Actions Across Australia Case Study – Medicines Safety

4. Better availability and access to prescriptions and medicines information

Below is a summary of some of the actions government, clinical, technology, industry and advocacy organisations told the Australian Digital Health Agency are already underway to ensure better availability and access to prescriptions and medicines information.

Digitally enabled paper-free options for medication management

The aim to increase convenience for people filling prescriptions and improving overall medicines safety will be achieved through providing digitally enabled paper-free options for all medication management in Australia. 

The Australian Government has allocated funding in the 2018 budget to support a national electronic prescribing system that will contribute to Pharmaceutical Benefits Scheme (PBS) efficiency, compliance, drug safety and data collection. It will also create an electronic prescribing framework that will provide an option for prescribers and their patients to have a fully electronic PBS prescription as an alternative to paper-based PBS prescriptions. The upgrades will make the system more user friendly and enable prescribers to better identify prescribing options that best meet the needs of their patients, with doctors to retain the final say in advising patients on which medicines to use.

Paper free prescribing is being advanced by Fred IT Group who have invested heavily over the last 10 years in the creation of a national prescription exchange infrastructure that connects over 22,000 prescribers and 4,900 pharmacies across Australia. This existing infrastructure has transacted in excess of 2.1 billion prescribed and dispensed records and continues to transact over 300 million records per year.

Telstra Health, Fred IT and the Pharmacy Guild of Australia will take a lead role in industry consultation on implementation of paper-optional prescribing. Consultation should identify user workflows for prescribing, dispensing and ordering workflows to be supported by technical solutions. This will contribute to understanding of changes required to implement an effective, inclusive solution for paper- optional prescriptions, and will complement government- led consultation.

Using technology to make prescribing effective and efficient 

The digital management of medications promises to significantly improve patient safety, reducing avoidable hospitalisations and other adverse events. 

State and territory governments continue to invest in electronic medications management solutions. eHealth NSW’s eMeds program, which provides support for doctors, nurses and pharmacists to prescribe, order, check, reconcile, dispense and record the administration of medicines, will be expanded from 25 to 178 hospitals. WA Health has invested in Pharmacy Automation systems at the Perth Children’s Hospital which provide an automated drug inventory management system.  These systems enable staff to access real-time information relating to drug inventory.

The Australian Digital Health Agency has developed the Medicines Information View in the My Health Record that collects patient medicines information from multiple sources (such as prescription and dispense records, shared health summaries and e-Referral notes) into a single view, which can be sorted by date or alphabetically, showing the patient’s most recent (and up to two years’) prescription and dispense records and other Pharmaceutical Benefits Scheme claims information.

Healthdirect has developed a database currently being used by Australians approximately 296,000 times per month of over 7,000 medications to provide consumer-oriented information drawn from multiple sources. The database already supports advice on recalls, warnings for elderly patients (“Beers List”) and is being enhanced with addition of multi-platform electronic consumer medication information.

Powered by eRx Script Exchange, MedView is the national cloud based platform that gives health professionals a full picture of their patient’s medication history, as well as tools to manage their care. It connects over 22,000 prescribers and 4,900 pharmacies annually. Patients who give permission will have their records stored securely in the MedView repository. Healthcare professionals can then access this information on their desktop PC and mobile devices.

MIMS is working with various partners to design and develop Enhanced models of Medication Management and Adherence to ensure patients are remotely monitored to improve their health outcomes, and to drive cost efficiencies within the healthcare ecosystems. 

NPS MedicineWise has developed an app which has been downloaded more than 80,000 since it was launched in 2014. The MedicineWise App enables consumers to build, edit and share a list of their medicines, set the dose and appointment alerts, view rich media content and record important health information – in the future this app will link with the My Health record to download a list of medicines.

Working closely with the Australian Digital Health Agency, EBOS Group companies Zest and MedAdvisor are helping to define new innovative digital solutions that aim to reduce the need for hospital admissions or re-admission where possible. They provide innovative patient-specific drug compliance management programs that will allow early appraisal of at risk patients to be flagged before they enter the hospital system, while also helping to manage patient-program compliance after leaving hospital. 

Using technology to reduce harm and increase patient safety

Electronic recording and reporting of controlled drugs supports medicine safety for consumers by helping health practitioners to meet their clinical professional practice obligations to reduce error and harm associated with the misuse of drugs of addiction. Australian Health Ministers have agreed to progress national real time prescription monitoring as a federated model with jurisdictions committed to progressing development and adaptation of systems to connect to and interface with Commonwealth systems to achieve a national solution.

The Victorian Department of Health and Human Services is taking action to reduce the growing harms, including deaths, from high-risk prescription medicines by implementing SafeScript, Victoria’s real-time prescription monitoring system developed by Fred IT Group supported by Microsoft. SafeScript will provide health professionals with real time alerting to their clinical desktop and access to their patients’ prescription history for certain high-risk medicines to enable safer clinical decisions on whether to prescribe or dispense a medicine. A comprehensive change management and training program to support the deployment of SafeScript is being delivered by Western Victoria Primary Health Network as the lead agency for a consortium comprising the Victorian PHN Alliance, NPS MedicineWise and other partners.

The Tasmania’s Department of Health and Human Services has developed Drugs and Poisons Information System Online Remote Access (DORA), a webpage-based information system providing clinicians with timely and secure access to a DHHS database to view clinical information and dispensing data relating to Schedule 4 and 8 opioids and all other Schedule 8 drugs. Queensland Health is developing a business case to examine how real time reporting of controlled drugs could be implemented in Queensland, and WA Health has also commenced planning for a real time prescription monitoring service solution for controlled drugs.

Supporting better health outcomes for those affected by allergies has been advanced by the formation of the National Allergy Strategy. Allergic diseases have become an increasingly important chronic disease and public health issue in Australia, contributing to increased demand for medical services, significant economic cost of care and reduced quality of life of people with allergic diseases and their carers. Currently affecting more than 4 million Australians, the rapid and continuing rise of allergic diseases is therefore a serious public health issue that requires action by all levels of government and the community.

The National Allergy Strategy has engaged with the Australian Digital Health Agency and the Australian Commission for Safety and Quality in Health Care to identify key issues in drug allergy management in terms of clinical education requirements and potential improvements to My Health Record to increase patient safety for drug allergy. NPS MedicineWise has been working with the National Allergy Strategy group with a view to building standardised coding and presentation of allergy and adverse reactions in clinical systems, including in the MedicineWise app. 

A hub for the 250,000 young Australians living with severe allergies’ www.250K.org.au - aims to provide age-appropriate information and resources to assist young people who are living with severe allergies, and to help them to feel more connected with other teens and young adults going through similar experiences in a fun but informative way. MIMS is working to incorporate SNOMED CT-AU substance terms into their allergy alert product, which they believe is key to the successful, deeper integration of allergy recording and alerting within medicines management systems. 

Read more - National Digital Health Strategy Activities