Software Vendor Meeting - 17 September 2015

  • Time: 8.30am to 5pm
  • Venue: Holiday Inn Melbourne Airport,  10-14 Centre Rd, Melbourne VIC

Agenda

  • 08:30 Arrival/set-up
  • 09:00 Welcome/introduction
  • 09:15 Review Action Items
  • 09:45 PBS XML Schema version 3.0
    • a) Schedule
    • b) Working Group, establishment of
    • c) Transition Plan
  • 10:30 Morning tea
  • 11.00 PBS XML Schema version 3.0
    • a) Restrictions
    • b) Increases
    • c) Temporal Data
  • 12:30 Lunch
  • 13:30 AMT v3
  • 13:45 Nehta FHIR initiative
  • 14:15 Post-Market Authority Review
    • a) S100 harmonisation
    • b) Initial/Continuing Authorities
  • 14:45 PBS XML Schema version 2.11
    • a) AHI
    • b) Default Dispensing Rule
  • 15:00 Afternoon tea
  • 15:30 6CPA Changes
    • a) PFDI
    • b) EFC Compounding
    • c) LSDP
  • 16:00 PBS XML Schema version 2.12
    • a) Copayment Discount
    • b) Originator Brand
  • 16:30 Other Business
  • 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 1- Introduction, Welcome

  • The forum's purpose is to advise software vendors and other external stakeholders of the current information available, processes for PharmCIS and also the direction in which the system is heading.

Agenda Item 2 - Review Action Items

  • The action items from the previous Software Vendor Forum were discussed and:
    • Test Data for CAR drugs has not been made available.
      • Outcome: Health is still in discussion around the CAR drug business rules. The outcome will be announced on the developers website within the next 2-3 weeks.
    • Health to investigate whether non-AMT concepts should be kept explicitly separate from AMT concepts using the scheme attribute or remove the code. Health will produce test data for comment.
      • Outcome: Heath need to more clearly define AMT and health code mapping for the v2 xml. 1 July Budget measures deferred this work and the action item remains open.
    • Further discussions in incorporation of temporal data and consequences on the file size.
      • Outcome: Discussed later in the day.
    • Feedback requested on utilisation of changes list and whether including embedded changes in element content is preferred.
      • Outcome: Discussed later in the day.
    • Health to investigate whether restrictions on extemporaneous preparations are still required.
      • Outcome: The removal of restrictions caused problems with the legal instrument. V2.10 schema change will include restrictions. Restricted items cause problems for Vendors. Health will change extemporaneous listings to avoid restrictions.
    • Provide our feedback, comments and concerns with current processes for PharmCIS.
      • Software Vendors have been making use of the Discussion Forum as well as emailing PBS.Contact@health.gov.au for more targeted questions. Discussion confirmed this was a good way to continue to communicate between the Department and Vendors in the future.

Agenda Item 3- PBS XML Schema version 3.0

  • Initial discussion regarding XML V3 commenced about 12 months ago.
  • Schema requirements are completed. There are still more technical requirements to complete.
  • Implementation timeframes are April 2016 for a Production release, for use with the May 2016 schedule.
  • March release of AMT will be loaded into Production.
  • Sample data for use as a test file will be produced in pre-prod and distributed to vendors.
  • Small teleconferencing Working Groups will be held to discuss the transition. People who volunteered to participate are; Daniel Gottleibsen, Andrew Griffin, Brian Donaldson and Reuben Daniels.
  • A transition period is required as it’s not feasible to have a hard cut over from V2 and go straight to V3. The length of the transition period is still to be determined but would be most likely approximately 12 months.
  • To help with the phased transition Health will provide a V2 to V3 Up-conversion software and similarly a V3 to V2 down-conversion software, these will become available shortly.
  • V3 to V2 will run through conversion style sheets to generate text extracts.
  • No text extracts will be generated from V3 in their current format.
    • The August meeting showed an overwhelming response for the need of text files.
    • The current text files have gaps in the prescribing and dispensing data creating more manual effort.
    • 15 text files pieced together is not a sustainable option. We need to move forward with a new simple tool/format for generating text.
    • Health is seeking feedback and consultation with Vendors on what options would suit their needs for consumption of the PBS data to help transition use to XML. Vendors can email preferences and ideas to PharmCIS Support, to the PBS webmaster or via the discussion board.
  • Vendors commented that PBS is not the only data being consumed into Vendor’s systems and it is unfair to simply cut the text files off. When V3 is implemented and has a firm start date, Vendors will then work towards their transition.
  • The XML is the single source of truth. Allette take the XML and process it for downstream clients.
  • Explanation of how the PharmCIS database works (white board drawing)

PharmCIS drawing

Temporal Data -

  • Provides a way of representing data over time. History going back one change will be captured as a hybrid design of active data.
  • Potential changes to prescribing rules – for further discussion later in the day.
  • Space and complexity is the driving force that determines how far back the history goes.
  • The working group can determine the size ie if the history goes back 12 months.

Restrictions –

  • Separate restriction code from streamlined authority code.
  • Separate legal text from informational text.
  • Max Quantity is tied to Prescriber types. PR has a maximum quantity. Can have multiple benefit types.
  • Currently PBS authority items are obtained over the phone and generic questions are derived from the XML.
  • The questions / statements will be derived from the text within the restriction and put onto the website.
  • Render the XML to construct the authority statements. Identify tests and results and what values it should be. Ultimate goal would be to automatically populate the record using SnoMED.

