Sweeping reforms see creation of National Medicines Record

Every prescriber will soon have to record all patient medication-related information under a major Federal Government overhaul to My Health Record, which includes development of a National Medicines Record.
 
In an Australia-first requirement, patients, prescribers and pharmacists will have access to a complete profile of a patient’s medicines history.
 
While many general practices are already using software that automatically uploads electronic scripts, a rapid rise of online telehealth providers are not following the same process, leading to fragmented care and risk to patient safety.
 
Under the first stage of the landmark reforms, requirements will be in place to ensure accurate and up-to-date medicines-related information from online prescribers is made available to patients and their care teams through their My Health Record.
 
This includes medicines prescribed and dispensed through online platforms and the clinical reasoning for prescribing, in efforts to reduce harm to patients due to medication errors, adverse drug reactions, or inappropriate use.  
 
RACGP President Dr Michael Wright welcomes the ‘sensible move’ to strengthen continuity of care and reduce medication-related harm.
 
‘As GPs, when patients come to see us, we make records that can be viewed by our colleagues which can be shared with My Health Record,’ he told newsGP.
 
‘But that hasn’t been the case for the online or telehealth providers, and that means we’ve got information silos and fragmentation of care.
 
‘We don’t have visibility of the care that’s been provided, and that’s led to not just bad health outcomes, but deaths – and that’s really prompted this change.
 
‘These online services need to meet the same standard that we do in general practice.’
 
The incoming changes follow ongoing advocacy from Alison Collins, whose 24-year-old daughter Erin overdosed last year while taking stockpiled medications prescribed through multiple digital health providers.
 
Erin’s My Health Record contained warning messages from hospital staff, and her care team had arranged for her to pick up a controlled dose of her medication from the local pharmacy each day.
 
Ms Collins raised concerns about multiple telehealth providers providing medications to her daughter and not checking My Health Record, where her treating team had made it clear she should not be prescribed more medications.  
 
She praised the ‘swift response’ of the Government following her daughter’s death.
 
‘These new reforms give our family hope and peace of mind,’ Ms Collins said. ‘Erin’s story is creating change, so no other family has to go through what we did.’
 
Federal Health and Ageing Minister Mark Butler said the mother’s ‘bravery and advocacy will have a profound impact on the safety of online prescribing practices’.
 
‘Ensuring this information is accessible to a patient’s usual GP and other healthcare providers will support safer clinical decision-making, reduce the risk of medicine-related harm and strengthen trust across the healthcare system,’ he said.
 
While telehealth and online services can ‘provide great convenience’, Dr Wright said it is vital they are provided safely.
 
‘In general practice we already have software so that medicines are recorded automatically, but the online providers aren’t following that process,’ he said.
 
‘It’s got to be shared with your regular GP.
 
‘Healthcare is a serious job, and the first thing we need to do is maintain patient safety – and that’s got to be prioritised above access, convenience and profit.’
 
The changes mark the first step towards the establishment of a National Medicines Record, of which existing digital health capabilities, such as electronic prescribing, Active Script List and My Health Record, will inform the design and development.
 
It is anticipated the National Medicines Record will become an overarching prescription monitoring system linked to a patient’s My Health Record.
 
While the existing national Real Time Prescription Monitoring system and state-based models such as Victoria’s mandated SafeScript record high-risk medications like opioids, Dr Wright is calling for a broader system to record all medications, given the risk of adverse reactions from any drug.
 
But Dr Wright says any new system also needs to be designed to not add to GPs’ workload.
 
‘We need to make sure that whatever this new system is, it makes it easier for us to have visibility of our patients’ medications,’ he said.
 
‘And that it easily fits into our workflows and doesn’t create a higher administrative burden, which is what we’ve seen from the real-time prescription monitoring in some states with a traffic light system that sometimes doesn’t make sense, and then you end up checking for medications that the patient is on.’
 
A consultation period is now underway for the National Medicines Record, with the first phase expected to be completed by December – the RACGP is providing input as this progresses.
 
‘We need to look at how that might work – who would have access to it, who would need to upload it? How would you check for it?’ Dr Wright said.
 
‘And then also potentially moving beyond that to not just include prescribing but also dispensing. So that would be helpful for us to understand if I’ve just prescribed a drug, but has my patient had it dispensed?’
 
The RACGP President says that if the National Medicines Record is implemented well to provide GPs and other members of a care team with an accurate and up-to-date view of patients’ medicines information, it will strengthen safeguards, reduce hospitalisations, and improve care across the health system.
 
The 1800Medicare app, which allows patients to access their prescription history through My Health Record, will continue to be enhanced to improve medication management.
 
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