Electronic records and real-time prescription monitoring hold the potential to enable new ways to prevent harms associated with prescription medication use. Industry experts in attendance called for clear legal principles around what the duty of care looks like in the age of electronic records.
More people in Victoria have lost their lives from the use of prescription medicines than the road toll for five years in a row.
MinterEllison and Scriptwise recently hosted experts, Dr Jennifer Stevens, Anaesthetist at St Vincent's Hospital, and Matthew McCrone, Director of Real-Time Prescription Monitoring Implementation at Victorian Department of Health and Human Services, to discuss effective ways that hospitals, health services and primary health care services can reduce growing harms from prescription medicines.
"We are hearing increasing calls for action from professional bodies, coroners and not-for-profit organisations involved in supporting families and individuals affected by the harms from prescription drugs," said Dr Stevens. "There is growing recognition of the harms caused by high-risk prescription medicines, and we need to be innovative about solutions."
Electronic records and prescription monitoring can enable effective ways to help health professionals prevent dependence in the first place and diagnose and treat patients already at risk.
Dr Stevens highlighted the success of her program at St Vincent’s Hospital to reduce opioid prescribing by junior doctors. Dr Stevens said using data to show doctors their rate of prescribing in comparison to the rate of prescribing of their peers and the recommended guidelines, was the most effective way to change behaviour. The program has led to a 62% reduction in the level of opioids prescribed in the hospital.
Matthew McCrone provided more details about SafeScript, Victoria's real-time prescription monitoring system. SafeScript is computer software that will provide prescribers and pharmacists with access to their patients’ prescription records for high-risk medicines, during a consultation, to enable safer clinical decisions. The implementation of the system is scheduled to start later this year.
"SafeScript will be quick, easy-to-use and custom-built to meet the needs of Victorian clinicians." said Mr McCrone.
ScriptWise CEO, Bee Mohamed Ismail said that the use of SafeScript will also start life-saving conversations between clinicians and their patients .
“Unfortunately the stigma around dependence and addiction issues means that people often find it difficult to speak up if they’re concerned about their medication use. Health professionals can help to assure their patients that they are not alone, and that effective treatments are available.”
"Development of software, like SafeScript, is very important… software can provide data to facilitate collaboration and discussion," said Dr Stevens. "Data can help us facilitate changes in prescribing and dispensing practices, and on prescription drug abuse in general."
"SafeScript will go a long way to facilitate confidence in decision-making. Clinicians, through technology, will be able to make clinical decisions based on electronic data," Noelia Boscana, Special Counsel at MinterEllison says.
New technologies will bring important considerations for legal advisors, in particular in matters of professional conduct.
“What are clinicians permitted to do? What alternatives do the professionals have? It will be an interesting time now that prescribers and dispensers have data," she said.
Dr Stevens also noted that the use of prescription monitoring software raises questions about the right to access medical information about patients, and about protection of patients’ information.
"There are lots of privacy concerns that will need a legal lens to ensure all prescribers and dispensers have confidence in a system," said Dr Stevens. "From a legal standpoint, we need to support clarity on the changes and expectations in a monitoring system."
Industry experts in attendance called for clear legal principles around what the duty of care looks like in the age of big data and electronic records.
"We need legal frameworks and principles to carry innovative solutions forward," said Dr Stevens. "There are regulatory obligations – but the more challenging concepts are the professional obligations and behavioural changes, and that's where legal advisors can help. Everyone wants to do the right thing, but we need the data and the legal framework to support this."
ScriptWise is a non-profit organisation dedicated to preventing the harms associated with prescription medication use and misuse. ScriptWise was established to amplify the voices of family members and individuals who have been personally affected by prescription medication misuse and overdose.
ScriptWise works with key health organisations, professionals, governments and those personally affected to address the root causes of this multifaceted issue. Our vision is to reduce overdose fatalities caused by prescription medication misuse across Australia to zero. Veronica Scott a Special Counsel with MinterEllison is Secretary and Director on the Scriptwise Board. www.scriptwise.org.au