The commonwealth-led effort to stamp out doctor shopping will require all medicines-related information from telehealth prescribers to be uploaded to My Health Record.
In the wake of a preventable overdose death, health minister Mark Butler has announced the creation of a central, My Health Record-connected script database alongside requirements for telehealth providers to upload prescription information.
While it’s unclear what the changes will look like for GPs on a day-to-day basis, RACGP president Dr Michael Wright told The Medical Republic that it was a welcome step against fragmentation.
“Telehealth-only and online-only services can provide great convenience, but we [as GPs] have been concerned about increasing fragmentation of care,” he said.
“Fundamentally, we’ve got to firstly be concerned about patient safety, which is what I think, as GPs, we do.
“When you come and see me, I’ve got a record [for you that] other GPs in the practice can see, that could be uploaded to My Health Record.
“But that hasn’t been the case for these online-only providers.”
The changes themselves are twofold.
First, the federal government will implement requirements for online telehealth providers to upload all medicines-related information to a patient’s My Health Record.
This will encompass not just medicines which are prescribed or dispensed online, but also the clinical context for prescribing.
The second tranche of reforms will be the development of a national medicines record, which Mr Butler said will use existing digital health capabilities like e-prescribing, the Active Script List and My Health Record.
Supposedly, this will support prescribers and pharmacists to access up-to-date medicines information on patients.
According to Mr Butler, the changes are a direct response to the overdose death of 24-year-old Erin Collins.
The Victorian woman died last year after accessing and stockpiling prescription medications written by multiple online prescribers, none of whom were aware of the others.
Victoria’s real-time prescription monitoring system, SafeScript, monitors Schedule 8 medicines, benzodiazepines, codeine containing products, quetiapine, pregabalin, gabapentin, tramadol, zolpidem and zopiclone.
It is understood that the medicines implicated in Ms Collins’ death were not monitored by the program.
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“I think this shows that you shouldn’t be prescribing medications in isolation … from the patient’s usual GP, who might not prescribe those medications because they’re dangerous, or because they don’t work, or because we know the patient better,” Dr Wright said.
A consultation on the proposed changes is already underway, according to Mr Butler, with the “first phase” of work set to be completed by December this year.
Dr Wright said the consultation period would give GPs the chance to ensure that any new system will integrate into existing practice software.
Dr Matt Vickers, the clinical director at telehealth giant Eucalyptus, also welcomed the development of a national medicines record.
“While we already send clinical update letters to community GPs with patient consent and are working towards My Health Record integration, a single national medicines record will further assist to ensure that treatment decisions are made with the best available information,” he said.
