Real-time reporting of monitored medicines
In 2018 the Commonwealth Department of Health in collaboration with other states and territories proposed a new federated real-time prescription monitoring solution. Under this model, states and territories will aim to integrate with a national data exchange to enable a real-time prescription monitoring system in each state.
QScript will be Queensland's real-time prescription monitoring system.
From commencement of the Medicines and Poisons Act 2019, relevant health practitioners will be required to check the patient's QScript record before:
- prescribing a monitored medicine
- dispensing a monitored medicine
- giving a treatment dose of a monitored medicine.
This applies to all health practitioners authorised to prescribe and dispense a monitored medicine, including those in hospitals, aged care, prisons, and other health services.
The importance of QScript for Queensland
Prescription medicines are available to prevent, manage, treat and cure disease, but statistics show that certain prescription medicines are commonly a cause of considerable physical, mental and social harms. Deaths and harms caused by prescription medicines is a significant public health issue.
There is a growing challenge to increase awareness about the potential risks of prescription medicines, and to implement mechanisms that promote the quality use of medicines and minimise harm. Reducing prescription medicine-related harms is multifaceted and requires both system level and individual level action to succeed.
QScript is one component of the system level changes occurring in Queensland to improve the safe and quality use of monitored medicines.
Who will have access to QScript
The following health practitioners, who are able to prescribe or dispense monitored medicines, will have access to QScript:
- medical practitioners
- nurse practitioners
- endorsed midwives
- podiatric surgeons and endorsed podiatrists
Other health practitioners may also be authorised to prescribe monitored medicines in limited circumstances or subject to certain conditions.
Medicines captured by QScript
QScript captures a comprehensive list of medicines that have a recognised therapeutic use but may also present a high risk of physical, mental and social harms. The Medicines and Poisons Act 2019 refers to these medicines as ‘monitored medicines’ which includes:
- all schedule 8 medicines (e.g. opioids, alprazolam, nabiximols, dexamphetamine)
- the following schedule 4 medicines:
- all benzodiazepines
The list of monitored medicines has been determined based on local and international research and incorporates the recommendations of a multi-disciplinary working party. Numerous factors were considered when determining whether a medicine was suitable for inclusion in the list, including the evidence of harm (on its own or in combination with other substances) and trends in prescribing, misuse and abuse.
Ongoing research and trends in prescribing medicine will inform any future changes to the monitored medicines list.
QScript is a read-only online system that will integrate with the everyday workflow of compatible prescribing and dispensing software. The system will alert health practitioners to review a patient’s monitored medicine prescription history at the point of care.
The data in QScript will be collected automatically from Prescription Exchange Services (PES) 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 will send a record of the prescription to QScript in real-time.
Healthcare happens in real-time. So health practitioners need real-time information to support their clinical decisions.
QScript is Queensland's real-time prescription monitoring system. It captures information about certain medicines, called monitored medicines, which can present a high risk of patient harm.
So how does QScript work? QScript securely receives monitored medicine prescription data automatically in real-time via a cloud-based system. Prescribers and pharmacists can access this information to inform their clinical decision-making.
When integrated with clinical software, QScript can deliver important alerts and notifications using a traffic light system. A red notification means a potentially high-risk circumstance. An amber notification means patient data is available. And a green notification means no patient data currently exists. The traffic light system prompts health practitioners to carefully review the patient's history, but does not prevent prescribing or dispensing.
While QScript is designed to integrate with existing software and clinical workflows, it's also accessible via a secure web-based portal.
Visit QScript online for more information.
Deciding the best course of treatment is the responsibility of those individual health practitioners involved in a patient’s care, and the principles of the quality use of medicines remain.
Preparing for QScript
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 use experience of the system once it is available.
In Australia, there are 2 PES systems in operation, eRx Script Exchange and MediSecure. Approximately 90 per cent of all community pharmacies in Queensland are already connected to 1 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
QScript is enabled by the Medicines and Poisons Act 2019.
The Medicines and Poisons Act 2019:
- gives the head of power for the establishment of the real time prescription monitoring system, called QScript
The Medicines and Poisons (Medicines) Regulation 2021 (to be made):
- specifies the S4 and S8 medicines, known as monitored medicines, to be captured by QScript
- specifies the health practitioners required to use QScript when proposing to prescribe, dispense or give a treatment dose of a monitored medicine.
The Medicines and Poisons Act 2019 will commence when the Medicines and Poisons (Medicines) Regulation is made.
Program of Work on Monitored Medicines
Monitored Medicines Unit
Phone: 0439 593 882