Real-time reporting of monitored medicines
In Australia there is considerable evidence of widespread misuse of prescribed medication. Levels of prescription opioid and benzodiazepine overdose are at record levels.
Providing real-time prescription information directly to treatment providers is one means of significantly improving prescribing and dispensing decisions and reducing harms from inappropriate and/or unsafe use of higher risk prescription medicines.
The Queensland Office of the Health Ombudsman and the South East Coroner have recommended that Queensland Health implement a real-time prescription monitoring system.
In 2018 the Commonwealth Department of Health in collaboration with the states and territories proposed a new federated ICT real-time prescription monitoring solution based on the Victorian SafeScript model. Under this model states and territories will integrate with a national data exchange to enable real-time prescription monitoring system in each state.
Real-time reporting in Queensland
Queensland has a prescription drug monitoring program that collects dispensed schedule 8 (S8) prescription drug information on a weekly basis and provides a telephone enquiry service for doctors. However, the data isn’t available in real-time or automatically accessible to clinicians. In response to this Queensland Health has implemented a program of work on monitored medicines.
The program of work aims to provide prescribers, pharmacists and dispensing medical practitioners with a real-time reporting ICT solution to enable safer decision-making when prescribing and dispensing certain high-risk medications ('monitored medicines'). The proposed real-time reporting system will:
- contain prescription data about monitored medicines which has been uploaded automatically at the point of dispensing, in real-time
- be directly accessible by Queensland prescribers, pharmacists and dispensing medical practitioners, to inform their clinical decision-making.
In October 2019, an agreement was signed between Queensland Health, the Commonwealth Department of Health, and pharmacy IT solution provider Fred IT Group Pty Ltd for development of Queensland's real-time prescription monitoring system. The system - to be know as 'QScript' - will integrate with the Commonwealth Department of Health's National Data Exchange, which may facilitate the sharing of prescription information across borders as part of a national real-time prescription monitoring solution.
Implementation of QScript is subject to parliamentary processes associated with the commencement of the Medicines and Poisons Act 2019 and subordinate legislation.
It is anticipated that QScript will be available to Queensland practitioners following enactment of the Medicines and Poisons Act 2019.
How real-time reporting will work
When a prescription for a monitored medicine is dispensed, the information will automatically be uploaded to a prescription exchange service. These prescription records will then be transmitted to QScript.
QScript will be able to accessed by prescribers, pharmacists and dispensing medical practitioners during a consultation with a patient. The information available is transmitted in real-time during a consultation and ultimately aids the prescribers, pharmacists and dispensing medical practitioners in making safer clinical decisions for their patients.
Connecting to a Prescription Exchange Service (PES)
In preparation for QScript and the implementation of the Medicines and Poisons Act 2019, pharmacies and medical clinics that dispense any monitored medicines referred to in the legislation are encouraged to connect to a Prescription Exchange Service (PES).
Connecting your dispensing software to a PES allows the upload of prescribing and dispensing data into the system, giving more complete patient information and a better user experience of the system once it is available.
In Australia, there are two PES systems in operation, eRx Script Exchange and MediSecure. Approximately 90 per cent of all community pharmacies in Queensland are already connected to one or both prescription exchange services.
To connect to a PES, please contact your software vendor for more information or contact a PES provider on the details below.
Phone: 1800 472 747
eRx Script Exchange
Phone: 1300 700 921
Impact for prescribers and pharmacists
The decision to prescribe or supply a patient with monitored medicines will still be made by the prescriber, pharmacist or dispensing medical practitioner. QScript will not prevent patients from obtaining medicines that are required to manage medical conditions.
All prescribers, pharmacists and dispensing medical practitioners, including those working in hospital settings, will be able to access QScript to review prescription records of those patients in their care.
It is intended that QScript will be quick and easy to use and will have minimal impact on clinical workflow to ensure focus remains on providing patient quality care.
Medicines that will be monitored
To inform which medicines should be monitored within QScript, a working party was convened to identify and discuss which medicines posed the greatest risk of harm to Queenslanders.
Recommendations were then made to the Monitored Medicines Steering Committee. The steering committee includes representatives from a diverse range of medical and pharmaceutical professional bodies, as well as consumers and relevant organisations such as Coroners Court of Queensland. The steering committee endorsed that the following medicines should be monitored in Queensland.
- All schedule 8 substances
- The following schedule 4 medications:
- all benzodiazepines
Please note the list of medications that will be monitored within QScript is subject to parliamentary processes associated with the commencement of the Medicines and Poisons Act 2019 and subordinate legislation.
Program of Work on Monitored Medicines
Monitored Medicines Unit
Phone: 0439 593882