The QScript system
QScript is a read-only real-time prescription monitoring system that notifies health practitioners to review a patient’s monitored medicine prescription history at the point of care.
The system will conveniently integrate with the everyday workflow of compatible prescribing and dispensing software.
As QScript is an online system, an internet connection is required to access the system. It can be accessed via mobile and tablet devices.
Process flow for QScript
- Patient visits prescriber.
- Prescriber accesses QScript to check the patient’s monitored medicine prescription history.
- Prescriber uses their clinical reasoning to decide whether to prescribe.
- If prescribed, the patient presents the prescription to a pharmacy.
- Pharmacist accesses QScript to check the patient’s monitored medicine prescription history.
- 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.
Prescription information in QScript
QScript is a read-only system; health practitioners will not be required to manually enter any information into the system. Prescription 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.
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
- all 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.
All Australian states and territories are working towards implementing real-time prescription monitoring solutions, with the aim of establishing a national system. Once this is established, information about monitored medicines dispensing events occurring in other states and territories may be recorded and viewable in QScript.
Discussing patient care
When a health practitioner views a patient record, their name and organisation contact details are logged. This information is visible to QScript users so health practitioners can contact each other to discuss the patient’s care. Visit the QScript learning portal for information on discussing QScript with patients.
QScript is designed to integrate with existing clinical software. This allows health practitioners to receive notifications when prescribing or dispensing a monitored medicine. When a notification appears, users need to simply click on the link to be taken directly to the relevant QScript patient record, where one exists.
Red notifications mean the prescription has triggered an alert to a high-risk clinical scenario, and careful review of the patient’s QScript record is required.
Amber notifications mean a careful review of the patient’s QScript record is required, but no alert for a high-risk clinical scenario has been triggered.
Green notifications mean no matching patient record has been found in QScript. Green notifications contain a link that directs users to the patient search screen in case the user would like to manually search for a patient record (although there is no legal requirement to do this).
Notifications and legislative requirements
Did the prescription trigger an alert to a high-risk scenario?
Do I have to check the patient’s QScript record?
Patient record exists and
Patient record exists
No matching record found
Visit the QScript learning portal for more information on using the system.
Alerts to a high-risk clinical scenario
Prescribing and dispensing events may trigger an alert within a patient’s QScript record when a high-risk clinical scenario has been identified.
There are six high-risk clinical scenarios:
Patient currently registered on the Queensland Opioid Treatment Program.
Patient previously registered on the Queensland Opioid Treatment Program.
Patient receiving monitored medicines from multiple prescribers: a patient who in the previous 90 days has been dispensed monitored medicine prescriptions written by 4 or more prescribers.
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.
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.
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.