ePrescribing General Questions
What happens with ePrescriptions if the internet is down?
If the internet is unavailable, it will be up the pharmacy to dispense under emergency supply provisions and/or by contacting the prescriber to request a paper prescription.
There has been the suggestion that manually entering the barcode will bypass the process and provide access to the ePrescription. This is not that case as typing in the barcode is the same as scanning the barcode.
Do ePrescriptions change the way we deal with Drugs of Dependency and Schedule 8 drugs?
The introduction of ePrescriptions does not significantly change the way pharmacies handle Drugs of Dependency (DDs). DD “duplicates” or records of the script will be stored electronically in the Prescription Delivery Service Exchange (eRx or MediSecure), rather than as paper copies. Inspectors will be able to view your electronic records alongside your paper DD duplicates for audit purposes.
It will no longer be possible to handwrite on the ePrescription so this requirement will be addressed by the ability to annotate the ePrescription and repeats (via the prescribing and dispensing systems) when they are prescribed and dispensed.
It remains the responsibility of the Pharmacist to ensure they are fully aware of the jurisdiction specific regulations regarding DDs.
There are some items where we cannot substitute to a generic as it is under a different PBS code, is there a way around this?
There are business rules from a PBS perspective as to whether a PBS code can be substituted or not as reflected in drug files. There is no difference be it a paper or electronic prescription. Regarding ePrescriptions, if the prescriber does not allow substitution, Fred Dispense/ Fred NXT Dispense will display that substitution is not allowed during the dispense process.
How secure is the ePrescription service?
Significant work has gone into the design of the ePrescription architecture, including the security model, to ensure it is as secure as possible.
Can ePrescriptions be cancelled and removed from the Prescription Delivery Services (eRx and MediSecure)?
ePrescriptions can be cancelled by the original prescriber only. The prescriber can perform the cancellation through their prescribing software which will result in the cancellation being reflected in the Prescription Delivery Service (eRx or MediSecure).
How does the pharmacy scan check with ePrescriptions?
Scan checking is performed the same way with ePrescriptions, as it is with a paper prescription. The introduction of ePrescriptions is simply a way of injecting the prescription data into the pharmacy dispensing software, which continues to be used to dispense the prescription.
Do ePrescriptions change how PBS claims are made?
PBS claiming is a function of the dispensing software. As a result, the introduction of ePrescriptions does not change the way the PBS claims are made.
What about defer prescriptions with ePrescriptions?
There is no need to defer scripts with ePrescriptions. As there is one token per prescribed item the prescription simply sits in the prescription exchange service ready for future dispensing. If a patient wishes to maintain a “script file” of sorts with the pharmacy, they should opt into the MySL service.
Will ePrescriptions finally remove the need for owing prescriptions?
The introduction of ePrescriptions will begin to remove paper from the process, but it is not currently government policy to remove the option for patients to receive paper prescriptions. It’s anticipated that paper prescriptions will continue to exist for some years to come.
As a result, MedView Flow is designed to enable paper prescriptions (with or without an eRx or MediSecure barcode) to be added to the same queue as ePrescriptions for more efficient workflow management. To find out more click here.
With the introduction of ePrescriptions, do you think patients will start to fill their scripts in different ways?
Yes, as ePrescriptions are becoming more widely used we are starting to see more and more patients submitting their ePrescriptions remotely. Some using MedView Patient Connect and others starting to embrace the variety of mobile apps available.
MedView Flow is designed to provide patients with flexibility around how they submit their prescriptions to pharmacy and provides pharmacies with a single queue to manage prescriptions. Fundamentally this means pharmacies don’t have to pick a specific app to align with – they can let their patients decide which app or website they prefer.
Do we know what patients think about us receiving their prescription on a phone – will they be concerned about confidentiality?
