From February 2021, it is mandated that medications are prescribed using their active ingredient, instead of their brand name.
The goal of Active Ingredient Prescribing is to help people understand what medicines they are taking. Under new medicine regulations, doctors must include the active ingredient names when preparing prescriptions for Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS (RPBS) medicines. This will mean most medicines will be prescribed by their active ingredient, not the brand name.
If you are a GP your software will automatically prescribe by active ingredients, and prescribers will need to select the inclusion of brand if clinically necessary.
Changes won’t apply to handwritten prescriptions, paper-based medication charts in residential aged care, a small number of PBS and RPBS items which should be prescribed by brand name for safety and practicality reasons.
You can read more about active ingredient prescribing here.
For more resources and demos click on the links below:
- Best Practice Users
Active Ingredient Prescribing: What Does It Mean For You?
- Medical Director Users
Active Ingredient Prescribing is coming: here’s what you need to know
Active Ingredient Prescribing in Genie
Electronic medication management seeks to improve the process of prescribing, dispensing, administering, and monitoring of medicines to ensure good health outcomes and cost-effective use.
The Australia Digital Health Agency has information and resources about electronic medicine management. Find out more here.
Electronic Transfer of Prescriptions (ETP)
ETP involves the creation of an electronic message alongside the paper prescription, which is transmitted to a Prescription Delivery Service (PDS). At the time of prescribing, a barcode is generated and printed on a paper prescription. A pharmacy then dispenses the prescription by scanning the barcode which downloads the prescription information from the PDS.
- Reduces the likelihood of transcription related dispense errors.
- Assists in meeting the Practice Incentives Program eHealth Incentive (ePIP) requirements.
- Enables upload of prescription and dispense records to My Health Record.
- Supports the technical requirements for electronic prescriptions.
- Improves quality and efficiency of both prescribing and dispense processes.
- Improves communication between prescribers and dispensers.
There are currently two prescription delivery services available for providers — eRx Script Exchange and MediSecure. The two services are interoperable, meaning prescription information sent using one PDS can be downloaded by a pharmacy connected to the other PDS.
Access ETP Checklist for General Practice to ensure you are registered with a Prescription Delivery Service (PDS).
Electronic Prescribing (ePrescribing)
Electronic prescribing allows for the prescribing and dispensing of medicines without the need for a paper prescription, which can improve efficiency and medicines safety.
Electronic prescribing is an initiative as part of the National Health Plan. It was originally due to be rolled out next year, but its delivery has been progressed to support telehealth consultations and to help protect healthcare providers and patients from infectious disease, in this case COVID-19, by removing the need to present to your GP in person to get a prescription.
Instead of a paper prescription, the patient can choose to receive their prescription via an app, SMS, or email in the form of a link to a unique QR code or ‘token’.
The token is scanned by the pharmacy to unlock the electronic form of the prescription from an encrypted and secure electronic prescription delivery service. If the patient has a repeat for a prescription, they will receive a new token from the pharmacy that replaces the original token.
Electronic prescriptions will not be mandatory. Patients will have a choice to receive either an electronic or a paper prescription from their prescriber (but not both).
By the end of the year, pharmacy will also be able to access and dispense from an ‘active script list’, which provides a list of all the patient’s current prescriptions, including repeats.
- 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 (COVID-19 for example).
- Maintains patient privacy and integrity of personal information.
Peak body links
- The Australian Digital Health Agency (ADHA) website contains information, factsheets, and checklists for prescribers.
- The My Health Record website contains information on sending prescription and dispense records to a patient’s My Health Record.
- RACGP website contains information for patients.
- Best Practice - All Your ePrescribing Resources Available in One Spot
- Medical Director - How to prepare for ePrescribing with MedicalDirector Helix and Clinical
- Prescribers wanting to order digital media assets:
If you would like to order any digital media assets in preparation for electronic prescribing, please see below login details for the Australian Digital Health Agency (ADHA) Digital Health Resource Library. Here you can order online and point of sale items at no cost to you:
Log in to the Digital Health Resource Library:
- Username: GP
- Password: digitalhealth
You can simply download and copy any of the online assets and paste to your social media sites/websites. Any point of sale advertising items, just add to the cart, enter your address, and the agency will send the assests directly to you at no cost.
- The Australian Digital Health Agency (ADHA) website contains information, factsheets, and checklists for dispensers.
- The My Health Record website contains information on sending prescription and dispense records to a patient’s My Health Record.
- RACGP website contains information for patients.
