ePrescribing Webinar July 8

For more information on ePrescribing, including FAQs and our readiness checklist, visit our ePrescribing page.

LOTS ePrescription Webinar Questions

 

We received over 125 questions (during and following) our ePrescription Webinar held on Wednesday, July 8.

A number of these questions were included in the FAQs on our website. A summary of questions (many of which were common in concern), is detailed below. For access to the full FAQs, please follow this link.

ePrescribing is continually evolving and our learnings from the rollout in Communities of Interest (COI) will be shared in the coming weeks.

How do I know I am in a Community of Interest (COI)? 
 

We are working closely with the ADHA and all other vendors in the space to track and manage the COIs. If your pharmacy falls into a COI, we will inform you as early as possible, so you have time to prepare and implement the required change.

Should you hear from any other healthcare providers that electronic prescriptions are coming to your area, please let us know so we can work with you and other vendors, to ensure you are ready to go.

 

 

Do we need both eRx and Medisecure?

 

You only need to be connected to one provider. We have done the integration for ePrescriptions with eRx and if you are connected to eRx, you will be able to dispense any ePrescription whether it is from eRx or Medisecure.

 

Each states legislation varies slightly so we would encourage you to contact the relevant authority if you have any concerns.

 

 

 

What happens if a patient doesn’t have a smart phone?

 

There are a couple of options; they could get an electronic script sent to an email address. However, if this isn’t possible, the patient is better off continuing to get a paper script.

Electronic scripts will not replace paper scripts; they are an option for patient to receive scripts.

 

 

Do we need a mobile number to accept SMS and issue repeats via SMS?

 

If a patient comes in with a token, you will not need a mobile number to scan this- you would simply scan the barcode and that will then pull the information from the PES/PDS. For any repeat tokens that are sent to the patient this is handled by the PES/PDS so again you will not need an SMS number for the pharmacy to send this. It will be handled automatically by the system.

 

 

Can a patient direct a doctor to send an ePrescription directly to a pharmacy?

 

The doctor must send the ePrescription directly to the patient; the script can’t be sent to a specific pharmacy as it is up to the patient where they send or take their script.

 

 

What’s the difference between “token” and “barcode”?

 

There is no difference; the token is a barcode (QR code).

 

 

Can you stop the transmission of a prescription if you are doing multiple dispensing of the same item to save SMS cost and only SMS when you are ready to send the token to the patient?

 

LOTS will send an SMS at the end of each dispense.

 

 

What is the cost of the SMS when we generate a token for a repeat? Is this reimbursed by Medicare?

 

During the Community of Interest (COI) phase, this cost will be covered but when the system is rolled out, the cost will be passed on to the pharmacy. At present, we do not have an indication on the cost per SMS.

 

 

Can the patient view the ePrescription before it goes to the Pharmacy? For example, if they want to know the name of the medication prescribed?

 

The patient can see limited information when they get the ‘token’. This will include the details of the item prescribed but they will not be able to retrieve the full script information. If they are using patient apps such as Medadvisor, they may be able to see more detail, but this is dependent on what that vendor implements.

 

 

Do we take the patient’s phone to dispense a token or are we relying on front of shop staff to queue scripts?

 

There are several options available and it will depend on how your pharmacy wants to adopt it.

Scanning the token can be done from any LOTS terminal provided a compatible scanner is attached to the workstation. It could be done at the front counter or at a scripts-in counter.

Initially, we envisage many people will simply want to scan and print a token so it can be adopted into the current paper queuing system. Our ‘Printing and Reissue ePrescribing Token’ video can be viewed here.

 

 

Can that initial token be used twice in two different Pharmacies? Similarly, if a Pharmacy reissues a token, will we be notified if that token had been used before?

 

A token can only be used once. If it is scanned again after being dispensed, a notification will be displayed informing the pharmacist.

 

 

Are the Tokens being scanned directly from phones? Can you discuss the logistics of this in a busy pharmacy?

 

Tokens will need to be scanned from phones. Each pharmacy will operate differently; we will work with stores and ensure we implement the best process for that situation.

For busier pharmacies we envisage they will either use the electronic or manual queues they will need to scan the phone at the ‘scripts in counter’ and either create a manual or electronic queue record. From this point onwards the patients phone is not needed so there should be minimal impact to workflows.

 

 

Are annotations that are added to ePrescriptions visible to another dispensing pharmacies/the patient?

 

Annotations on the electronic script are visible. If you make notes against the patient or prescriber, these will not be visible outside of your pharmacy.

 

 

If an e-script has been deleted, would the token be accessible to scan and dispense again?

 

If you need to delete an ePrescription that has already been dispensed, you would do this the same way you currently do it within LOTS. The token for that script will be re-enabled so the patient will be able to get it dispensed at another time.

 

 

What happens if a script needs to be cancelled because of a valid reason (e.g. dispensed but no stock available, wanted a different brand, etc)?

 

You can cancel the dispense as per your current process and the patients token will become active again for them to come back or get the script filled elsewhere.

 

 

If you delete a script from a token, can ‘the token be re-dispensed?

