Electronic Prescriptions - For Prescribers

 Important reminder: You are still required to adhere to the National Health Act and relevant State or Territory regulations when prescribing and supplying medicines using an electronic prescription. 

Electronic prescriptions will improve medicines safety and provide new options and convenience for patients and their medicine supply. This initiative is a key priority within the National Digital Health Strategy.

The Commonwealth Department of Health (the Department) is leading the work to enable electronic prescriptions in partnership with the Australian Digital Health Agency and Services Australia. The Department is also working with State and Territory governments to ensure electronic prescriptions can be made available across Australia.

Under the National Health Plan for COVID-19, the Australian Government has accelerated the delivery and electronic prescriptions will be introduced in a steady and managed approach from the end of May 2020. The implementation of electronic prescriptions will help protect people most at-risk from COVID-19.

Different forms of Prescriptions

Electronic prescriptions will not be mandatory; patients will have a choice to receive either an electronic or a paper prescription from their prescriber (but not both). Electronic prescriptions will continue to support a patient’s right to choose their prescriber and pharmacy to supply their medicines.

Both electronic and paper prescriptions will need to comply with the relevant Commonwealth and State and Territory legislation requirements.

To generate an electronic prescription, you will need the capability built into your clinical information system. For more information, please see How to prepare your practice for electronic prescriptions on this page, and contact your software provider directly.

Two models for Electronic Prescriptions

There will be two models available to support electronic prescriptions, which include the Token Model and the Active Script List Model. Electronic prescriptions will be introduced in a steady and managed approach from the end of May via electronic prescribing communities of interest. Only the Token Model will be available initially, with progressive roll-out to include the Active Script List Model expected to be available from the end of September 2020.

Token Model: The solution for the delivery of electronic prescribing has been accelerated and will be progressively available from the end of May 2020 and will see a unique QR barcode known as a ‘token’ sent via an app (if your patient has one), SMS or email.

A token is not a legal prescription, but it can be used by an authorised pharmacy to unlock the legal prescription.

Ensure your practice is connected to a Prescription Delivery Service through a Prescription Exchange Service (eRx or MediSecure) so you can access and dispense your patient’s Electronic Prescriptions.

Active Script List Model: By the end of this year, more functionality will be available in addition to the token.

Under this model pharmacists will be able to access a patient’s electronic prescription by retrieving it from an Active Script List (ASL). The patient must prove their identity to the pharmacist.

The ASL is expected to overcome the issue of lost tokens and assist medication management and adherence, especially for patients who are using multiple medicines.

Benefits of Electronic Prescribing

Benefits of electronic prescribing extend to the patient, healthcare provider and more broadly at a system level. These include:

  • Reducing administrative burden for healthcare providers and organisations (e.g. more effective management of prescription refill requests).
  • Supplementing delivery of telehealth services to ensure continuity of patient care.
  • Providing an opportunity to protect community members and healthcare providers from exposure to infectious diseases (e.g. COVID-19).
  • Maintaining patient privacy and integrity of personal information.

How to prepare your practice for Electronic Prescriptions

  • Ensure your practice has a Healthcare Provider Identifier-Organisation (HPI-O) and is connected to the HI service. This is a core requirement for electronic prescribing. Information about how to register your organisation for a HPI-O is available here.
  • Ensure your practice is connected to an open Prescription Delivery Service via a prescription exchange service. Existing prescription exchange services include eRx and MediSecure.
  • Update your patients’ and their carers’ contact details on file (mobile phone number / email).
  • Subscribe to your software provider newsletters and correspondence
  • Stay up to date with communication from clinical peak organisations
  • Check to ensure you know any legal rules that are specific to your state or territory such as the management of controlled medicines.
  • Keep your staff informed about electronic prescribing and how they may respond to patient’s questions about electronic prescriptions.

Resources

Frequently Asked Questions (FAQs)

Q: Are there different State and Territory regulations for electronic prescriptions?

The same regulations for prescribing and supplying medicines exist for both paper and electronic prescriptions. Clinicians are required to adhere to the National Health Act and relevant State or Territory regulations when prescribing and supplying medicines using an electronic prescription. This is particularly important for controlled medicines. Please contact your relevant jurisdiction for more information.

Q: Does a patient on multiple medications needs multiple tokens?

