How QScript works
QScript is Queensland’s real-time prescription monitoring system which conveniently integrates with the everyday workflow of compatible prescribing and dispensing software.
As QScript is an online system, an internet connection is required to access it. It can be accessed via desktop, mobile and tablet devices.
Access QScript here or read more about the QScript system in practice (PDF 124 kB).
Process flow for QScript
- Patient visits prescriber.
- Prescriber accesses QScript to check the patient’s monitored medicine prescription history.
- Prescriber uses their clinical reasoning to decide whether to prescribe.
- If prescribed, the patient presents the prescription to a pharmacy.
- Pharmacist accesses QScript to check the patient’s monitored medicine prescription history.
- Pharmacist uses their clinical reasoning to decide whether to dispense.
- If dispensed (other than in a public sector hospital) monitored medicine prescription information is automatically uploaded into QScript.
Prescription information in QScript
QScript contains records of monitored medicines that have been dispensed to a patient (sold on prescription) in Queensland community and private hospital pharmacies. All monitored medicines dispensing records from these pharmacies are recorded in QScript regardless of whether they are subject to the Pharmaceutical Benefits Scheme (PBS) or Repatriation Schedule of Pharmaceutical Benefits (RPBS) subsidy or are a private prescription.
QScript also contains records of monitored medicines prescribed for patients if the prescription was written by a health practitioner using clinical software connected to a prescription delivery service (PDS).
In addition, QScript:
- contains other monitored medicine-related information which may assist clinical decision-making—such as whether a patient is or has been registered on the Queensland Opioid Treatment Program
- can automatically generate alerts when certain conditions are met that suggest the presence of a ‘high-risk clinical scenario’ (where a health practitioner’s clinical software is integrated with QScript).
QScript is a read-only system; health practitioners are not required to manually enter any information into the system. Prescription data in QScript is collected automatically from PDSs which support the transfer of electronic prescriptions and prescription information from prescribers to pharmacies.
When a prescription is issued by a prescriber or dispensed at a pharmacy connected to a PDS, the PDS sends a record of the prescription to QScript in real time.
Patient records not included in QScript
QScript typically does not contain records of:
- monitored medicines
- dispensed from public sector hospital pharmacies
- supplied in other states/territories
- administered to patients in health services such as hospitals, prisons and aged care facilities
- given as a treatment dose, i.e. not dispensed by a pharmacist
- monitored medicine prescriptions which were handwritten or generated in clinical software systems not integrated with a PDS (until they have been dispensed at a community or private hospital pharmacy)
- Queensland Opioid Treatment Program records prior to 2015
- Schedule 8 prescribing and dispensing events prior to December 2019
- Schedule 4 monitored medicine prescribing and dispensing events prior to 27 September 2021.
Australia-wide integration of prescription monitoring solutions
All Australian states and territories have implemented real-time prescription monitoring solutions, with the aim of establishing a national system. The intent is once the necessary technical capabilities and legal and administrative frameworks and arrangements are in place, information about monitored medicine prescribing and dispensing events occurring in all states and territories will be available in each jurisdiction’s real-time prescription monitoring system, to inform clinical decision-making.
Connecting to a prescription delivery service (PDS)
Connecting clinical software to a PDS allows the automatic upload of monitored medicine prescribing and dispensing data into QScript.
Under the Medicines and Poisons Act 2019, all health practitioners dispensing monitored medicines (other than those practising in public sector hospitals) are required to make their monitored medicine dispensing records in dispensing software connected to a PDS. This ensures these records are uploaded into QScript in real time.
Prescribers are not required to use clinical software connected to a PDS but it is highly encouraged as this helps ensure more complete patient information is captured in QScript.
eRx Script Exchange is the only PDS in operation in Australia.
Contact your software vendor for more information about connecting to a PDS or contact eRx Script Exchange directly.
Notifications and alerts
Pop-up notifications
QScript is designed to integrate with existing clinical software. This allows health practitioners to receive notifications when prescribing or dispensing a monitored medicine. When a notification appears, users simply click on the link to be taken directly to the relevant QScript patient record, where one exists.
