Sharing-by-default laws will soon require all online prescribing services to upload medicines-related information to My Health Record.
The Department of Health, Disability and Ageing has an ambitious plan to bring online-only telehealth clinics in from the cold before the year is up, having accepted that telehealth offerings aren’t going anywhere.
Announced in part earlier this year, the Department is working on a two-part reform to address doctor shopping.
One part of this is the introduction of a national medicines record, which will use existing digital health capabilities like e-prescribing, the Active Script List and My Health Record to give prescribers and pharmacists an accurate picture of what medicines a patient is on.
The other component is to require online telehealth providers to upload medicines-related information to each patient’s My Health Record.
DoHDA has now opened a public consultation on this phase, which it aims to have finalised by the end of the calendar year.
“Online prescribing services are now an established and increasingly visible component of healthcare in Australia,” the consultation paper reads.
“Online prescribing services operate across virtual settings using telephones, video consultations, emails and text-based communication to deliver clinical consultations with patients and prescribe medicines.”
It includes models where care is delivered via email, an online questionnaire or an app.
The definition of online prescribing services was left intentionally broad and is “intended to encompass all online prescribing services operating in Australia, regardless of whether consultations are billed through the Medicare Benefits Schedule.”
Because these businesses operate entirely outside of the MBS and the PBS – i.e., patients pay completely privately – up until this point the DoHDA has had limited oversight of the operations at online-only clinics.
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These include relatively mainstream services like Eucalyptus’ Juniper, Kin and Pilot clinics.
“Safety risks may increase where online prescribers do not have timely access to, or do not adequately review a patient’s medical and medicines history prior to prescribing,” the department wrote.
“This includes where information about medicines prescribed and dispensed is not effectively shared with other healthcare providers involved in the patient’s ongoing care.
“These risks are heightened in fragmented models of care, reinforcing the importance of strong information-sharing arrangements to support safe prescribing practices.”
While the department appears to have fixed on implementing some form of requirement for online-only clinics to share medicines information, consultation feedback will guide the exact scope of those requirements.
It will inform, for instance, what information will need to be shared and whether different categories of medicines – e.g., opioids and benzodiazepines – should be subject to additional safeguards.
One of the key barriers to completing reforms before DoHDA’s self-imposed December deadline may turn out to be the interoperability element.
“To share medicines information to My Health Record, online prescribing services will need to be registered and able to connect to My Health Record and, where relevant, electronic prescribing infrastructure to share information,” the consultation paper said.
“This includes having organisational (HPI-O) and individual healthcare identifiers (HPI-I) in place and using software that meets existing digital health conformance requirements.”
While many software vendors may already offer compliant products, the department said it was “interested” in hearing whether requiring online prescribing services to author and upload medicines information to My Health Record “may affect their current model of clinical care, including impacts on workflow, costs and accessibility for providers and patients”.
The consultation closes on Tuesday 7 July.
