E-health and minimising script harms

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A group of experts are calling for clear legal principles around how a duty of care looks in the age of electronic records

Dr Jennifer Stevens, Anaesthetist at St Vincent’s Hospital, and Matthew McCrone, Director of Real Time Prescription Monitoring Implementation at the Victorian Department of Health and Human Services, recently attended an event on reducing harms hosted by MinterEllison and ScriptWise.

The event aimed to examine effective ways that hospitals, health services and primary health care services can reduce growing harms from prescription medicines.

The organisers point out that more people in Victoria have lost their lives from the use of prescription medicines than from the road toll for five years in a row.

“We are hearing increasing calls for action from professional bodies, coroners and not-for-profit organisations involved in supporting families and individuals affected by the harms from prescription drugs,” said Dr Stevens.

“There is growing recognition of the harms caused by high-risk prescription medicines, and we need to be innovative about solutions.”

Bee Mohamed Ismail (Scriptwise), Noelia Boscana (MinterEllison), Matthew McCrone (DHHS), Jennifer Stevens (St Vincents), Shane Evans (MinterEllison), Jonathan Kelp (MinterEllison).
Bee Mohamed Ismail (Scriptwise), Noelia Boscana (MinterEllison), Matthew McCrone (DHHS), Jennifer Stevens (St Vincents), Shane Evans (MinterEllison), Jonathan Kelp (MinterEllison).

The stakeholders said that electronic records and prescription monitoring can enable effective ways to help health professionals prevent dependence in the first place, and treat patients already at risk.

Dr Stevens outlined the success her program at St Vincent’s has had in reducing opioid prescribing by junior doctors: the program has reduced the level of opioid prescribing at the hospital by 62%.

She said that the most effective way to change behaviour was to show doctors their rate of prescribing in comparison to the prescribing of their peers, as well as to the guidelines.

She also noted that the use of prescription monitoring software raises questions about the right to access patients’ medical information, as well as protection of their information.

“There are lots of privacy concerns that will need a legal lens to ensure all prescribers and dispensers have confidence in a system,” said Dr Stevens.

“From a legal standpoint, we need to support clarity on the changes and expectations in a monitoring system.”

The experts all want clarification on how duty of care looks in the age of big data and electronic records.

“We need legal frameworks and principles to carry innovative solutions forward,” said Dr Stevens.

“There are regulatory obligations – but the more challenging concepts are the professional obligations and behavioural changes, and that’s where legal advisors can help.

“Everyone wants to do the right thing, but we need the data and the legal framework to support this.”

Matthew McCrone updated attendees on the status of SafeScript, Victoria’s real-time prescription monitoring system.

SafeScript will provide prescribers and pharmacists with access to their patients’ prescription records for high-risk medicines, during a consultation, to enable safer clinical decisions. The implementation of the system is scheduled to start later this year.

“SafeScript will be quick, easy-to-use and custom-built to meet the needs of Victorian clinicians,” said Mr McCrone.

ScriptWise CEO Bee Mohamed Ismail said that the use of SafeScript will also start life-saving conversations between clinicians and their patients.

“Unfortunately the stigma around dependence and addiction issues means that people often find it difficult to speak up if they’re concerned about their medication use,” she said.

“Health professionals can help to assure their patients that they are not alone, and that effective treatments are available.”

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