Waiver from Ministry offers opportunity to trial e-prescription

Reference: Teleheath Prescribing Update - April 2020

Released to support virtual care during the Level 4 lockdown, the Ministry of Health’s new waiver regarding electronic prescriptions is paving the way for more clinicians to trial the concept of e-prescriptions.

Prior to the COVID-19 lockdown, clinicians could only provide prescriptions electronically via the NZePS system. If not set up for NZePS, the clinician would need to print, sign, fax and post copies of the prescription to the pharmacy – a process which is time-consuming, and which isn’t ideal during a period of enforced social distancing.

Enabling safe, virtual care

The waiver recognises prescriptions not signed personally by the prescriber to be legal if they meet a variety of conditions, including a format which prevents the prescription from being modified and distribution via a secure email system. Aiming to mitigate potential impacts such as the postal service experiencing delays or clinicians being unable to access office-based technology for scanning or faxing, the waiver is enabling care to be delivered in a manner which maintains the safety of all parties.

“This is a huge barrier-breaker and, following the removal of lockdown restrictions, I would be very surprised if many clinicians would want to go back to the old system. The situation we found ourselves in now is like a ‘dummy run’ for electronic prescribing,” says Dr Ruth Large, Clinical Director Information Services and Virtual Healthcare, Waikato DHB and Chair of the Telehealth Leadership Group.

Aiming for wider use of technology in health

In her role as Chair of the Telehealth Leadership Group, Dr Large would like to see the widespread adoption of key aspects of telehealth, including electronic prescriptions. “Using NZePS is by far the ideal as it provides a continuous record of the patient’s prescriptions. Over the weekend I used the system with two of my patients – one who wasn’t sure if their antibiotic had been prescribed previously or not and another who wanted a repeat on an old-fashioned anti-inflammatory which she had had good success with. Without being able to look up both patients’ prescription records on NZePS, I would have been unable to help them.”

Dr Large notes, however, that there are still some barriers in place to the widespread adoption of NZePS. The cost of integration and models which incur a charge per prescription can be a barrier to smaller GP practices while at the DHB level, the integration can be complex from a technology point of view. “To me it’s about trying to break down barriers in what have been the antiquated, paternalistic ways we deliver medicine. We know what the barriers are – we’ve just never had the impetus to step over those barriers until faced with this epidemic,” says Dr Large. “At this point, we need to look together at where the barriers are and collaborate to break them down. Collaboration has got us to where we are now – we’re a small country, it has to be the right way to go.”

• For full information on the temporary waiver from the Ministry of Health, click here.
• To join the discussion around improving access to NZePS for all NZ clinicians, contact the Telehealth Leadership Group by emailing enquiries@ithealthboard.health.nz with the words ‘Telehealth’ in the subject line.