The system was designed by the ADHA and Federal DOH in collaboration with a myriad of industry and consumer stakeholders, and has undergone privacy impact assessments. It is also important to remember that consumers can always opt to stick with paper-legal prescriptions – there is no requirement to receive an ePrescription.
Do you think ePrescriptions will change the way our customers shop with us?
ePrescriptions on their own won’t change too much, however they open up a lot of opportunities. Things like click and collect, in-pharmacy kiosks and script waiting wallboards, are all possibilities and manageable with MedView Flow. The more efficient dispensing process will also allow us to spend more quality time with patients – implementing better value added services.
How quickly do you think paper prescriptions will decline?
It will be interesting to see – COVID has proven to us that the community can switch to digital faster than we expected. No matter what happens it’s critical that pharmacies can blend the paper and electronic prescription workflows easily – which is one of the big reasons MedView Flow is focused on broader workflow, rather than just catering for the minimum required to dispense a single ePrescription.
When will prescriptions be completely paperless and all electronic?
The Government has not foreshadowed any removal of paper-based prescribing but we would expect to see less paper scripts as consumers and doctors see the benefits of ePrescriptions.
What would be some challenges to prepare for and consider when implementing ePrescriptions in my pharmacy?
Please refer to the ePrescription checklist and guide to prepare your pharmacy.
Do we need to have a pharmacy mobile phone number?
Patients may want to send tokens to your pharmacy in a variety of ways. They may use a medication management app, a website or they may simply forward you the text message or email. MedView Patient Connect provides your pharmacy with a streamlined method of accepting ePrescriptions via email or SMS directly into MedView Flow, without the need to maintain your own mobile number.
For patients that keep their prescriptions in the pharmacy, how do we go about continuing the service?
MySL is essentially the same as your existing prescriptions on file service, without the drawers full of paper.
Can patients use an old type mobile phone that does not have a screen, unlike the modern smartphones?
Patients with particularly old mobile phones would be able to consent to the MySL service but would not be able to display a token on their phone screen. These patients, where they do not want to participate in the MySL service, may consider paper or email tokens where they want an ePrescription.
Are we able to dispense a token for a patient which is dated into the future?
Dispensing a prescription that is dated in to the future is not legal.
If patient has a token as well as the paper script for the same script item, can they only use one?
A patient can only have one of the other. You can’t have a normal paper script and an eprescription for the same prescription.
What if I accidentally delete a prescription after dispensing. How do I recover that again if it came as a token and was processed through MedView Flow?
If you cancel a prescription the SCID for that script will be re-instated and can be re-used to dispense later on.
Are dispensary technicians going to be able to dispense under their own initials then the pharmacist checking it and initialling the label?
Only authorised/responsible pharmacists can complete ePrescriptions, dispensary technicians can input the ePrescriptions, however a responsible pharmacist must authorise the final step of dispensing. There are options to set a responsible pharmacist for a session, however, all dispensing’s will be as if the responsible pharmacist has performed the dispensing.
How do I handle compounded scripts that require adjusting such as changing the quantity?
There are items in prescribing that are required to be prescribed as volume for the purpose of PBS but are dispensed as packs (eg. 100g of a compounded cream is dispensed as 1 jar of 100g). The prescribed qty will be passed and shown as 100g, however when downloaded in dispense, the qty field is defaulted to 0 to allow the user to enter the correct qty per dispense (1 for 1 jar).
With a completely new patient, do I register them in our dispensing system first, then in MedView Flow?
Ultimately a new patient can be added into dispense via MedView Flow or directly in dispense, but in the interim they will need to be added in dispense first.
Why can’t ePrescription tokens be scanned directly into Fred Dispense or Fred NXT Dispense?
It certainly would have been less change for pharmacists if Fred had enabled ePrescriptions within the dispensing platform, but we didn’t do this for a number of really important reasons.
- Firstly, dispense platforms are already crowded and we took the view that displaying the full legal prescription in MedView Flow, alongside the dispensing screen and in a familiar format would drive clinical safety.
