Huge rise in ‘very helpful’ electronic prescribing

Jolyon Attwooll

14/07/2021 1:43:15 PM

The number of electronic prescriptions being used in Australia is increasing by 500,000 every week.

Electronic prescription
Around 11.3 million original and repeat electronic prescriptions have been issued since the system was launched. (Image: Australian Digital Health Agency)

The continued growth of electronic prescriptions is being supported by a Federal Government subsidy that is funding general practices to prescribe via SMS, and it was recently announced that the scheme will continue until at least the end of September.
Dr David Adam, a member of RACGP Expert Committee – Practice Technology and Management (REC–PTM), welcomed the extension to a system he says has been working very well.
But Dr Adam would also like to see more clarity regarding any proposed funding support for electronic prescriptions beyond that date, with the current subsidy meaning the SMS prescriptions are free for GPs to issue.
‘Overall, I think everyone involved can be really pleased, the system seems to be working really well,’ Dr Adam told newsGP.
‘We need some certainty about what’s happening in the long term. The cost [unsubsidised SMS prescriptions] is not huge but it’s not insignificant – it will definitely make a difference to practices.’
As of 6 July, 11,298,828 million original and repeat electronic prescriptions have been issued since the system was launched, according to data collated by the Australian Digital Health Agency (ADHA), which oversees the scheme.
These include ‘tokens’ – a link to a unique QR code representing a prescription – issued by SMS, email or via an app.
In a REC–PTM survey of GPs’ experiences with electronic prescribing, more than a quarter (27%) said they would not continue to use SMS for sending tokens if the subsidy were to be removed. A further 50% say they are unsure whether they would continue.
Among the respondents, 85% had prescribed medicines electronically, with the true number of GPs issuing electronic prescriptions standing at a little over 50%, the ADHA believes.
While the total number of electronic prescriptions is still a relatively small proportion of the total – which is around 300 million through the Pharmaceutical Benefits Scheme (PBS) each year – it is increasing exponentially, with the ADHA expecting the numbers to carry on rising.
A newer tool for managing electronic prescriptions, Active Script List (ASL), is being trialled before it is made available more broadly.
Patients can opt in to ASL, which lists all active prescriptions and repeats to be dispensed and adds prescriptions once they are generated. It is being introduced to pharmacies with compatible software, with a further upgrade due to take place later this year.
Dr Adam said he would like to know whether the SMS subsidy could be available in the long-term beyond the September deadline or whether it would end when ASL became more widely available. He has also previously raised concerns regarding potential patient privacy breaches when using the ASL.
Andrew Matthews, Director of ADHA’s Medicines Safety Program, said the ‘pharmacy-centric’ approach still had some way to go.
‘There’s still some more work to be done for that,’ he told newsGP. ‘The next round of software upgrades will include the full functionality, which includes GP visibility of the ASL and the ability to register patients if they wish to do so.’
Mr Matthews emphasised that the option of electronic prescribing is a consumer choice but hopes that the simplicity of the system will encourage as many doctors as possible to use it.
‘We’re trying to get a message out now to say it’s not that hard – and when there are lockdowns in Sydney, this is the ideal time to try it,’ he said.
Electronic prescribing is part of the National Health Plan, with an original launch date of this year. It was fast-tracked to support telehealth consultations under lockdown restrictions last year, removing the need to present to GPs in person to get a prescription.
The current COVID outbreak in Greater Sydney and other parts of New South Wales is a reminder of the difference the new system is making, Dr Adam says.  
‘I know that my colleagues who are in areas that have had protracted lockdowns have really appreciated the convenience and the safety and the efficiencies that come from having electronic prescriptions,’ he said.
‘It’s definitely helpful for those of us who are in pretty restricted circumstances of practice.
‘I would certainly encourage any general practices that haven’t looked at it yet to look into it. Of all their various programs that have been implemented over the past few years, I think this is one of the best supported that we have seen.’
Most Australians have the option of receiving an electronic prescription if they wish, with the ADHA saying more than 97% of PBS-approved pharmacies now dispense electronic prescriptions.
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Dr Jeffrey Ian Willcox   15/07/2021 8:49:52 AM

Meanwhile Genie Solutions seem to have quietly dropped e-scripts from their implementation roadmap altogether, leaving us Genie users with no e-script functionality at all. I'm not sure they appreciate the importance of it.

Dr Arlene Nicol Suttar   18/07/2021 9:35:35 AM

It is a good system in lockdown and for a few who find travel to the practice physically challenging but in many cases it is helpful to have an extra incentive for some patients to be reviewed ( a physical examination ) twice a year and receive their scripts with 5 repeats in person . Then there is the " the GP just has to register the patient " and then electronic prescribing is easy. One more little job to be done in our own time along with registering our indigenous patients online for CTG, applying for authority to prescribe narcotics for chronic pain patients , adding health problems to patients notes and altering their medication list after hospital stays and specialist visits. And for months now we have been handling the fear among patients about covid 19 infection and vaccinations.