- With regards to a My Health Record security and access policy, please see this comprehensive guide by the PSA, which includes a policy template.
- Software/clinical workflows:
- Dispensers wanting to order digital media assets:
If you would like to order any digital media assets in preparation for electronic prescribing, please see login details for the Australian Digital Health Agency (ADHA) Digital Health Resource Library. Here you can order online and point of sale items at no cost to you:
Log in to the Digital Health Resource Library:
- Username: Pharmacy
- Password: digitalhealth
You can simply download and copy and of the online assets and paste to your social media sites/websites. Any point of sale advertising items, just add to the cart, enter your address, and the agency will send the assets directly to you at no cost.
Sullivan Nicolaides Pathology (SNP) is able to upload pathology results to a patient’s My Health Record for episodes that are referred as an electronic order (eOrder), also known as eRequesting, that includes the patient’s Individual Health Identifier (IHI) and the flag to indicate the patient has given consent to send pathology results to their My Health Record.
Doctors will then have a seven-day window for consultation and discussion of the results with their patients, after which patients can access their results in their My Health Record.
To enable this to happen, requesting doctors must send their eOrders electronically from a compliant practice management system such as Best Practice (Lava SP3 and later) and Medical Director (3.17.2 and later) and each practice doctor needs to have the ‘Opt-in’ functionality enabled in their software. The practice also needs to complete the attached form and email it to email@example.com or fax to (07) 3318 7409.
For more information, please contact your Medical Liaison Manager on 1300 767 284.
The NQPHN Digital Health Team have developed the above short video about electronic requesting and how to get your general practice connected. The video covers:
- What is electronic requesting?
- How will it benefit your practice and patients?
- How to get connected.
Click here to watch the video.
The HPP service provides summary patient healthcare details to registered and authenticated health practitioners. All information on display is provided via secure tunnel access to Queensland Health’s read-only clinical application, The Viewer. This read-only online access will allow GPs, nurses, midwives, and paramedics to view public hospital information including appointment records, radiology and laboratory results, treatment and discharge summaries, and demographic and medication details.
Informed consent in healthcare is about ensuring patients have the means to understand their choices and rights relating to examinations, tests, treatment, medicines, or procedures and consent to the ultimate decisions.
It is important the practitioners clearly define for the patient:
- all options available
- the purpose of the examinations, test, treatment, medicine, or procedure
- the method of the examinations, test, treatment, medicine, or procedure
- potential risks
- the benefits.
Reasonable time should be given to discuss and consider each decision.
View the resources list below to assist you to have informed consent conversations with your patients.
Informed consent can be more difficult for people with impairments impacting their cognitive or communications skills, or people who do not speak English as a first language. In these scenarios, it may be necessary to:
- employ the services of an interpreter
- engage a friend, family member, or carer as part of the conversation.
Translating and interpreting service providers recommended by Queensland Health include:
My Community Directory is a not-for-profit community information platform endorsed by NQPHN as a preferred access point for healthcare providers and community members to quickly and easily find health, social, and community service organisations and events.
Having a single, robust, and well utilised services directory improves navigation of the healthcare system, for both providers and community, and strengthens the quality of service mapping. My Community Directory helps build community resilience and self-care by providing to-the-minute information about what services are available and when to users in any time or place.
The benefits for providers include:
- link to other services to enhance your referral network
- update your information at any time
- promote events for free
- see what other services are available in your area
- build and communicate with your industry network
- provide valuable data to map available services in our region
- advertise for volunteer positions
- have access to online resources and support
- instant language translation of your business details
- imbed directory and events page into your own business website.
My Health Record is a secure online summary of a patient’s health information collected from patients, providers and Medicare. Primary care providers can quickly access information about patients’ history such as shared health summaries, discharge summaries, prescription and dispense records, pathology reports and diagnostic imaging reports.
My Health Record is an initiative of the Australian Government Department of Health, which provides information, resources, training, and support on their Healthcare Professionals webpage.
NQPHN strongly endorses the use of My Health Record because it allows:
- timely access to up-to-date patient records, supporting clinical decision-making and continuity of care
- quick access to safety information, such as allergies and pre-existing medical conditions
- enhanced patient self-management
- a reduction of service and test duplication, increasing efficiency of service.
You can access user support for My Health Record here.
The Australian Digital Health Agency offers online training on My Health Record. Find their resources here.
Access resources and templates for General Practice on the RACGP website.