- Secondly, we identified that a future-proof queueing system would be critical to help pharmacies blend workflows from a myriad of existing and new sources. MedView Flow provides a global standard, software agnostic platform for all sorts of apps and websites to send prescriptions to your pharmacy. This means you don’t have to log into lots of different platforms to gather prescriptions from all the various channels your customers choose to utilise.
Why does Fred Dispense print a Repeat Authorisation when a token is dispensed?
Assuming a traditional Repeat Authorisation; when dispensing a token this should not print out. If that occurs, the pharmacist/technician has escaped back to the patient name and dispensed the script manually. This should not be done.
Why does Fred Dispense need to be cleared every time before we can dispense a token from MedView Flow?
The dispense screen could be sitting in a patient update screen or any other child screen which could have unintended consequences.
Will the script format of Fred Dispense become more efficient?
ePrescriptions should improve the efficiency of the dispensing process once the workflows are embedded in practice. The workflow in pharmacies using a combination of a Fred dispensing solution and MedView Flow will be the most efficient way of managing the multiple streams of work that ePrescriptions enable.
If we are asked by the Pharmacy Board Officers to bring up an ePrescription that we have dispensed, how do we do this?
- Fred Dispense: Reports >Script>Electronic Script Export for Regulatory Body
- Fred NXT Dispense: Reports>Regulatory Report
Will a dispensed ePrescription automatically be put on eHealth record?
MyHR is a separate system, however ePrescription records will be displayed the same way as paper-legal dispensing records do today. Contact your vendor if you’re interested in how your records are uploaded today.
Why wasn’t the ePrescription system built and extended on the existing barcode scanning system that was already in place?
ePrescribing is built on the existing eRx (and MediSecure) infrastructure.
Are there dummy QR codes available for us to test?
If you wanted to test the MedView Flow process you can use the QR code on a paper eRx prescription
What is MyHR?
MyHR is an online summary of an individual’s health information. To find out about more please visit myhealthrecord.gov.au.
Will we get clear and concise guidelines as to how the system works step by step?
Both the PSA and the Pharmacy Guild have been working very closely with government and other industry participants like Fred and eRx to develop suitable education and guidelines for ePrescribing.
MySL and Token Questions
How is MySL different to the Token model?
MySL (My Script List) is an optional extension to provide an enhanced patient experience. As with the token model, MySL relies on conformant electronic prescription messages instead of paper prescriptions.
The key difference between MySL and the Token model is that if a patient registers for a MySL they no longer require a token to access their prescriptions. The MySL enables patients to provide relevant pharmacies, doctors and third-party intermediaries of their choice with access to their personal list of active scripts for dispensing. This access is revocable but may otherwise be ongoing or temporary depending on the access granted by the patient to each viewing party.
It is important to note that this is purely a list of the patient’s active scripts for future dispensing and not their full medication profile. Once access is granted, a pharmacy may dispense the items requested by the patient and doctors and third-party intermediaries may view the list.
How will patient medication management apps interact with ePrescriptions, both the Token model and MySL?
Patient apps will provide an important service as part of the Token model and MySL. In the initial stages patient apps will be able to store the patient’s tokens to provide the patient with the ability to forward the token to their chosen pharmacy. This will also allow the app to provide their usual services for the patient such as script reminders.
The integration of patient apps to the MySL service will provide a number of important features including the ability of the patient to:
- Sign up for a MySL and subsequently opt out of having a MySL
- Manage the consent process, allowing their chosen health practitioners to access their MySL and subsequently remove access should they choose
- View their MySL via the app. It is not initially possible for patients to view their MySL directly, so the use of a patient app is required to have this access.
How does the patient access their MySL? Is this through a website or mobile app?
Patients can view their MySL at their pharmacy, prescriber (if they have software with MySL capability) or via several third party apps.
Which patient medication management apps will link to MySL?
