The world of science and technology is constantly changing and evolving, always for the better. The purpose of this change is to improve the quality of care and make the entire process more efficient.
Medical Prescription
E-prescribing (electronic prescribing) is an example of such evolution. It focuses on digitalizing the prescription process to increase patient safety and improve workflow. E-prescription basically refers to the immediate filling of a prescription in the pharmacy after the doctor writes the prescription onto a digital device and puts it in the system.
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The service was initiated in 2003, and it was recently adopted by the Australian government as a part of the Australian Government Budget Measure. This alteration will still allow the patients to choose the pharmacy they would like to pick up their prescriptions from. It just reduces the need for paper prescriptions although they are still available if the prescriber or the patient chooses to opt for them.
Benefits of E-Prescribing
E-prescribing is more than a fancy electronic prescription. In fact, it has several other benefits that add to its appeal, such as the following:
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Avoid wrong prescriptions
More than one drug can be used to treat a medical condition, but those drugs may also be prescribed for different types of patients based on specific patient characteristics. When using the e-prescription software, all of the patient information is added to the system, which means that the wrong prescriptions cannot be prescribed as the system will notify the doctor.
More than that, handwritten prescriptions can be quite difficult for the pharmacist to read, and often, the wrong medication may be given. This potential error can be life-threatening but with the help of e-prescription, it can be completely avoided.
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Know Patient History
The patient’s medical history is not only important for the diagnosis but also for the prescription of appropriate medications. At certain times, the patient may not recall that they are allergic to certain medications, but that is already recorded in the system, which means that the likelihood of prescribing the culprit drug is almost zero.
The e-prescription system also keeps track of all medications that have been prescribed to a patient. So, if the patient doesn’t remember the exact medicine they take, the doctor can still figure out their medication list and prescribe appropriate treatment.
- Prescribe and monitor controlled substance prescription
The prescription of controlled substances should be done with extreme care to avoid overprescription or doctor shopping. These potential problems, which are associated with controlled substances, can be eradicated using the e-prescription software as it keeps track and informs the doctor when levels are already dangerously close to over-prescription.
Similarly, a database exists that collects all present information about prescriptions and dispensation of controlled substances. This database, when combined with e-prescribing software, prevents doctor shopping and overprescription which could lead to drug addiction.
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- Track Prescriptions
With the e-prescription software, it is easier for doctors to track if the prescription has reached the pharmacy and if it has been picked up by the patients. All of this information is made available with a single click rather than lengthy follow-ups associated with traditional methods of drug prescription.
Australian Government and E-Prescription
The Australian government has made legislative changes to allow and legalize e-prescription services in the medical and pharmaceutical sectors. As the change requires a digital network, the government has been working with the Australian Digital Health Agency to provide the said network and improve the experience for both prescribers and patients.
The software involved in the e-prescriptions model in Australia:
- Practice software: This is used to generate the prescription;
- Prescription delivery service (PDS): Combines a prescription exchange (PE) and also holds the prescription;
- Pharmacy software: This software is the one that gets the e-prescription and is also used to oversee the prescription.
A legal electronic prescription (e-prescription) can only be created and administered by health practitioners through the use of authorized software that complies with national standards. For more on this, check out these helpful resources to understand the technical details!
The main aim of implementing these changes has been to increase drug safety, and patient privacy, and to reduce the pressure on healthcare personnel. The changes are being applied to different parts of the country, one by one, and the results are being thoroughly studied to check for any potential problems and make the whole system run as efficiently as possible. Any bugs or problems that arise or may arise are fixed and the system is updated regularly.
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As part of their new initiative, the Australian government is asking for all community pharmacies and General Practitioners to start utilizing the network by providing training opportunities with the Australian Digital Health Agency. For the success of this new e-prescribing system, all prescribers need to use and report its efficiency.
How did Australia Implement E-prescription services in remote areas?
The rural areas of Australia, like most rural areas in the world, do not experience the effects of health services with the same efficiency and speed as their urban counterparts. One of the most important aspects that health services lack the most is drug prescription and distribution.
Keeping this in mind, the Australian government decided to implement e-prescription services along with a lenient ruling on who can make the prescriptions and who can administer the drugs in rural settings.
The following changes, in order, allow the rural areas to benefit from a more efficient form of drug distribution:
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Non-medical prescribers
Usually, the plan for appropriate treatment is decided by medical personnel like health practitioners. However, an amendment made in 2005 allowed therapeutically endorsed and eligible non-medical personnel to prescribe medications in the rural areas of Australia, specifically Queensland. This step was taken as there is a serious lack of prescribers in rural areas of the country.
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Supply of medications by non-pharmacists
Another common sight in the healthcare industry is that only pharmacists are allowed to supply medications to patients. However, due to the recent lack of pharmacists in rural areas, legislative changes were made to allow medical personnel like nurses, midwives, and Indigenous healthcare workers to administer medications without a pharmacist present.
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Hospital and medical personnel skill-mixing
The skill mixing of nurses, especially in rural staff, increases the mutual relationship between medical and administrative staff by easing the pressure of all the paperwork on the administration.
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E-prescription
E-prescription services further reduce the pressure on both healthcare workers and the administration of the facility. Not just that, as more and more non-practitioners and non-pharmacists are allowed to prescribe and supply medications, it is important that this system be put in place to avoid any wrong prescription order being put in. The system already has the relevant information of the patient and will not allow for any wrong prescription to be made.
- Medication information transfer between rural and urban areas
The digitalization of the whole process allows for patient history and prescription information to be transferred between hospitals and healthcare facilities in rural and urban areas.
All of these changes made by the Australian government have allowed them to implement e-prescription digital networks in rural areas. And the benefits of the software are clearly visible.
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Frequently Asked Questions
Can you get a prescription without seeing the doctor?
Going to the doctor can be an issue and act as a barrier of a sort, especially when the issue is small. However, it is necessary to visit the doctor or the healthcare practitioner to receive a prescription.
Can someone else pick up my electronic prescription?
Most prescriptions are delivered electronically directly to a pharmacy by the physician. Someone else can pick up the prescribed medications as far as consent is given by the patient and the pharmacy is made aware of this by the patient themselves.
How long does it take to electronically send a prescription?
It usually takes a couple of hours but if it still doesn’t appear in your pharmacy, you can contact the doctor to make sure everything is alright. The doctor can then contact the pharmacy to check up on the progress of your prescription.
How are electronic prescriptions handled compared to paper prescriptions?
Electronic prescriptions are written and signed by the healthcare practitioners electronically, and then forwarded to the staff of the facility to be sent to the pharmacy. Whereas paper prescriptions may be written electronically or by hand, and are signed by the doctor by hand. They are then processed and the patient can take the paper prescription to the pharmacy so they can receive their medication.
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References
- Tan, A.C.W., Emmerton, L. and Hattingh, H.L. (2012), A review of the medication pathway in rural Queensland, Australia. International Journal of Pharmacy Practice, 20: 324-339. https://doi.org/10.1111/j.2042-7174.2012.00193.x
- Selina Taylor, Alice Cairns, Beverley Glass, Consumer perspectives of expanded practice in rural community pharmacy, Research in Social and Administrative Pharmacy, 10.1016/j.sapharm.2020.03.022, (2020)
- McMullin ST, Lonergan TP, Rynearson CS. Twelve-month drug cost savings related to using an electronic prescribing system with integrated decision support in primary care. J Manag Care Pharm. 2005;11:322-332.
- Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311-1316.
- Evans RS, Pestotnik SL, Classen DC, et al. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med. 1998;338:232-238.
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