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About the NZ ePrescription Service

It enables a prescription to be generated by the prescriber, transmitted to the NZePS health information exchange broker, and downloaded electronically at a community pharmacy.

The prescriber can note the reason for prescribing and make other comments at the time of prescribing. This will be sent as part of the prescription information passed electronically to the pharmacy. Prescribers can request a notification when a patient’s medication has not been dispensed, and pharmacists can send dispensing comments back to the prescriber.

The NZePS is integrated with the Medtech, MyPractice, Indici, Profile for Windows, Medimap, Elixir and Expect Maternity practice management systems, as well as the Waikato District’s Clinical Workstation Outpatient Prescribing service. The Ministry is also working with other Prescribing System providers and residential care electronic charting services to enable their customers to access NZePS.

Expanding the NZ ePrescription Service

From 22 December 2022, changes to the Misuse of Drugs Regulations 1977 allow signature-exempt prescriptions for controlled drug medicines to be made through the NZePS. This reduces the administrative burden for prescribers and pharmacists because it was previously a requirement for the prescriber to provide a hard copy, signed version of any prescription for a controlled drug medicine.

The changes also allow, in principle, prescriptions for Class B controlled drug medicines to cover a period of up to 3 months (instead of 1 month) when the prescription is issued through the NZePS. This improves access for patients who need these important medicines by reducing the number of prescriber visits required, which is of particular benefit to those in rural areas. There is no change to the requirement that the maximum amount of a controlled drug that can be dispensed is an amount sufficient for 1 month of use.

The changes do not remove the requirement for prescribers to operate within the limits of the Pharmaceutical Schedule managed by Pharmac. Prescribers must also continue to take a cautious approach toward controlled drug medicines. This includes carefully considering the appropriate duration that a drug should be prescribed for and the appropriate schedule for dispensing.

As a result of the amendments to the regulations, Pharmac recently consulted on amendments to the Pharmaceutical Schedule to determine what appropriate controls should be placed on specific Class B controlled drug medicines. Pharmac is considering all feedback that was received before submissions closed on 21 December 2022 and is expected to confirm any changes to the Schedule in early 2023.

Benefits

Over time, NZePS prescribing will improve patient safety and quality of care through:

  • reduced risk of transcribing errors during dispensing
  • better communication between the prescriber and pharmacist, which will help reduce oral miscommunication and decrease the need for phone calls between them
  • ability to evaluate and address patient medicines adherence issues. With NZePS, the prescriber can choose to be notified when a patient’s medication has not been dispensed, which can help determine whether or not a patient’s treatment plan is working
  • improving the quality of patient medication history information, as the patient clinical record can be updated when medicines are dispensed.

Security of information

Information on the NZePS broker is transmitted to and from the NZePS broker by the secure private health network. The barcode on a paper prescription is a unique code. Electronic prescriptions and dispensing details are also encrypted when they are sent to and retrieved from the NZePS broker.

Frequently Asked Questions - Secure Messaging

Please note: We update these FAQs regularly so practices and pharmacies should check back for the latest updates on these Q&As. 

Any additions will be added, or changes made, at the beginning of each month.

If you need further information please email onlinehelpdesk@health.govt.nz.

You can also download these FAQs:

 

Can pharmacies now receive prescriptions by email (barcoded and not barcoded)?

A practice can scan and email a prescription (barcoded or not) to a pharmacy if:   

  • Non-barcoded prescriptions must be physically signed by the authorised prescriber AND
  • all secure messaging criteria are met by the sender.

The same rules apply as they do now for requiring the original to be sent to pharmacy for faxed prescriptions.

The original prescription is NOT REQUIRED by the pharmacy:

  • If the emailed prescription has a NZePS barcode AND
  • is downloaded from NZePS at the pharmacy

The original signed prescription IS REQUIRED by the pharmacy:

  • If the barcode (SCID) is not used on an emailed, signed NZePS prescription, at the point of dispensing. OR
  • If the emailed prescription is signed and does not have a barcode.

Can a practice or pharmacy receive analogue faxes if they do not have a copper (analogue) line but have been set up to receive digital faxes?

Pharmacies may have the capability can receive analogue faxes as emails as long as their telecommunications provider has met the standard for email security set out by the Ministry (click here to access the guidance).

What is the difference between SSL and TLS? Is SSL adequate for the security requirements?

TLS (Transport Layer Security) and SSL (Secure Socket Layer) are both technology protocols that are used for encryption.  TLS 1.2 or higher is the minimum-security standard requirement as SSL by itself is not adequate.  You can find guidance on how to set up TLS online or through your IT service provider.

What email servers meet the security requirements? E.g. Gmail, G-suite, Hotmail, Yahoo, Outlook 365

Gmail, Yahoo Mail, Hotmail, G Suite mail services and Microsoft 365 / Office 365 email services DO use the required email security standard (TLS) by default.

If you use another email system e.g. Xtra, you will need to contact your provider, e.g. Spark, to confirm if your email system meets the requirements

Is there a way for a practice or pharmacy to check if their email is secure?