The MySL integration will be open to all conformant patient apps, and there is currently a number of vendors who have already commenced integration work.
Will patients be able to select which prescriptions are viewable on MySL? How do patients retract permission to view their MySL?
Patients, in consultation with their prescriber will have the ability to stop particular items from displaying in their MySL at the time of prescribing. This may be useful where the patient and prescriber consider the item to be sensitive or embarrassing. Patients will also be able to use the app of their choice to manage the visibility of items in MySL, and which pharmacies, practitioners and intermediaries have permission to view their MySL.
Will MySL display both paper and electronic prescriptions?
MySL will show both ePrescriptions and paper scripts as long as the paper scripts have an eRx or MediSecure barcode on them.
If someone has a MySL which shows a paper prescription they do not have with them, can it be processed?
No, paper prescriptions will be visible on the MySL but the paper script must be in the possession of the pharmacist for legal supply to occur.
When a patient registers for MySL are all older dated scripts loaded onto MySL?
The patient has the choice to show existing Active Scripts in their MySL or just new prescriptions going forward.
How can we access a patient’s current paper scripts that we store at the pharmacy on MySL?
Consenting these patients for the MySL is the start of this process. If these patients also consent to the historical bulk upload of their existing scripts, then their paper-legal scripts should appear in their MySL.
Will out of date MySL scripts be deleted automatically?
Yes, MySL will only display Active Scripts. You will not see any expired scripts in the MySL view for a patient.
What happens if a prescription has been written but is not showing up in the patients MySL?
This should not happen and would require investigation by your vendor.
Can more than one pharmacy have access to a patient’s MySL?
Patients can provide multiple pharmacies, doctors or apps with a view of their MySL. Access is controlled by the patient and can withdraw this access as they wish.
What’s to stop a person giving consent to Pharmacy ‘a’ and also ‘b’ then getting hounded by each Pharmacy at day 21 to dispense their scripts?
Pharmacies should only dispense a prescription upon request of the patient or their agent. Dispensing without authorisation would not be legal.
How will MySL affect customer loyalty?
The introduction of MySL is not expected to affect customer loyalty and will make patient medication management apps work even better. Once a patient has consented, patient apps will be able to display the MySL to the patient and remove the need to add tokens or paper prescriptions to the app manually.
Is MySL suitable for aged care home residents? And what about my Community Websters?
The current token model is not ideal for residents living in aged care homes. If the facility is not running ‘charts’, then MySL may be a reasonable interim solution for patients (assuming you can work through the opting-in process with each resident/carer).
The best solution will be electronic chart prescribing, which is likely to become available during 2021. MySL is suitable for your community dose administration aid patients so having them consent to the model should improve the administration challenges around managing those prescriptions.
How does consent for MySL work for aged care residents? Can consent be from a third party?
A patient can be registered for MySL with either a carer or agent. In the case of aged care residents, the RACF can register as an agent on behalf of the patient, but the patient’s mobile or email MUST be used as the primary contact number utilised for consenting of practitioner access (Agents and facilities cannot consent on behalf of the patient to practitioner access).
What is the cost of MySL to the patient and pharmacy?
MySL is provided at no cost to both the pharmacy and the patient. If the pharmacy chooses to send a token to a patient via SMS (if they are not consented to the MySL) then SMS charges would apply.
Can you sign up patients for MySL now before the roll out?
No, you will need to wait for the functionality to be made available prior to consenting patients into the service.
When will the ASL and MySL be available?
Whilst ADHA are still finalising the conformance scheme for Active Script Lists, Fred and eRx are actively testing the system. MySL will be made available to pharmacies as soon as possible.
Which dispensing software solutions are compatible with MySL?
The MySL functionality is open to all software vendors that are conformant to the ADHA conformance scheme for ePrescribing. Contact your vendor to ask when this functionality might be ready.
Will MySL be processed through MedView Flow?
Yes, MedView Flow will help you to view and queue items from MySL for dispensing.