Red notifications mean the prescription has triggered an alert to a high-risk clinical scenario.
Amber notifications mean a matching patient record has been found in QScript, but no alert for a high-risk clinical scenario has been triggered.
Green notifications mean no matching patient record has been found in QScript. Green notifications contain a link that directs users to the patient search screen in case the user would like to manually search for a patient record (although there is no legal requirement to do this).
Notifications and legislative requirements
QScript notification | Did the prescription trigger an alert to a high-risk scenario? | Do I have to check the patient’s QScript record? |
|---|---|---|
Red notifications [Patient name] - Check QScript. Active alerts(s) exist. | Yes | Yes |
Amber notification [Patient name] - Check QScript. Patient record exists. | No |
Yes (unless an exemption (PDF 533 kB) applies) |
Green notification [Patient name] - No matching record found. | No | No |
Alerts for high-risk clinical scenarios
Prescribing and dispensing events may trigger an alert within a patient’s QScript record when a high-risk clinical scenario has been identified.
There are six high-risk clinical scenarios:
- Scenario A : Patient currently registered on the Queensland Opioid Treatment Program
- Scenario B: Patient previously registered on the Queensland Opioid Treatment Program
- Scenario C: Patient receiving monitored medicines from multiple prescribers
- Scenario D: Increased patient overdose risk—average total daily opioids of 100mg oral morphine equivalent (OME) or greater
- Scenario E: Increased patient overdose risk—opioid and benzodiazepine/z-drug (zolpidem or zopiclone) combination
- Scenario F: Patient receiving an opioid or benzodiazepine/z-drug (zolpidem or zopiclone) for the first time in 90 days.
Visit Alert Rules for further alert details.
QScript security and privacy
As part of the registration process for QScript, Queensland Health collects certain personal information from health practitioners to verify their identity.
Additionally:
- certain personal information about prescribers and pharmacists contained in monitored medicine prescribing and dispensing records is recorded and displayed to other QScript users, e.g. the practitioner’s name and clinic/practice/pharmacy address where the medication was prescribed or dispensed
- when a health practitioner views a patient record, their name and organisation contact details are logged. This information is visible to QScript users so health practitioners can contact each other to discuss the patient’s care and is recorded even if no prescribing or dispensing activity was undertaken.
Personal information collected by Queensland Health is handled in accordance with the Information Privacy Act 2009.
There are offences and strict penalties for inappropriate use or disclosure of information contained in QScript.
Queensland Health commissioned a Privacy Impact Assessment, which analysed the flows of personal and confidential information in QScript and potential privacy impacts. A summary of the QScript Privacy Impact Assessment (PDF 157 kB) is available.
For further information refer to the privacy collection notice for health practitioners.
Discussing QScript with patients
If patients or carers are concerned about QScript, health practitioners are encouraged to discuss with them the information contained in their QScript record and explain the benefits of having this information as part of their care.
Patients and carers should be aware that this is not an opt-in or opt-out system.
QScript is not integrated with My Health Record. While My Health Record may contain prescription medication information, due to the ‘opt out’ provisions, this data may be incomplete.
Patients are not able to opt-out of having their monitored medicine prescription information recorded in QScript.
Patients may have some concerns if alerts or notifications are triggered on their QScript record. It is important to note that QScript does not instruct healthcare providers on what they should do, nor does it prevent them from prescribing or dispensing. The decision on whether to prescribe or dispense remains a clinical decision of the prescriber or pharmacist.
Ideally, a discussion about the benefits, risks and how to reduce potential harms from their current medicines should have already occurred. However, QScript may present a new opportunity to discuss with patients their current treatment plan.
If patients or carers are concerned about their privacy, practitioners may wish to reassure them that only those health practitioners involved in their care are authorised to view their QScript record. Patient searches by health practitioners are logged and can be audited to monitor inappropriate use. Authorised Queensland Health and other regulatory officers can also access QScript, to manage the operation of QScript and to exercise powers or perform functions under the Medicines and Poisons Act 2019 relating to monitored medicines.