Electronic prescriptions for Australia

Digital Health and Telemedicine SummitAndrew Matthews4 December 2020

Acknowledgement

We acknowledge the Traditional Custodians of the lands we are meeting on.

We pay our respects to their Elders, past, present, and emerging, and

acknowledge and extend that respect to other Aboriginal and Torres Strait

Islander people and Elders from other communities who may be joining us today.

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Overview

1. Describe electronic prescriptions and how these differ from existing prescription options authorising medicines supply.

2. Introduce the two different ways for Australians to manage their electronic prescriptions.

3. Demonstrate the Australian Digital Health Agency and Department of Health’s accelerated approach to implement electronic prescriptions in response to the COVID-19 National Health Plan.

4. Recognise successes so far and next steps for broader national roll-out.

Project Team

The Australian Government Department of Health in partnership with the Australian Digital Health Agency, have led the implementation of electronic prescribing that has been fast tracked in response to COVID-19.

Australian Digital Health Agency: A Matthews, D Beams, A Rhind, J Groome, O Williams, G Campbell, K Fraser, T Hodgson, B McCulloch.

Australian Government Department of Health: R Sierant, R Martin, A Nichol, M Ingram

National Digital Health Strategy – roadmap for delivery

High-quality data

with a commonly

understood

meaning that can

be used with

confidence

Health information

that can be

exchanged

securely

Digitally enabled

models of care

that improve

accessibility,

quality, safety

and efficiency

A thriving digital

health industry

delivering

world-class

innovation

A workforce

confidently using

digital health

technologies to

deliver health

and care

Health

information that is

available

whenever and

wherever it is

needed

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Better availability

and access to

prescriptions

and medicines

information

MEDICINESSAFETY

Co-designed with all states and territories and agreed by COAG Health Council

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Introducing electronic prescriptions

• Electronic prescriptions are an alternative option to paper prescriptions.

• Previously, only a paper prescription signed by a prescriber has been the legal form by which medicines can be supplied.

• Paper and electronic prescriptions both meet the relevant Commonwealth, state and territory legislation.

• Electronic prescriptions are not mandatory.

• Patients and prescribers are able to choose between a paper and electronic prescription.

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Electronic prescriptions – token and active script list

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Token

• Subjects of care may elect to manage their tokens on

their mobile devices.

• The mobile device will display the token in a manner

suitable for scanning using existing pharmacy equipment.

• Progressively available since May 2020 via Communities

of Interest (COI).

Active Script List (ASL)

• Dispensers can access an electronic prescription for a patient

from an ASL following proof of identity.

• ASL overcomes the issue of lost tokens and assists medicine

management and adherence, especially for patients who are

taking multiple medicines. Available from late 2020.

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Foundations for a pandemic responseThroughout 2018-2019 the Department of Health and the Agency have collaborated to develop the technical components of electronic prescribing, the conformance framework and national change and adoption activities.

Regulatory Framework

• Changes to the National Health (Pharmaceutical Benefits) Regulations 2017 allow the use of an electronic prescription under the PBS.

• Individual states and territories have made changes to their own Drugs and Poisons Acts/Regulations (or equivalent) to also recognise an electronic prescription.

Technical Framework

• The technical framework has been co-designed by the Agency’s Electronic Prescribing Technical Working Group (TWG). TWG membership includes representatives from prescribing software vendors (community and acute care), dispensing software vendors (community and acute care), aged care software vendors, prescription delivery service providers, peak medical and pharmacy bodies, consumers, state health departments, Services Australia and Health.

• This technical framework details the requirements for clinical software upgrades to ensure alignment with the legal framework, adherence to privacy and security principles and maintenance of patient choice.

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COVID-19 National Health Plan and ‘fast track’ of electronic prescriptions

• On 11 March 2020, the Australian Government announced its COVID-19 National Health Plan.

• Acknowledging the foundational work already done, the Plan included acceleration of the implementation of electronic prescriptions to support telehealth medicine initiatives.

• Goal to enable electronic prescribing in general practice and dispensing of electronic prescriptions in community pharmacy, within 8 weeks.

• Health and the Agency negotiated agreements with 12 major software products (representing >80% of the clinical information system software used in general practice and community pharmacy to prescribe and dispense medicines) to build and release conformant software within the timeframe.

• Australia’s first electronic prescription was successfully transmitted on 6 May 2020, eight weeks after the COVID-19 fast track implementation announcement.

