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General
Real Time Prescription Monitoring (RTPM) systems are clinical decision support computer software tools. They allow prescribing and/or dispensing records for high-risk monitored medicines to be transmitted in real-time to a centralised database, which can then be securely accessed by prescribers and pharmacists during a consultation.
They are a feature of best-practice health care and are used globally to enable prescribers and pharmacists to make better informed decisions regarding the judicious prescribing and dispensing of high-risk monitored medicines such as opioid analgesics, benzodiazepines, and psychostimulants. They have been shown internationally to help prevent harm associated with target medicines and promote the quality use of medicines.
Tasmania was the first Australian jurisdiction to implement a RTPM system in 2009. The clinician facing component of the system, called DORA, was first made available to prescribers and pharmacists in 2011.
DORA has allowed prescribers, pharmacists and medicines regulators in Tasmania to view real-time information regarding the supply of monitored medicines to a patient, which can be considered prior to prescribing or dispensing a monitored medicine.
TasScript is Tasmania’s implementation of the national RTPM solution. TasScript will provide Tasmania with a nationally consistent RTPM system and replace DORA.
TasScript will leverage newer technology to facilitate RTPM integration with prescribing and dispensing software and allow secure access by registered users from anywhere in Australia and on multiple device types.
The My Health Record is a patient-controlled summary of a patient’s health record, in which patients can choose what is included and who can view their medication history. TasScript is different because it allows doctors and pharmacists involved in a patient’s care access to a complete record of high-risk monitored medicines that have been prescribed and supplied.
Patients are not able to opt-out or restrict what medication history can be viewed in TasScript. This is necessary to ensure a comprehensive medication history can be captured to allow health practitioners to make better informed clinical decisions and reduce the harms caused by high-risk monitored medicines.
In 2018, the then Council of Australian Government’s Health Council agreed to progress national RTPM as a federated model with jurisdictions committing to progressing development and adaptation of systems to connect to, and interface with the Commonwealth Government’s National Data Exchange (NDE) to achieve a nationally consistent solution.
TasScript is Tasmania’s implementation of the Australian Government’s RTPM solution, the NDE, and replaces Australia’s first RTPM system known as DORA
TasScript provides prescribers and pharmacists with a clinical decision support tool to make better informed decisions about the prescribing or dispensing of high-risk monitored medicines, and facilitate the early identification, treatment and support for patients who are at increased risk of harm, including developing signs of substance use disorder.
Australia has a growing national problem with the unsafe use of prescription medicines. The number of harms, including deaths from prescription medicines, has increased and is now higher than illegal drugs.
Tasmania’s experience as the first jurisdiction to implement an RTPM solution has shown the potential value of this clinical decision support tool being used across Australia. Between 2000-09 Tasmania had the highest rate of prescription opioid related deaths in Australia (NDARC). Australia’s Annual Overdose Report 2023 published by the Penington Institute confirms that since DORA’s introduction, together with an uplift in the collaborative efforts of Tasmania’s prescribers, pharmacists and medicines regulators:
- Tasmania has experienced a much lower percentage increase in unintentional drug-induced poisoning deaths compared with the rest of Australia; and
- Tasmania’s prescription benzodiazepine, opioid, and amfetamine poisoning deaths are now below the national average.
Unfortunately, the harms and increasing number of deaths from prescription medicines remain a major public health concern across Australia. Every day in Australia, nearly 150 hospitalisations and 14 emergency department admissions involve issues relating to opioid use, and 3 people die from the harm that results (AIHW).
Drug-induced deaths in Australia are now more likely to be due to prescribed pharmaceutical drugs than illegal drugs, with benzodiazepines being the most commonly involved single drug type in drug-induced deaths in Australia (AIHW).
The implementation of a nationally consistent RTPM system represents a natural progression for Tasmania to ensure our prescribers and pharmacists can utilise more contemporary technology when making clinical decisions for high-risk monitored medicines.
Based on the best available international and local data, and with the support of stakeholders, TasScript monitors prescription medicines that are causing the greatest harm to the Tasmanian community.
