The canon of plastic surgery

Electronic prescriptions gaining momentum

On 6 May2020, Australia transmitted its first electronic prescription in primary care –end to end, from the doctor to the patient –using a digital token via an encrypted digital exchange to be dispensed by the pharmacist, and then PBS claimed through Services Australia at the other end. The March -April 2020 edition of Surgical News 1 previously reported that implementation of electronic prescriptions was underway. Acceleration of the implementation of electronic prescriptions to support the associated telehealth medicine initiatives was announced on 11 March as part of the Australian Government’s COVID-19 National Health Plan. The goal was to enable electronic prescribing in general practice and dispensing of electronic prescriptions in community pharmacy, within 8 weeks.

Electronic prescribing is the process by which a prescription is electronically generated by a prescriber using software which conforms to technical requirements as published by the Australian Digital Health Agency 2 (the Agency). Following changes to Commonwealth PBS regulations, all state and territories have now made regulatory changes to recognise the form of the electronic prescription as a legal alternative to a paper prescription. Electronic prescribing is not mandatory, and patients and prescribers will be able to choose either an electronic or paper prescription.

Staged and managed implementation

The Agency and the Department of Health, in conjunction with clinical software providers, are now evaluating electronic prescribing in a number of ‘electronic prescribing communities of interest’ 3 around Australia.

“These communities of interest have been established to ensure any technical or workflow issues can be addressed on a smaller scale before broader national roll-out, and is part of the standard betatesting evaluation that software providers would normally undertake,’ said Mr Andrew Matthews, Director of Medicines Safety at the Agency.

‘What makes the evaluation more complex is that it is not the test of one software product but the connection through four products associated with prescribing, prescription exchange, dispensing and subsequent PBS claim.’ Successful transmissions of real, legal electronic prescriptions are happening now. At the time of writing there were over 30 established communities of interest.

Get ready for electronic prescriptions

The technical solution provides two models for electronic prescriptions.

Token:

A token is received as a QR code on a patient’s mobile phone by SMS (or by email). When scanned, the token unlocks the electronic prescription from a secure, encrypted, cloudbased prescription delivery service.

Primary Care

Figure 1: Technical framework for electronic prescribing - Token and Active Script List models.

Electronic Prescription Token (Paper) Community Pharmacy

Active Script List (ASL): An ASL displays a list of a patient’s active prescriptions available to be dispensed, to those health professionals who the patient has consented to view their ASL. Scanning a token is not required, and patients can manage and view their own prescriptions via an App. Active Script

Prescriber

Prescribing System

Clinical Information System

Only the Token Model is to be introduced nationally first (August – September) with the Active Script List model to be available late 2020.

Providers of practice management and prescribing software are progressing changes to their products to ensure conformance against the electronic prescribing technical requirements; those products participating in communities of interest are already declared conformant 4 . Surgeons will need to use a conformant product to generate electronic prescriptions.

To learn more, the Agency’s electronic prescriptions eLearning courses for both prescribers and dispensers are now available. The eLearning courses are free and accessible at training.digitalhealth.gov.au.

Find out more on how to get ready for electronic prescriptions here.

Electronic prescribing implementation underway: RACS Surgical News 21(2) pg. 50 March-April 2020 Electronic prescribing: Developer Centre, Australian Digital Health Agency Electronic prescribing – implementation via communities of interest Open Prescription Delivery Service

Electronic prescribing conformance register List Registry

Mobile Intermediary

Dispenser

Dispensing System

Clinical Information System

Electronic Token

Patient Identity