What is electronic prescribing?
Electronic prescribing or ePrescribing is a technology framework that allows physicians and medical practitioners for the prescribing and dispensing of medicines without the need for a paper prescription, which can improve efficiency and medicines safety. Electronic prescribing is currently facilitated by eRx Script Exchange, and it has been developed to improve patient safety ensuring that the information on a patient’s prescription arrives exactly as intended.
How does it work?
Instead of a paper prescription, the patient can choose to receive their prescription via SMS or email in the form of a link to a unique QR code or ‘token’.
The token is scanned by the pharmacy to unlock the electronic form of prescription from an encrypted and secure electronic prescription delivery service. If the patient has a repeat for a prescription, they will receive a new token from the pharmacy that replaces the original token.
What does a token look like?
The token is a QR code and displays the following information when sent as SMS or email or print Evidence of Prescription:
|SMS Token||Email Token||Evidence of Prescription|
What happens if the patient loses a prescription token?
The token is not the legal prescription it provides access to the legal electronic prescription held in the Prescription Delivery Service. Therefore, the token can be reissued, as the prescription can only ever be dispensed once.
What if the token is sent to the wrong email address or mobile number?
You must cancel the electronic prescription, which will invalidate the token. You should create a new electronic prescription and issue a new token.
Setting up for Electronic Prescribing
In order to use Electronic Prescribing and generate Paper Prescribing token, the following information is required.
How to register for Electronic Prescribing with eRx
To use Electronic Prescribing, each prescriber in a practice is required to register individually with eRx (script exchange) and to obtain your eRx Provider Entity Id. If you work in more than one practice, you will need to register multiple times.
Please follow this link: https://register.erx.com.au/prescriber to register with eRx for Electronic Prescribing services. Please have your prescriber number on hand to complete your registration.
When entering your details, make sure you select the “Clinic to Cloud” option in the Prescribing Software drop-down.
Once you have successfully subscribed you will receive your eRx Provider Entity ID from eRX.
To obtain the Practice HPI-O go to https://www.servicesaustralia.gov.au/hpos and click on 'Log on using PRODA', alternatively call PRODA on 1800 700 199 or HPOS on 13 21 50.
Enter your HPI-O number into your Clinic to Cloud environment by going to Settings > Practice Details and clicking on the Accounting tab and enter the last 10 digits of your practice HPI-O number.
Your HPI-O number in Clinic to cloud should be 16 digits in total and start with 800362 example below.
Enabling Electronic Prescribing
Go to Settings > Practice Details and click on the Electronic Prescribing tab, select Enable eRx.
NOTE: The Acknowledgement Timeout indicates the duration (in seconds) of an "Acknowledgement of Receipt Timeout" (AORT) for electronic prescription.
The default timeout is 10 seconds, enter a value of 0 (zero) for no timeout if preferred.
As a Doctor go to Settings > My Settings and click on the User Settings tab. As a Practice Admin go to Users > select the Doctor > Update and Configure > and click on the tab User Settings enter the practitioner/doctor HPI-I and eRx Provider Entity ID. Click Save when complete.
NOTE: The eRx Provider Entity ID is provided by eRx upon registration of Electronic Prescribing.
Additional User Settings - Practitioner Qualifications
In order to use Electronic Prescribing, Doctor's or Specialist’s qualifications are mandatory.
To enter the qualifications as a Doctor go to Settings > My Settings and click on the User Settings tab. As a Practice Admin go to Users > select the Doctor > Update and Configure > and click on the User Settings tab - Scroll down to "Doctor Specialty".
Type and select the relevant qualifications from the list or click + to view the list of qualifications.
When viewing the list of qualifications, click:
Add Item to add a new qualification if required.
Hide item to hide any qualifications that are not required, rather than deleting them.
Edit item to change the qualification code and description if required.
Delete item to delete any qualifications that were entered by mistake.
IHI Certification - Patients
Patient’s must have their Individual Healthcare Identifier (IHI) number existing in their profile to be eligible for ePrescribing.
The patient’s Individual Healthcare Identifier (IHI) number is generated and entered automatically upon saving a patient’s record. An IHI number may only be retrieved for patients who have a Medicare or a DVA number recorded.
From the Patients, list search for a patient.
Click Edit, then Account Info.
If the patient is registered for Closing the Gap (CTG), tick the Register for Closing the Gap checkbox.
What is Closing the Gap?
Closing the Gap is a strategy that that aims to improve the life outcomes of Aboriginal and Torres Strait Islander people with respect to health and wellbeing, education, employment, justice, safety, housing, land and waters, and languages.
The Closing the Gap PBS Co-payment Program, which reduces or removes the PBS Co-payment for eligible Aboriginal and Torres Strait Islander people, will apply to medicines supplied under Continued Dispensing from 1 July 2022, where the medicines are eligible for supply under Continued Dispensing arrangements.
Electronic Prescribing workflow changes
Current Consult - Patient Hospital Category
When in the Current Consult screen, the options in the list of Patient Hospital Category are:
Current Consult - Current Medications
When in the Current Consult screen and viewing current medications for a patient, you will now see the buttons and icons specific to our Electronic Prescribing feature these are:
eRx> button: Click to reissue electronic prescription or reprint a paper token.
Audit button: Click to view the Electronic Prescription audit log.
eRx> icon (next to Successfully Sent): Indicates the prescription is electronically prescribed.
Amend button: Click to amend the Electronic Prescription for alerted prescriptions.
