National e-prescribing imminent

48653728 - young female pharmacist talking to a customer at the counter pleasantly.

Token model to go live outside of communities of interest in August, ADHA confirms, while Active Scripts List will roll out across the country in October

E-prescribing is coming to Australia, but what exactly does this mean for consumers?

The Consumers Health Forum (CHF) hosted a webinar on Thursday with experts from the Australian Digital Health Agency (ADHA) and other speakers to discuss the e-prescribing model, the current roll-out plan, privacy concerns and the importance of patient choice.

Andrew Matthews, director of the medicines safety program at the ADHA, explained that the agency decided to test e-prescribing through communities of interest first to make sure the system works smoothly before rolling out nationally.

Only the token model for electronic prescribing is currently being tested using the electronic prescribing communities of interest. The Active Script List (ASL) model is to be included in communities of interest from August 2020.

“It’s a big change in the way consumers manage their scripts and it’s going to take time,” said Mr Matthews.

“Let’s remember that the acceleration of e-prescribing came under the COVID-19 National Health Plan,” he said, adding that the system would otherwise have taken another six months to prepare.

“The Government felt it was an important and safer opportunity rather than image-based medicines supply that is very much an interim arrangement that is happening now.

“It has been accelerated and that’s why we have gone with the token model first up.

“It is very early days and like with any electronic technology, some people will take time, there will be some people who jump on board straight away, some who will sit on the fence for a while and some who will take their time to see us.

“That’s why it’s got to be a slow and steady approach.”

Mr Matthews confirmed that e-prescribing should be going live further outside of communities of interest in August, with token model availability from this time and Active Scripts Lists (ASL) to become available from October.

However while most states and territories have made legislative changes to recognise the electronic form of prescriptions, some have been lagging behind.

For example, South Australia only gazetted their changes on 18 June.

The final state to make the changes, Queensland, is “a week or two away” said Mr Matthews.

There is a specific legal instrument that needs to be put into place. At that time, each state and territory will be enabled legally for electronic prescriptions.

Nicola Graham, provider adoption lead at the ADHA, said accessibility from August will also depend on whether each pharmacy has been set up to provide e-scripts.

“A patient should also contact their pharmacy to see if they’re electronic prescription ready, or ask the doctor’s receptionist if they can check with your pharmacy to see if they can receive your prescription. If they are not enabled for e-scripts, they will not be able to process your e-script. You will need a paper script.”

Webinar facilitator, CHF Policy Director Jo Root, said once patients start coming into pharmacies with tokens in August, pharmacists will be “at the cutting edge”.

Lily Pham, professional support officer in the electronic prescribing unit at the PSA, said pharmacists can expect to experience positive changes around administration time in regards to processing prescriptions.

“Hopefully with the electronic prescriptions we’re more able to streamline processes and spend more time with patients as well,” said Ms Pham, who is an early career hospital and community pharmacist based in NSW.

“I think my team at the PSA is doing a great job so far, what we’re doing is really engaging with pharmacies in the community to get on board with the communities of interest and really push the whole process forward. That’s really vital, getting all of that community awareness up and coming. Hopefully if we keep doing what we’re doing, things will start rolling ahead.

“Currently where we’re at is a little bit confusing at the moment because we’re transitioning through the conformance software and the systems,” said Ms Pham.

pharmacist holding script, medicine
“Remember it will always be the patient choice, so if you prefer you can still receive the paper prescription.”—Nicola Graham, ADHA.

“But once we go through all of that it’s really important for the patient to have the choice between paper and electronic. There are patient groups out there who feel more comfortable with paper, I don’t necessarily think [handwritten scripts] are going to go away but this is one more way that patients can access their scripts.”

Ms Graham emphasised that patients will have choice.

“Remember it will always be the patient choice, so if you prefer you can still receive the paper prescription,” she said.

“A patient will be able to choose whether to have an electronic prescription token or a paper prescription, but you will not be able to have both. And if you already have an existing paper prescription, you will not be able to convert that to an electronic prescription.”

Ms Graham added that the ASL model “will really be the better solution for those patients that are on multiple medications”.

While tokens for one-off medicine will be practicable, if a patient provides consent to any provider, for example multiple pharmacies or GPs, those health professionals can access a patient’s ASL, said Mr Matthews.

Monique Mackrill, Tasmanian Branch Director at Pharmacy Guild of Australia, who attended the webinar, commented that the Guild is “committed to e-prescribing”.

“The tokens will be fine for people who aren’t on multiple medications. GPs can still print the information with a token on it and a patient can simply give that information to their chosen pharmacy,” she said.

“Pharmacies are actively taking steps to ensure that their pharmacies are ready for e-prescribing and also cognisant in regional areas with people travelling that this is very important.

“Pharmacists are also advocating for continued dispensing for those people who don’t have a prescription of their regular medication (they may have not been able to get to their GP) but can still get a one-month supply of their regular medication in the event of not being able to get into a GP or for some reason that pharmacies are not yet set up.”

Note: This article has been corrected. It is South Australia that gazetted their changes on 18 June, not the Northern Territory as originally reported.

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