Medicines that are monitored in TasScript include:
- all Schedule 8 medicines (eg opioids, benzodiazepines, amfetamines)
- all Schedule 4 opioids (codeine, tramadol, dextropropoxyphene)
- benzodiazepines, such as diazepam
- gabapentin
- olanzapine
- pregabalin
- quetiapine
- ‘Z-drugs’ (zolpidem, zopiclone)
TasScript monitors all prescriptions for these medicines regardless of whether they receive a Pharmaceutical Benefits Scheme (PBS) subsidy or are private non-PBS prescriptions.
Ongoing review of relevant epidemiological data, intelligence inputs, and the national policy agenda will occur to inform what medicines are monitored in the future.
Prescribers (eg doctors, nurse practitioners, dentists) and pharmacists are authorised under the Tasmanian legislation to securely access TasScript to view records of all high-risk monitored medicines that have been prescribed or dispensed to patients under or seeking their care.
This enables these health practitioners to make safer and more informed clinical decisions, and facilitates the early co-ordination of treatment and communication by giving these health practitioners visibility of all clinicians involved in the patient's care regarding these medicines.
Authorised Department of Health staff will also access TasScript as part of their regulatory role in supporting the safe supply of medicines in the Tasmanian community.
TasScript is the Tasmanian implementation of the national RTPM system. The software is maintained by a national RTPM vendor and is overseen by the Australian Digital Health Agency in coordination with the jurisdictions.
Further information regarding TasScript is available on the Tasmanian Department of Health’s Medicines and Poisons Regulation webpage. General enquiries regarding TasScript can be made by calling 03 6166 0400 or via email [email protected]
Technical support enquiries can be made by calling the national RTPM vendor, Fred IT Group, on 1800 776 633 or via email [email protected]
Mandatory use
It is mandatory for prescribers and pharmacists to take all reasonable steps to check TasScript prior to prescribing or dispensing a high-risk monitored medicine. This follows worldwide best practice as mandatory systems adopted in other countries have shown to support greater reduction in harms from high-risk prescription medicines.
Like other jurisdictions, the legislation allows for exceptions in some circumstances, including when treating patients physically located in medical institutions (hospitals and residential aged care facilities) and palliative care, end-of-life settings.
Regulation 95G of the Poisons Regulations 2018 details the specific exemptions when a prescriber or pharmacist is not required to check TasScript, these include prescribing or dispensing:
- a VAD substance in accordance with the End-of-Life Choices (Voluntary Assisted Dying) Act 2021 ; or
- a substance to a person who is suffering an incurable, progressive, far-advanced disease or medical condition; and has limited life expectancy due to the disease or medical condition; and is receiving palliative treatment; or
- a substance to a person who is an in-patient being treated in a medical institution; or
- a substance to a person who is a patient being treated in an emergency department of a hospital and the monitored medicine is to be administered in the course of treatment given in that emergency department.
A medical institution is defined Regulation 3 in the Poisons Regulations 2018 as an institution the sole or main object, or one of the main objects, of which is, or is held out to be, the provision of accommodation (whether with or without medical or other treatment) for –
(a) persons suffering from any illness, injury, infirmity or mental disorder; or
(b) pregnant women or women immediately after childbirth; or
(c) persons who are substantially and permanently handicapped by illness, injury or congenital deformity, or by any other disability; or
(d) persons who are aged;
The Poisons Act 1971 specifies penalties that can be imposed on prescribers and pharmacists if they do not take all reasonable steps to check TasScript when prescribing or dispensing a high-risk medicine. The penalties for failure to comply with this requirement is a fine not exceeding 10 penalty units.
While the Act has provisions to prosecute for failure to comply with these requirements, non-compliance is assessed within a risk-based framework that focusses on conduct that poses the most significant risks of harm to patients and practitioners who have repeatedly failed to comply with TasScript and Poisons Act 1971 requirements.
The Department of Health utilises a range of compliance tools, including education, audit and counselling, to assist practitioners to meet their regulatory obligations, and takes individual circumstances into account before any consideration is made on a decision to initiate prosecution.
Following the launch of TasScript to prescribers and pharmacists, the Poisons Act 1971 requires prescribers and pharmacists to take all reasonable steps to check TasScript when prescribing or supplying a high-risk monitored medicine.