Shared services contacts
Provider Digital Access (PRODA) Help Desk: 1800 700 199
Health Professional Online Services (HPOS) Help Desk: 1800 723 471
Healthcare Identifier Service Help Desk: 1300 361 457 (for help registering an organisation in My Health Record and the HI Service)
NASH PKI eBusiness Service Centre: 1800 700 199 (for help with a NASH PKI certificate request and any online technical support for software vendors).
- 26 November 2020: Digital health update - Specialists
- 26 November 2020: Digital health update - Allied health
- 3 December 2020: Digital health update - Healthdirect video call
- 3 December 2020: Digital health update - Nurses
- 13 January 2021: Digital health update - Specialists
- 13 January 2021: Digital health update - General practice
- 1 March 2021: Digital health update - Specialists
- 30 March 2021: Digital health update
- 7 April 2021: Digital health update
The Practices Incentives Program eHealth Incentive (ePIP) is an initiative run by the Australian Government’s Department of Human Services on behalf of the Department of Health. It aims to encourage general practices to update their digital health activities and implement new technologies as developments occur.
To take part in the incentive, the practice must be accredited or registered to be so. They must also have compliant medical software, which you can check here at the PIP eHealth Product Register.
The ePIP Guidelines are available on the Department of Human Services website.
Provider Digital Access (PRODA) and Health Professional Online Services (HPOS) are complementary tools from the Australian Government Department of Human Services.
Provider Digital Access (PRODA)
PRODA is an online identity verification and authentication system to allow you to securely access government services such as:
- Medicare Online
- Pharmaceutical Benefits Scheme Online (PBS Online)
- Disability Medical Assessment Online service
- Aged Care Provider Portal
- Australian Immunisation Register (AIR)
- Practice Incentives Program (PIP)
- Practice Nurse Incentives Program (PNIP)
- DVA Webclaim
- My Health Record National Provider Portal
To register for PRODA, click here.
If you are already registered, access your PRODA account here.
Health Professional Online Services (HPOS)
HPOS is a web-based service provided by Medicare that gives primary care providers the ability to send and receive information to or from Medicare securely. It is used by general practitioners, specialists, allied health professionals, nurses, practice managers, and practice staff.
The Australian Government Department of Human Services website has more information, including this overview of the HPOS home page.
To access the full range of information and services available through HPOS, log on through Provider Digital Access (PRODA).
QScript: what you need to know
Following the Commonwealth Department of Health’s proposal in 2018, Queensland Health has introduced QScript—a real-time prescription monitoring system. Since 28 October 2021, all relevant health practitioners are required to have registered and be accessing the system.
All Australian states and territories are working towards implementing real-time prescription monitoring solutions, with the aim of establishing a national system. Once established, information about monitored medicines dispensing events occurring in other states and territories may be recorded and viewable in QScript.
Relevant health practitioners are required to check QScript for patient records before:
- prescribing a monitored medicine
- dispensing a monitored medicine
- giving a treatment dose of a monitored medicine.
The following health practitioners have access to QScript:
- medical practitioners
- nurse practitioners
- endorsed midwives
- podiatric surgeons and endorsed podiatrists.
QScript captures medicines that have a recognised therapeutic use but may also present high-risk harm. The Medicines and Poisons Act 2019 refers to these medicines as ‘monitored medicines’:
- all schedule 8 medicines (e.g. opioids, alprazolam, nabiximols, dexamphetamine)
- the following schedule 4 medicines:
- all benzodiazepines
Numerous factors were considered when determining whether a medicine was suitable for inclusion in the list, including the evidence of harm and trends in prescribing, misuse, and abuse. Ongoing research and trends in will inform any future changes to the monitored medicines list.
Queensland Health have reported that every two minutes one Australian is hospitalised because of prescription medicines. Associate Professor Suzanne Nielsen, the Deputy Director of the Monash Addiction Research Centre at Monash University, hosted a webinar for QScript, Preparing for QScript – Having meaningful discussions about opioid-related risks. In this webinar A Prof Nielsen discusses that one in four patients prescribed long term opioids meet criteria for ‘addiction’ and four in five have meaningful opioid overdose risk, though little knowledge of risk or symptoms.
Associate Professor Nielsen also provides recommendations for reducing interim risks, including consideration of a staged supply, naloxone (including education for carer/family), and specialist consultation (pain services, addiction medicine specialists). The Alcohol and Drug Clinical Advisory Service (ADCAS) is a specialist phone support service for health professionals in Queensland that provides clinical advice regarding the management of patients with alcohol and other drug concerns. This is a free service available between 8am-11pm, seven days a week. ADCAS can be contacted on 1800 290 928. A poster is available here.