There are several online tools that enable you to check if your email or that of the practice or pharmacy that you intend to communicate with is secure.  One such tool is CheckTLS (https://www.checktls.com/TestReceiver) which allows you to put in your email address or that of a practice or pharmacy to get an instant security assessment. A confidence factor score of 90 or better on CheckTLS that shows “OK” under the TLS column is an indication that adequate security is in place to protect the Email during transmission to the destination. 

If you find that the practice or pharmacy you’d like to send your patient’s prescription or information to gets a score of less than 90, or if you have any doubts at all, you can still:

  • Encrypt or password protect your scanned prescription before emailing it. Don’t forget to share the password to the file with the receiving practice or pharmacy using another method, such as text message or phone call, OR
  • Post the prescription or give a copy of the prescription to the patient to take to the pharmacy.

There are several tools that allow you to encrypt your scanned files.  Some versions of Acrobat provide you with the ability to set a password for your file.  There is also a free tool called 7-zip that allows you to compress and password protect your file so that it can be sent securely, even if the practice or pharmacy you’re communicating with has not turned on required security.

Instructions on how to use tools like 7-zip can be found online including

https://fredonia-edu.atlassian.net/wiki/spaces/AN/pages/1111949535/How+to+Password+Protect+and+Encrypt+Files+using+7-Zip+for+Windows?src=search

What should I do with an email prescription after I’ve sent it or dispensed it?

If you’re a prescriber who has emailed a prescription to a pharmacy you should ensure that you have a record, or note of that prescription being sent, in your Practice Management System and then fully delete the email, including any locations such as Sent items, Inbox, and permanently delete from Trash.

If you’re a pharmacy that has received an emailed prescription you should delete the email as soon as you have printed the prescription and dispensed the medications.

Email services should NOT be used to store prescription information.

Here, email is just replacing fax. Where we currently fax prescriptions, we're allowing prescribers to securely email them. For NZePS barcoded prescriptions these can only be dispensed once. So, the risk of fraud/duplication is managed. For prescriptions that are not barcoded (non NZePS), the original signed prescription still needs to be sent to the pharmacy (just as it is today with faxed non-barcoded prescriptions).

Can a prescriber electronically send a 'signature exempt' prescription from their PMS directly to a pharmacy?

Yes, so long as all conditions are met:

Can a patient email their prescription (with or without a barcode) to the pharmacy of their choice?

There is nothing that physically stops a prescription from being scanned and emailed by a patient to a pharmacy. However, pharmacies are advised not to dispense medicines off prescriptions emailed to a pharmacy from anywhere other than the email address related to the authorised prescriber who has generated the prescription.

Whilst some assurance of the authenticity would be provided if the prescription was downloaded from NZePS the original prescription would be required to be obtained in all cases before releasing the dispensed medicine(s).

Where the prescription is a non-NZePS prescription, and no download of the barcode is possible, then there is the potential for the prescription to be emailed to multiple pharmacies and dispensed more than once.

Should I tell my local pharmacy or practice that I am using secure email?

Yes. This will make it easier for your pharmacy or practice to trust prescriptions that have been received from you. In some regions, the Districts would also like to be notified if or when you’re using a secure email system. Your local District will be contacting you if this is a requirement in your district.

Can I use a digital or electronic signature for my prescriptions?

No. A physical (ink, wet) signature is still required if the prescription does not meet the requirements for signature exempt prescribing:

  • For NZePS prescriptions the prescribing system used must have role-based access and meet all other NZePS requirements. It is the responsibility of the prescriber to ensure this condition is met.
  • The pharmacy must use the NZePS barcode (SCID) to dispense the prescription.

For non-NZePS barcoded prescriptions, the prescription must meet all the requirements of the “Director-General authorisation of an alternative form of prescription pursuant to regulation 43 of the Medicines Regulations 1984”, which will expire on the 31 October 2024.

When do I need to have moved to secure email and stop using faxes?

Your email had to meet the security requirements by January 2020. 

You will need to stop using analogue faxes by December 2020 at the latest. 

You will also need to confirm that you’re no longer using faxes by emailing Te Whatu Ora at itsecurity@health.govt.nz.

Do we (pharmacy) still need to print the script after receiving by email and scanning the barcode?

Yes, pharmacy do need to print the emailed prescription as they are still required to annotate on the paper prescription and file in the batch. Note: The original prescription is required for ALL scripts (barcoded or not) that are emailed from a patient.

Exemption for Signatures on Prescriptions without NZePS (without an NZePS barcode) authorisation

We have introduced rules to make it easier for you to provide electronic prescriptions to support virtual care.

Some of the rules apply to systems that are integrated to the New Zealand Electronic Prescription Service (NZePS) and are enduring and scheduled to be codified into legislation.

Others are temporary and will expire on 31 October 2024. This authorisation enables systems and settings that are working towards NZePS integration time to complete this work.

Read more on our Telehealth and online tools webpage.

Letter to sector - Patient Choice of Pharmacy

A reminder for clinicians of the patient's right to choose their own pharmacy.