Getting a prescription renewed is one of the more frustrating things about having a chronic disease. I should know. I take blood pressure medication every day and have done for the past three years. Some of this frustration has been lessened by the arrival of online prescribing services in Australia.
In health policy we use a term to describe these services and that is “asynchronous prescribing”. What that means is that there is a disconnect in time between the patient providing the information and the doctor receiving it. In other words, as patients we provide information through an online form and not by directly speaking to a doctor. A doctor reviews our information and issues a prescription.
What’s not to like? Well for millions of Australians, there is everything to like about these services. Quick, convenient and all done on a smart phone. The uptake of these services in the post pandemic era has been huge.
Unfortunately, these services have raised the concerns of the medical regulators, the Australian Health Practitioners Regulatory Agency (AHPRA), and the members of the Medical Board of Australia.
Its easy to understand where the concerns come from. If a patient who has a chronic disease gets their medications online for two years, then there is no opportunity for a GP to touch base and see if that medication is effective. This applies across a range of conditions from blood pressure to diabetes to mental health. Also, for initial consultations, its hard to imagine that the best care is given through filling out an online form. But remember, no one is suggesting that online prescribing replace face to face medicine, just that it be an option for patients who otherwise find it hard to get to the GP.
I would always recommend, even for patients who are familiar with and access online prescribing services, that they also have a regular GP that they catch up with face to face. I know how hard it is to find a good GP, and so part of all of this is that General Practice in Australia needs to get better at providing services to its patients. In short, there’s no point in cutting out online prescribing if the alternative isn’t available and clearly better.
So the regulator has concerns, but there are also good reasons to give patients access to online prescription services. What do we do? AHPRA has commissioned a consultation on a draft revision to the regulations governing online prescribing. But that draft paper has a conclusion in it already. AHPRA does not support these services.
We have then a very difficult problem. Millions of patients have chosen to access these services, but on face value AHPRA does not want them to exist. What is the solution? The Australian Patient’s Association has joined with one of the major online prescribing partners, Instant Scripts, to plead with AHPRA to moderate its position.
At APA we believe that all online prescribing services should have robust clinical governance frameworks that maintain quality of care for patients – just like any other health service. We do not believe that a regulator has sufficient justification to regulate these services out of existence and will continue to make representations to AHPRA and to government to allow them to continue to provide online prescription services.
Dr Nick Coatsworth is the APA’s Ambassador for Health Reform