How does QScript work?
The data in QScript is collected automatically from Prescription Exchange Services (PESs) which currently support the transfer of electronic prescriptions and prescription information from medical clinics to pharmacies. When a prescription is issued at a medical clinic or dispensed at a pharmacy connected to a PES, the PES sends a record of the prescription to QScript in real-time.
The expected workflow is:
- when prescribing, a prescriber follows the direction of the QScript notification prompt
- prescriber uses their clinical reasoning to decide whether to prescribe
- if prescribed, the patient presents the prescription to a pharmacy
- when dispensing, a pharmacist follows the direction of the QScript notification prompt
- pharmacist uses their clinical reasoning to decide whether to dispense
- if dispensed (other than in a public sector hospital) monitored medicine prescription information is automatically uploaded into QScript.
QScript is a read-only system; health practitioners are not required to manually enter any information into the system.
When a notification appears, users click on the link to be taken directly to the QScript patient record, where one exists.
*Green notifications contain a link that directs users to the patient search screen (although there is no legal requirement to do this).
Discussing QScript concerns with patients
If patients or carers are concerned about QScript, health practitioners are encouraged to discuss their QScript record and explain the benefits of having this information. QScript is not integrated with My Health Record. While My Health Record may contain prescription medication information, due to the ‘opt out’ provisions, this data may be incomplete.
Patients are not able to opt-out of having their monitored medicine prescription information recorded in QScript. They may have some concerns if alerts or notifications are triggered on their QScript record. If patients or carers are concerned about their privacy, reassure them that only those health practitioners involved in their care are authorised to view their QScript record. Patient searches by health practitioners are logged and can be audited to monitor inappropriate use. Authorised Queensland Health and other regulatory officers can also access QScript, to manage the operation of QScript and to exercise powers or perform functions under the Medicines and Poisons Act 2019 relating to monitored medicines.
A poster for general practice can be found here.
Patient records not included in QScript
QScript contains records of monitored medicines that have been dispensed to a patient (provided on prescription) in community and private hospital pharmacies in Queensland. It also contains some records of monitored medicines prescribed for patients. QScript does not contain records of:
- monitored medicines dispensed from public sector hospital pharmacies
- monitored medicines supplied in other states/territories
- monitored medicines administered to patients (e.g. in health services such as hospitals, prisons, aged care facilities)
- monitored medicines given as a treatment dose (i.e. not dispensed by a pharmacist)
- prescriptions which are handwritten or generated in clinical software systems not integrated with a Prescription Exchange Service will not be included in QScript until they have been dispensed at a community or private hospital pharmacy
- Queensland Opioid Treatment Program records prior to 2015
- prescription and dispensing events prior to December 2019.
An explanation of alerts to high-risk clinical scenarios
There are six high-risk clinical scenarios which will trigger a ‘red’ notification:
Scenario A: Patient currently registered on the Queensland Opioid Treatment Program
Scenario B: Patient previously registered on the Queensland Opioid Treatment Program
Scenario C: Patient receiving monitored medicines from multiple prescribers: a patient who in the previous 90 days has been dispensed monitored medicine prescriptions written by 4 four or more prescribers
Scenario D: Increased patient overdose risk – average total daily opioids of 100mg oral morphine equivalent (OME) or greater. A patient whose average total daily opioid dose:
- is currently 100mg OME or greater – based on the amount of opioids dispensed over the previous 90 days; or
- will be 100mg OME or greater – based on the amount of opioids dispensed over the previous 90 days (if any) and the amount of opioids proposed to be prescribed or dispensed.
Scenario E: Increased patient overdose risk – opioid and benzodiazepine/z drug combination.
A patient who in the previous 90 days has been dispensed:
- an opioid and a benzodiazepine/z-drug (zopiclone or zolpidem); or
- an opioid—and it is proposed they are prescribed or dispensed a benzodiazepine/z-drug; or
- a benzodiazepine/z-drug — and it is proposed they are prescribed or dispensed an opioid.
Scenario F: Patient receiving an opioid or benzodiazepine/z drug for the first time in 90 days. A patient who in the previous 90 days has not been dispensed:
- an opioid – and it is proposed they are prescribed or dispensed an opioid; or
- a benzodiazepine/z-drug – and it is proposed they are prescribed or dispensed a benzodiazepine/z-drug.
What happens if I don’t check QScript when required?
