Electronic prescribing

​Electronic prescribing is available in the community setting. It provides healthcare providers and patients with an option to receive an electronic prescription as an alternative to a paper prescription. 

Electronic prescribing process: Conformant software is used by prescribers to create an electronic prescription which is sent as a unique electronic token (in the form of a QR code) to the patient or their authorised agent via SMS or email. The patient or their authorised agent may request the token to be sent to a pharmacy or to the Active Script List (ASL). The prescriber should document this request.

The token is a key that unlocks the electronic prescription and can be provided to the pharmacist to dispense and supply the medicines. More information on electronic prescriptions and tokens is available on Department of Health and Aged Care and the Digital Health.

An exemption from the NSW Poisons and Therapeutic Goods Regulation has been granted to allow electronic prescriptions to be legally issued and dispensed in NSW.

On this page

1. Information for prescribers​ 
   
2. Information for community pharmacists​ 
   
3. Information for software vendors

​Information for prescribers

Electronic prescribing is permitted for both PBS and non-PBS prescriptions in the community where all software systems participating in the prescribing, transmission and dispensing of the prescription are conformant with the Australian Digital Health Agency (ADHA) conformance requirements and technical specifications. Conformant prescribing systems are listed on the Electronic Prescribing Conformance Register with a Conformance ID. Your software vendor can also provide you with your system's Conformance ID if it has one.

Prescribers must ensure that the electronic prescription created by their prescribing system contains all the required details (see PRES-17 below).

The requirements in NSW are the same as those for paper prescriptions with a small number of exceptions. Prescribers of conformant electronic prescriptions do not need to comply with the following paper prescription requirements:

• handwriting and hand signature on the prescription
• underlining and initialing of any dose that could be regarded as dangerous or unusual
• for Schedule 8 (S8) medicines, the quantity to be dispensed written in words as well as figures

If a prescribing system does not have a designated field for a required detail (e.g. NSW Ministry of Health approval number, which is required for certain S8 medicine prescriptions), a prescriber must ensure the detail is entered into the system so it will be displayed to the dispensing pharmacist. A pharmacist can dispense an electronic prescription only if all required prescription information is displayed. Contact your software vendor if you have any concerns or queries about how to enter details in your prescribing system.

Electronic prescriptions are not valid for veterinary practitioners.

For more information on electronic prescribing visit the Australian Digital Health Agency's Electronic Prescribing - For Prescribers.

​Information for community pharmacists

When dispensing an electronic prescription, community pharmacists must ensure that all of the systems participating in the prescribing, transmission and dispensing of the prescription are conformant with the ADHA conformance requirements and technical specifications. Conformant prescribing and dispensing systems are listed on the Electronic Prescribing Conformance Register.

Electronic prescriptions must include details required for it to be legally valid in NSW (see PRES-17 below). Pharmacists should ensure that the on-screen display includes, if applicable, the repeat interval and the NSW Ministry of Health approval number. See below for more information.

Pharmacists should not assume that a prescription is legal merely because it has been digitally transferred.

Requirements for electronic prescriptions

Electronic prescriptions have the same legal requirements as those for paper prescriptions with the following exceptions:

• Patient date of birth is required for electronic prescriptions.
• Prescribers do not need to:
• hand write or hand sign the prescription,
• underline or initial any dose that could be regarded as dangerous or unusual,
• write the quantity for S8 medicines in words and figures.

Pharmacists who dispense conformant electronic prescriptions are exempted from the following requirements:

• endorse in ink:
• the date of dispensing
• the pharmacy address
• the prescription reference number
• the word 'CANCELLED' where no valid repeat supplies remain
• keep S4B and S8 prescriptions in hardcopy
• store S4B and S8 hardcopy prescriptions separately.

Pharmacists are exempted from these requirements because conformant systems record the date of dispensing, the pharmacy address and the prescription reference number, and securely transmit and retain details of prescriptions which are easily searchable. Hence, repeats of conformant electronic prescriptions for S4B and S8 medicines do not have to be dispensed at the same pharmacy which dispensed the original prescription. A patient can take the new token for their repeat prescription to a different pharmacy if they choose so.

Repeat intervals

When dispensing electronic prescriptions, pharmacists should ensure that the on-screen display shows repeat intervals where required. For prescriptions for a S4B or S8 medicine with repeats, an interval must be shown. If no repeat interval is displayed, the directions for any repeat supplies are invalid and no repeats can be dispensed. The pharmacist may only dispense a single supply, and the prescription should be electronically cancelled to prevent a new token from being issued.

