Real-Time Prescription Monitoring (RTPM): Configuration & Quick Guide

Contents:

1. What is Script Monitoring?
2. Enabling Script Monitoring
3. Using Script Monitoring
4. Coloured Alerts
   • Green Alerts
   • Amber Alerts
   • Red Alerts
5. Cross-Border Considerations

What is Script Monitoring?

Each state has its own prescription monitoring system and drug list:

• SafeScript monitored drug list (VIC)
• SafeScript monitored drug list (NSW)
• QScript monitored drug list (QLD)
• ScriptCheckSA (SA)
• Canberra Script (ACT)
• ScriptCheckWA (WA)
• TasScript (TAS)

When prescribing, the medication name is checked against the monitored drug list for the practice's state, regardless of the drug's restriction or schedule. This ensures alerts are generated consistently when a state department updates its monitored drug list. MediRecords does not own or maintain the drug list or the API used to validate the drug.

Enabling Script Monitoring

You will need to register for an account with the relevant state portal before enabling this feature in MediRecords.

1. Click the Person Icon, then select Preferences.
   
    
2. Select Prescribing, check the box for Real-Time Prescription Monitoring, then click Save.
   

Script Monitoring is now enabled.

Using Script Monitoring

Script Monitoring notifications appear when creating or editing a prescription for Schedule 8 drugs and other high-risk medicines. MediRecords connects automatically to the relevant state portal once the prescription details are entered.

The following patient fields are required for an automatic RTPM check to occur:

• Surname
• First name
• Date of birth
• State

Note: Patients with a single name cannot be verified via the automatic RTPM check. The script monitoring portal must be checked manually for these patients.

Coloured Alerts

A notification appears in the top-right corner of the prescriptions window. It dismisses automatically after three seconds, or can be closed using the X.

Green Alerts

A GREEN notification appears when:

• No prescription for a monitored medicine has been issued or dispensed in the last 6 months.
• Prescriptions for a monitored medicine in the last 6 months have all been issued by the same prescriber or medical practice, with no alerts.

A green alert does not require any action. You can click the notification to go directly to the relevant state portal if you wish to review further.

Amber Alerts

An AMBER notification appears when:

• Prescriptions for a monitored medicine in the last 6 months have been issued by more than one prescriber or medical practice, or by 4 or more pharmacies.
• The daily morphine equivalent dose (averaged over the last 90 days) is between 50mg and 100mg MED — a medium-risk dose.

Red Alerts

A RED notification appears when there is a current alert relating to the patient's prescribing or dispensing history. Red alerts include:

• Multiple provider episodes: Prescriptions from 4 or more prescribers or medical practices recorded in the last 90 days.
• High-risk drug combinations: Prescriptions for any of the following combinations recorded in the last 90 days:
  • Methadone + a benzodiazepine
  • Methadone + a long-acting opioid
  • Fentanyl + a benzodiazepine
  • Fentanyl + a long-acting opioid
• Opioid dose threshold: The daily morphine equivalent dose (averaged over the last 90 days) exceeds 100mg.

For Amber and Red notifications, you must click the notification to review the patient's history before proceeding. The notification includes a link that opens the patient's profile in the Health Professional Portal in a new tab. The Prescribe button remains greyed out until this link has been opened.

Cross-Border Considerations

RTPM systems are managed at a state and territory level and are not fully integrated across jurisdictions. SafeScript (Victoria) and TasScript (Tasmania) operate independently, meaning prescribing events recorded in one system are not automatically shared with another.

In practice, this means:

• Prescriptions written by Victorian prescribers are generally recorded in SafeScript (Victoria).
• These prescribing events are not automatically visible in the Tasmanian RTPM system.
• Tasmanian pharmacists may therefore not see Victorian prescribing history when reviewing records prior to dispensing.

Pharmacists and prescribers should check the RTPM system for their own state or territory. In cross-border scenarios, additional clinical diligence is recommended.

Further Reading

• Active Script List
• Prescribing: Provider Preferences
• Writing Prescriptions: Quick Guide