Frequently Asked Questions from our electronic prescription Masterclasses

Last updated: 02 December 2020

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Bp Premier Jade Service Pack 3 with electronic prescribing has been released now. You will need to upgrade to SP3 or later to use electronic prescribing.

This article presents the questions asked by Bp Premier users from all Australian states and territories during the Electronic Prescribing Masterclass webinars delivered by Best Practice Software starting 26 May 2020.

This article contains questions about:

Question

Answer

Legislative approval

Does this mean that BP scripts are legal forms of prescriptions in NSW, VIC, ACT and NT? Since this is where you have them available in the Jade SP3 release?

Electronic prescriptions are a legal form of prescription in all states and territories.

Do you have any idea when SA and QLD will get involved?

Since this Masterclass was run, electronic prescriptions have now become a legal form of prescription in SA and QLD.

Installing and configuring electronic prescriptions

Can we access the electronic prescribing functionality in Lava, Indigo, or Jade SP1?

You will only be able to use Bp Premier electronic prescriptions in Jade Sp3 and later.

If you're on an older version of Bp Premier, you may wish to consider upgrading. You don't need to contact our support team in order to upgrade. An upgrade checklist and guide for practices on Summit and later is available.

If only currently using Bp Clinical, to use ePrescribing, would we also need to start using Bp Comms in Management? Can you use Bp Comms with out using the other functions of Management?

In the fast-tracked version of electronic prescribing, available in Jade SP3, sending an electronic prescription token will not cost your practice any Bp Comms credits. Electronic prescription funding by the Department of Health will cease at some point in early 2021. Until funding has ceased, you may utilise electronic prescribing without Bp Management.

Bp Comms is a component of Bp Management and can't be used standalone in Jade SP3 and SP4.

Who is the best person to view the download disclaimer: Practice Manager, GP, or IT personnel?

Do all GPs have to do it individually?

The disclaimer on the website will be able to be viewed by anyone. The check boxes need to be acknowledged in order to download the utility.

You'll only need to download the utility once to enable Bp Premier electronic prescribing. It's not required to be downloaded by every Doctor in your Practice, as long as every Doctor understands the requirements of prescribing via electronic prescription.

Will Electronic Prescribing functionality be included on the training version of Best Practice (for internal training of staff), rather than practising in the live BP database?

No. eScipts functionality won't work in the samples database, nor would it be available in the trial or evaluation version of Bp Premier.

 

Is there any way we can integrate with a secure portal in our practice website?

Please contact the Bp Partner Network Team partners@bpsoftware.net to discuss your needs.

I don't think our Bp installation is currently able to send emails in any other format. Is there something we need to do to turn on this function?

No, you don't need to set up email for the fast track electronic prescribing version in Jade SP3. The emails are being generated by the Prescription Exchange Service. This may change in future releases of electronic prescribing.

Medisecure

 

There is no mention of Medisecure being used with Bp. I use Medisecure. Is this going to restrict my use of ePrescribing?

Yes. Because of the government timeframes given for the development of this functionality, we couldn't get both out at the same time. Medisecure is on our roadmap for development. We hope to have this to you in early 2021.

Was Medisecure supported by AHDA to participate in this? If not, why not?

Yes they were, but from a Best Practice perspective, with the government time frame of 8 weeks given for development, we would not have been able to deliver this functionality to you in that time frame.

I will not be using electronic prescribing. Can I still use Medisecure in Jade SP3?

Yes. If your practice will not be issuing electronic scripts, you can upgrade to Jade SP3 and continue to use Medisecure as normal.

Sending electronic prescriptions

Will patients be required to download an application or will the QR code require a specific browser? EG iPhone using safari and other smart phones use google.

Most smart phones with enabled browsers will be able to accept and view the QR code. The patient is not required to download a specific app. However, there may be some apps developed which integrate electronic prescriptions into their product as well.

What if you are in a bad mobile reception area? Many of our patients don't have reception within the building.

It's very likely your patient will receive the SMS as they return to reception, when the token moves from the PES to the patient's phone carrier. If the patient is concerned they will not receive a token by SMS, they can receive a paper token or a paper script.

