4. Medicines Safety

Better availability and access to prescriptions and medicines information

WHAT WILL BE DELIVERED BY 2022

  1. By the end of 2018, all consumers and their healthcare providers will have access to comprehensive views of their prescribed and dispensed medications through the My Health Record system, irrespective of who prescribed and dispensed the medicine.
  2. By 2022, there will be digitally enabled paper-free options for all medication management in Australia. People will be able to digitally request their medications online, and all prescribers and pharmacists will have access to electronic prescribing and dispensing, increasing convenience for people filling prescriptions and improving overall safety.

The National Digital Health Strategy outlines the case for why better availability and access to prescriptions and medicines information will reduce the incidence of medication errors and adverse drug events, and minimise harm to patients and create significant cost savings.

Capturing a patient’s current medicines and allergy information in a structured, coded, standardised and shareable form will support improved sharing of accurate and complete information across care boundaries, support quality use of medicines, prevent avoidable injuries and deaths, reduce hospital admissions and give consumers the opportunity to take more control of their own health and care.

This priority area aims at establishing a nationally coordinated digital medicines program to implement the digital services and solutions that will increase the safety and quality of medicines use across health and care.

The benefits for Australians and the Australian healthcare system are:

  • Risk and harm to health consumers will be minimised through reduced adverse drug events.
  • Prescription misuse will be reduced through real-time monitoring.
  • The cost of hospital admissions for adverse drug events will be reduced (reduced drug–drug interactions, allergic reactions and inadequate dosing, either due to inadequate prescription or dispensing errors).
  • Health system capacity will be increased due to more efficient and accountable administration of medication, improved consumer self-management and reduced hospital admissions.
  • Complications and disease progression will be reduced for patients due to higher medication adherence.

Roles of participants in order to achieve benefits

4. Role of participants index table
Healthcare consumers Driving change by expecting that governments and healthcare providers are working together to implement measures which support the safe and efficient prescribing and dispensing of medicines. Use the My Health Record as a means to share information with their treating healthcare professionals about their medicines and allergies
Healthcare providers Use the My Health Record as a means to minimise the burden of medication errors by ensuring adequate communication between treating professionals, and on transition from one care setting to another. Implement measures which improve medications management, including capturing a patient’s current medicines and allergy information in a structured, coded, standardised and shareable form.
Industry & technology sector Provide technical platforms which are user friendly and co-designed and developed closely with healthcare providers so they are able to extract the medication profile information to upload to their conformant repositories for use in cross facility, cross care setting and multidisciplinary team based scenarios. Design innovative approaches to build new linkages between a patient’s medicines information and CMIs, recalls and alerts to assist consumers manage their own health and care needs.
Peak organisations Provide leadership to develop and use professional standards and guidelines to drive improvements in clinical decision support. Work collaboratively with industry to develop more user friendly systems, providing consistent and standardised collection and presentation of information
Australian Digital Health Agency Provide expert advice in the development of conformance requirements and standards to support the electronic prescribing, dispensing and claiming. Drive standardised decision support for prescribing, and administer Australian Medicines Terminology which identifies all commonly used medicines in Australia in a structured and coded format supporting the automation of drug-allergy, drug-drug and dose-range checking
Commonwealth Government Lead the review of regulatory frameworks to support national objectives for electronic prescribing, and facilitate collaboration between states and territories to ensure national agreement of approval processes to enable electronic prescribing, dispensing and claiming to occur
State and territory governments Implement measures which improve medications management, including capturing a patient’s current medicines and allergy information in a structured, coded, standardised and shareable form. Review, and if required, amend regulatory frameworks to support national objectives for electronic prescribing. Provide technical platforms which are user friendly and co-designed and developed closely with healthcare providers so they are able to extract the medication profile information to upload to their conformant repositories.

Priority actions for co-development 2018 - 2022

4.1 Establish and implement a nationally coordinated digital medicines program

Improve access to information about medicines, allergies and adverse reactions, to support safe and efficient medicines use and reduce adverse medication events by implementing a nationally coordinated digital medicines program to increase the safety and quality of medicines use across health and care. 

4.1.1. Digital Medicines Program Blueprint

Co-design and publish a Digital Medicines Program Blueprint

Timeline to Co-design and publish a Digital Medicines Program Blueprint

Australian governments and industry will work in collaboration to improve medications management for both healthcare consumers and providers by co-producing and publishing a national digital medicines management blueprint, which will include development of the infrastructure, specifications, policies, legislation and change, adoption and training activities for clinicians. The program blueprint will cover sequencing of current and planned digital medicines management related projects and programs outlined below.

