Chief Pharmacist of Western Australia, Neil Keen, walks through the process of ePrescribing for doctors and their patients.
Electronic prescribing refers to the use of wholly electronic means to prescribe and dispense medicines. The legal prescription only exists in electronic form and there is no paper-based prescription.
Any paper involved is for patient access purposes only, rather than having any legal standing.
When using electronic prescribing, medical practitioners will not need to print or sign paper prescriptions. Similarly, pharmacists will not need to handle or store paper prescriptions.
Electronic prescribing is expected to increase efficiency for health practitioners and reduce administrative burden. There will also be increased convenience and choice for health consumers.
Using approved systems, prescriptions and patient information will remain private and secure. Advantages include efficiencies in areas such as aged care facilities, telehealth services and a potential reduction in prescribing and dispensing errors.
The Australian model will make use of clinical systems already in place – the fundamental processes for prescribing and dispensing will not change.
Existing medical practice systems will act as the Prescribing System, generating prescription information that can then be sent to a Prescription Delivery Service, where it will be securely held.
The Prescribing System will also generate a ‘token’, provided to the patient or carer in the form of a unique QR barcode sent via email or SMS.
This token is unique to a specific prescription, medicine and instance of supply. The patient or carer will be required to present the token to the pharmacy to dispense the medicine. In future stages of electronic prescribing, an Active Script List Registry will be available for patients as an alternative to the use of tokens.
An electronic prescription will be able to be dispensed at any pharmacy that has an approved Dispense System. Using the token, the pharmacy Dispense System will connect to an approved Prescription Delivery Service via a prescription exchange service. The medicine will be dispensed based on the electronic data supplied by the Delivery Service.
The token is not reusable. If there are repeat supplies ordered by the prescriber on the prescription, a new token will be issued by the pharmacy. The repeat token can be used at the same pharmacy or taken to another pharmacy participating in electronic prescribing.
All system components of the prescribing and dispensing process require approval. Prescribing, Dispensing and Delivery systems are currently undergoing required changes and seeking approval according to conformance requirements issued by the Australian Digital Health Agency (ADHA).
To obtain necessary commonwealth and state and territory approvals these systems must first be registered on the Electronic Prescribing Register of Conformance.
Paper prescriptions will remain valid and continue to exist alongside electronic prescribing for the foreseeable future.
A prescription must be in either paper or electronic form, but cannot be both. Paper and electronic prescriptions are not interchangeable and cannot be converted from one form to another.
The decision to use a paper or electronic prescription must be made at the point of prescribing and will depend on patient preference and preparedness, as well as the participation of the patient’s preferred pharmacy.
Electronic prescriptions will be valid for both Pharmaceutical Benefits Scheme (PBS) and private prescriptions. Electronic prescriptions are required to contain all the usual information held in a paper prescription. Other normal requirements of prescriptions remain in place, for example, prescriptions continue to be valid for 12 months from the date of creation.
Electronic prescribing capability is being progressively rolled out in Australia, with a number of approved systems in advance trials.
For more information on the approval status of a system, anticipated start dates or to register interest in an advance trial, medical practices and pharmacies should contact their own software provider in the first instance. General information is available from the ADHA.
To prepare for electronic prescribing, practices need to address requirements for a Healthcare Provider Identifier-Organisation (HPI-O) and connect to an open Prescription Delivery Service, via a prescription exchange service.
It is also recommended that practices ensure their patient and carer mobile phone and email contact details are updated and correct.