‘Just not used to the process of checking ePrescriptions.’


pharmacist with tablet in store

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.

 

Case study

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”.

 

Considerations

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.

 

Privacy considerations

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.

 

Resources

The following list of resources can help you implement electronic prescriptions in your pharmacy.

Australian Digital Health Agency Electronic Prescriptions webpage

Department of Health Electronic Prescribing webpage

Department of Health Fact Sheet

eRx eprescribing

Medisecure

Agency Digital Health Cyber Security Centre

OAIC website ‘Privacy for health service providers’

OAIC ‘Guide to securing personal information’

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.

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6 Comments

  1. Paul Sapardanis
    28/11/2020

    More work and responsibilities yet the same money? Sounds fair right.

    • TALL POPPY
      29/11/2020

      Mate, Eprescriptions are horrendous! The implementation is second rate and a total embarrassment to the profession. Big $$$ for those behind the scenes I am sure. But i’m not sure how pharmacist professional bodies allowed this to get through.
      It’s actually far more confusing and time-consuming to process an escript plus it opens the way for centralised dispensing (good luck if that happens).
      It’s a bit like the new FRED NXT. I don’t hear anyone on the front-line singing its praises compared to the ‘classic’ version. And it’s plain to see why. What is going on pharmacy profession? Strive for excellence!

      • Paul Sapardanis
        29/11/2020

        Centralized dispensing is probably already occurring ( anecdotal evidence ). Have our professional bodies now turned into business’s that sell us services at our cost? Hope not. Hope their primary role is to still represent us not sell us stuff

      • Andrew
        30/11/2020

        “eRx Exchange is wholly owned by FRED IT”, which in turn is partnered/co-owned by Guild and Telstra who I’m sure you’ll agree have a shocking record of implementing large-scale technology projects. There’s also relationships between Guild and Telstra.

        Someone is making a lot of money from this.

        Would be cool to develop Open Source competition to FRED, any young underemployed pharmacists with coding background interested?

      • Ex-Pharmacist
        01/12/2020

        Give me ‘FRED Classic’ any day! FRED needs you to come back Rod!

  2. Anthony Tassone
    01/12/2020

    As disclosure, the Victorian Branch of the Pharmacy Guild is a part owner of FRED IT, along with its CEO, Paul Naismith and Telstra Health.

    The Pharmacy Guild as a member’s association exists for the purpose of representing and advocating on behalf of its members. That is our purpose for existence and our highest priority over any commercial or other business activities.

    Electronic prescribing has posed challenges for pharmacies, prescribers and patients in adoption, and it’s probably fair to say the biggest change management has been for pharmacies.

    Dispensing systems will continue to adapt and mature to deal with this latest development being electronic prescriptions. There will be benefits and advantages for when the Active Script List (ASL) is deployed into the network, expected early 2021 which will further help patients with multiple and chronic medications manage their prescriptions with their pharmacy of choice.

    in terms of the suggestion by Andrew that the Guild and Telstra ‘have a shocking record of implementing large-scale technology projects’ I would point towards the award winning real-time prescription monitoring system ‘SafeScript’ where the Victorian Department of Health and Human Services were recipients of Australian Information Industry Association iAward in the category of Infrastructure & Platforms Innovation of the Year.

    Besides the co-ownership of FRED IT between Telstra Health and the Victorian Branch of the Pharmacy Guild, the only other relationship with Telstra has been a previous MoU in terms of looking to collaborate in areas of digital and electronic health.

    There are international examples of electronic prescriptions whereby there is less patient choice, a greater risk of channeling from prescriber direct to a pharmacy with much care to mitigate this in the Australian model.

    Anthony Tassone
    President, Pharmacy Guild of Australia (Victoria Branch)

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