Digital first

Andrew Matthews MPS is the Australian Digital Health Agency’s Director of Medicines Safety. In that role, he hopes to ensure pharmacists are fundamental to healthcare’s digital future.

With a career including hospital and community pharmacy, academia, industry executive positions and now government, what has been most personally rewarding?

Pharmacy continues to provide a broad range of opportunities as a career, beyond what would typically be recognised as ‘pharmacy’. This is reflected not only in the variety of roles I have undertaken, but in the diversity of jobs that many pharmacists now are appointed to.

Despite training for a specific vocation, pharmacy provides a solid foundation in core sciences and problem solving that is adaptable to many different roles. No matter what the role, it’s the opportunity to make a difference that is personally rewarding. This may be directly to one patient or indirectly, for example, through the impact of a national program.

How challenging was it to move into government and the digital space?

Very challenging! It’s a whole new world of terminology and acronyms and job titles. I’ve been grateful for the initial confidence in me from my employer. They reassured me that I wasn’t appointed for my technical skills in digital technology. That’s why we have a team of technical experts such as solution architects and business analysts. What I first brought to the agency was an extensive network of connections and a solid awareness of medicines safety principles and an understanding of the health system and pharmacy industry.

What are the major ways that digital healthcare can benefit medicines safety?

Digital healthcare in medicines safety is about health professionals having better medicines information for their patients and about their patients, at the point of care. We know that transitions between episodes of care are prone to error and are times of risk. The absence of complete and up-to-date medicines data can contribute to instances of care becoming high risk, resulting in medicine misadventures and unnecessary hospital re-admissions.

From a software perspective, this digital information needs to be seamlessly integrated into workflows and to provide efficiencies, not extra steps and processes.

How will My Health Record and other digital transformations change healthcare in the coming years?

As of March 2020, there were nearly 122 million medicine documents uploaded into My Health Record. The agency received good-use cases of its functionality during the bushfire disasters this year. Pharmacists were able to source medicines information of patients who had lost their scripts (and may not have been a regular customer of that pharmacy) and supported emergency medicine supply and continuity of care in a safe and legal fashion.

The first legal electronic prescription in primary care was prescribed and dispensed on 6 May 2020. For our electronic prescribing work and the introduction of electronic prescriptions, it is more about what this digital future will enable: enhanced patient convenience, reducing administrative burdens for healthcare providers and organisations, new models for prescribing and script access (e.g. through telehealth and remote script provision) and innovative apps and software functionality.

Real-time prescription monitoring is already having an impact. Tasmania has had a clinician view of clinical information and dispensing data about Schedule 8 drugs since 2011. Data shows a shift in Tasmania’s per capita death rate from prescription opioids from about 30% above the national average (from 2002–2006) to about 27% below the national average (from 2012–2016). Similar benefits have  followed the implementation of SafeScript in Victoria.

And the future of digital healthcare?

I want us to overcome fragmentation of data across organisational silos. I see My Health Record becoming more intrinsic to daily pharmacist and medical practice as a source of clinical information. More broadly, I see greater interoperability across systems with consistency in standards and terminology.