The Medicines and Poisons Act 2019 specifies penalties that can be imposed if health practitioners do not take reasonable steps to check QScript when required. There will be exceptions in some circumstances, including when treating patients in an emergency. A maximum of 20 penalty units ($2,757 as of 1 July 2021) will apply if a relevant practitioner fails to check QScript when required— unless they have a reasonable excuse. Queensland Health will monitor the system. In cases where QScript has not been checked, health practitioners will be advised of their legal requirements and be provided with information on how to register for and access QScript, if they haven’t already done so. If a health practitioner continues to not check QScript, enforcement action may occur.
Northern Queensland Primary Health Networks (NQPHNs) Digital Capability Team can assist health professionals with basic troubleshooting and education.
Basic troubleshooting tips include:
- when integrating QScript, ensure your clinical software is the latest version
- third party cookies need to be enabled in browsers
- QScript have recommended logging in to QScript every morning. Set up a pin for the day (which lasts for 12 hours), and stay logged in. If integration is complete, you can click on a QScript notification to be taken to the patient history in QScript.
Some clinical software, including Best Practice, provide helpful resources on integrating QScript. Check with your clinical software provider for available resources.
If users have technical issues registering for or logging into QScript that they have not been able to resolve after reviewing the help topics, they can contact 13 S8INFO (13 78 46) phone line operated by Queensland Health and select option #2 for technical assistance.
As healthcare becomes increasingly digitised, providers and patients alike are demanding better security of data and personal information. Reliable, secure provider-to-provider communication is key. This requires a commitment to secure messaging – safe, streamlined, and confidential information sharing across all healthcare providers and consumers.
Benefits for providers:
- secure exchange of clinical information and documents
- reduced use of paper and decreased need for scanning, printing, filing
- less time chasing clinical information or referrals
- patient confidence in confidentiality
- send/receive receipts
- faster access to information.
Visit the Australian Digital Health Agency to find out more, including information about their Secure Messaging Program.
Queensland Health’s Smart Referrals program streamlines the creation and management of referrals to Queensland specialist outpatient services with the aim of improving patient experience and safety.
The program brings together GP Smart Referrals, Referrals Service Directory, Referral Lodgement and Tracking, Smart Referrals Workflow, and HHS Smart Referral. Smart Referrals integrates with HealthPathways.
Smart Referrals aims to bring:
- safety and quality of care - enhanced quality of referral information, informs clinical handover, triage and treatment of patients
- workflow efficiency - faster, streamlined referral management supports better patient outcomes
- patient experience - enhanced quality of referral information reduces wait times
- GP experience - quicker and easier for GPs to refer
- clinician experience - enhanced decision support information improves patient care
- financial benefits - reduction in referral rework and avoidable appointments.
Find out more on Queensland Health website.
What is telehealth?
Advancements in technology enables primary healthcare providers to improve health equity, access to services, and workforce needs through the use of telehealth.
Information and communication technology can be leveraged to provide telemedicine, medical education, and health education to people living in regional, rural, and remote areas. Practitioners transmit voice, data, images, and information to patients to diagnose, treat, or educate whilst being physically distant. This means patients can receive care in their community, without the need to travel.
The Australian Government Department of Health website has information on telehealth, including what services are Medicare-funded.
Find the standard Telehealth MBS Items here.
In March 2020, the Australian Government announced new bulk-billed items for telehealth for vulnerable patients or vulnerable health practitioners relating to the COVID-19 Pandemic. These items are for GPs, specialists, consultant physicians, obstetricians, consultant psychiatrists, nurse practitioners, allied mental health workers, and midwives:
- Bulk-billed pathology services where a medical practitioner has requested a test for SARS-CoV-2 under a new item.
- Bulk-billed pathology services for a pathologist to test for SARS-CoV-2 and relevant respiratory viruses, if the treating practitioner did not request them.
View the updated items here.
healthdirect Video Call telehealth service is free for General Practices, Aboriginal Medical Services (AMSs) and Aboriginal Community Controlled Health Organisations (ACCHOs) until 31 December 2021.
Health professionals working in aged care, allied health, Indigenous health, maternity health, and mental health services can use Video Call under the pilot program funded by the Australian Department of Health until 30 June 2022. Eligibility criteria is subject to change.
24 JanCommunity of Practice 24/01/2022 12.00pm- 1.30pm Online Aboriginal and Torres Strait Islander Health Workers, Child protection and disability workers, Child safety staff, Community-based child and youth focused organisations, Healthcare professionals, Indigenous peoples' organisations