Privacy and workflow concerns are issues for pharmacists to consider when it comes to electronic prescribing, PDL says in an alert to its members
The roll-out of electronic prescribing is gaining momentum around Australia as most pharmacies now have capability for dispensing electronic prescriptions.
PDL advises that dispensing ePrescriptions is covered under the PDL Master Policy as these prescriptions are treated by the Policy in a similar manner to paper prescriptions. At this time, PDL has not seen an increase in errors associated with ePrescriptions.
However, the PDL Professional Officers remind pharmacists to be aware of areas that require vigilance.
Changes to workflow
Any change or interruption to normal prescription workflow may lead to errors so the introduction of ePrescription processing should be carefully considered.
Extra monitors or devices will be necessary for efficient workflow, especially for unimpeded checking of the dispensed item against the electronic version of the prescription.
The checking of prescriptions awaiting collection is an aspect of the supply process that needs to be considered. Presently, medicines awaiting collection are usually placed in a basket along with the paper prescription so a pharmacist can double check and counsel before handing out the medication.
Without a hard copy to refer to, an easily accessible monitor or screen should be available to check the dispensed medicines against the electronic version of the prescription.
The patient’s details as they appear on a paper prescription will not be available to confirm the patient’s identity so other steps must be taken to ensure the medicine is supplied to the correct patient.
The following extract from a recent incident report demonstrates how changes to workflow need to be managed in a different manner.
The patient presented an ePrescription for Palexia SR 50mg, quantity of 20 tablets.
The pharmacist stated “I believe I may have given a full box (28 tablets). Just not used to the process of checking ePrescriptions.
“I would usually take the S8 duplicate to file and refer to this when retrieving the medicine from the safe, however there is no such ability with e-scripts as there is no duplicate to file”.
ePrescriptions for S8 medicines are valid and do not require a handwritten component. Other requirements to validate a prescription still apply, including checking Real Time Monitoring systems in States where this is mandated.
Paper and ePrescriptions are not interchangeable, the format remains the same as the original prescription for the life of that prescription.
Check your State legislation and Health Department websites to ensure you understand the integration of ePrescriptions into local regulations.
Never assume that all data has been accurately transferred as there may be instances where a portion of the E-script isn’t correctly transcribed into the dispensing program. Always check the dispensed item against the ePrescription before supply.
Application of clinical considerations to ensure the medicine is safe and appropriate for the patient still applies. If a pharmacist is not comfortable dispensing an item, discuss these concerns with the prescriber and patient.
Absence of a paper prescription could lead to situations where pharmacists or assistants may inadvertently breach privacy or confidentiality. Always consider maintaining a patient’s privacy.
Consent will be required for access to a patient’s Active Script List (when available, likely in early 2021) and consideration may be needed in cases of consent for partners or children.
There may be occasions when a token needs to be sent to the pharmacy for downloading on the pharmacy’s device. It is preferred to have a corporate text number to receive these tokens rather than a personal device.
Extraction of an ePrescription from the Prescription Exchange Service (PES) requires permission via a pharmacist’s HPI-I. Pharmacists should not allow others to have access to their individual login details or password.
The following list of resources can help you implement electronic prescriptions in your pharmacy.
For immediate advice and incident support, members can call PDL on 1300 854 838 to speak with a Professional Officers. PDL is there to support its pharmacist members 24/7, Australia-wide.