There may be circumstances where prescribers or pharmacists may not be able to check TasScript but they consider it necessary to prescribe or supply a high-risk monitored medicine. The phrase “all reasonable steps” takes into consideration what measures were taken by a prescriber or pharmacist to attempt to satisfy this requirement.
Examples include:
- Contacting the Department of Health to enquire about a patient’s history in TasScript
- Contacting the patient’s usual pharmacy to enquire about the patient history in TasScript
- If access to TasScript is temporarily unavailable, prescribing or supplying limited quantities and checking TasScript at the next available opportunity
Prescribers and pharmacists who do not check TasScript simply because they have not registered or have not arranged access to a computer, and do not consider other measures to establish the patient’s history in TasScript, are unlikely to satisfy this requirement.
Health practitioners are not required to monitor fellow practitioner’s compliance with checking TasScript. The Department of Health will be routinely auditing the TasScript use by all practitioners and following up as necessary with persons that may not be complying with their obligations under the legislative framework through a mixture of risk-informed regulatory tools.
Health practitioners can notify the Department of Health in writing if they hold suspicions of alleged practice behaviour which may be inconsistent with TasScript mandatory checking requirements for assessment. If there are departures from accepted clinical practice, this may also need the notifying health practitioner to consider their mandatory obligations to report such practice to Ahpra. This is a decision that would need to be made by the notifying health practitioner on a case-by-case basis.
Where TasScript, along with any other relevant information, informs a health practitioner of ongoing risk that may require clinical intervention the first option should always be to discuss this risk with the treating health practitioners identified in TasScript. This will be the most efficient and professionally collaborative way to resolve any concerns and support safe patient care.
How TasScript works
TasScript can be integrated into prescribing and dispensing software allowing for real-time notifications to be sent to prescribers and pharmacists prior to prescribing or dispensing a monitored medicine. Notifications are sent to prescribers and pharmacists as a pop-up in their software with a link to information in TasScript that should be considered prior to a prescription for a monitored medicine being prescribed or dispensed.
Prescribers and pharmacists will also be able to securely view this information via the TasScript Health Practitioner Portal.
The information in TasScript will also be accessible to the Tasmanian Department of Health. The information will allow the Department of Health to execute statutory functions and public health monitoring activities required under the Poisons Act 1971.
The data required for TasScript is collected automatically from the national Prescription Exchange Service (PES) that support the electronic transfer of prescriptions from prescribers working in medical practices and hospitals to pharmacists working in pharmacies.
When a prescription is issued at a medical practice or dispensed at a pharmacy, and the clinical software is connected to the PES, the PES is required under Tasmanian legislation to send a record of the prescription in real time to TasScript.
For extemporaneously compounded or unregistered medicines where there is no Australian Medicines Terminology (AMT) code for the product, TasScript identifies the medicine using ‘key word’ identification.
TasScript does this by detecting words entered by the pharmacist or the prescriber into the product or drug name field in their dispensing or prescribing software. When a key word is detected TasScript creates an event in the database that can be viewed in the future when a health practitioner checks the patient profile.
Examples of ‘key words’ detected by TasScript include:
Type of product | Keyword |
Medicinal cannabis extemporaneously compounded product tetrahydrocannabinol | cannabis |
Medicinal cannabis unregistered finished product imported from overseas tetrahydrocannabinol | cannabis |
Extemporaneously compounded ketamine | ketamine |
Extemporaneously compounded cocaine | cocaine |
Prescribing or dispensing software must be connected to a Prescription Exchange Service for TasScript to detect the keyword and record a prescribing or dispensing event.
It is a legal requirement for Prescription Exchange Services to provide the record of prescribing and supply to TasScript where clinical software is connected to a Prescription Exchange Service.
Pharmacists and prescribers are not required nor able to manually enter data into TasScript, as the system does not support manual data entry.
Extemporaneously compounded Schedule 8 medicines are not exempt from TasScript.
TasScript monitors all prescriptions for these medicines regardless of whether they receive a PBS subsidy or are private non-PBS prescriptions.
For further information about ‘key words’ please contact IT support by emailing [email protected]
No. Handwritten prescriptions will not display in TasScript, however any dispensing event for these prescriptions will be displayed in the system.
Tasmanian poisons legislation requires all prescribing and dispensing systems that connect into the national electronic prescribing system to report these transactions into the national RTPM system. All community pharmacies in Tasmania are connected.