How does the patient “forward” the token to pharmacy without physically presenting to the pharmacy. Can you send the token directly to the Pharmacy?

The patient can forward the token to the pharmacy by sending it via SMS or email to the pharmacy (e.g. to the pharmacy email address or the pharmacy dedicated mobile number). Noting that not all pharmacies have a dedicated SMS line, so in that circumstance email would be the preferred option.

Best Practice Software does not recommend sending the electronic prescription token directly from the practice to the pharmacy. It is important that the patient, carer, or nominated person has the choice of which pharmacy they prefer to have their prescriptions filled, along with each of the remaining repeats. Sending the token to the patient also allows the patient to confirm that the token has been received straight away.

Is the token sent to the client via standard (non-secure) email? How does this fit with our Privacy obligations and laws?

There is no personal identifiable information in the token. The QR Code holds an identifier, which is a key used by the prescription delivery service to pull the prescription details from the database. The identifier is meaningless unless scanned in a PDS with the required connectivity and authorising processes in place to check for a legitimate and legal request to the information.

The token only contains minimal information as defined in the ADHA conformance profile, therefore having an end to end encrypted email isn't necessary. The email service does use encryption for sending but not end to end.

Will a log be easily viewable of exactly how, to whom, and by which method the token was sent?

Not quite. The Past prescriptions section shows whether script was sent as an electronic prescription or regular prescription, but not the electronic prescription method. The method is recorded in the database however, and if you needed to extract that, our support team can assist.

If a couple shares a mobile phone, can they have two tokens on the one phone?

Yes. If the couple are sharing the phone, a unique token is generated for every prescription and will include patient details and info about the prescription and repeats left.

When viewing the QR code, is the patient able to view the name of the medication ?

Yes. The patient will be able to view the name of medicine and also repeats left.

When a script is emailed, what is the sender email address? Will it be from the Doctor's email address? If a patient replies to the email, where will the patient reply go?

The email is sent from a no-reply address: support@erx.com.au. Replies are ignored.

Will hospitals be able to send electronic prescriptions to private pharmacies on discharge, and will a copy be sent to the GP?

It depends on the software used. Prescribers are required to use software with electronic prescriptions capability. Currently, this feature will be rolled out for software used in general practices and community pharmacies; the focus is not yet on hospital prescribers. But there will be alternative electronic prescription solutions coming out later this year for hospitals.

If a patient receives an electronic prescription token by email, and they forward it to another email address, is there a way that the electronic prescription cannot be dispensed twice at different pharmacies?

The electronic prescription can not be dispensed twice at different pharmacies. The information can only be retrieved once from the Prescription Delivery Service.

How do patients know they can not reply or respond on the phone number that the electronic prescription was sent from?

In the email and SMS it should have text referring them back to the practice, as opposed to directly replying.

Can you edit or change the text that goes out with the SMS or email?

No.

Can the token for repeats be stored in a "wallet" on Smart phone?

It remains to be seen what storage options will be available for patients to store tokens for prescriptions or indeed "repeats". The Active Script List Model available later this year will be tailored slightly more towards patients on multiple medicines or with chronic diseases.

For the time being, with the token model, the token will remain in either the patients SMS list or email account until required.

Does it make any difference if the patient has an IOS device or Android?

It will not make any difference which OS the patient has on their smart device.

We are a small community with two pharmacies. With patient permission, would we be able to send the token directly to the patient's pharmacy?

Best Practice Software recommend that tokens are sent to the patient, carer, or nominated person, to maintain patient choice of pharmacy. Sending the token to the patient also allows the patient to confirm that the token has been received straight away.

If the token model is not appropriate, normal paper scripts remain an option. The Active Script List model available later this year may be a more convenient option for some but is not yet available.

For SMS, does the patient need a smart phone, or any phone with MMS capability?

The patient can use any phone that accepts SMS.

What is the impact of not having up to date patient contact details?

