The Australian Government, in collaboration with states and territories, has accelerated the delivery of electronic prescribing to help protect people most at-risk from COVID-19. Electronic prescribing, where available in the community, will provide patients with a choice to receive either an electronic or a paper prescription from their prescriber. Visit the Electronic Prescriptions website for more information.
An exemption from the NSW Poisons and Therapeutic Goods Regulation has been granted to allow electronic prescriptions to be legally issued and dispensed in NSW.
To participate in electronic prescribing, software vendors are required to meet the requirements in the Electronic Prescribing Conformance Profile developed by the Australian Digital Health Agency (ADHA). The ADHA publishes information for vendors on the Electronic Prescribing Conformance Process.
For an electronic prescription to be legally valid in NSW, all systems participating in the prescribing, transmission and dispensing of the prescription must be listed on the ADHA Electronic Prescribing Conformance Register with a Conformance ID. Such a prescription is then termed a 'Conformant Electronic Prescription'.
Specifications identified in the Electronic Prescribing Participating Software Conformance Profile as having a jurisdictional requirement are provided below and must be met.
For an electronic prescription to be legally valid for dispensing in NSW it must contain the details listed below. This list incorporates prescription requirements under the Poisons and Therapeutic Goods Regulation 2008. (Where possible, Reference IDs from the Conformance Profile are listed).
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Some requirements for paper prescriptions do not apply to Conformant Electronic Prescriptions.
Prescribers of Conformant Electronic Prescriptions do not need to comply with the following paper prescription requirements:
Pharmacists dispensing Conformant Electronic Prescriptions are exempted from the following paper prescription requirements:
Under the Poisons and Therapeutic Goods Regulation 2008, a person issuing a prescription for a Schedule 4 medicine listed in Appendix D of the Poisons and Therapeutic Goods Regulation 2008 (S4D) or a S8 medicine must keep a record of it for a period of at least two (2) years.Medical records otherwise must be kept as required under the Health Practitioner Regulation National Law. They should be retained in a retrievable format and readable state for their minimum required retention period.
All NSW required details (see PRES-17) shall be displayed.
Electronic prescriptions should be displayed in a similar manner to paper prescriptions.
The NSW Poisons and Therapeutic Goods Regulation 2008 has no mandatory requirement to record receipt of supply in the dispensing system.
For opioid substitution therapy, the pharmacist may record that the dose has been received by the patient.
All records must be retrievable in human readable format immediately by any pharmacist in charge at any time at the premises where the prescription was dispensed and retained for two (2) years from the date of dispensing.
The dispense record must contain:
All dispense records must be retrievable in human readable format immediately by any pharmacist in charge at any time at the premises where the prescription was dispensed and retained for two (2) years from the date of dispensing.
PRES-17 provides a list of prescription details required to be displayed to the dispensing pharmacist.
Records must be immediately retrievable in human readable format at the premises and retained for two (2) years.
A separate approval from NSW Health is not required where a system conforms under the Electronic Prescribing Conformance Assessment Scheme and has been listed on the Electronic Prescribing Register of Conformance with a Conformance ID.
Pharmacists are exempted from these requirements because conformant systems record the date of dispensing, the pharmacy address and the prescription reference number, and securely transmit and retain details of prescriptions which are easily searchable. Repeats of conformant electronic prescriptions for S4B and S8 medicines, therefore, do not have to be dispensed at the same pharmacy which dispensed the original prescription. A patient can take the new token for their repeat prescription to a different pharmacy if they choose so.
When dispensing electronic prescriptions, pharmacists should be particularly vigilant that the on-screen display shows repeat intervals where required. A prescription for a S4B or S8 medicine with repeat/s specified must show an interval for repeats. If no repeat interval appears, directions for any repeat supplies are invalid and no repeats can be dispensed. The pharmacist may only dispense a single supply. The prescription should be electronically cancelled to prevent a new token from being issued.
Pharmacists should also be vigilant that the NSW Authority number is displayed where it is required (see PRES-17 above). The Authority number must be displayed for a prescription for:
The Electronic Prescribing Conformance Assessment Scheme has safeguards to ensure the dispensing pharmacist can be confident in the identity of the prescriber issuing the conformant electronic prescription.
For conformant electronic prescriptions for S8 medicines that include all required details, a pharmacist does not need to contact the prescriber to verify the prescription where the pharmacist does not know the patient. If a pharmacist has doubt about the identity of the prescriber or any other aspect of the prescription or the patient’s treatment he/she should contact the prescriber directly.
Pharmacists must be confident the token presented by the patient or his/her authorised agent has not been fraudulently obtained or altered. Where the pharmacist has concerns, the same steps as used for paper prescriptions are appropriate, including sighting the patient’s or agent’s identification document/s (e.g. photo driver licence) and/or contacting the prescriber. If the token for a S8 or S4D prescription has been altered or fraudulently obtained, the electronic prescription should be cancelled to make the token invalid and unable to be used by any person. The Police should be informed immediately.
For more information on electronic prescribing visit the Australian Digital Health Agency's Electronic Prescribing - For Dispensers.