If the pharmacy is using integrated dispensing software, pop-up notifications will be generated during the dispensing process regardless of who is carrying out that process. However, pharmacy technicians and assistants are not eligible to register for TasScript and will not be able to log into the system through the pop-up notification. Only prescribers and pharmacists registered with AHPRA are legally authorised to access TasScript.
When using TasScript with integrated clinical practice software, it is important to differentiate between notifications and alerts. If your clinical practice software is not integrated, you will not receive pop-up notifications and will need to log in and check the TasScript Health Practitioner portal.
Notifications are the red, amber or green messages that pop-up on a prescriber’s or pharmacist’s computer monitor screen when they are prescribing or dispensing a high-risk monitored medicine. These notifications are designed to quickly and clearly signal to the prescriber or pharmacist if further checking of the patient’s record in TasScript is required.
Alerts exist within the TasScript health practitioner portal and indicate that the prescribing or dispensing history for a patient has met certain criteria for high-risk circumstances. Prescribers and pharmacists will be prompted to consider this information as part of their clinical decision-making.
A RED pop-up notification will appear when there is a current alert relating to the prescribing or dispensing history of a patient. These alerts are displayed in the TasScript health practitioner portal as follows:
- Multiple provider episodes: when prescriptions from four or more prescribers or medical practices have been recorded in TasScript within the last 90 days.
- Opioid dose threshold: when the oral morphine equivalent daily dose (calculated based on an average over the last 90 days) exceeds 100mg oral morphine equivalent dose daily (i.e. a high-risk dose).
- High-risk drug combinations: when prescriptions for certain drug combinations have been recorded in TasScript within the last 90 days.
- Methadone + a benzodiazepine
- Methadone + a long-acting opioid
- Fentanyl + a benzodiazepine
- Fentanyl + a long-acting opioid
- Treatment for opioid use disorder: when the patient is currently or has previously been treated for opioid use disorder on the opioid pharmacotherapy program in Tasmania
Prescribers and pharmacists who receive a RED pop-up notification are required to click on the pop-up notification to review the patient history to assess whether it is safe or appropriate to prescribe or dispense a monitored medicine.
An AMBER pop-up notification will appear in the following situations:
- Multiple provider episodes: when prescriptions for a monitored medicine have been dispensed from at least four or more different pharmacies in the last 90 days.
- Opioid dose threshold: when the oral morphine equivalent daily dose (calculated based on an average over the last 90 days) is between 50mg and 100mg oral morphine equivalent daily dose (i.e. a medium risk dose).
- Unauthorised prescriber: where a prescriber does not currently hold a legal authorisation to prescribe a selected schedule 8 medicine to the patient.
- The monitored medicines prescribed or supplied to the patient within the last 90 days involve more than one prescriber at different medical practices.
Prescribers and pharmacists are required to click on the AMBER pop-up notification to review the patient history to assess whether it is safe or appropriate to prescribe or dispense a medicine.
A GREEN pop-up notification will appear in the following situations:
- When there has not been a prescription for a monitored medicine issued or dispensed in the last 90 days, or
- When prescriptions for a monitored medicine in the last 90 days have been issued by the same prescriber or medical practice, and there are no alerts.
Prescribers and pharmacists are NOT required to click on the GREEN pop-up notification to review the patient history.
When using integrated software, each time you prescribe or dispense a high-risk monitored medicine to a patient, you will receive a pop-up notification. If you are prescribing or dispensing multiple monitored medications to a patient simultaneously, you will receive multiple notifications.
If you receive multiple green notifications, you do not need to click on each one to view the patient's profile in TasScript before proceeding with prescribing or dispensing the monitored medicine, as these green notifications are informing you there are no transactions indicating higher risk circumstances exist. However, if you receive multiple red or amber pop-up notifications, you only need to click on one of them and view the patient's profile once in TasScript to meet your obligations to check the system.
TasScript does not instruct you on what to do or make decisions for you. This remains your clinical responsibility and professional decision to determine whether the monitored medicine continues to be the safest and best option for your patient’s clinical needs.
An alert does not mean that you are not allowed to prescribe or dispense a medicine, but it indicates that some heightened risk has been identified which you need to consider and manage appropriately.
