New Zealand ePrescription Service

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About the NZ ePrescription Service

The NZ ePrescription Service (NZePS) provides a secure messaging channel for prescribing and dispensing systems to exchange prescription information electronically. It enables a prescription to be generated by the prescriber, transmitted to the NZePS health information exchange broker, and downloaded electronically at a community pharmacy.

The prescriber can note the reason for prescribing and make other comments at the time of prescribing. This will be sent as part of the prescription information passed electronically to the pharmacy. Prescribers can request a notification when a patient’s medication has not been dispensed, and pharmacists can send dispensing comments back to the prescriber.

Prescribers using Medtech, MyPractice or Indici practice management systems can contact their PMS supplier and request upgrades to link to NZePS. The Ministry is working with other primary care PMS providers and residential care electronic charting services to enable their customers to access NZePS in the near future.

In the future, the Ministry will also work with providers of hospital, specialist and community care IT systems to enable prescribers to issue electronic prescriptions for hospital discharge, outpatient, specialists, nurse prescribers (not in general practice), and midwife care.

List of NZePS locations

View the map to find your nearest NZePS participating medical practice:


Update

As of March 2019, the NZePS was used by 160 GP practices, up from 87 in March 2018 (84% increase).

In March 2019, prescribers generated 251,542 ePrescriptions compared to 148,450 in March 2018. Also one hundred and one practices have MoH approval to issue NZePS controlled drug barcoded prescriptions, up from 41 in March 2018 (146% increase).

Pharmacies processed 148,512 electronic prescriptions in March 2019 compared to 67,764 in March 2018.

The percentage of the total prescriber barcoded prescriptions issued in March 2019 that were scanned at pharmacy was 59%. This compares to 45% in March 2018.

The Ministry of Health is working with early adopter GP practices and pharmacies to identify new requirements that will increase the value of NZePS for users.

Benefits to prescribers and pharmacists

NZePS brings two key benefits for prescribers and pharmacists:

Prescribing controlled drugs will no longer have to be handwritten and in triplicate

Prescriptions for controlled drugs will no longer need to be handwritten on the triplicate controlled drugs form. The pharmacist will be able to dispense controlled drugs from an ePrescription provided it is:

  • generated via NZePS and printed with a barcode on a separate piece of paper
  • signed by the controlled drug prescriber
  • downloaded from the NZePS broker – the barcode is either scanned or manually entered into the system if it can’t be scanned.

The signed, printed prescription form with barcode remains the legal prescription, as the law currently requires a signature on paper prescriptions. If there is a discrepancy between the signed, printed prescription and the electronic version as displayed onscreen at the pharmacy, the signed and printed version takes precedence. The pharmacist can also clarify the prescription with the prescriber as per normal practice.

Class A and B controlled drugs remain separate from other prescription items and must be printed on a separate piece of paper. After they have been dispensed, the approved controlled drugs prescription form will be retained in the pharmacy for four years.

The NZePS controlled drug prescription is not a legal controlled drug prescription until the barcode has been scanned (or manually entered if it cannot be scanned) and the prescription downloaded from the NZePS broker. The controlled drug may not be dispensed if the NZePS prescription cannot be downloaded.

Faxed NZePS prescriptions no longer need originals (for non-controlled drugs only)

A faxed ePrescription for non-controlled drugs can be accepted as an original copy by a community pharmacy as long as it is signed, barcoded and downloaded from the NZePS broker at the pharmacy. It won’t be necessary to forward the original prescription to the pharmacy or for the faxed copy to be returned to the prescriber for signing, saving time for both prescribers and pharmacists.

This process is now in place for practices and pharmacies connected to NZePS.

Prescriptions generated and dispensed/downloaded via NZePS automatically qualify for this convenient method.

Benefits to patients

Over time, patients will generally benefit from improvements in patient safety and quality of care such as:

  • Reduced risk of transcribing errors during dispensing
  • Better communication between the prescriber and pharmacist, which will help reduce oral miscommunication and decrease the need for phone calls between them
  • Ability to evaluate and address patient medicines adherence issues. With NZePS, the prescriber can choose to be notified when a patient’s medication has not been dispensed, which can help determine whether or not a patient’s treatment plan is working.
  • Improving the quality of patient medication history information, as the patient clinical record can be updated when medicines are dispensed.

Security of information

Information on the NZePS broker is transmitted to and from the NZePS broker by the secure private health network, Connected Health. The barcode on a paper prescription is a unique code. Electronic prescriptions and dispensing details are also encrypted when they are sent to and retrieved from the NZePS broker.

A prescriber can note on the electronic prescription that a patient has asked for access to information about a medication to be restricted. Other health professionals will be able to see the restricted information only in an emergency, and will have to give a reason for accessing the information.  Access to information will be regularly audited. Patient information is not provided to manufacturers or advertisers.

Digital certificates ensure a site is authorised to access NZePS

At present, three organisations and one application per organisation have been approved by the Medicines Information Governance Group for secure access to the data. At this time, no further applications are being accepted until the trials are in production and have been evaluated.

Prescription storage and access

Prescriptions are stored at the following locations:

  • Prescriber system – the generated prescription and dispensed details if the prescriber requested notifications.  These can be accessed by users authorised to see the patient's clinical record.
  • Pharmacy system – the prescription and the dispensed details. These can be accessed by users authorised to see the dispensing records.
  • NZePS broker - the prescriptions are stored in an encrypted form and the broker does not know who the prescriptions are for or what has been prescribed. Only authorised systems can access the broker/exchange and even then it is to send/receive individual prescriptions. The broker/exchange is not a searchable repository. Prescriptions will be held in the broker until clinical data repositories (CDRs) are set up and approved.

An electronic prescription remains available on the NZePS broker for three months after it has been fully dispensed or has legally expired.

In the future, prescriptions will also be stored in the following:

  • Approved Clinical Data Repository/ies (CDR) – once the CDR is in place, a prescription will be removed from the broker once it has been filled or within three months after expiry. Access will be controlled and limited for clinical purposes only.
  • National Data Warehouse – once this is in place, data will be encrypted. Access will be limited to authorised users of the data warehouse.

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