NSW Ministry of Health approval numbers

Pharmacists should ensure that the NSW Ministry of Health approval number is displayed (see PRES-17 below) on prescriptions for:

• a S8 psychostimulant (e.g. dexamfetamine, lisdexamfetamine, methylphenidate)
• a pharmacist-compounded S8 medicine
• a Schedule 4 (S4) medicine listed in clause 37 of the Poisons and Therapeutic Goods Regulation 2008 (e.g. clomifene, isotretinoin), unless the prescriber belongs to an authorised specialist group. In this case, instead of including the Approval number the prescriber may include their relevant specialist qualification and the words “issued under clause 37 of the Poisons Regulation” or words to that effect.

Key points to note

• The token presented to the pharmacy is not a legal prescription. It is used by the pharmacist to ‘unlock’ the legal prescription so it can be dispensed.
• A prescription that is created, transmitted or dispensed from a system that is not listed on the Electronic Prescribing Conformance Register with a Conformance ID is not legally valid for dispensing.
• Electronic prescriptions are not valid for veterinary practitioners.

Validity of tokens and suspicious electronic prescriptions

The Australian Digital Health Agency has safeguards to ensure that electronic prescribing meets specific technical and security standards so that prescriptions created, transmitted, and dispensed electronically are legally valid, secure, and compliant with Australian regulations. Despite these safeguards forgeries have been detected and pharmacists should not assume prescriptions are valid because they were issued electronically.

Pharmacists must be confident the token presented by the patient or their agent has not been fraudulently obtained or altered. If a pharmacist is concerned about the validity of a prescription, they should request sighting the patient’s or agent’s identification document/s (e.g. photo driver licence) and/or contact the prescriber.

If the prescription is for a Schedule 8 medicine a pharmacist must verify the patient and/or prescriber identity. This means that the pharmacist must ensure they know the patient, or the prescriber, or confirm the prescription is valid by independently verifying it with the prescriber. Prescriber contact details should be sought via a source other than what is on the prescription, such as via an internet browser search, Ahpra register etc.

What to do if you suspect a forgery

If presented with a suspicious electronic prescription that appears to be forged, altered, or fraudulently obtained, do not dispense it. The prescription should be cancelled to make the token invalid and unable to be used by any person. For information about how to cancel an electronic prescription please contact your dispense vendor for instructions on how to cancel or disable these.

Fraudulent prescriptions must be reported to Pharmaceutical Services via the online notification form and the police. If the prescription is electronically issued, the Digital Health Agency (fraud@digitalhealth.gov.au) should also be informed.

For more information on electronic prescribing visit the Australian Digital Health Agency's Electronic Prescribing - For Dispensers.

Information for software vendors

To participate in electronic prescribing, software vendors are required to meet the Australian Digital Health Agency (ADHA) conformance requirements and technical specifications. For more information see the Digital Health Developer Portalon electronic prescribing.

NSW requirements

For an electronic prescription to be legally valid in NSW, all systems participating in the prescribing, transmission and dispensing of the prescription must be listed on the ADHA Electronic Prescribing Conformance Register with a Conformance ID. Such a prescription is then termed a 'Conformant Electronic Prescription'.

A separate approval from NSW Health is not required where a system conforms under the ADHA conformance requirements and technical specifications and has been listed on the Electronic Prescribing Conformance Register with a Conformance ID.

Specifications identified in the Electronic Prescribing Technical Framework of the Electronic Prescribing Conformance Profile  as having a jurisdictional requirement are provided below and must be met. These include:

PRES-13

Electronic prescriptions are accepted in all circumstances where systems are conformant (i.e. each participating system has a Conformance ID) and the prescription contains all required details (see PRES-17).

PRES-17

For an electronic prescription to be legally valid for dispensing in NSW it must contain the details listed below. This list incorporates prescription requirements under the Poisons and Therapeutic Goods Regulation 2008 (the Regulation). (Where possible, Reference IDs from the Conformance Profile are listed).

• Conformance ID of the system used to create the prescription (PRES-83)
• Healthcare Provider Identifier – Organisation (HPI-O) of the practice or organisation from which the prescription is issued (PRES-18)
• Healthcare Provider Identifier – Individual (HPI-I) of the prescriber (PRES-83) (see Note 1)
• unique prescription number for the prescription (PRES-83)
• prescriber name, practice address and telephone number
• date (and time) of issue
• patient’s full name (first name and last name)
• patient's address (PRES-18) (or email address or mobile phone number but only in specific circumstances - see Note 2)
• patient’s date of birth (PRES-18)
• name, strength and form (if not readily apparent) and quantity of the medicine (PRES-18)
• adequate directions for use (including route of administration if not readily apparent) (PRES-18)
• number of repeat supplies authorised, if any (PRES-18)
• interval between any repeats (PRES-18) (see Note 3)
• the NSW authorisation reference number (known as the NSW approval number) (PRES-18A) where required under the Act (see Note 4)
• prescriber specialist qualification (PRES-18) (see Note 5)
• annotation with the words “issued under clause 37 of the NSW Poisons and Therapeutic Goods Regulation” or similar (see Note 5)