You'll need the patient's correct mobile number or email to send them the token. If incorrect contact details are stored in your clinical software, there is a risk that the electronic prescription would be sent to the incorrect SMS or email.

How do doctors manage electronic prescriptions for patients in aged care facilities? This is a currently a huge time cost for GPs.

The active script list available later this year will offer a more complete solution to cater for this issue.

Is there a cost to a pharmacy to participate? What are the pharmacy software products that electronic prescriptions are available through? e.g FRED

It remains to be seen whether there will be a charge for pharmacies. Individual pharmacies should contact their software providers directly about this.

There is a list of conformant software available on the ADHA website. Also just because a software is conformant does not mean that practices or pharmacies have the software required or switched on.

Does it mean that a third party SMS provider can't be used with electronic prescribing and Bp?

That's correct, you are not able to use a third party SMS provider at this point.

Will this require BP Comms permissions to be enabled for every patient wishing to participate in e-prescribing?

When Bp Comms is used in a future release, the normal SMS consent process will apply.

Is email sending integrated in BP?

You can email a token with the mail server you currently use.

As I understand, when using our mail server, sending electronic prescriptions to email is similar to sending an email out of BP and is not using any secure messaging facility.

There is no personal identifiable information in the token. The QR Code holds an identifier which is a key used by the prescription delivery service to pull the prescription details from the database. The identifier is meaningless unless scanned in a PDS with the required connectivity and authorising processes in place to check for a legitimate and legal request to the information.

The token only contains minimal information as defined in the ADHA conformance profile, therefore having an end to end encrypted email isn't necessary. The email service does use encryption for sending but not end to end.

Say a token is scanned at the pharmacy and script is accessed to dispense, then the patient changes their mind or medication is out of stock for example, and dispensing is cancelled.

Is the original token still valid, does the token need to be regenerated by the prescriber, or does the pharmacy provide a new token?

The token remains valid until the prescription has been fully dispensed. That is, the patient leaves the pharmacy with prescription medicine in hand.

How does the urgent supply process work, if tokens can't be directly sent to the pharmacy but tokens also aren't sent to the patient?

Urgent supply or owing electronic prescription tokens can be retrieved once prescribed by the dispensing pharmacy.

 

Cost of electronic prescriptions

Will we have to purchase credits to be able to send these tokens via SMS?

The Department of Health will be covering the cost until at least Sept 30 2020, after which you will need to use Bp Comms credits.

Department of Health will cover costs of tokens being sent to end of September; WA doesn't yet have the capability to do this. Will Department of Health offer a similar cost subsidy to WA when ePrescribing is launched here?

Western Australia has since approved Bp Premier electronic prescriptions as a legal form of prescription.

If we do not use BP comms, are we still able to send tokens to patients?

At this stage, yes. However, when the Department of Health funding ceases, SMS tokens will require Bp Comms.

Is it free to send tokens via email?

At this stage, yes. However, when the Department of Health funding ceases, SMS tokens will require Bp Comms.

If patient needs five different medications, after the DOH ceases covering the cost, will the cost be 4c x 5 tokens = 20c, or 4c to send all five medications?

4c per token, one medicine per token. Five tokens would cost 20c to send.

Are there any costings available especially when each medication requires individual token?

Each token to send or resend via SMS will be 4c after the Department of Health funding ceases, or 3c for the Best Health App.

Those costs are clear in the presentation, but how many credits per day for a typical practice say with two doctors seeing 60 patients a day?

Printing prescriptions on pre-printed script paper remains an option for you. Equally, printing a paper token on plain A4 paper is an option. If you choose to use electronic prescriptions via SMS, there will be a cost, however, there will equally be a reduction in printing costs.

Sending multiple electronic prescriptions

If three scripts are being supplied, this means three separate SMS messages, or can three QR codes go on one SMS?

Yes, this will mean three separate SMS tokens, one for each script.

Can you only send one electronic prescription token per patient per day? What if the patient is on multiple drugs?

In that instance, the patient will receive multiple tokens, one for each medication prescribed. Patients and prescribers still have the option to receive a paper prescription if for any reason an electronic prescription cannot be sent.

