PBS-subsidised registered nurse prescribing is set to launch in less than a month, but the medical software industry warns the rollout could leave nurses in the lurch similar to the delayed assignment of benefit changes earlier this year.
Technical roadblocks ahead
From 1 October, registered nurses who have completed extra training will theoretically be able to write authorised prescriptions for Schedule 4 and Schedule 8 medicines. They must work under an active agreement with an authorised health practitioner that outlines their specific roles, the drugs they can prescribe, and the conditions they can treat.
The Medical Software Industry Association (MSIA) convened a meeting with industry representatives, Services Australia, the Australian Digital Health Agency, and the nursing union on 25 August. Just 25 working days remained before the go-live date.
According to the association, more than 70 different questions came up during that session. It was unclear how vendors would identify and validate eligible RN prescribers or enforce restrictions on the medicines they were allowed to write.
MSIA CEO Emma Hossack told The Medical Republic that the situation feels like a game of whack-a-mole. She said questions are answered only to raise new ones, calling it an unsustainable way to deliver policy.
“It’s not a good way to deliver policy,” Hossack said.
Comparison to previous failure
GPs faced a similar crisis in June when it became clear that planned assignment of benefit changes would not be ready on the intended start date. The Department of Health, Disability and Ageing decided to delay those changes by one year, but the announcement came just eight working days before the intended launch.
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Hossack said the current situation for nurse prescribing could be even worse than that previous failure.
“I can’t get a time from industry until I’ve got enough specs for them to go ‘okay, this is what we have to deliver, and this is how long it’ll take’,” she said.
She noted that development and testing are required, and there appear to be significant changes to the business rules and logic for prescribing software that would require conformance testing.
This pattern mirrors earlier IT disasters where policy changes outpaced technical preparation. When agencies fail to provide clear specifications or patterns for developers to follow, the resulting delays are rarely about a lack of willingness to cooperate, but rather an impossible requirement to build without the necessary documentation.
Hossack stressed that the lack of readiness is not due to a lack of enthusiasm or cooperation within the medical software industry.
“The department and agencies … did not advise industry what they needed,” she said. “Well, who would be ready when they still don’t have the pattern to develop to, now [just] days out?”
