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Electronic transfer of prescriptions (eTP)

The electronic transfer of prescriptions (eTP) is an important step towards an eHealth enabled healthcare system and improving medication management.  It is the secure exchange of prescription information between prescribing and dispensing systems. The greater use of electronic prescribing processes will improve the accuracy and safety of prescribing.

There are currently two eTP services available — eRx Script Exchange and MediSecure.

The prescribing process begins with a clinical judgement to prescribe; a prescription is generated and printed from the local clinical system that includes a printed barcode. Electronic transfer of the prescription occurs at this point by sending a copy of the information on the prescription to a repository called the prescription exchange service or the PES.  When the patient presents the paper prescription to the pharmacist, the barcode is scanned and the information is sent directly to the pharmacy dispensing system from the PES without the need to re-enter the information.  This reduces the risks of transcription errors.

View this video to hear about eTP and how it works in daily clinical practice.

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Transcript

Introduction

Dr Liz Marles: Hi, I’m Liz Marles and I’m President of the RACGP and I wanted to talk to you today about the electronic transfer of prescriptions. The electronic transfer of prescriptions is part of the eHealth reform process and is designed to reduce transcription errors and improve patient safety. If your practice has already signed up with ERX or Medisecure, and you notice when you print off a prescription there’s a barcode on the bottom this means that you’re already participating in the electronic transfer of prescriptions. Everytime you print off a prescription with that barcode a copy of it is sent to the prescription exchange service. When your patient takes the prescription to the pharmacist, if the pharmacist has also signed up with ERX or Medisecure then they will scan the barcode and a copy of the prescription will be downloaded for them. This means that they no longer actually have to manually transcribe any of the information from the prescription and of course that will reduce transcription error. It’s probably also a more efficient process for the patient and hopefully will be a bit faster for them as well.  If the pharmacist is not signed up then they will just dispense as they have always done in the past according to the paper prescription that is presented to them.  For general practice it’s essentially business as usual.  This initiative doesn’t add any time to your consultation or increase the amount of paperwork you have to fill in.  As a result it’s very easy and I would really encourage all GPs to consider signing up for the electronic transfer of prescriptions.

Interview

Dr Magdalena Simonis: Hello Nathan, thank you for coming in to talk to me today about electronic transfer of prescriptions, known as eTP.  I’m pretty comfortable with electronic prescribing and have the software to print off the prescriptions and hand a hard copy to a patient which they then present to a pharmacy. Is that what eTP is essentially?

Dr Nathan Pinskier:  Electronic transfer of prescriptions or eTP is essentially a process whereby we can capture the information that you’ve created in the process of generating a script electronically and transfer that information securely to the pharmacist via a prescription exchange service. So at the point that you generate the prescription, a barcode will appear on the script and when the patient takes that script to the pharmacist, the pharmacist can scan the barcode and retrieve the information from the prescription exchange service. This means that the information that you’ve created through your practice is exactly the same as the information that will appear at the pharmacy end.  So the process essentially eliminates human transcription error and which means that we have improved clinical safety in the prescribing process and that leads to improved healthcare outcomes.

Dr Magdalena Simonis: And in fact it seems that there’s not going to be that much of a change to my workflow or my day to day operations from the sounds of things.

Dr Nathan Pinskier:  Magda, the only real change is the initial installation process. So once you’ve chosen a preferred eTP vendor and the software is installed and is capable of interacting with a Medicare electronic certificate, from your perspective there is really no change. When you print a prescription a barcode will appear on the bottom that’s he visible evidence that eTP is happening. Other than that nothing much changes.

Dr Magdalena Simonis: So it seems that I have already been using eTP in that, when I print a prescription it has a barcode.

Dr Nathan Pinskier:  Yes and that’s a common scenario. The eTP software has been out in the marketplace now for about two to three years. So a lot of practices have already gone through the processes of installing one of the preferred products and the barcodes have been appearing on the scripts. In many instances doctors actually pay no attention to it, because they may have assumed it was part of a national program. But in fact someone in the practice made a decision to install the eTP software.

Dr Magdalena Simonis: Should I have any concerns about privacy using eTP?

Dr Nathan Pinskier:  Privacy in healthcare is paramount; I think we all understand that. So this process is leveraging the Medicare digital certificate, so at the point the prescription is generated the electronic message is encrypted and it can only be decrypted by the pharmacist who has the paper prescription in front of them. So the data can’t be used for any other purposes other than for the purpose of generating a prescription.

Dr Magdalena Simonis: Are there any different legal requirements that we need to be observant of?

Dr Nathan Pinskier:  So the legal ability to create a prescription is governed by state and territory legislation and from that perspective the only legal prescription is a hard copy script that you’ve signed. So nothing changes from that perspective. What we’re doing is capturing information electronically thereby eliminating the transcription issues. Otherwise, really nothing is changing.

Dr Magdalena Simonis: With respect to Schedule 8 and Schedule 11 drugs, will it change my workflow and will it have a different legal obligation?

Dr Nathan Pinskier:  So there’ll be no change to requirements, what we’re doing is capturing information electronically, but you’ll still be required to meet the same requirements as per today.

Dr Magdalena Simonis: Authority scripts? Do they still need to be authorised over the phone?

Dr Nathan Pinskier:  There will be no change, if an authority needs to be authorised over the phone the same process with continue to apply

Dr Magdalena Simonis: Will it change the current practice around  issuing repeat prescriptions for patients?

Dr Nathan Pinskier: So the process for issuing a repeat remains essentially unchanged and from the pharmacists perspective the patient will still be issued with a hard copy of those repeats.  So look I think look what we have really have discussed here today is that that from a practical perspective or a work flow perspective there is really very little change at the practice end and once the system is installed and operates it really should operate relatively seamlessly you’ll continue to interact with your clinical software system and the data will flow electronically.  Hopefully overtime as the system matures we’ll start to see some innovative features being developed  - the capability to undertake electronic reconciliations of prescriptions and dispensed medications and that will eventually lead to improvements in the system in terms of quality and safety, it will lead to long term benefits and those system designs are currently well advanced so we will start to see these changes being implemented over the next few years

Dr Magdalena Simonis Thanks Nathan it seems like it is an exciting new phase in medicine

Dr Nathan Pinskier:  Absolutely

Dr Magdalena Simonis Terrific

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