Normal scripts vs printed electronic prescriptions

Would the pharmacist be able to convert an SMS electronic token to a paper token ?

After dispensing an SMS token, a pharmacy is able to provide the new repeat token printed on paper (or SMS or email), whatever the patient prefers.

Does Best Practice allow prescribing despite no allergy information having been recorded?

Not all patients have allergies, so yes.

If printing an electronic prescription token on paper, does it need to be printed on plain paper?

Token can be printed on plain paper, as long as it is clearly visible.

Can electronic prescriptions be issued for all medications?

Yes, there are no restrictions on which medicines can be prescribed using electronic prescribing.

Would practices need to keep paper prescriptions at hand for record-keeping, even if an electronic prescription has been issued?

No. Electronic prescriptions are designed to meet legislative requirements.

However, phone-approval authority prescriptions and some other types of prescriptions may still be a work in progress. Best to ensure you remain compliant with individual state and territory legislation. Peak body groups and the Department of Health can advise on this.

electronic prescriptions and repeats

 

Will repeat QR codes be sent at a certain date after the first is filled, or will doctors have to action this in Bp first?

Repeat electronic prescriptions will be sent immediately after the pharmacy has processed the original electronic prescription token (the pharmacy will issue the repeat token).

Are repeat tokens send to the patient automatically? Or does the patient need to request the repeat from the pharmacy?

After the initial dispensing of an Electronic Prescription which has repeats, the patient will receive a token for the subsequent repeat directly from the pharmacy that dispensed the initial prescription.

What if the patient loses the token for the repeats? Do they need to go back to the same pharmacy?

In the scenario of a lost token for a repeat prescription, the pharmacy can regenerate or reissue a replacement token for the patient.

Does the repeat token get produced from the pharmacy software?

Yes. After the initial dispensing of an Electronic Prescription which has a repeat, the subsequent repeat token will be issued by the dispensing pharmacy.

Can you get a repeat dispensed at a different pharmacy?

Yes, any pharmacy which is enabled for electronic scripts can dispense a repeat supply.

If a patient goes away and wants to use their token repeat at another pharmacy that is enabled, can that occur?

Once a token is used to dispense a script, any other copies of that same token become invalid.

If a patient is away and forgot to take medication or needs to get more, do they have to call their doctor and get an electronic prescription over the phone?

If they do not have their token with them for the next supply, the patient can contact their prescriber to re-send the token. If this is a repeat supply, the pharmacy can also re-issue the repeat token.

Does one Medication per token mean no repeats are allowed on the same token?

Yes. Repeats aren't on the same token, but a new token issued by the pharmacy.

 

For owing Rx, what does the patient need to do? At the moment, they have to give the Rx to a pharmacist.

The patient does not need to do anything. The token would be forwarded to the pharmacy that dispensed the owing supply.

Does the repeat token come as soon as the first script is dispensed, or after the first round of medication (say 28 days) is up?

Once a script is dispensed, the new token for the next repeat supply is sent to the patient immediately.

Schedule 8 prescriptions

Will a token be available for S8 and Authority scripts?

Yes, there are no medication restrictions.

Where is the password generated ?

The password required for a schedule 8 electronic prescriptions is your normal Bp password.

Does this system have real time monitoring of patients and drugs of addiction? For example, will it alert if a patient has received a script for say Endone in the last couple of days?

No, there is no real time monitoring of patient and drugs of addiction built into electronic prescribing. However, prescriptions sent by electronic prescription from practices who participate in a real time prescription monitoring program, such as SafeScipt in Victoria, will still be checked before being sent by electronic prescription.

Pharmacies

The pharmacy doesn't need a copy of the electronic token?

The patient needs to present the token to pharmacy to be scanned, or send the token through electronically via SMS or email.

Does it have to be the same pharmacy? What if the patient can't remember where it was generated?

The token will go to a prescription exchange that can be accessed by any electronic prescription-enabled pharmacy when they scan the token provided by the patient.