Yes, the token model allows for only one token to be issued per medication.

Q: Are there safeguards to prevent patients using their token at multiple pharmacies?

The token itself is not the prescription, however it is an evidence of a prescription. Once the token is scanned and used by a pharmacy to dispense the medicine, it is invalid and cannot be reused. The Prescription Delivery Service (PDS) will lock a script as soon as it is accessed, so no other pharmacy can dispense it at the same time.

Q: Where do I send the token?

The token can be sent to the patient via SMS or email address which the prescriber can validate at the time of generating the prescription.

Q: Does the patient have to get all repeats from the original pharmacy or can they take their token to different pharmacies?

The patient will always have a choice to get their next repeat dispensed at a different pharmacy and present the new token.

Q: Are repeats accessed from the original token?

If a patient has repeats on a prescription, the pharmacy will send them a new token for their next repeat. The patient will need to give the new token to the pharmacist when it is time to get their medicine.

Q: Can carers with smart phones receive the prescription token on behalf of the person they care for who do not have a smart phone?

Yes, the patient can forward the SMS or email containing the token to their carer/agent. Alternatively, the patient may also ask their prescriber to send the token directly to their carer/agent, during the consultation.

Q: Can GPs send tokens directly to a patient's preferred pharmacy if the patient doesn’t have a smart phone/access to email?

No. There are options available for patients who are not able to access electronic prescriptions, these include:

  1. the patient can ask their prescriber to send the token directly to their carer/agent
  2. receive a paper prescription.

Q: What happens if the token is sent to the incorrect person's email or phone number?

The prescriber should confirm the patient has received the token via email or SMS before ending the consultation. In the event that a token was incorrectly sent, the prescriber should cancel the prescription and generate a new token in the case the token has been sent to incorrect mobile number/email.

Q: Will there be electronic prescribing available if I use a paper based medical record?

Participation in electronic prescribing requires a conformant Clinical Information System (CIS) that is capable of authoring an electronic prescription. Contact your software provider for further information.

Q: How can I set up electronic prescriptions?

To prepare for electronic prescribing, you will need to ensure the practice has:

  1. registered for a Healthcare Provider Identifier-Organisation (HPI-O) and is connected to the HI service;
  2. installed eRx or MediSecure (PDS);
  3. the latest version of clinical software and;
  4. updated patients’ and their carers’ contact details (mobile phone number/email).

For more information, please visit the electronic prescriptions webpage here.

Q: Can the token be sent to 2 mobile numbers (patient and carer/family member)?

At the time of generating or dispensing a prescription, the token can only be sent to one mobile number or email address. The patient can forward a text message to their carer so both mobile numbers have a copy of the token if required.

Q: Does the token need to be kept for any repeats?

No, once an electronic prescription is dispensed, the initial token can no longer be used, and a new token is issued by the dispensing pharmacy for the repeat. The new token will need to be kept for when more medicine is needed.

Q: Do I need to notify my prescription software provider that I wish to move to electronic prescribing or will this be automatic?

Confirm with your software provider if they are progressing electronic prescribing capability.

Q: Can patients get electronic prescriptions if they don't have My Health Record?

A patient does not need to have a My Health Record to receive an electronic prescription.

The patient must have an Individual Healthcare Identifier to receive an electronic prescription. This is a unique 16-digit number that is assigned to all individuals enrolled in Medicare or the Department of Veteran Affairs (DVA).

Q: Is written consent required from the patient for electronic prescriptions?

Written consent is not required for the token model.

By the end of 2020 the Active Script List (ASL) will provide another option for the way patients manage their electronic prescriptions. For this option, a patient must register for an Active Script List which will require a patient to provide their consent to which healthcare professionals can access their ASL.

Q: What will the patient see when they receive an SMS or email?

The message will have the patient's name, a barcode and some information about the medicine. No instructions will be included.

Q: Why is the ASL not available immediately?

The ASL is a more complex technical build and as such is taking longer than the token model to build. It will be available from late 2020.

Q: How is the information in the token secure if it is sent via a “normal” email?

The QR Code holds an identifier which is a key used by the Prescription Delivery Service (PDS) to pull the prescription details from the database. The identifier is meaningless unless scanned in a PDS with the required connectivity and authorising processes in place to check for a legitimate and legal request to the information.