What is prescription in pharmacy

Electronic prescribing allows prescribers and their patients to use an electronic prescription. It forms part of an Australian Government budget measure to make the PBS more efficient.

Table of Contents Show

Why electronic prescribing is important
Goals of the initiative
Meeting our goals
PBS regulatory framework
Information for prescribers and dispensers
Writing a prescription
Benefits of using electronic prescribing
Image-based prescribing
State and territory requirements
Australian Capital Territory
New South Wales
Northern Territory
South Australia
Western Australia

Electronic prescriptions are part of the broader digital health and medicines safety framework. They enable the prescribing, dispensing and claiming of medicines, without the need for a paper prescription.

Electronic prescribing does not fundamentally change existing prescribing and dispensing processes. Patients can still choose which pharmacy they attend to fill their prescription.

While paper prescriptions are still available, prescribers and patients can choose an electronic prescription to be issued instead.

Why electronic prescribing is important

Electronic prescribing is important because it:

provides greater choice for patients
makes prescribing and dispensing medicines more efficient
may reduce prescribing and dispensing errors
supports electronic medication charts in hospitals and residential aged care facilities
removes the need for handling and storing a physical paper prescription
supports digital health services such as telehealth services to ensure continuity of patient care
provides an opportunity to protect community members and health care providers from exposure to infectious diseases (for example, COVID-19)
maintains patient privacy and integrity of personal information.

Goals of the initiative

Electronic prescribing aims to provide convenience and choice to patients while improving PBS efficiency, compliance and drug safety.

Meeting our goals

We have implemented electronic prescribing. The Australian Government has changed legislation to make electronic prescribing of PBS medicines legal. States and territories have made changes to their legal frameworks to allow for electronic prescriptions in their jurisdiction.

We are continuing to work with the Australian Digital Health Agency to deliver the technical framework to help clinical software systems create, collect and store electronic prescriptions. This technical framework details the requirements for clinical software to:

maintain patient choice of prescriber and pharmacy for supply of their medicines
adhere to privacy and security principles
ensure alignment with legislation.

Services Australia has also changed the PBS claim-for-payment system to support the new arrangements.

Timelines

The rollout of electronic prescribing is nearing completion. Clinical software that can create, collect and store an electronic prescription is increasingly available across Australia.

The Australian Government encourages community pharmacies and prescribers to learn about using electronic prescriptions. This includes getting software ready and participating in training opportunities the Australian Digital Health Agency, peak bodies and software providers are delivering.

See Electronic prescriptions at the Australian Digital Health Agency site.

PBS regulatory framework

The regulatory framework to allow for electronic prescribing under the PBS has several components.

Changes to the National Health (Pharmaceutical Benefits) Regulations 2017 allow the use of an electronic prescription under the PBS.

Four instruments under these regulations support the use of electronic prescriptions, including electronic prescriptions that are medication charts.

The Form of the Electronic Prescription 2019 defines the information fields required when a PBS prescriber writes an electronic prescription.
The Electronic Prescriptions Information Technology Requirements 2019 details system requirements for participating in electronic prescribing.
The Form of the PBS Hospital Medication Chart details requirements for paper and electronic forms of medication charts for use in hospitals.
The Form of the National Residential Medication Chart details requirements for paper and electronic forms of medication charts for use in residential care facilities.

The following policies guide electronic prescribing:

For further information regarding the Commonwealth Privacy requirements, see the Electronic Prescribing Privacy Impact Assessment Public Summary.

Further information about the Department of Health’s privacy policy can be found online.

Changes to the National Health (Claims and under co-payment data) Rules 2012 allow PBS claims from electronic prescriptions. The rules state what information approved suppliers must provide about supplying PBS medicines from electronic prescriptions.

Information for prescribers and dispensers

Writing a prescription

A prescriber can write prescriptions for dispensing by pharmacists in the following 2 ways:

Use standard prescription paper forms.
Write prescriptions electronically – you will need to update your clinical information system to do this. Read about setting up electronic prescribing, or you can contact your software provider directly.

All prescriptions must follow certain rules. Read more on rules for prescribing PBS medicines and information for pharmacists. You must continue to adhere to the National Health Act 1953 and relevant state or territory regulations when prescribing and supplying medicines.

Benefits of using electronic prescribing

Prescribers can create electronic prescriptions in their software during consultations, where their software is conformant. A unique electronic token (in the form of a QR code) is created and sent to the patient as an SMS or email. The token is a key that unlocks the electronic prescription. Patients can provide the token to the pharmacist to enable dispense and supply of the medicines.

There are many benefits to electronic prescribing, including enabling prescribers and pharmacists to assist their patients in a way that was not previously possible.