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Scale of change

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Evolution of Prescriptions

Electronic Prescription Token-legal prescription

stored in PDS

Screen shots and patient views

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Token – demonstration patient SMS view

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*Note appearance will differ depending on Prescription Delivery Service used

Token – expired, dispensed, or cancelled scripts

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Prescription Repeats – Token

Paper Prescription Repeat Electronic Prescription Token Repeat

Pharmacies will provide electronic prescription repeat tokens via: SMS, Email or Printed on paper.

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Success so far✓All 8 states and territories now legally recognise electronic prescriptions.

✓Implementation across all Victoria, metro-Sydney, ACT and S.A plus existing ‘communities of interest’

covers 13,420,000 people.

✓Now 37 electronic prescribing software products conformant and listed on the Agency’s electronic

prescribing conformance register.

✓Over 1,400,000 original script tokens plus pharmacy repeat tokens generated

✓More than 6,600 individual prescribers have generated an ePrescription; More than 4,100

unique pharmacies have dispensed an ePrescription

✓15,680 attendees and online video views of >140 Agency education events since April

✓1,761 eLearning enrolments to date (849 prescribers + 912 dispensers)

✓658 podcast listens to date*Statistics current as at 30 November 2020

Prescriber Uptake and Pharmacy Adaptation to ePrescribing Workflows

Prescribers:

In November, prescribers have been generating over 88,000 electronic prescriptions per week.

This demonstrates the ease and convenience that ePrescriptions have introduced for the GP and their patient, especially in circumstances where physical distancing is crucial to the preservation of patient health and safety. Over 6,000 GPs in all states and territories are actively meeting the needs of patients who are asking for electronic prescriptions.

Community Pharmacy:

Community pharmacy has shown resilience and initiative in adapting to use dispensing software to combine workflows for paper and electronic prescriptions. This is being achieved without reducing the quality of service that patients expect.

Pharmacies who have not activated for electronic prescriptions are generally able to activate within 15 minutes (through the support of their software provider) of the patient presenting their ePrescription Token at the dispensing counter. Once activated, the pharmacy can continue to dispense as ePrescriptions into the future.

statistics as at 30 November 2020

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Agency Resources

• Electronic prescriptions Webpage• Prescriber and dispenser information

pages• Upcoming Webinars• ePrescribing Podcasts• Fact sheets• eLearning modules for healthcare

professionals• Electronic Prescribing Toolkit/Print on

Demand Resources

Department of Health Resources

• Electronic prescribing webpage• Fact sheet• Electronic Prescriptions Security and

Access Policy• Electronic Prescriptions Privacy Policy• Electronic Prescriptions Data Usage Policy

Available resources

Peak Body Resources

• RACGP webpage and webinars• ACRRM webpage and webinars• Dissemination of communications and

messaging• Guild member information available on

website• Agency modules hosted on GuildED• PSA pharmacy phone support line• PSA pharmacy workflow analysis• Presentation and recording of PSA

webinars• PSA dedicated resource to banner groups

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This is a fantastic solution! So streamlined and easy to use. It’s like banking – there is no way I would go back to the branch now that I use online banking… I feel the same way about electronic prescriptions”

- CONSUMER, VICTORIA

I’d been waiting for electronic prescribing to be available. My patients love it and it is so much more convenient for them. It saves me on admin time and speeds things up like S8 scripts. This is a game changer!

- GP, NSW

While the process is not perfect now, I know the benefits will be there in the future once we switch to one electronic queue. Then we will be saving on paper, doing less admin. It’s also better for our customers as they always have their script with them.

- PHARMACIST, VICTORIA

ADHA: How do electronic prescriptions work? https://youtu.be/3nCXHneBexc

S.A Ch 9. news exclusive on expansion of electronic prescriptions 1/12/20:

www.facebook.com/watch/?v=2688460024740080

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Conclusions and next steps

• Electronics prescriptions are providing safe, secure and convenient new options for health practitioners and Australian health consumers, especially those affected by COVID-19 lockdowns/self-isolation.

• Work established before the COVID-19 pandemic laid the foundation for an accelerated approach to implementation.

• Broad stakeholder engagement across clinical peak bodies (e.g. RACGP, AMA, ACRRM, PSA, PGA), software vendors, states and territories continues to be crucial to the implementation success.

• Demonstrated example of across-Government (Agency/Health/Services Australia) collaboration to achieve success.

• Currently progressing broader national roll-out and the Active Script List token management solution.

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Further information and support

Australian Digital Health Agency

Web: www.digitalhealth.gov.au

Email: help@digitalhealth.gov.au

Agency help line: 1300 901 001

LinkedIn: linkedin.com/company/australian-digital-health-agency

Facebook: https://www.facebook.com/AuDigitalHealth

Twitter: twitter.com/AuDigitalHealth