Lockdown sees e-script boost

More than 400,000 original electronic scripts have now been created in Australia, driven by rapid uptake in Melbourne and Victoria over the past six weeks

The volume of e-prescriptions being written in the country is “increasing exponentially”, said Andrew Matthews, Director of the Medicines Safety Program at the Australian Digital Health Agency (AHDA), during a webinar hosted by Fred IT Group last week.

“The volume of prescriptions – it was about 26,000 in August, about 170,000 in September, and the growth even in just this first week or so of October has been more than 70,000 in the week,” said Mr Matthews.

Original scripts, not including repeats, have now clocked over 400,000 across the country, he confirmed to AJP on Wednesday. More than 80% of these have been created in the last six weeks alone.

Rapid uptake has been mainly driven by the broad expansion of e-scripts throughout Melbourne and Victoria, he said. E-script capability was expanded across Melbourne in late August, then made available to the rest of Victoria in late September in context of the COVID-19 pandemic.

Over 2800 Australian pharmacies have now dispensed at least one electronic script. In comparison, just five months ago when Fred IT Group ran its first webinar on e-prescribing, there were five pharmacies doing electronic prescriptions, said Fred CEO Paul Naismith.

“Today we know it’s just over half of all pharmacies in the country have done electronic scripts, so it’s an incredible thing,” said Mr Naismith.

“Whilst COVID-19 has had a really dark and dramatic impact on all our lives, it has certainly progressed innovation and thinking about doing things differently,” said Mr Matthews.

“There’s no doubt that the opportunities through telehealth and electronic prescriptions as presented in that fashion has been a really substantial contribution, it was really a lot of the doctor groups that were actually pushing for the rollout, especially across greater Melbourne associated with COVID-19 and the opportunity to do electronic prescriptions provided for the telehealth services.”

On the frontline

Jane Mitchell, co-owner at the 24-hour Ascot Vale Pharmacy in Melbourne, told webinar viewers that her pharmacy was only presented with its first e-script six weeks ago. It wasn’t yet part of a community of interest at the time, but soon they came on board.

“From six weeks ago when we were doing one e-script every couple of days, today we’re probably getting about 30, maybe 40 e-scripts through,” said Ms Mitchell.

“I think it’s just the way of the world at the moment that people are using the pharmacy as an excuse to get out of the house,” she said.

“Most people day and night are bringing their e-scripts in on their phone, and not sending them on through the MedView Patient Connect yet, but I think that will change quite exponentially again in this next couple of weeks when hopefully Melbourne comes out of our hard lockdown and I think patients will change the way they do it. And that’s around us also educating patients about the ways to use the token.

“So yes, you’ve got it on your phone, but you can send it directly to the pharmacy, answer a few questions and it can be ready for when you get here or it can be delivered.”

Jason Bratuskins, owner of Anglesea Pharmacy, Victoria – where the very first e-prescription in all of Australia was dispensed in May – and product manager at Fred IT Group, said he has encountered a broad range of experiences within the pharmacy and with patients regarding e-scripts since that time.

“Since May we’ve come across lots and lots of different experiences … We’ve seen anything with just how easy it can be – where the token is actually the right model for a particular type of patient, where they just get an antibiotic, a one-off item, they walk in, they have the SMS, we scan it, queue it, dispense it, check it and it goes out. Everything just works as it should. We’re seeing a lot of that.

“We’ve also seen the other extreme – with just how hard tokens are. Yes, it’s the only thing we’ve got at the moment, but for particularly for the complicated patient where there’s lots of repeats, again we’ve had the benefit of time, but you can imagine if you’ve got five medications each with five repeats, how do you know where you are? It’s very confusing for some patients, some are okay,” said Mr Bratuskins.

“We’ve seen lost phones, we’ve seen people swap phones, we’ve had broken screens, we’ve had no reception, we’ve had people come in and say, ‘what’s an SMS?’ We’ve had everything.

“But really, it’s moved to just being a normal part of the business now, just as PBS Online did and eRx does today, customers are accepting it, a lot of them – actually the majority of them – are just expecting it.”

What about Active Script List?

Meanwhile viewers were reminded that the Active Script List (ASL) model – or My Script List (MySL) as being built and promoted by eRx and Fred IT and partner MediSecure – is on its way.

“The ASL has always been part of the original design, but the opportunity to go live with electronic prescriptions through the token [model] first up was part of the National COVID-19 Health Plan,” explained Mr Matthews.

“But it’s given us a lot of learnings and given us the opportunity to revisit the solution associated with ASL and certainly pharmacy itself has pushed the ASL model, this is why we’ve got this first release coming out,” he said.

“We look forward to Fred IT and other software providers, especially from a dispense point of view, becoming conformant very soon and rolling out this functionality in this initial release phase.”

Mr Naismith added that MySL will soon become available for all the vendors to use in their software – pharmacies, doctors as well as apps such as MedAdvisor and GuildLink.

He reminded pharmacists of some important features of the ASL / MySL:

  • It’s optional – However it’s very important that you have to have explicit consent from the consumer. “That’s really one of the critical things in the MySL design is to make sure the consumer actively knows that they’ve given you consent to see that list,” said Mr Naismith.
  • It’s free – It doesn’t cost the consumer anything to have a MySL, and also doesn’t cost the health professional to access the MySL. “It’s not an extra cost, it’s one that’s covered by the script exchanges, MediSecure and eRx,” he said.
  • It includes all active original and repeat scripts

However he also emphasised what it isn’t:

  • It isn’t a patient history – “If you want to see that, continue to use My Health Record. It is purely a list of active scripts that are available to be dispensed for that patient anywhere in Australia. I think some people are getting confused about what it is.”

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