4.1.2. Electronic prescriptions

Give all prescribers and pharmacists access to electronic prescribing and dispensing

Timeline to Give all prescribers and pharmacists access to electronic prescribing and dispensing

The Australian Government will provide $28.2 million over five years to support a national electronic prescribing system. This will contribute to an electronic prescribing framework that will provide an option for prescribers and their patients to have a fully electronic prescription as an alternative to paper-based PBS prescriptions. National infrastructure will be leveraged, and the specifications and regulatory framework required will be developed, to enable consumers, prescribers and pharmacists to have access to electronic prescribing and dispensing, including alignment of the existing prescription exchange services, and dispensing capability.

4.1.3. Best Possible Medicines List

Deliver a best possible medicines list via the My Health Record system

Timeline to Deliver a best possible medicines list via the My Health Record system

In Australia, health consumers’ medication histories are stored across a variety of paper-based and electronic systems that are often inconsistent, making consolidation into a single view highly problematic. Healthcare providers and consumers will be able to access a best possible medicines list in a structured data format via the My Health Record system by evolving the Available Medicines View, including pharmacy curated medicines list and consumer-uploaded medicines (including over the counter medicines), to support medicines reconciliation, and enable providers to upload the reconciled medicines profile.

4.1.4. National Medicines Data Service

Establish a National Medicines Data Service building on existing programs

Timeline to Establish a National Medicines Data Service building on existing programs

Medicines data is managed differently across all state and territory health systems which are not aligned to a standard code set. A National Medicines Data Service will be established, building on existing programs (e.g. NSW scoping and pilots) and infrastructure, enabling jurisdictions and health service organisations to maintain their own tailored medicines master data of all medicines suitable for use, or receive a managed service.

4.1.5. Medicines information for consumers

Provide consumers targeted medicines information via the My Health Record system

Timeline to Provide consumers targeted medicines information via the My Health Record system

There is an opportunity to make reader-friendly medicines information more easily available to consumers to provide information on the safe and effective use of prescription and over the counter medicines. There will be targeted consumer information via the My Health Record system which includes Consumer Medicines Information (CMIs), consumer entered OTC medicines information, as well as information on recalls and warnings targeted on the basis of a consumer’s current medicines list.

4.1.6. Medicines Decision Support Tools

Enable the development and expanded use of medicines decision support tools

Timeline to Enable the development and expanded use of medicines decision support tools

Clinical decision support at appropriate interactions (e.g. meaningful alerts and warnings about a consumer’s medicine allergies, any contraindications with current medicines, and identifies ‘at risk’ patients and most appropriate medication) improves the quality of medicine management and safety of consumers. Through co-production with relevant agencies and peak bodies, a minimum set of functional guidelines and conformance requirements will be developed to provide consistent and standardised collection and presentation of information in Clinical Decisions Support Systems.

4.1.7. Enhance incident reporting capabilities

Enhance incident and adverse event reporting capabilities through digital solutions

Timeline to Enhance incident and adverse event reporting capabilities through digital solutions

Currently, information about medication safety incidents is collected on paper or in unstructured electronic forms. There is evidence that 230,000 ADEs lead to hospitalisation every year, most of which are not officially reported. There is an opportunity to investigate ways to enhance incident and adverse event reporting capabilities through digital solutions, including the development of a dedicated national framework for medicines adverse event reporting.

4.1.8. National Allergy Strategy Align National

Digital Health Strategy priorities to the National Allergy Strategy

Timeline to Align National Digital Health Strategy priorities to the National Allergy Strategy

Ensure alignment to the National Allergy Strategy which seeks to ensure consumers’ allergy information is easily accessible for healthcare providers in the My Health Record. The National Allergy Strategy aims to improve the health and quality of life of Australians with allergic diseases and minimise the burden of allergic diseases on individuals, their carers, healthcare services and the community.

4.1.9. Real time prescription monitoring

Implement national capability for real-time prescription monitoring

Timeline to Implement national capability for real-time prescription monitoring

Real Time Prescription Monitoring will provide an instant alert to pharmacists and authorised prescribers if patients received multiple supplies of prescription-only medicines, assisting to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines. National capability for real-time prescription monitoring will be established, building on existing programs and specifications, and utilising national infrastructure.

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View the Actions Across Australia Case Study – Medicines Safety