Current Consult - New Medications
When in the Current Consult screen and adding a new medication for a patient, you can:
1) Indicate whether the prescription is Closing the Gap prescription by selecting the Closing the Gap checkbox. Once the prescription is finalised the script annotation for Closing the Gap (CTG) is generated.
2) Indicate whether the patient would like the medication to appear on their active script list.
Note: By default, the electronic prescription will send to the active script list to Exclude from Active Script List click on the toggle..
3) When a medication is marked as ‘Emergency Supply’ (The common term for this is “Script owing”) on the New Medication screen, only paper tokens will be permitted (no SMS or email). Do not provide it to the patient. No electronic token will be sent to the patient. The Note to Pharmacist is only for electronic prescription. A prescriber can choose to include a note to the pharmacist in the electronic prescription payload sent to the dispensing software.
4) You will now be required to enter authority/ approval numbers.
- General Authority Number = PBS or DVA Prescription Authority Number
- Approval/Streamline Number = Phone Approval Number or Streamline Authority Number if applicable.
- Authorisation Number - When a medication is a Schedule 8 (S8) for controlled substance, you will be required to enter your state/territory authorisation number, below tables shows what the authorisation number is referred to in your relevant state/territory:
|State/Territory||Number referred to as:|
|NSW and NT||Authorisation number|
|WA and TAS||Authority number|
|QLD and ACT||Approval number|
NOTE: A medical practitioner must hold a State or Territory issued number(s) to prescribe restricted medicines in that State or Territory. In order to prescribe restricted medicines, the valid State or Territory number held by the prescriber must be entered and is required by State legislation to endorse each restricted medication to be prescribed.
5) Where the electronic prescription contains an unusual dose, select the Unusual Dosage checkbox.
NOTE: When an item is a Schedule 4B (NSW) or Schedule 4D (TAS) medication, the prescriber must enter the minimum interval between repeats (i.e. Days between repeats. In C2C it is called ‘Interval’).
This is existing behavior for S8 items but has been expanded to include the S4B and S4D.
6) The New Medication screen with additional the eRx button provides the options to SMS or Email an electronic token or Print a Paper Token.
Select Update mobile phone in patient demographics checkbox if required. This will update the patient's mobile number in the patient's demographics detail.
Select Update email address in patient demographics checkbox if required. This will update the patient's email address in the patient's demographics detail.
7) Clicking on the Send to Pharmacy toggle will result in a paper token to be printed only.
NOTE: DO NOT provide the paper token to the patent. No electronic token will be sent to the patient.
The Note to Pharmacist text box is only for electronic prescription. A prescriber can choose to include a note to the pharmacist in the electronic prescription payload sent to the dispensing software.
8) When prescribing controlled substances, Re-authentication is required. You will be prompted to enter your password and clicking on Login before you can proceed.
Amending an Electronic Prescription
To amend an electronic prescription, locate the prescription in the Current Medications list.
Click on Amend, this will open the Edit Medication screen. You can make any required changes to the prescription before clicking on the eRx button to save the changes made.
NOTE: The 'Save' and 'Save & Print' buttons are no longer available when amending or editing an electronic prescription.
Cancelling an Electronic Prescription
To cancel an electronic prescription, locate the prescription in the Current Medications list. Click on the down arrow on the far right of the respective line item, a drop down list will appear.
Click on Cancel; this will cancel the electronic prescription and update the status to Cancelled.
Ceasing an Electronic Prescription
If the electronic prescription been issued with a number of repeats and some repeats have a been dispensed, use the Cease option to halt the remaining repeats.
To cease an electronic prescription, locate the prescription in the Current Medications list. Click on the down arrow on the far right of the respective line item, a drop down list will appear.
Click on Cease; this will cease the electronic prescription and update the status to Ceased.
NOTE: The Cease operation is only available for electronic prescriptions, not paper prescriptions.
Reissuing Electronic Prescriptions
If a patient does not receive their electronic token via SMS or Email, it is recommended that you do not re-prescribe the medication, as this does not cancel or invalidate previous tokens or prescriptions. The recommended steps would be to verify the patient’s email address or mobile number are correct and reissue the token. This prevents the issue of the patient having multiple active scripts.
To re-issue a token, locate the prescription in the Current Medications list.
Click the eRx> button next (next to Audit), then select SMS, email, or print a paper token before clicking Send.
NOTE: This does not create a new electronic prescription, and the token that was initially sent is still valid. Re-issuing the original token resends it to the patient via the correct delivery method in the event there was an issue with the patient successfully receiving the token when initially sent.
NOTE: You can resend or reissue the electronic prescription as many times as you like and to multiple email addresses or mobile phone numbers, but the electronic prescription itself is dispensed only once.
Electronic Prescription Audit Log
To view electronic prescription details in the audit log, from the Current Medications list, select Audit. The eRx Audit screen will appear.
The electronic prescription audit log can be filtered by entering date range parameters, before clicking Show to display the results.
The electronic prescription audit log can be exported in MS Excel format by clicking Download Excel.
To view the metadata of an electronic prescription in the audit log, click on the note icon.
User Audit Log
Only users with Practice Admin permissions can view user audit log details in practice settings.
The user audit log tracks user logon, logoff, stage-change, and credential change activity.
To view user details in the audit log, click Settings and then select User Audit Log.
The user audit log can be filtered by entering date range parameters before clicking Show to display the results.
The user audit log can be exported in MS Excel format by clicking Download Excel.