History was made this month in Australia, with the very first electronic prescription being prescribed and dispensed in Anglesea, Victoria. We are about to embark on a significant change period for pharmacy and if you are not thinking about the impact of digital health already, you should be!
The first electronic prescription used the “token” or QR barcode model, that provides the patient with the QR barcode to take (or send) to their pharmacy. This is the first model that will go live progressively from now, and therefore the focus of this article.
Initial advice to us suggested that May 30th was the expected rollout date for this initiative, but the latest advice from the Digital Health Agency suggest that test sites will run from June onwards in ‘Communities of Interest’  and will then see progressive deployment from September onwards. Another model, the Active Script List model, is still under development and the timeframe is also September for completion of that project.
What do you need to do to get ready for electronic scripts?
Whilst you may not see an electronic prescription until later in the year, it’s still very important to get ready now. When discussing electronic scripts, we should be clear at the outset – there are still plenty of details that are currently being worked through! Having said that, these are steps you can take now:
- Ensure you have a barcode scanner
You will need a scanner than can read a QR code! Set this up at the script-in counter, or if your software allows it, you can look at using a tablet device with a camera to scan prescriptions. That way you can roam the pharmacy and scan a script outside the dispensary area!
- Ensure you are connected to the ‘Healthcare Identifiers’ Service
You will need to have an HPI-O for your pharmacy. If you had already registered the pharmacy for MyHealthRecord, chances are you have done this already.
- Your dispense software provider may require you to have a NASH PKI certificate
This allows you to share health information securely online.
- Ensure your pharmacy has either eRx or MediSecure Prescription Exchange Service
This is the key infrastructure for the system to work
- Keep in contact with your dispense software provider and ensure you have the latest version installed
If you haven’t heard from your dispense software provider lately, we recommend confirming with them that they are progressing capability towards electronic prescriptions. Keep your eyes out for any new software updates that may be required.
- Consider your options for queuing prescriptions electronically
In current pharmacy practice, scanning a barcode typically occurs at the point when dispensing occurs. We now find ourselves in a situation where we may want to scan a barcode on a patient’s phone, and dispense later, if there is a queue of scripts in front. Otherwise, you’ll have to take the patient’s phone and put it in a basket in the queue! There is software being developed for this purpose such as MedView Flow, but you should also consider whether you Dispense Vendor is planning on making a queuing feature available as an extension of the current software. Call them or subscribe to their mailing list to find out.
- Let your local prescribers know you are ready!
Keeping in contact with prescribers can help you assess their readiness to proceed, and to build your relationship with them. They might have questions about this that you can answer.
Workflow will change
Your workflow will depend on your dispensing software installed. Queueing of prescriptions is one element we believe will change significantly over time. At low electronic prescription volumes there will be a tendency to keep the existing physical script queue and make some simple tweaks, but as the volume of electronic scripts increases, it’s likely the basket queue makes way for a true paperless electronic queue system in time.
We will likely see some innovative ways of accepting a QR code in the pharmacy over time. We may see the emergence of a terminal or kiosk for a patient to ‘check in’ themselves. The question which remains unanswered at the time of writing, is how patients can send in their QR codes to the pharmacy. We expect to see innovation in this space either through the use of pharmacy apps, the use of a ‘pharmacy mobile’ with a number given out to patients to text their codes to, or perhaps a dedicated email account set up to receive codes. Time will tell which method gains the most traction.
What we are hearing from pharmacies
We have been impressed by how pharmacists have embraced this change, even in the midst of a pandemic! Over the past few weeks, we’ve seen a flurry of activity with pharmacists becoming familiar again with acronyms such as PRODA, HPOS, NASH, and HPIs.
We are being asked whether pharmacies will need more hardware such as additional screens – at this stage it’s not yet clear whether more screens will be required for dispensing and in particular checking of prescriptions, so we would not advise that you rush out and purchase anything without being sure of your needs. We will provide more information as it’s available, but we may initially only see limited numbers of electronic prescriptions and therefore whilst this feels urgent, it may be less so.
All things considered, in the space of a few short weeks, the majority of pharmacies we coach have made leaps forward in the digital health space.
With all the technological change, don’t forget your people
Change can make people feel uncomfortable and anxious, especially about their role now and in the future in this new system. People may be wondering how their role will change, and if they will still be valued for their skills in the ‘new world’. Make sure everyone in your team is aware of this coming change, and they understand why the pharmacy is going through it and most importantly, how it benefits the pharmacy, the team and the patients. Over time you can upskill the team and reinforce the change, but the first step is to start creating awareness and desire for this new system now.
Need some help?
You can read more about electronic prescriptions on the Digital Health website (https://www.digitalhealth.gov.au/get-started-with-digital-health/electronic-prescriptions).
At instigo, we’ve helped hundreds of pharmacies get ready for electronic prescriptions. Contact us for a chat about our digital health coaching support.
02 9248 2600