We do a lot of owing prescriptions to pharmacies for nursing home patients. Would that be something we could do with the token?

The token will need to be sent in the case of an owing prescription to the Pharmacy that dispensed it.

If Pharmacies currently scan eRx codes on paper scripts, does that mean they will be able to scan token?

In most cases yes, but there are also ways they can check if their scanner can effectively scan a QR code as well.

Most pharmacies don’t have email as part of their dispensing system process. It will be interesting to see how many can actually receive them without the patient physically presenting.

Pharmacies receiving prescriptions from telehealth consultations is a relatively new process, but most pharmacies do have an email address so should be able to accept the token and scan it into their dispense software or queueing system.

Is anyone keeping a list of pharmacies, or do we just have to ring around all our local pharmacies?

Currently there is not a central source of known pharmacies who are participating in electronic prescriptions. So speaking with your local pharmacies to check if they are enabled is a good idea.

Communication materials will be released for pharmacies in the near future, whereby they can advertise on their website, via email or in store (e.g. with window decals) that they are ready to accept electronic prescriptions.

So it appears that for electronic prescribing to happen in a telehealth environment, the pharmacy will need to be set up so that the patient can somehow transfer the token to them: SMS, e-mail. Do we know what pharmacies are planning, or is it completely individual?

Most pharmacies will be able to accept tokens via the pharmacy email address. Some pharmacies also have a dedicated SMS line so can receive tokens via SMS as well. The exact workflow will differ on the pharmacy. If the consult is not run via telehealth, the patient can have the token scanned physically in the pharmacy at the scripts in counter.

Why do you say that some pharmacies can't receive tokens yet? The tokens can be forwarded by SMS or email. Are you saying that some pharmacies have neither a mobile phone nor an email address?

Pharmacies will need to configure their software and be enabled to receive electronic prescriptions. Dispense software providers will need to release electronic prescription functionality for their consumers.

The consumer can forward the token to pharmacy (via sms/email), but this will differ depending on the pharmacy.

I can see we will need to check with local pharmacies if they are ready to receive tokens. Can you guide us on what to ask them? What will they need to do to prepare?

Like General Practices, pharmacies will also need a HPI-O and to be connected to the HI service. A Readiness check list for pharmacies is published on the ADHA's website and you may want to ask the pharmacy when they are planning to start using electronic prescriptions. This will depend on their software provider.

The ADHA is working with a number of dispense software providers, who will progressively roll out the token model functionality from the end of May.

Is there a database of Pharmacies who are configured to accept electronic prescriptions, so that I do not have to contact them directly?

If they are already accepting eRx scripts they can receive the electronic prescriptions?

Not yet. No formal list of conformant or enabled pharmacies is available. Keep in contact with your local community pharmacies, software providers, and the Department of Health.

If a patient goes to a pharmacy that is not digital script ready, can the digital script then be converted to a conventional script?

No. If the patient's pharmacy of choice is not yet enabled for electronic prescriptions, it would be best to provide a paper prescription or encourage the patient to visit a pharmacy that has the conformant software enabled.

How would the doctor know at the time they are generating the prescription if the patient's pharmacy of choice is enabled for electronic prescriptions?

It is the responsibility of the prescriber and patient to determine the most appropriate prescription format on a case by case basis. There is no central register of pharmacies which have Electronic Prescription dispense capability.

Does the pharmacy and prescriber's prescription delivery service have to be the same?

No, they do not need to have the same prescription delivery service. The two available prescription delivery services in Australia (eRx and Medisecure) are interoperable.

Active script list

Will active script list be available for residents of aged care facilities?

Active Script List functionality will be progressively rolled out from later in 2020 and there will be options for aged care facilities to use this feature. Pharmacies dispensing medicines for aged care facilities will also be able to use this feature.

How is the Active Script List accessed by patients?

Active Script List is not included in Bp Premier fast-tracked electronic prescriptions in Jade SP3,

Active Script List is on our roadmap. The details of the Active Script List available later this year are not yet finalised, such as patient controls, visibility, and patient access.