1. See the Electronic Prescribing - Technical Framework Documents for requirements for Open PDS and Direct PDS.
2. In a case where the prescription is for azithromycin for the treatment of chlamydia in the partner of the presenting patient, email address or mobile phone number of the partner is accepted as an alternative to the physical address.
3. The interval between any repeats must be stated for medicines in Schedule 8 (S8) of the Poisons Standard ('controlled drugs' or 'drugs of addiction') and Schedule 4 medicines listed in Appendix B of the Poisons and Therapeutic Goods Regulation 2008 (S4B) (e.g. anabolic/androgenic steroids). The interval between each repeat supply must be clearly specified (e.g. stated as number of days). The interval between each repeat supply must be clearly specified (e.g. stated as number of days).
4. The NSW authorisation reference number (known as the 'NSW Approval number') is distinct from, and independent of, the 'authority code' associated with an Authority PBS prescription for restricted medicines.
   
   The NSW Approval number is issued by the NSW Ministry of Health and is alphanumeric in format, and may be prefixed with a text string of letters/characters, including 'A', 'AU', 'CNS', 's28c', 'CA2023', 'CL', 'RA', and 'PG(T)'. Examples are AU123456789, RA998.
   
   
   • a Type A drug of addiction (see clause 122 of the Poisons and Therapeutic Goods Regulation 2008), i.e. Schedule 8 psychostimulants and pharmacist-compounded Schedule 8 medicines
   • a Schedule 4 (S4) medicine listed in clause 37 of the Poisons and Therapeutic Goods Regulation 2008 (e.g. clomifene, isotretinoin) (or as specified in Note 5)
5. For S4 medicines listed in clause 37 of the Poisons and Therapeutic Goods Regulation 2008 (e.g. clomifene, isotretinoin) the prescription must include either:
• the prescriber's specialist qualification (abbreviation is acceptable and could be up to 12 alphabetical characters) and the text “issued under clause 37 of the Poisons and Therapeutic Goods Regulation 2008" or words to that effect, or
• the NSW approval number (see Note 4).

PRES-23

Under the Poisons and Therapeutic Goods Regulation 2008, a person issuing a prescription for a Schedule 4 medicine listed in Appendix D of the Poisons and Therapeutic Goods Regulation 2008 (S4D) or a S8 medicine must keep a record of it for a period of at least two (2) years.

Medical records otherwise must be kept as required under the Health Practitioner Regulation National Law. They should be retained in a retrievable format and readable state for their minimum required retention period.

PRES-24

All NSW required details (see PRES-17) shall be displayed.

Electronic prescriptions should be displayed in a similar manner to paper prescriptions.

DISP-4

While there is no requirement for each dispenser to login for each dispense transaction, the pharmacist authorising the process must ensure their identity is recorded. This can be done by entering their initials before every dispense event.

DISP-33

The NSW Poisons and Therapeutic Goods Regulation 2008 has no mandatory requirement to record receipt of supply in the dispensing system.

For medicines under theNSW Opioid treatment Program (OTP), the pharmacist may record that the patient has received the dose.

DISP-34

All records must be retrievable in human readable format immediately by any pharmacist in charge at any time at the premises where the prescription was dispensed and retained for two (2) years from the date of dispensing.

DISP-36

The dispense record must contain:

• details of the prescription (see PRES-17)
• the date (and time) on which the prescription was dispensed
• the name (first name and last name) of the pharmacist who dispensed the prescription (that is, the pharmacist who personally dispensed the prescription)
• the pharmacy name and address

All dispense records must be retrievable in human readable format immediately by any pharmacist in charge at any time at the premises where the prescription was dispensed and retained for two (2) years from the date of dispensing.

DISP-50

PRES-17 provides a list of prescription details required to be displayed to the dispensing pharmacist.

DISP-51

Records (prescribing and dispensing) must be searchable, filterable and retrievable by categories including by patient, by prescriber, by medicine, by legal category (at least S8, S4B, S4D, and S4, and optionally S3, S2, and unscheduled).

MI-10

Records must be immediately retrievable in human readable format at the premises and retained for two (2) years.

MI-10A

Records (prescribing and dispensing) must be searchable, filterable and retrievable by categories including by patient, by prescriber, by medicine, by legal category (at least S8, S4B, S4D, and S4, and optionally S3, S2, and unscheduled).

For any enquiries email MOH-PharmaceuticalServices@health.nsw.gov.au