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- Issue 81: April 2009
- Issue 80: March 2009
- Issue 79: February 2009
- Issue 78: December 2008
- Issue 77: November 2008
- Issue 76: October 2008
- Issue 75: September 2008
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- Issue 73: July 2008
- Issue 72: June 2008

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Numbers and Computer Systems.

Terry Irvine
Community Pharmacist Perspective

Issue 78: December 2008
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During the week we had a new patient visit our pharmacy, a young lady who had travelled for an hour or so, passing a number of doctors along the way to visit a doctor 25Km from us. 
She chose to call in to our pharmacy on her way back home, requesting we dispense three items, benzodiazepines and some paracetamol and codeine. 
She had her pension card, the Medicare number was on the prescription. 
When she was asked to pay for the medication she declared they should be free as she had “that other number” that allowed her to get free medicine, and she thought that somehow that entitlement was associated with her pension number and therefore we should know it. 
Without giving us the opportunity to enquire of another pharmacy as to her Safety Net number, she demanded the return of her prescription, and dashed off the some other pharmacy, presumably in possession of her “other number”.

This set me thinking of the service we receive with PBS on-line (PBSOL), and the complexity of numbers in the lives of every citizen, and in particular those with a relationship with Centrelink.

From birth we have a Medicare number, although it can change completely or have a subtle change each time a new card is issued.

If we somehow are granted a Centrelink number, the number stays with us for life, unchanging, immutable, everlasting.
Even if the benefits are sometimes withdrawn, when granted again the old number returns, probably through a number of address channges.

If we serve in one of the services we have another number, and so it goes on, the system seems to go out of its way to allocate new numbers for everything we have, telephones (one number, dial the number, the system finds us at home or work or mobile – that would be nice), credit cards, insurance policies, drivers licenses, passports, and so on.

But it is with the PBS that pharmacists have the most challenges.

It is a great system that allows the government to put money in our bank accounts every week, even if reconciling the payments and ensuring that none have been denied for some bureaucratic whim is daunting.
The incorrect recording of a prescribers number, a date, an authority number, or an item code number will give them an excuse not to pay – sometimes for a while – sometimes for ever!

PBSOL will even tell you if a patient no longer has a Centrelink entitlement – why does it not tell you they do have an entitlement when you have correctly entered their Medicare number?

Why does the patient, with the cooperation of their pharmacies, have to monitor the total value, or number, of their prescriptions for the year, when PBSOL must be able to calculate when the Safety Net threshold has been reached, and automatically attach this information to all the relevant Medicare numbers? 
If a Safety Net claim is made for a Dependant Child, Medicare knows the age of the child and refuses the claim until a change has been made to Dependant Student. 
They probably know, or can ascertain that a child is an enrolled student anyhow.

I have asked Medicare, but received no reply, why the narcotic prescription information is not electronically passed to the appropriate State monitoring authority. 
I should ask why there is not a National Data Base of narcotic prescription usage.  Communities that exist on state borders must be havens for people who excessively use, or divert, narcotics.

Wouldn’t it be nice if when we were born, or arrived as permanent residents of this country, we were issued with a number, just one number?
From then on all the entitlements, permissions, and facilities we had were linked to that number?

Will I live long enough to see it happen?
Perhaps Santa will bring us such a number, even if not may everyone have a Merry Christmas and a less numeric challenged New Year, except for prosperity.


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