Do you have to use MedView Flow to access MySL, or can you access through Fred Dispense/Fred NXT Dispense?
Pharmacies using Fred dispensing solutions will be able to access MySL through Flow. This has been done to create the best workflow once ePrescriptions are working at scale from multiple sources.
What is required for a prescriber to migrate a patient to the ASL/MySL?
Prescribers don’t necessarily have to do anything for a patient to begin using MySL. Prescribers can consent patients for the service, but it is likely this will predominantly happen in the pharmacy.
Will a prescriber have the ability to prescribe either a token or direct to the ASL/MySL?
Importantly, with ePrescriptions the workflow for both Token and MySL is the same. The legal document is the prescription sitting in the prescription exchange service (eRx and MediSecure). A token and the MySL simply provides the patient with control over who can access or view that script. Once prescribing systems have integrated to the MySL, and where the patient chooses to have an ePrescription, the doctor will longer need to send a token to patients who have opted into MySL.
Can a GP directly send a new script to the pharmacy? How do they access the MySL?
In most circumstances the GP must convey the script to the patient and should not channel it directly to a pharmacy. GP’s using systems that have integrated to the MySL will be able to access the system with patient consent but do not necessarily need to do so in order for the ePrescription to appear in the MySL.
What happens if we sign them up to MySL, but their GP doesn’t have ePrescribing? Or if the patient does have a MySL, how does the GP know?
Prescribing vendors have the ability to allow prescribers to see if a patient has MySL, if they choose to do this work in their system. A patient’s paper script can still show in MySL if it’s prescribed as a normal eRx or MediSecure script.
What measures are being taken to increase the uptake of MySL at the GP end?
The peak bodies for General Practice are working with Government on appropriate education for prescribers, however prescribers do not need action anything for their patients to participate in the MySL.
How do people without mobile phones sign up for MySL?
Initially MySL consent will rely on the patient or their authorised carer having a mobile phone.
How do we receive consent to access a patients’ MySL?
Once the patient responds to the MySL consent SMS the pharmacy will see the MySL consent indicator change in MedView Flow and allow access.
If we can dispense tokens, will we automatically be allowed to use MySL, or does that need to be activated separately?
The MySL functionality will be made available in MedView Flow when ready, you will not need to undergo additional steps to activate.
What happens if a wrong script was selected and dispensed via MySL and you want to cancel it?
You can cancel an ePrescription the same way you cancel a normal paper script
How are ePrescription tokens processed?
To see how tokens are processed with MedView Flow and Fred Dispense please watch our demonstration.
Does the repeat token automatically send to the client’s mobile after the first dispensing?
The repeat token will default to the preferred method of delivery as per the patient’s profile in the dispense software.
If I put my pharmacy email in for an ePrescription Token and email the repeats to myself (to leave scripts “on file”) is that an issue?
The token must be returned to the patient or their agent via contact details saved in the Fred dispensing solution for the patient. MySL is the ePrescription version of the traditional script on file service.
What do we do if the patient keeps prescriptions on file and has tokens for multiple medications but needs to defer one and dispense one?
Every prescribed item is associated with an individual token so there is no need to defer ePrescriptions. Items not needed immediately can simply remain in the prescription exchange with the token remaining valid until dispensing is required (or the script expires or is cancelled/ceased).
Is there any way to print a copy of the prescription with the ePrescription token?
Printing a copy of the prescription should not be necessary with ePrescriptions, but some systems may provide you the option to produce a copy of the prescription. Importantly, it is not possible to convert an ePrescription to a paper-legal script.
MedView Flow Questions
What is MedView Flow and how does it work?
MedView Flow is a pharmacy workflow management tool which enables patients to choose how they would like to submit their electronic prescription, either in person or electronically.
The tool seamlessly blends your existing paper prescription workflow with the new electronic prescription workflow.
