facilities over the next two years, more than a third said they intend to decrease their visits (20 per cent), not take on any new patients (7 per cent) or stop visiting facilities altogether (9 per cent).
This, in a time when the senior’s population demographic is exploding.

The most urgent aged care issues reported by all survey respondents are improved availability of suitably trained and experienced nurses and other health professionals (67 per cent) followed by increasing funding for medical practitioners (58 per cent), according to the survey.
Presumably, pharmacy is included in the “other health professionals” segment.
Surely this is an argument for specialist pharmacists to increase their participation in aged care services to fill gaps in unmet aged patient needs?
And surely the best type of support service that pharmacists could provide would be in the form of clinical pharmacist independent prescribing, collaboratively with all other stakeholders involved in aged care.
Preferably without complaints of “turf war”, and definitely with a “Bridgebuilder” attitude – healthcare leaders must embrace a process of continuous culture change if Australian healthcare is to remain relevant and affordable.
Given that everybody is aware that the increase in size of the senior citizens’ demographic was reported on nearly 20 years ago, why is Australian pharmacy lagging the rest of the world in developing the clinical service of prescribing?

The lead article for this edition continues the prescribing debate.

In a hospital setting as a clinical pharmacist my role regularly extended to the training of junior doctors in the intricacies of hospital patient prescribing.
I was able to educate nurses and doctors about prescribing, correct prescribing errors or suggest better alternatives, but never able to prescribe in my own right – even in an emergency or other situations when a doctor was not available.
I have always thought it strange that I was never able to “close the prescribing gap” even though as a senior clinical pharmacist I was respected for my drug knowledge and its clinical application.
Time wasted, patient damage and systems coming to a halt represents a major cost in a hospital environment.
Even in the community, gaps involving prescribing involve similar costs.
Australian pharmacy lags in being able to extend its patient care by adding prescribing to its repertoire – it’s time to simply just do it!
Read: Pharmacist Prescribing – It’s Time!

Gerald Quigley is back with a view that community pharmacy may have lost lost perspective in the provision of care by simply concentrating on service.
This is partially confirmed in another article in this edition written by Barry Urquhart highlighting that service is costing business “big time” but that community pharmacy still rates highly in this regard.
“Pharmacist Care” involves a range of skills that when systemised, efficiently creates a favourable experience with a patient – and the reason for being a pharmacist.
Care requires a system of patient engagement, good communication, a mentoring “educative” style that increases patient health literacy, with all delivered simultaneously with a unique warm and personal style.
Patients should “feel” care.
Service is the delivery after-component of care.
It completes the patient satisfaction level.
Read: The Difference Between Care and Service is Significant

Barry Urquhart from Marketing Focus reports that community pharmacies rate high in customer service satisfaction.
Not that this is any cause for complacency, because it should be allowing you to develop higher levels of patient care that match your service delivery levels.
It is apparent that patient care needs an injection of effort to create a balanced scorecard.
Life wasn’t meant to be easy!
Read: Marketing Focus Newsbrief – Australian Service Standards Costing Business Big Time

Daniel Hussar is a prominent pharmacy thought leader in the US.
In his current newsletter he writes about the destruction of pharmacy healthcare by corporate chains in the US – and how health professionals seem to have lost their appetite to fight back.
His writing gives Australian pharmacists an insight as to what may eventually happen in Australia as political lobbyists make inroads into local regulations governing Australian pharmacies. Protecting and developing core business is a strategy that is slow-moving in Australia and it is that complacency that will allow the lobbyists their ultimate victory if we lose sight of the basics.
Read: THE CORPORATE DESTRUCTION OF HEALTH CARE: Part 1 – And Health Professionals are Letting It Happen!

Harvey Mackay is back to remind us that communication is one of the most important skills in the inventory of any health professional.
Patient communication, if successful, can win you a patient for life.
Patient communication should always occur with clarity, empathy and brevity – but not that brief that the patient feels “hurried”.
Patients are always delighted if they leave their engagement having learnt some new insight of their concerns.
It is the job of a pharmacist to ensure that happens.
Health literate patients are happy patients.
Read: Communication Need  Not  Be Complicated