Cancelled electronic prescriptions

Will the prescriber know if a cancelled script has been already dispensed? So they don't reissue a new script, for example, for controlled drugs?

No, Bp Premier does not show the current status of the electronic prescription. The Pharmacy will know if a token presented has already been dispensed or cancelled.

If the patient loses his token and asks for a paper script, can we re-issue a paper script?

Yes, you can cancel the existing token and issue a paper script.

If an electronic prescription is given to patient and they then decide that they want a normal printed script, does another script have to be written into their record?

Yes, the electronic prescription must be cancelled and then reissued as a paper script.

If a patient loses a token and requests a new token, can we find out if the original token has been used?

You can cancel a lost, unfilled script from Bp Premier and be advised in the software if the cancellation was successful. If the script has already been dispensed, you will not be able to cancel it.

Patient and carer demographics

 

Are carer's details required for QR codes to be sent for children under 14 years old?

The electronic prescription is still for the child, even if sent to their parent. Medicolegal responsibility falls to the prescribing GP.

Is there any reason why the patient couldn't give you the pharmacy's SMS or email address?

It is recommended that the Doctor sends the electronic prescription token directly to the patient, so the patient has the choice of which pharmacy they want to have the medicine filled, including repeats for that prescription.

Where does the phone number from the doctor sending the token come from?

This would be a random number that shows on the patient's phone as generated by eRx.

Does the patient's phone number in their demographics need to not have spaces, or be formatted a certain way?

Bp Premier will sanitize the number from the patient demographics, so you can enter it in here with or without spaces, which ever is your preference.

What is the importance of having carer details?

In the instance where the patient cannot go to the Pharmacy to collect their medicines, the carer can take the token to the Pharmacy on their behalf, just like they would take a paper prescription.

Will the SMS (other) not default to the carer's mobile recorded for that patient?

No. The only number electronic prescription functionality prepopulates is the patient's number from demographics.

Patients without Medicare or My Health Record

Will patients without Medicare still be able to use electronic prescribing?

Patients will need to have an IHI (i.e., be a Medicare or DVA card holder) to be able to receive an electronic prescription. Some overseas visitors may be entitled to have an IHI number, but best to check with your local health department. If in doubt, the normal paper prescription option will continue to be available

How can electronic prescriptions be implemented in RACF residents?

The active script list available later this year will be a solution more suited to this requirement.

If a patient has opted out of My Health Record, can they receive electronic prescriptions?

Yes. You do not require a My health Record to partake in electronic prescriptions. You do require an IHI and practitioners require a HPI-I or HPI-O.

Do we have to be registered to My Health Record?

You will require a connection to a Prescription Delivery Service as well as a HPI-I for individual doctors or HPI-O for practices to partake. Readiness materials for practices are available from the Bp Premier Knowledge Base. Select Help > Online from the software.

Can patients who are on a work visa, working holiday visa, or student visa (who don't have Medicare) get an IHI number?

Please contact Medicare for more information.

Marketing materials and other resources

Has BP or anyone made posters for our practice to let patients know about Electronic Prescribing?

Yes. The ADHA is looking after this.

The Australian Digital Health Agency has an electronic prescriptions toolkit for prescribers and dispensers:

Will you be promoting uptake of this functionality with dispensers?

Please refer to the ADHA.

Do you know of any policy templates, maybe by AGPAL, for ePrescriptions?

Please refer to the ADHA.

Where is the information about setting up BP for sending the token via email?

Written steps will be available via our Knowledge Base as soon as Jade SP3 is released. Select Help > Online in the software and search for 'escripts' to view related articles.

Will the e-prescriptions functionality will be available in the ADHA on-demand training portal?

Probably best to contact your software provider directly. They will be able to provide you with a variety of resources to ensure you are ready for electronic prescriptions.

Are there any formal 'checklists' that exist that a practice can use to start their preparedness?

Some readiness checklists are listed in the PowerPoint deck which will be sent to you after the session.

Will this webinar be accessible after today?

Yes, it is now available on our Vimeo channel.

Will the presentation slides for this Masterclass be shared?

No.