 

With eRx, it doesn’t dispense if the eRx deleted after being dispensed as eRx. You can cancel the dispense as per your current process and the patients token will become active again for them to return or get the script filled elsewhere.

 

 

Can you correct an eScript if it has wrong strength prescribed?

 

You can correct an ePrescription if any details are incorrect. This works in the same way it does now with eScripts.

The original information will remain the same when you do your checking but the information for that dispense will upload to the PES/PDS with what you dispensed.

 

 

For S8 scripts, the repeats currently need to be kept in the pharmacy in most states through Australia, how will that work with ePrescribing?

 

All jurisdictions have updated regulations that support paperless prescriptions including S8’s (the exception being Queensland, legislation is yet to be passed).

This includes updates which mean you don’t have to store a physical paper repeat but a copy of the electronic version of the prescription for auditing purposes.

Each states legislation varies slightly so we would encourage you to contact the relevant authority if you have any concerns.

 

 

Is a doctor’s signature required on a script in the Token model?

 

There is no signature required including for S8 items. The process of sending the script to the PES/PDS (i.e. the legal document), is all that is required.

 

 

What about S8 Recording? Is that also electronic?

 

ePrescribing accommodates the supply of Schedule 8 medicines.

Pharmacists should dispense these medicines in accordance with their relevant state and territory drugs and poisons (or equivalent) legislation.

 

 

If a print of the token is done, do we have to keep that on record for two years? Or is it just for the purpose of manual queuing and the record is electronic?

 

It is just for the purpose of manual queuing. The legal record of the script is always the electronic version.

 

 

How do we reconcile our claim at the end of each month with the current model of serialising our scripts?

 

The claiming process has not changed within LOTS for ePrescriptions. All scripts will still be serialised whether they are electronic or paper.

All electronic scripts are stored within the PES systems and can be retrieved as required. If you want to keep a paper copy for your records, you can print an evidence of prescription. See how this is done here.

 

 

When ePrescriptions are offline, how do we know which medication to dispense?

 

If ePrescriptions are offline, there is some basic information provided in the SMS or email which includes the medication details. This should allow you to dispense the item even if you cannot download if from the PES/PDS. Obviously, we would always encourage you contact the prescriber where possible and ensure you have all the information needed prior to doing an offline dispense.

 

 

What if the Internet is down (either token database or our scanner)?

 

If the internet is down or the software cannot connect to the PDS (e.g. eRx), scripts will need to be dispensed as owing. The pharmacist will need to be satisfied that they have the required details to dispense as an owing script; they would likely contact the prescriber/previous dispenser. A manual dispense can then be done and marked as owing. An extra field will be displayed where you enter token id. Once the connection has be re-established, the script will need to be marked off and reconciled against the PDS record and the electronic script information displayed. The dispense can then be completed as normal.

 

 

Is there a time limit of seven days to untick the owing for PBS reimbursement?

 

A pharmacist may dispense using the ‘owing prescription’ provision. The pharmacist can confirm the patient’s current medication details with the prescriber, or a prescriber may direct a pharmacist to supply a medicine to a patient in an emergency.

Patients may be issued the amount authorised by the prescriber.  The prescriber must forward a prescription to the pharmacy to cover the emergency supply as soon as practicable, in accordance with the Poisons and Therapeutic Goods Regulation 2008.

44 Emergency supply by pharmacists on direction of certain health practitioners

 

    1. A pharmacist may supply a person with a restricted substance (including a prescribed restricted substance) in accordance with a direction given under clause 36.

    2. A prescription that is subsequently sent in confirmation of the direction must be dealt with in accordance with clauses 41 and 42, and details of the supply must be recorded in accordance with clause 55, in the same way as if the restricted substance had been supplied on prescription.

    3. If such a prescription is not received within seven days after the substance is supplied, the pharmacist must report that fact to the Director-General.

 

How does a patient authorise a pharmacist/pharmacy to view their ASL?

 

When a pharmacy requests access to an ASL via LOTS, the patient receives an SMS (to the number used in their ASL registration). This SMS provides the patient three options:

 

a) Provide access. This will give the requesting pharmacy access until the patient revokes it;

b) Provide access for 24 hours. After 24 hours this will then be automatically revoked; or

c) Deny access.

 

When a patient replies with one of these options, access is then set.

 

 

Why is ASL not available now?

 

The ASL is technically more challenging to implement and with the COVID-19 pandemic, it was determined that efforts would be focused on getting the token method operational as soon as possible. The ASL design is still being finalised but is expected for trial in late August/early September.

 

 

How does this fit in to Medadvisor?

 

Initially patients will be able to have their scripts within Medadvisor but will need to come to the pharmacy to scan them.

We are working with Medadvisor to build an integration into LOTS. Patients will be able to remotely push scripts to a pharmacy via the app and request a pickup time. This will create a record in the LOTS Script Queue enabling the pharmacy to dispense.

 

 

If the patient is not using a third-party app, will they see any other information regarding their prescription other than the token?

 

The patient can see limited information when they get the ‘token’. This will include the details of the item prescribed but they will not be able to retrieve the full script information.