Real time prescription monitoring

Real-time prescription monitoring (RTPM) enables prescribers, pharmacists and medicine regulators to access real-time information about a patient’s medication history. This includes information about specific high‑risk drugs and legal authorisations to prescribe.

About Tasmania’s RTPM system

Tasmania was the first Australian state to implement an RTPM system in 2009. The clinician facing component (DORA) has been available to prescribers and pharmacists since 2011 to help reduce the growing harms in the community associated with pharmaceutical abuse and misuse. DORA is an extension of the Drugs and Poisons Information System (DAPIS) used by our Pharmaceutical Services Branch (PSB) as its RTPM system.

A national RTPM is being developed to connect to and interface with the Australian Government’s National Data Exchange (NDE). This forms a significant clinical practice, information technology and regulatory change. We are working with the Australian Government about how the NDE will work in Tasmania.

On 17 December 2021 amendments were made to the Poisons Act 1971 to facilitate implementation of a nationally consistent RTPM solution in Tasmania, including integration with the NDE. These amendments allow for planning and implementation activities to be undertaken before “go live” for prescribers and dispensers. Tasmania’s implementation of the national RTPM solution will be called TasScript™.

How DORA works

DORA is a secure real time prescription monitoring website allowing prescribers and pharmacists to access information about Schedule 4 and 8 opioids and all other Schedule 8 drugs dispensed from pharmacies for Tasmanian patients before you write or dispense a prescription.

As a prescriber or pharmacist, you can check DORA for any patient presenting to you. Information in DORA includes:

• patient details
• their Schedule 4 and 8 opioid and Schedule 8 drug dispensing history

Why use DORA?

• DORA is a clinical support tool to enable you to better identify and manage patients exhibiting signs of drug-dependency or drug-seeking behaviours, such as ‘doctor shopping’.
• DORA is not intended to disadvantage patients where there is a legitimate clinical need for a medicine and where a prescriber is authorised to prescribe.

Is using DORA mandatory?

DORA is not mandatory, but it is an important part of clinical practice to minimise potential harms.

You are required to seek approval under Section 59E of the Poisons Act 1971 prior to prescribing a Schedule 8 drug where:

• a patient is or has been declared drug-dependent in Tasmania
• the drug has been prescribed for a period of more than two months
• a medical practitioner has issued a Section 59B notification for the patient,
• the substance carries an increased risk of harm due to potency or patterns of use requiring prior approval under the Poisons Regulations 2018 (for example, fentanyl, hydromorphone, ketamine, methadone and psychostimulants).

What information is contained in DORA?

• DORA contains information about Schedule 4 and 8 opioids and all other Schedule 8 drugs dispensed in Tasmania for patients.
• Currently, information will not appear in DORA for Schedule 4 and 8 opioids or Schedule 8 drugs dispensed in other jurisdictions for patients.
• DORA may include relevant signals to assist clinical decision-making.

Registering to use DORA

• Any prescriber of Schedule 8 drugs or pharmacist may apply to access DORA.
• Prescribers include doctors, dentists and nurse practitioners.
• Intern doctors or pharmacists may also apply to access DORA.
• Applicants must hold current AHPRA registration.

How to access DORA

Contact the Pharmaceutical Services Branch for information on how to access DORA.

To access the DORA website, you need to use a device with a Medicare Public Key Infrastructure (PKI) Site Certificate installed. This secures the connection to ensure the security of patient records. For more information, please visit the Department of Human Services Public Key Infrastructure website.

Real time reporting from pharmacies

• Real Time reporting is used by pharmacies to send dispensing information and for dispensing events from hospitals where the patient is not admitted.
• All Tasmanian pharmacies are required to report supplies of all relevant substances in accordance with the Poisons Regulations 2018.
• All Tasmanian community and hospital pharmacies report dispensing information via their dispensing software.
• Community or hospital pharmacies unable to report in real time need to submit electronic reports.

Where to get more information

• Contact the Pharmaceutical Services Branch