Should you decide that a medicine is no longer the safest treatment, you are reminded that safe clinical practice involves ensuring that appropriate continuity of care is provided for your patient.
Abruptly discharging the patient from your care or stopping treatment in patients who have been taking high-risk monitored medicines over a long period of time may be contrary to patient safety. There may be implications to discontinuing some medicines too quickly.
Prescribers and pharmacists are also reminded of their responsibilities as part of their professional registration, contained within their code of conduct. It is important that all patients receive the same standard of care, remembering that anyone can develop a dependency on prescription medicines.
Access
All prescribers and pharmacists can access the TasScript Health Practitioner Portal on their computer or via a tablet or mobile device.
TasScript can also be integrated with your clinical software to save you time. Pop-up notifications appear within seconds of prescribing or dispensing a high-risk monitored medicine to inform you whether there are records in TasScript requiring your review. A click on the notification takes you to the patient's TasScript record.
Information about integrating your clinical software is available in the TasScript Help Portal.
No, only prescribers and pharmacists registered with AHPRA are legally authorised to access TasScript.
Patient records in TasScript may only be lawfully accessed when you are involved in that patient’s clinical care and in the context of the high-risk medicines which are monitored.
If you do access a patient's record in TasScript, you will need to make sure you can substantiate this access in your capacity as a registered health practitioner.
The following is a non-exhaustive list of practical circumstances where accessing patient records in TasScript would be consistent with the intention of the legislation:
- when prescribing or supplying a monitored medicine to the patient,
- when reviewing the patient’s medication history as part of a patient consultation (e.g. when a doctor takes a patient history or a pharmacist conducts a medication review), or
- when reviewing and considering the patient’s medication history with other registered health practitioners who are involved in that patient’s care.
You must not use the information in TasScript for any other purpose.
Prescribers and pharmacists are encouraged to explain to their patient the role TasScript plays in supporting safe clinical decision making for high-risk medicines; however, prescribers and pharmacists who are involved in the care of a patient are legally authorised to access a patient’s record in TasScript, without consent or permission from the patient, for the purposes of ensuring the patient’s safety from prescription medicine related harm.
This authorisation is made under the Tasmanian Poisons Act 1971.
All prescribers and pharmacists can access the TasScript health practitioner portal on their computer or via a tablet or mobile device.
TasScript can also be integrated with your clinical software to save you time. Integration of your clinical software with TasScript enables pop-up notifications appear within seconds of prescribing or dispensing a high-risk monitored medicine to inform you whether there are records in TasScript requiring your review. A click on the notification takes you directly to the patient's TasScript record utilising Multi-Factor Authentication.
Information about integrating your clinical software is available on the Setting up and accessing TasScript page.
While TasScript has been designed to electronically integrate with clinical workflows for clinicians using prescribing software, prescribers are not required to use medical practice software to access TasScript.
Access is available at all times via the secure TasScript health practitioner portal for prescribers who write paper prescriptions. The portal is also available on mobile or tablet devices.
Handwriting prescriptions for monitored medicines does not remove the mandatory need for a prescriber to check TasScript.
Understanding patient records
There are three different types of patient records in TasScript.
Transactional - A “Transactional” patient record contains a patient’s prescribing and/or dispensing history of high-risk monitored medicines.
Regulatory - A “Regulatory” patient record contains information about their identity, addresses, previous and active authorities and any alternative identities they may have. These patients do not have any transactional information (i.e. prescribing or dispensing records) associated with them.
Linked - “Linked” patient records have combined regulatory and transactional data information. They have a prescribing/dispensing history and a profile page with identity and authority history.
The patient must have either a “Linked” or “Regulatory” record to allow for an application for authority to prescribe.
More information on patient profiles can be found in the TasScript Help Portal.
The two main reasons why a patient record may not be found are:
- the patient does not have an authority or high-risk medicine history recorded; or
- the data entered into clinical systems that feed into TasScript may have errors or gaps that have prevented accurate identification.
If you believe there is inaccurate data or multiple patient records for the same patient, please contact the national RTPM vendor, Fred IT Group. They can be reached by email [email protected] or by calling 1800 776 633.
Please provide any key information that may help them understand why this information may be inaccurate.
