Opinion

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Is it time to start using electronic prescriptions?

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The start of a new year can be a time to reflect on what has and hasn’t been working in your practice and whether there are better ways of doing things.
 
Electronic prescribing has been around for some time now, and while many have adopted this technology, some GPs are yet to get started.
 
If you’re not using electronic prescriptions, now might be a good opportunity to get set up and start offering these as an option for your patients.
 
Electronic prescribing allows for the prescribing and dispensing of medicines without the need for a paper prescription, which can be easily lost or damaged.
 
It provides convenience and choice to patients, but most importantly it improves safety through prescribing and dispensing efficiency and accuracy, reducing the risk of transcription and dispensing errors.
 
Patients can choose to receive their prescription by SMS or email, which contain a link to a unique QR code or ‘token’.
 
These are automatically added to an Active Script List (ASL), a solution that contains a consolidated list of a patient’s active prescriptions, including barcoded paper scripts generated on a computer and scripts issued by other clinicians.
 
Tokens are secure. The token itself is not the legal prescription. When scanned by the pharmacy it unlocks the electronic form of the prescription from an encrypted and secure electronic prescription delivery service.
 
If a barcoded paper script is issued this still needs to be presented to the pharmacy for medicines to be dispensed.
 
If the patient has repeats as part of their electronic prescription, they should receive a new SMS token from the pharmacy that replaces the original token (sometimes pharmacies need to be prompted for this, otherwise all the repeats remain at the original dispensing pharmacy).
 
Once used, the old token is no longer valid, and this is where some confusion lies with patients saying their eScript no longer works. This leads to frustration and a request to go back to paper scripts.
 
Electronic prescriptions have been invaluable for telehealth consultations, allowing us to send a prescription directly to the patient at the click of a button.
 
This is a win for both practices and patients – saving us all time and ultimately getting the patient their medicines when they need it.
 
Patients can send tokens to another person to pick up medicines on their behalf which is great for those with mobility issues.
 
I know some patients and GPs initially found electronic prescription tokens difficult to keep track of, often having to reissue misplaced tokens.
 
The ASL overcomes this. To set up the ASL (also known in pharmacies as MySL) a patient needs to register once for this at a pharmacy with their appropriate ID (100 point check). This can be a barrier to implementing the ASL.
 
I have found the ASL can be particularly useful for patients on multiple medications, those who travel around Australia a lot (using different pharmacies) and people with dose administration aids where you are happy to provide prescriptions without seeing the patient, for example patients in disability care.
 
There are several proprietary mobile apps available to help patients manage their electronic prescriptions and some pharmacies have their own apps. These run independently of the ASL.
 
The 1800MEDICARE app (formerly my health app) now enables patients to view electronic prescriptions and access their ASL in the app.
 
But of course, electronic prescriptions aren’t for everyone – some patients simply prefer a paper prescription, and we’re still able to provide one.
 
It is important to note though, you can’t issue both a paper prescription and an electronic prescription for the same medicine.
 
Some patients may not have a smart phone or email or may just not be comfortable with a digital token for their prescription.
 
I have many patients who fall into this category. If this is the case, they can opt to have their token printed out, have their token sent to a family member or carer, or they can receive a paper prescription as normal.
 
Getting started
If you have not started using electronic prescriptions, there are some steps you need to take to prepare your practice: 

• Make sure your clinical information software (CIS) supports electronic prescriptions and that you are using the latest version – contact your software provider for more information
• Ensure your practice has a Healthcare Provider Identifier-Organisation (HPI-O) and is connected to the Health Identifiers Service (HI service)
• Ensure each prescriber in your practice is connected to the National Prescription Delivery Service via the prescription exchange service
• Update your patients’ and their carers’ contact details on file – specifically their email and mobile number
• Provide your practice team with information about electronic prescribing to enable them to answer patient questions
• Stay up to date with information from your software provider – subscribe to your software provider newsletters
• Stay up to date with information from the RACGP – subscribe to the Practice Technology and Management newsletter and visit the website for up-to-date information on electronic prescribing
• Ensure prescribers know where to include all the details required to meet legislative and PBS requirements, for example, approval/warrant numbers, repeat intervals, etc if required under your state legislation. Your practice should have policies in place to cover security and access, privacy and data usage

 
The RACGP and the Australian Digital Health Agency have some great information to help you get started.
 
I also recommend you speak with colleagues who are already using electronic prescriptions to hear about their experiences and where they find it most useful. Your software vendor may also have educational materials such as videos to assist.
 
Electronic prescribing doesn’t require a huge change to the way you prescribe, it is not mandatory and paper prescriptions still exist.
 
There are some real benefits to both practices and patients, and I encourage you to give it a try, or retry it, in 2026.
 
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electronic prescriptions e-scripts

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