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Regulator clamps down on RTPM notifications

A recent spike in regulatory action targeting doctors who fail to check Real Time Prescription Monitoring (RTPM) systems suggests that regulators are intensifying their scrutiny of RTPM compliance.

Dr Kelly Nickels, MBBS (Hons) (Monash) MHlth&MedLaw (Melb), Claims Team Manager - Professional Conduct VIC / Senior Medical Adviser

Tuesday, 25 June 2024

regulator-clamps-down-on-rtpm-notifications

A recent spike in regulatory action targeting doctors who fail to check Real Time Prescription Monitoring (RTPM) systems suggests that regulators are intensifying their scrutiny of RTPM compliance.

All states and territories in Australia have RTPM to help alert prescribers to patients who may be at risk of over-supply or who engage in doctor shopping. Mandatory checking has been required in some jurisdictions since 2020.

Avant medico-legal experts helping members with questions from the regulator, have found many members don’t understand the requirements of RTPM in their state or territory.

“I didn’t know I had to check SafeScript every time.”

“I usually check QScript in my practice but I was doing a locum and forgot.”

“I saw the notification in my practice software and considered it, but I didn’t know I had to do more than that.”

“The notification was green, so I thought that meant I didn’t need to check.”

Requirements not always clear

From our work with these members, it appears that some of the materials provided by health departments and medical practice software providers can be confusing.

While it’s clear that red and amber alerts in medical practice software must be clicked, it’s not obvious that green alerts also have to be clicked to take the doctor through to the state or territory RTPM system.

The legislation however is clear – where RTPM is mandatory, a doctor (with a few exemptions) must check the RTPM system every time before prescribing a monitored medicine.

State and territory differences

There are legislative differences between states and territories which can also confuse, especially for doctors in areas close to borders. The biggest difference is whether the RTPM system is mandatory or not in your state or territory. Five jurisdictions currently have mandatory checking:

  • Victoria – SafeScript
  • Queensland – QScript
  • South Australia – ScriptCheckSA
  • Northern Territory – NTScript
  • Tasmania - TasScript

We recommend doctors check their RTPM system every time, whether it’s currently mandatory or not in your state or territory. If you are not sure whether it is mandatory, still check!

How RTPM systems work

Each state or territory RTPM system is slightly different, but they all have common features.

When a doctor looks at a patient’s record in the RTPM system, it registers that they have done so. If a prescription is written, this will be logged in the system, which means a doctor can see if another doctor has prescribed a monitored medicine for that patient.

The systems also show when a prescription has been dispensed by a pharmacist, so the doctor checking the record has a complete view of the patient’s monitored medicines history.

This detailed recorded history also means the regulator can see if a doctor viewed a patient’s record in the RTPM system before prescribing a monitored medicine. This is how doctors who haven’t checked their RTPM system are coming to the attention of the regulator.

Advocacy to clarify requirements

Several states are currently reviewing their processes and requirements regarding RTPM systems. Avant has recently made a submission to the SafeScript review in Victoria, highlighting the confusion outlined above.

This article was originally published in Connect magazine issue 22.

More information

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.

Resources: Prescribing safely - Avant by doctors for doctors

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IMPORTANT:
This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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