Discussing the E-script change

The introduction of electronic prescriptions has meant a big change in the way medications are dispensed, but in general this has been “pretty positive”, says pharmacist Joshua Lee

The new system at present means patients can come in with a QR code on their phone – which has been sent to them by their prescribing doctor – which has all the details of the prescription which are downloaded in the pharmacy and then the medications are dispensed.

After a very small amount of training and minor changes to dispensary workflow it has been a seamless transition with little disruption to our daily routines.

One of the great advantages of the electronic prescribing system is that it does away with hand-written prescriptions which have always added scope for prescribing and dispensing errors. The reality is that at times the hand writing has been pretty bad but we have always checked with the prescribing doctor when that happens, the problem being that prescribers are difficult to speak to at the best of times.

In addition, the new system is much faster that the paper-based system in specific circumstances. For example, for scripts known as Schedule 8 drugs which have to be sent away to the Department of Health for approval the paper-based prescription method meant patients could wait two to three weeks for that approval to come through.

We have had cases where the approval has come through in just a few hours which aids in medication compliance and reduces the need to contact prescribers to provide medications in the interim.

Of course a major change like this doesn’t happen without some problems surfacing apart from the increased reliance on technology, which we can almost guarantee to fail at the most crucial time.

We have found that patients are unsure of what the QR code prescription is all about. Doctors are able to push a button and the prescription appears on the patient’s phone but they often don’t have time to explain how it all works.

It would be great if the Government had a campaign that explained to patients what it was all about. Doctors don’t have the time or resources to do this so patients are turning to us as there is still a lot of confusion as to what the whole new system is all about, what it means and how it works and assurance that it’s an add-on, not a replacement for the old scripts.

We take time to explain to our patients but it is interesting that there is still quite a bit of suspicion about e-scripts, paired with the confusion and fear of new technology. Some patients need a bit of reassurance that it’s fine and that it’s not that hard to use.

We are constantly warned to beware of scams and spam and I think this is triggering the defence mechanism in many people.  A lot of them are asking us to print out the prescription from the QR code and keep it on file in the pharmacy which is sort of reverting to the paper-based system of old.

They are basically defaulting to paper partially out of suspicion and partially because it is easier for the patient for the pharmacy to keep and manage their scripts.

The need for education

A national campaign educating all Australians about what the system is and the benefits of it would be a really sensible approach. We are finding a lot of older people are having some difficulty coping with it but we are helping them through any problems they are having.

We also see problems with this system; in its current form dispensing scripts for patients with chronic disease states and multiple medications, the e-script system is actually a fair bit slower than the current paper-based system due to the extra steps involved in processing and checking prescriptions.

It is also more difficult to find and present scripts on the patient’s end as they are sent to their phone in a sea of messages in a single message thread with comparatively little indication of what link relates to what script. We are very excited to see how the second version of e-prescriptions improves upon this version.

It is an exciting and also challenging time for all of us but one which has the potential to change the landscape of how we are presented prescriptions.

Joshua Lee is Pharmacist in Charge at Armidale Life Pharmacy in NSW

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