There may be multiple patient records in TasScript depending on what information has been supplied to TasScript from clinical prescribing or dispensing systems connected to the electronic Prescription Exchange Service (PES).
TasScript reviews and combines matching records when sufficient patient identifying information is available. If there are any differences between the patient’s information, the system will treat these as different patients.
To improve matching of records, practitioners are strongly encouraged to enter the exact name on the patient’s Medicare card and record their date of birth, sex, and Medicare or Department of Veterans' Affairs (DVA) number in their clinical systems, validate a patient’s Individual Healthcare Identifier (IHI) number within their clinical systems, and provide accurate information when applying for authority to prescribe a Schedule 8 medicine.
If users see more than one record for the same patient and believe that they should be combined, they should submit a request to the [email protected]. or call 1800 776 633 and provide them with the following details:
- The full name and dates of birth of the patients, and
- Any identification numbers associated with the records.
Prescribing and dispensing transactions received and displayed in the national RTPM system are the result of data entered by pharmacists and prescribers. The quality of the data presented primarily relies on the accurate entry of patient and medicines details by prescribers and pharmacists. Here are some data tips for prescribing and dispensing events to ensure accurate data is displayed in TasScript:
- Ensure all practice or pharmacy details are correct and entered into your clinical information system, including:
- Business name
- Business phone number
- Business email
- Address, including suburb and postcode
- HPI-O
- Enter DOB for all patients.
- Validate IHI for patients.
- Consider enabling software prompts if available for DOB, Medicare card, and IHI validation.
- Don't add other information to patient names e.g. health insurance details, nursing home or ward flags, webster packing flags, account or payment details, other flag codes.
- Ensure vets are correctly identified in dispensing software i.e. as a vet not as a medical practitioner.
If you identify data that seems inaccurate or missing in TasScript, please contact IT support on 1800 776 633 or via email [email protected].
Understanding a practitioner’s profile
Your primary place of practice, linked organisations and communication preferences can be edited on your profile.
Some of the information in your TasScript profile is retrieved from AHPRA and pre-populated. This includes: your title, name, AHPRA number, profession, registrations, and prescriber number. This information is read-only and cannot be edited.
For more information, visit the TasScript Help Portal or contact TasScript technical support.
The term ‘organisation’ is used in TasScript to encompass various types of locations that users may be working at. This includes clinics, hospitals, pharmacies, correctional facilities, community health facilities, and more. Most commonly an organisation is a practice where a prescriber treats patients.
Authority to prescribe Schedule 8 medicines
Applying for authority in TasScript can be done in a few simple steps. For instructions on how to do this, visit TasScript Help Portal.
For more information on the authority assessment process, contact the Pharmaceutical Service Branch on 03 6166 0400 or via emailing [email protected].
No. If you want to prescribe a medicine to your patient and notice that TasScript shows an authority issued to another prescriber, you will need to contact this prescriber to discuss the care of the patient.
You need to ensure appropriate arrangements are in place for patient care and ensure there is one authorised prescriber of schedule 8 and schedule 4 declared restricted medicines.
Yes. TasScript allows users to view authority letters addressed to the authorised prescriber. These documents can be downloaded and saved in PDF format.
If you have integrated TasScript into your clinical system, you will be able to access the patient’s high-risk medicine history (or transactional profile) as per usual.
If that patient’s transactional profile is linked to a regulatory profile, you will be able to navigate to the patient’s regulatory profile by clicking the ‘Patient Profile’ button along the top right of the patient page and apply for authority from there.
If there is no high-risk medicine history for the patient, you will need to log into TasScript and search for the patient to confirm whether they have a ‘regulatory’ record available.
For more information, visit the TasScript Help Portal.
Correspondence
In My Correspondence, you will be able to view all the documents you have uploaded or received from the Pharmaceutical Service Branch (PSB) via TasScript, including letters about your Schedule 8 authority applications if you are a prescriber.
For more information, visit the TasScript Help Portal.
Training and support
Training and education materials on how to register, access and use TasScript are available for prescribers and pharmacists on the Medicines and Poisons Regulation - Information For Health Professionals-Real Time Prescription Monitoring web page
TasScript is a real time clinical decision support tool. It does not make clinical decisions for a prescriber or pharmacist when prescribing or dispensing high-risk monitored medicines. This remains the professional responsibility of the treating prescriber or pharmacist.