Agenda Item 4 - AMT v3

  • Has been in progress since June 2014.
  • Planning to be released to Production in December for use with the data in Feb 2016 Schedule.
  • Currently at phase 0; additions to the V2 mapping.
    • Post May 2014 has a 1 to 1 relationship with V2 / V3 data directly aligning.
    • Pre May 2014 is more difficult and more time consuming
  • Big difference between V2 and V3 is the treatment of multi components and the V3 non AMT PBS concept.
  • Reconciliation process is a manual one which will be done by a Pharmacist.
  • AMT data is one month behind. Nehta acknowledge this and are working on the delayed timing.
  • PBAC Guidelines have changed to collect AMT Id. Submissions to PBS with AMT terms must be included in the submission. A user must ring Nehta to obtain the AMT identifier then submit the submission.
  • AMT content will be included in SnoMED content as part of the National Australian SnoMED Release.

Agenda Item 5  - FHIR Initiative

  • National Clinical Terminology Service (NCTS)
    • First announced @ HIC
    • Complex terminologies
    • Rules for handling code systems
    • Release cycles
  • HL7 - Fast Health Care Interoperability Resource (FHIR)
    • Use case specific sets of codes matching and definition
  • LINGO – Nehta’s authoring maintenance and release tool.

Agenda Item 6 - 6CPA Changes

  • Thank you to John Green for your collaboration.
  • Two-tiered Chemotherapy Compounding Fees
  • $60 fee for infusions by TGA-licensed compounders
  • $40 fee for infusions by non-TGA licensed compounders.
  • PBS Online Schema Change;
    • Compounding Code (required field for EFC chemotherapy claims)
    • Infusion ID for each line item within an infusion (which may include non-chemotherapeutic agents).
  • Direct payment of compounding fees to compounders goes live 1 April 2016
  • Until then, $40 per infusible EFC item will be paid as part of PBS Online claim.  Manual $20 top-up to TGA licensed compounders via external payment agency.
  • From 1 April 2016, the $40 compounding fee will be removed from the Commonwealth dispensed price.
  • Infusion has been taken to mean a number of things; sellable item or a single infusible item.
  • Claiming EFC Drugs: I EFC = 1 claim. Each drug goes into the system as 1 ID. There is no definition between a combo of drugs or an individual drug.
  • Vendor comments to be directed via John Green.

Agenda Item 7 - Post Market Authority View

  • PBAC Recommendation for Streamlined Authority.
  • Motivation is to reduce red tape for prescribers.
  • It depends on how PBAC add the listing as to whether or not there will be repeats on the Authority.
  • How do prescribers define between the initial repeat and the streamline? The same issue occurs with CAR Items and needs to be considered very seriously.
  • Health to find out why the PBS Item Code can’t be printed on the script.
  • If there is a break in therapy the process will start all over again.
  • Pharmacy will not be checking the authority the prescriber will run the check.
  • Emergency provisions will remain as current provisions.
  • Must have 2 PBS codes as 1 item code two restriction levels is not permitted in the system.
  • Hospital Access – S100 Harmonisation has an Implementation date of 1 April 2016.
  • Can any Community Pharmacy dispense to HS. Health to look into this.
  • Either option has impact on Software.

Agenda Item 8 - PBS XML Schema 2.11

  • Thankyou for working to get the budget measures in place.
  • AHI is in the September 2015 Schedule.
  • The offset and variable fields will always populate amounts explicitly.
  • Steve to check up on Mark Up bands for Private Hospital dispensing rule.

Agenda Item 9 - PBS XML Schema version 2.12

  • Has an implementation date of 1 January 2016 and will be release to production late November.
  • Hospitals may discount up to the entire co-payment.
  • If the amount the patient paid is not equal to $37.70 less discount the claim is rejected.
  • Vendors are keen to have testing done by 1 December.
  • Health to create test data with the changes injected and distribute to vendors. Coordinate with DHS to load data into the test environment to be available late October.

Agenda Item 10 - Other Business

  • Reissuing of schedules creates delays in testing timeframes. Vendors are always grateful to have a heads up on delays.
  • John Green gave praise / thanks for the Tier 2 arrangement solution.
  • Roadmap for alpha releases documented on the Dev website more generally available.

Meeting Close 4.22 pm

Summary of action items from this meeting

Action Item

Agenda Item

Action

Member(s) responsible

1

Meeting March 2015

6 - AMT v3

Health to investigate whether non-AMT concepts should be kept explicitly separate from AMT concepts using the scheme attribute or remove the code and will produce test data for comment.

Health

2

Meeting March 2015

8 – Other business

Health to investigate whether restrictions on extemporaneous preparations are still required.

Health

3

4 – AMT v3

Map Drug Tariffs to AMT Substances.

Health

4

4 – AMT v3

Map V2 control vocabularies to V3 terminology concepts.

Health

5

7 – Post Market Authority Review

Health to find out why the PBS Item Code can’t be printed on the script.

Health

6

7 – Post Market Authority Review

Can any Community Pharmacy dispense to HS.

Health

7

8 – PBS XML schema 2.11

Health to check Mark Up Bands for Private Hospital dispensing rule.

Health

8

9 – PBS XML schema 2.12

Health to create xml 2.12 schema test data with the changes injected and distribute to vendors. Coordinate with DHS to load data into the test environment to be available late October.

Health