eScripts — how electronic prescribing works, and how to issue one

• Paper OR electronic — not both. The patient chooses one delivery method for a given prescription; they cannot hold a paper copy and an electronic copy of the same script.
• The token is not the legal prescription. The token (the SMS or email link) is evidence of a prescription; the electronic record is the legal script. Once a token is scanned and dispensed, it becomes invalid and cannot be reused.
• No double-dispensing. The prescription locks the moment a pharmacy accesses it, so two pharmacies cannot dispense the same script at once.
• If you issue a barcoded paper script instead, the patient must physically bring that paper copy to the pharmacy to be dispensed.

• What the software needs is an IHI, not a Medicare card. The Digital Health Agency’s developer specification requires the IHI to be validated against the HI Service (within the previous 24 hours) before it goes into the eScript. If validation fails, the identifier is not included and the prescribing action stops. HI Service — additional requirements for electronic prescribing.
• Who has one. Patients enrolled in Medicare or with DVA are assigned an IHI automatically; patients with neither can apply to Services Australia (Practice Assist fact sheet; MediRecords). The HI Service search in the specification accepts an IHI, Medicare card number or DVA file number, and lets you resubmit with amended details if there is no match.
• PBS vs private. One vendor states Medicare is only needed for PBS-subsidised eScripts and a private (non-PBS) eScript needs only an IHI (MediRecords; international patients). PBS eligibility itself is set out at pbs.gov.au.
• Unverified IHIs. One vendor’s help page says unverified IHIs are generally for people not eligible for Services Australia services, such as overseas visitors, but does not say whether that software accepts them for ePrescribing (MedicalDirector Helix). The Agency specification only describes validated IHIs, so confirm with your software vendor what your product allows.
• Paper remains available. A paper prescription needs neither an IHI nor a Medicare number (MediRecords). Also note eScripts issued in Australia are for use in Australia only (Department of Health FAQ).

General information for clinicians — not clinical or legal advice. Software behaviour varies by vendor and version; the sources above are vendor and Agency documents and may change.

The same regulations apply to electronic and paper prescriptions — the National Health Act 1953 and the relevant State or Territory legislation. This matters most for controlled medicines: an S8 can be prescribed electronically, but your jurisdiction’s drugs-of-dependence rules and Real-Time Prescription Monitoring still apply. Contact your jurisdiction’s health department if unsure.

The Australian Digital Health Agency runs free, CPD-accredited eLearning modules and webinars for prescribers on what an eScript is, how it is prescribed and dispensed, the ASL, and the legislation behind it. A useful starting point if electronic prescribing is new to you — search “electronic prescribing” on the Digital Health Agency’s training pages.