What does electronic prescribing mean for GPs in the fight against coronavirus?

Anastasia Tsirtsakis

7/04/2020 3:28:08 PM

GPs can now send prescriptions to pharmacists electronically as an interim solution during the pandemic. 

Graphic representing digital prescriptions.
The interim measure allows GPs to send prescriptions electronically to pharmacists without having to mail out a physical copy.

‘This is a vital part of the puzzle to enable GPs to continue providing the same quality care to their patients via telehealth as they do face to face.’
RACGP President Dr Harry Nespolon has hailed the Federal Government’s response to strong lobbying by the college as a ‘breakthrough’ for GPs in the fight against coronavirus.
As part of the COVID-19 National Health Plan telehealth model, the new interim measure allows GPs to send prescriptions electronically to pharmacists without having to mail out a physical copy of the original paper prescription with a GP’s wet-ink signature.
Patients can then have their script filled and medication delivered to their door, helping to minimise the risk of virus transmission in accordance with social-distancing measures.
Dr Nathan Pinskier, GP and member of the RACGP Expert Committee – Practice Technology and Management (REC–PTM), says the arrangement is a positive step forward with ‘huge benefits’ for practices during the crisis.
‘It’s certainly going to make it easier for practices, because they are being inundated with pharmacists asking them to post prescriptions to them,’ he told newsGP.
‘I know at my practices it’s causing substantial concern.
‘We’re getting calls every day from pharmacists saying, “I can’t dispense unless you send me the hardcopy paper”, and we’re saying, “We don’t have the resources to keep running out and buying stamps, and it’s just not safe to put staff in that position”.
‘So we’ve had a bit of a stalemate for the last few weeks and this is a great outcome in the short term.’
As outlined in guidelines issued by the Department of Health (DoH), GPs will be required to do as follows:

  1. Create a paper prescription during a telehealth consultation. This will need to be signed as normal or using a valid digital signature
  2. Create a clear copy of the entire prescription (a digital image such as a photo or PDF including the barcode where applicable)
  3. Send via email, fax or text message directly to the patient’s pharmacy of choice
Schedule 8 and 4(D) medicines such as opioids and fentanyl are not part of the interim arrangement.
If the digital copy of the script is being sent via email, Dr Pinskier highlights the need for GPs to inform patients of the small, yet possible, privacy risk.
‘Clinical communication sent over ordinary email could be intercepted,’ he said. ‘So it’s really important that practices and doctors ask the patient if they are comfortable with it being sent by ordinary email.
‘It’s a safety measure in terms of minimising the risk of being exposed to COVID-19, but the patient should be aware of it.’
If the patient prefers to receive the legal paper prescription, the practice will need to mail it to them. When it comes to a digital copy of the prescription, however, the new guidelines stipulate that GPs must only send the script to the pharmacist.
While not legally required, the DoH encourages practices that are able to continue sending the original script to pharmacies to do so as soon as possible. All other practices must retain the paper prescription for a period of up to two years for audit and compliance purposes.
Vulnerable patients with existing prescriptions or repeats who are self-isolating will require someone to visit the pharmacy with the original prescription on their behalf. Alternatively, they will need to have a new prescription issued by their GP via telehealth.
It is important that GPs check they have the correct address for patients during the telehealth consultation, as once dispensed, medicines will only be delivered to the address printed on the prescription.
At this stage, the DoH has said the arrangement will cease on 30 September in accordance with the COVID-19 National Health Plan telehealth measure.
‘It’s not a long-term solution, but for the next few months it will certainly meet the requirements,’ Dr Pinskier said.
‘The long-term problem is, if COVID-19 persists for eight to 24 months, we’ll be storing a lot of paper in our practices and that’s probably not a good thing.
‘We may need to have another conversation with the Government down the track if that becomes an issue.’
The Federal Government has a new Electronic Prescribing (EPP) system in the works that generates a QR code and is sent to a patient’s device. The DoH has sped up the process in response to the current health crisis, and estimates it will be ready for use in practices by May.
But Dr Pinskier says this is an ambitious move during a pandemic and, given the history of software rollout in healthcare, is ‘likely to take longer’.
‘It’d be great if in three months every practice and every pharmacy has the capability to legal prescribing [in this way]. But it will still require an interim measure because if the patient’s not going into the pharmacy the QR token still needs to be somehow delivered to the pharmacy,’ he said.
‘So maybe we’ll still be going through a similar process using a newer technology.’
The RACGP has more information on coronavirus available on its website.
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