For example, prescribers can print evidence of an electronic prescription in the form of a token and fax/email to a pharmacy with the patient's consent. As long as the token is legible, pharmacists can scan it and safely dispense the electronic prescription.

As the electronic prescription is linked to the token, it can only be downloaded once. Therefore, the risk of safety and quality and fraudulent activity is greatly reduced.

Another advantage to electronic prescribing is the Active Script List (ASL).

The ASL is a token management system that provides a list of the patient’s active prescriptions. It has the ability to display all current active eligible barcoded paper and electronic prescriptions any time a prescriber/pharmacist accesses the patient's ASL. Patients are able to elect which prescriptions are sent to their ASL and which prescribers and pharmacist can view their ASL.

From this list, the pharmacist can dispense electronic prescriptions, including electronic prescriptions that were issued before the ASL was registered where the script has repeats remaining to be filled. Patients on multiple medicines are encouraged to talk to their pharmacist about using an ASL.

Find out more about the Active Script List.

Image-based prescribing

Electronic prescribing should not be confused with image-based prescribing.

Image-based prescribing arrangements implemented at the start of the COVID-19 pandemic will now end on 31 March 2022, except with hospitals. From 1 April 2022, image-based prescribing will only apply to the supply of pharmaceutical benefits for patients treated in public and private hospitals.

A prescription written for a hospital patient can be lawfully dispensed by a hospital pharmacy. This arrangement for will extend until 31 March 2023.

Electronic prescribing is the preferred electronic option; image-based prescribing should only be used if electronic prescribing is not possible, and after 31 March 2022, it will no longer be legal in community settings.

Fact sheets on interim arrangements for supply of medicines to support telehealth patients in the community setting are available for prescribers and pharmacists.

Although the Special Arrangement which allows certain supplies to be made based on a digital image or copy of a prescription (provided to an approved supplier by a PBS prescriber) is being limited to approved hospital authorities, residential care services can continue using copies of medication charts for PBS prescribing. This is allowed by section 45(2) of the National Health (Pharmaceutical Benefits) Regulations 2017 which specifies that an approved supplier may supply a pharmaceutical benefit on the basis of a medication chart prescription only if the supplier has seen a medication chart or a copy of the medication chart that includes all prescribing information requirements.

Patients are still not required to sign to acknowledge receipt of supply if it is not practical for them to do so. The pharmacist may sign on behalf of the patient unless it is not practical for them to do so. Signature exemptions for safety net concession cards also continue to apply. This interim arrangement will also continue until 31 March 2023 to help prevent the transmission of COVID-19.

Prescriptions written before 31 March 2022 with existing repeats that were dispensed under image-based prescribing in the community setting will continue to be honoured in community pharmacies after 31 March 2022. These must continue to be retained by the pharmacist for subsequent supply of the medicine, until the prescription runs out or expires.

While image-based prescribing in the community is ending, healthcare providers also continue to have utilisation of options that existed prior to the COVID-19 pandemic to enable remote support to patients. For example, if a patient prefers to receive their paper-based prescription following a telehealth or telephone attendance, they, or someone known to them, may still collect their prescription in person or receive it by post and arrange supply of medicines separately in line with existing processes.

State and territory requirements

Australian Capital Territory

In the Australian Capital Territory, the Medicines, Poisons and Therapeutic Goods Act 2008 enables electronic prescribing.

Read more about medicines management in the ACT during COVID-19.

New South Wales

In New South Wales, an exemption from the New South Wales Poisons and Therapeutic Goods Regulation enables electronic prescribing. See more information for:

Northern Territory

In the Northern Territory the Electronic Transactions (Northern Territory) Act 2000 enables electronic prescribing. Read about medicines and poisons control in the Northern Territory.

Queensland

In Queensland, the Medicines and Poisons Act 2019 and supporting Medicines and Poisons (Medicines) Regulation 2021 enables systems that meet the conditions specified in the Departmental Standard – Requirements for an electronic prescription management system (Version 1), to electronically prepare, transfer, retrieve and record prescription information (electronic prescription) for a medicine, and to record dispensing activities.

South Australia

In South Australia, the Controlled Substances (Poisons) Regulations 2011 enable electronic prescriptions. Read information for consumers, health professionals and software vendors.

Tasmania

In Tasmania, Regulations 21 and 46 of the Poisons Regulations 2018 enable electronic prescriptions, where approved by the Tasmanian Secretary for Health. The Secretary for Health must approve any software system used in Tasmania to prescribe, transmit, or dispense electronic prescriptions. Read about electronic prescribing in Tasmania.

Victoria

Read about electronic prescribing in Victoria.

Western Australia

In Western Australia, the Medicines and Poisons Regulations 2016 enable electronic prescribing. The Western Australian Department of Health must approve each product that is part of an electronic prescribing system. Read about electronic prescribing in Western Australia.