Prescribers and pharmacists are strongly encouraged to ensure they have considered their individual professional practice training and development needs regarding:
- the therapeutic role of high-risk monitored medicines (including initiation, maintenance, and discontinuation) in clinical practice;
- identification and management of high-risk clinical scenarios including:
- conducting clinical risk-benefit assessments and contemporaneously recording these assessment considerations and outcomes,
- communicating the risk and benefits of treatments with patients to support your clinical decision-making,
- self-awareness of potential biases, and
- engaging in difficult conversations and maintaining effective, respectful communication with patients, carers, and other treating health practitioners.
Professional practice training opportunities on these topics are available from your professional training organisations (eg Primary Health Tasmania, the Royal Australian College of General Practitioners, the Pharmaceutical Society of Australia, the National Prescribing Service, the Australian Commission on Safety and Quality in Health Care) to assist you when a high-risk circumstance is identified.
If you identify opportunities for professional practice enhancement in this setting, ensuring your professional continuing development activities include these elements will give you increased confidence and skills so you can continue to provide safe and appropriate ongoing care to your patient.
The implementation of TasScript is accompanied by several health practitioner education and training opportunities.
These include opportunities to attend TasScript training presentations in person and online, quick reference guides, process flow diagrams for common activities within TasScript, a help topics web page, FAQs, as well as dedicated technical support from the Australian Government’s appointed RTPM software vendor.
These opportunities and resources will exist alongside the existing regulatory support and advisory service regarding the regulation of monitored medicines provided by the Department of Health Pharmaceutical Services Branch.
Impacts of TasScript
There are some important differences between DORA and TasScript that prescribers and pharmacists need to be aware of.
The DORA system was developed by Tasmania’s Pharmaceutical Services Branch for the Tasmanian context. The national RTPM system was developed by the Australian Government for the Australian context, and the technology used is based on the RTPM system developed by another jurisdiction who did not have an RTPM system in the past.
The primary differences between DORA and TasScript are as follows:
- TasScript was designed by the Australian Government
- TasScript can be seamlessly integrated into clinical practice software
- TasScript applies Multi-Factor Authentication security requirements
- Access controls for TasScript are managed according to registration status in real time by Ahpra, not Pharmaceutical Services Branch
- There are more high-risk medicines viewable in TasScript
- Prescribing and dispensing events are viewable in TasScript
- An online s59E application form is available in TasScript
- TasScript utilises the national electronic prescribing infrastructure for transactional data transmission
- TasScript can be viewed securely on a mobile device
- Prescribers and pharmacists are mandatorily required to check TasScript
- TasScript does not provide real time transactional data or alerts to Pharmaceutical Services Branch
- TasScript will enable Tasmania to participate in nationwide data sharing once delivered by the Australian Government’s appointed RTPM software vendor
As prescribers and pharmacists have had access to DORA in Tasmania for over a decade, there has been substantial opportunity for familiarity with the purpose, use, and clinical value of RTPM in this state.
The primary impacts upon prescribers and pharmacists of adopting the national solution are:
- Integrated pop-up notifications in clinical practice software to ensure efficient risk identification
- Mandatory checking is required to ensure all treating prescribers and pharmacists are better informed of a patient’s history and can therefore manage any clinical risks related to high-risk monitored medicines
- Secure, contemporary multi-factor authentication and access
- More high-risk monitored medicines viewable in the solution
The system does not remove the requirement for prescribers to seek authorisation of the Secretary to make available Schedule 8 medicines under section 59E of the Poisons Act 1971. Further information on authority requirements is available on the Medicines and Poisons Regulation web page on the Department of Health website.
TasScript, like its predecessor DORA, is a clinical decision support tool that will support the safety of Tasmanians by enabling prescribers and pharmacists to make better informed clinical decisions before they prescribe or dispense a high-risk monitored medicine.
TasScript will not prevent a patient from obtaining their medicines to manage diagnosed medical conditions. The decision to prescribe or dispense a high-risk monitored medicines remains the clinical responsibility of the treating health practitioner following a clinical risk-benefit assessment.
Given the extensive use of DORA within Tasmania for over a decade, it is anticipated the transition to TasScript will have a limited impact on patients.
