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22 October 2018

Peter Crothers’ day can change minute by minute. He’s a pharmacist working in the outback community of Bourke, in far western New South Wales. The nature of his job means he can quickly go from an empty shop to having nine people who all need attention at once – some with serious issues.

“Pharmacies don’t operate on an appointment system. We’re more like emergency departments in hospitals – people just come in and we have to deal with them,” Peter says. “It can be stressful and we’re often under time pressure. But the thing we most often feel stressed about is not having enough information.”

Pharmacists are the most accessible healthcare professionals. It’s a particularly special role in Bourke, which has about 2,600 locals and lies 800 kilometres from Sydney.

The township has a mixed demographic, with a large public service component and an important pastoral industry. Bourke also has a significant indigenous community, making up about 32 per cent of its population. From a health perspective, this makes Bourke diverse needs – high and low income, varying degrees of health literacy, local and remote communities.

Peter might be recommending a medication one minute, then helping emergency workers understand what prescriptions a patient is taking the next. He recently dealt with a vulnerable patient, who had low education and health literacy, who incorrectly assumed that each new doctor she saw was up to date on her medical history.

“Her medications were in chaos,” he says. “She was using different combinations of medicines that had been prescribed by different GPs or medical specialists and dispensed by different pharmacies. She was terribly sick. We worked very hard to rationalise everything but it was extremely difficult.”

Peter says that a centralised digital system would have vastly improved her medication management. That’s why he’s so excited about My Health Record.

“There isn’t a single day that goes by where I’m not on the phone to a doctor trying to cover some gap in our knowledge of a patient,” he says. “We sometimes make an important save but we don’t know what we don’t know. We don’t know if there’s other information that we’ve missed.”

A key role in community healthcare

Peter grew up in Bourke. It was realising the important role pharmacy plays in an outback community that brought him back to the town.

“The thing I like most about Bourke is that it knows what its problems are, and it knows how to deal with them,” he says.

One of these challenges is its remote population. Bourke has a postcode the size of Denmark or Taiwan, and includes people who live up to 300 kilometres away from the town centre. They rely on a revolving door of locum doctors for their health needs, as well as specialists in Sydney or Dubbo when conditions are more serious.

“Those people are at greater risk just because of their distance from care,” Peter says. “They’re going to benefit a great deal from having a digital medical record.”

As a major rural town, Bourke also attracts lots of tourists and is particularly popular with retired Australians travelling across the country. Many of these older people have chronic health issues to manage.

“It surprises me how often they’ll have no idea of their own medical record,” Peter says. “They’ll ask for pain relief and tell me they have no problems when I ask about risk factors. Then when you ask about medications, they’re using six or seven different ones.

“With a pharmacist’s eye you quickly realise this person’s got a serious heart condition. Prescribing certain forms of pain relief would increase the risk of complications.”

This is the crux of why Peter believes My Health Record will make a real difference. Instead of wondering how many times they’ve missed important information, pharmacists will have more certainty. They’ll be able to see exactly what’s going on, make a much better risk assessment and provide expert advice.

“My Health record is going to be really helpful in those situations,” he says. “It has the capacity to transform the way we work. It will help us do a better job and, on occasion, it’s going to save lives.”