What is Real Time Prescription Monitoring (RTPM)?*
o RTPM is computer software that allows prescription records for some high-risk medicines to be transmitted in real-time to a centralised database which can then be accessed by practitioners and pharmacists during a consultation.
o RTPM provides prescribers and pharmacists with a clinical tool to make safer decisions about whether to prescribe or dispense a high-risk medicine. It facilitates the early identification, treatment and support for patients who are developing signs of dependence.
o Prescription medicines causing greatest harm to the community are monitored through RTPM. This includes all Schedule 8 medicines and other high-risk medicines such as benzodiazepines, zolpidem or zopiclone, quetiapine and codeine.
Medicines Monitored in Real Time Prescription Monitoring
Prescription medicines that present the greatest risk of harm for the Australian community are monitored through Real Time Prescription Monitoring. For information on specific medications, see Medicines Monitored in Real Time Prescription Monitoring (external link).
How to Enable Real Time Prescription Monitoring in Helix
1. Log in as a Health Care Professional.
2. Go to Settings > Preferences
3. Tick the Enable Real Time Prescription Monitoring check box.
Real Time Prescription Monitoring Notifications
Once Real Time Prescription Monitoring is enabled, alerts will be presented to the practitioner whenever S8 drugs or any monitored S4 drugs are prescribed. Depending on the situation, alerts are presented in three colours : Green, Amber, and Red .
For information on monitored medications, see Medicines Monitored in Real Time Prescription Monitoring (external link).
A RED notification will appear when there is a current alert relating to the prescribing/dispensing history of a patient.
These alerts are:
o Multiple provider episodes: When prescriptions from 4 or more prescribers/medical practices or 4 or more pharmacies have been recorded in Real Time Prescription Monitoringwithin the last 90 days.
o High-risk drug combinations: When prescriptions for certain drug combinations have been recorded in Real Time Prescription Monitoringwithin the last 90 days.
• Methadone + a benzodiazepine
• Methadone + a long-acting opioid
• Fentanyl + a benzodiazepine
• Fentanyl + a long-acting opioid
o Opioid dose threshold: When the daily morphine equivalent dose (calculated based on an average over the last 90 days) exceeds 100mg MED daily (i.e. a high risk dose).
When use of Real Time Prescription Monitoring becomes mandatory, prescribers/pharmacists will be required to click on the notification to review the patient history to assess whether it is safe or appropriate to prescribe/dispense a medicine.
An AMBER notification will appear in the following situations:
o When prescriptions for a monitored medicine in the last 6 months have been issued by more than one prescriber/medical practice
o When the daily morphine equivalent dose (calculated based on an average over the last 90 days) is between 50mg and 100mg MED daily (i.e. a medium risk dose)
When use of Real Time Prescription Monitoring becomes mandatory, prescribers/pharmacists will be required to click on the notification to review the patient history to assess whether it is safe or appropriate to prescribe/dispense a medicine.
A GREEN notification will appear in the following situations:
o When there has not been a prescription issued/dispensed for a monitored medicine in the last 6 months
o When prescriptions for a monitored medicine in the last 6 months have been issued by the same prescriber/medical practice, and there are no alerts
When use of Real Time Prescription Monitoring becomes mandatory, prescribers/pharmacists will not be required to click on the notification to review the patient history.
Using Real Time Prescription Monitoring
Real Time Prescription Monitoring Features
o Real Time Prescription Monitoring alerts are always shown on top of the drug interaction box.
o If the Real Time Prescription Monitoring alert is green, it will be categorized as “Other alerts(s)”.
o Clicking on the alerts message text at the top takes you to the alert details.
o Below are the following areas where the Real Time Prescription Monitoring alerts are expected to appear:
• Upon prescribing an S8/monitored S4 drug, Real Time Prescription Monitoring alerts appear in the existing drug interaction box.
• On the prescription screen, clicking on the "Details" link will take you to the Real Time Prescription Monitoring Portal to access the patient's records.
• On changing the default Quantity on the prescription screen. Clicking on the "Details" link will take you to the Real Time Prescription Monitoring Portal to access the patient's records.
• IMPORTANT: Real Time Prescription Monitoring can only recognise numeric values. Any calculation or test information cannot be recognised. In the below example quantity has been changed from 2*30 to 500.
o Once the prescription is created and saved for printing later. Note that when you re-open a saved prescription, the Real Time Prescription Monitoring alert displayed indicates the Real Time Prescription Monitoring status at the time the medication was originally prescribed.
o Once the prescription is finalised/printed, the Real Time Prescription Monitoring alerts are captured on the patient’s timeline.
Further Information on Real Time Prescription Monitoring (RTPM)
o Real Time Prescription Monitoring alerts notification are not available on re-prescribing.
o For quantity change, Real Time Prescription Monitoring alert will only be triggered if the quantity is a numeric value. Real Time Prescription Monitoring does not recognise non-numeric values e.g. 5L, 500mg, five or 2*30.
o If the S8/monitored S4 medication is not PBS listed, it will not trigger the alert.