Mandatory use RTPM systems such as TasScript support treating health practitioners to have complete and up-to-the-moment visibility on past prescriptions and supplies of high-risk monitored medicines.
These clinical decision support tools provide better information to health practitioners when making decisions; however, these systems do not make decisions for health practitioners to continue or change treatment with high-risk monitored medicines.
The decision to prescribe or dispense a high-risk monitored medicines remains the clinical responsibility of the treating health practitioner after consideration of risks and benefits.
If TasScript presents information to a health practitioner that indicates potential risk, the prescriber or pharmacist will need to utilise their professional practice skills to consider the risks, benefits and consequential management strategies of potential treatment options for their patient in their practice context and within their scope of practice.
Prescribers and pharmacist are strongly encouraged to consider their own professional scope of practice, and professional practice skills and experience in relation to high-risk monitored medicines use to ensure they are competent to manage these risks and communicate treatment pathways effectively. This may include professional development on:
- the therapeutic role of high-risk monitored medicines (including initiation, maintenance, and discontinuation) in clinical practice;
- identification and management of high-risk clinical scenarios including:
- conducting clinical risk-benefit assessments and contemporaneously recording these assessment considerations and outcomes,
- being aware of the clinical practice significance of these assessments
- communicating the risk and benefits of treatments with patients to support your clinical decision-making,
- self-awareness of potential biases, and
- engaging in difficult conversations and maintaining effective, respectful communication with patients, carers, and other treating health practitioners.
Prescribers and pharmacists are encouraged to contact their professional indemnity insurance provider to seek guidance on risk management strategies in the context of prescribing or supplying high risk medicines.
Data protection & privacy
When a prescription is issued or dispensed, there are existing regulatory requirements on what information must be included on the prescription or the dispensing record. This includes the details of the patient, the medicines that are being prescribed, as well as details of the prescriber and pharmacist. This information is collected by TasScript for certain high-risk monitored prescription medicines.
TasScript provides eligible health professionals secure access to view records of all high-risk monitored medicines that have been supplied to a patient from you and other clinicians. This enables health practitioners to make safer and more informed clinical decisions, and facilitates the timely co-ordination of treatment and communication between treating health professionals by giving visibility of all health professionals involved in the patient's care.
Authorised Tasmanian Government Department of Health staff will also access TasScript as part of their existing regulatory role in ensuring the safe supply of medicines in the community.
There are offences and strict penalties under the Poisons Act 1971 for improper or unauthorised use of TasScript.
A log is created each time a record is viewed in TasScript, and this is monitored by the Department of Health. If inappropriate use is detected, health practitioners may face penalties under Tasmanian law and the matter may be referred to the Australian Health Practitioner Regulation Agency for further investigation.
In addition to these arrangements, health practitioners must always adhere to privacy requirements set out in the Personal Information Protection Act 2004 for state service employees or the Privacy Act 1988 (Cth) for private practitioners, when handling patients’ health information. The Personal Information Protection Principles and Australian Privacy Principles specify the circumstances where health practitioners can access, collect, use or disclose health information about an individual.
TasScript has been built in accordance with Australian Government security measures, including the Australian Signals Directorate’s Information Security Manual. TasScript has been independently security tested to this standard. Any questions regarding the security of TasScript should be directed to the national RTPM vendor, Fred IT Group.
Data encrypted in transit and at rest
Data transmitted between medical practice systems, pharmacy systems, and the national RTPM database is always secured through an encrypted internet connection. Data stored in the database is also always encrypted.
Multi-factor authentication
TasScript utilises contemporary security measures to safeguard data against unauthorised access. Health practitioners are required to use multi-factor authentication (a username/password + PIN) to access the system.
De-identified data in TasScript may be used by the Tasmanian Government to inform service planning and policy decisions to improve healthcare for the Tasmanian community.
The harms from prescription medicines is a growing public health issue. Data in TasScript may also be published at an aggregate population level to respond to the increasing research interest in understanding the level and trends of prescription medicine usage.
All data that may be used for research and evaluation purposes is required to be in accordance with the requirements in the Personal Information Protection Act 2004, Poisons Act 1971 and the appropriate Human Research and Ethics Committee standards.