For a full description and video demonstration on how to configure MedView Flow in your pharmacy, as well as the end to end ePrescription process using MedView Flow, click here.
How do pharmacies handle both paper and ePrescriptions?
We are very conscious of providing pharmacies with a single queue for all prescriptions, which is why MedView Flow was created.
Both paper prescriptions and ePrescriptions can be queued in MedView Flow by scanning the barcode at your Scripts In counter or by the patient sending the ePrescription to the pharmacy’s MedView Flow.
To find out more click here.
How does MedView Patient Connect work?
Click here to learn how MedView Patient Connect works and see demonstrations of patient use.
How does MedView Flow support deliveries and can pharmacies configure their available delivery times or disable deliveries to patients?
Patients are able to request delivery when they submit their ePrescription to their pharmacy. This includes the ability to specify their preferred delivery date and any other items they may want included as part of the delivery. At this stage the pharmacy is not able to configure pharmacy specific days or times that delivery is available in MedView Flow. However, the pharmacy is able to use MedView Flow to communicate directly with the patient with regards to delivery requests. There are also a number of innovative delivery systems being developed to support the ePrescribing system.
What hardware do pharmacies need to process ePrescriptions?
With the introduction of ePrescriptions and MedView Flow it is important to consider how you will begin processing ePrescriptions and specifically what, if any, enhancements you will make to your store layout and computer hardware requirements.
This will vary from pharmacy to pharmacy, depending on your own personal preferences, customer demand, existing hardware and the physical layout of your pharmacy.
For detailed information on possible hardware options for handling ePrescriptions with MedView Flow at your pharmacy click here.
The other important consideration is ensuring your cyber security protection is adequate. This is not specific to ePrescriptions; however it is vital to ensure you have sufficient cyber security in place. For information on Fred Protect, a real time service tailored for pharmacies, dispensing and POS software, click here.
If we have a website or an App, is there a way to allow patients to send eScripts securely to MedView Flow?
Yes, MedView Flow is built in a way that makes it easy for patients using third party applications to send scripts to pharmacies using the platform. These third parties can be apps or webservices, a number of which are already in the process of integrating to MedView Flow
Once a patient has submitted an ePrescription to their pharmacy for dispensing, can they cancel that request?
Should a patient wish to cancel the order sent to the pharmacy, the patient would be required to contact the pharmacy directly and request the order be deleted from their MedView Flow queue.
Once the pharmacy has commenced or completed the dispense of the ePrescription, the legal ePrescription has been pulled down from the PDS (eRx or MediSecure) and locked to ensure it cannot be dispensed a second time. Should the patient wish to cancel that order, the pharmacist will cancel the dispense in their dispensing system which will reactivate the ePrescription in the PDS (eRx or MediSecure) and re-issue the token to the patient. Under the ASL model, cancellation of the order will result in the ePrescription being added back to the patient’s ASL.
How can I view a copy of an ePrescription once it’s been dispensed, checked and removed from MedView Flow?
The ‘Done’ feature within MedView Flow allows you to review completed orders and view dispensed prescription images.
How does a quick dispense work for DAA patients?
Assume dot dispensing, all ePrescriptions needs to go via MedView Flow currently.
Is MedView Flow compatible with MediSecure prescriptions?
Yes, MedView Flow works with both eRx and MediSecure prescriptions.
Is there a MedView Flow App for iPhone or iPad?
MedView Flow is a web-based platform that can be used in Safari, Chrome or other Internet browsers on many devices without an App.
The MedView Flow Mobile App is now available in the Apple and Google play stores. It provides the ability for your pharmacy team to wirelessly scan tokens or barcodes on prescriptions and queue into MedView Flow from anywhere in the pharmacy. View a demonstration
Download the MedView Flow Mobile App:
Is the MedView Flow script in app restricted to pharmacy use only e.g. can a Doctor have the app to forward scripts to the pharmacy?
The MedView Flow Store mobile App is intended for in-pharmacy use.