The federal government has unveiled an initiative this week designed to overhaul the way medications are dispensed and monitored. The goal is to minimize unsafe usage, curb the practice of stockpiling, and prevent “doctor shopping.”

This reform will unfold in two phases. Initially, it will mandate that all prescribers using online and telehealth services upload detailed information about a patient’s prescriptions to their My Health Record.

Following this, the government intends to create a comprehensive National Medicines Record. This database will serve as a centralized system to catalog and track all active prescriptions across the country.

So, how exactly will this system operate? Although some specifics are yet to be clarified, here’s what is currently understood.

In Australia, there is a growing trend of individuals taking multiple medications simultaneously. Recent studies on prescription patterns in the nation reveal that nearly two million Australians were on five or more regular medications by 2024.

While taking several medications may be necessary for managing multiple health conditions, it also poses potential risks for adverse side effects.

While multiple medicines are often needed to manage multiple conditions, there are risks of adverse effects.

And when a clinician prescribes medication or a pharmacist dispenses it without a full understanding of the patient’s current medications, it can lead to harmful interactions between them.

This can make a patient sicker and often lands them in hospital. An estimated 1.5 million people in Australia experience some kind of harmful side effect from using medicine each year.

Those at particular risk are older adults taking numerous medications, as well as those transitioning between health-care settings (such as going into hospital or returning home).

Sometimes patients also stockpile medications, including through consulting multiple doctors, known as “doctor shopping’. For example, they might do this to obtain extra supplies of addictive pain medication.

How does it work right now?

Currently, there is no centralised, mandatory register that records all of the medicines a person is prescribed and dispensed.

Instead, prescribing information may be siloed in hospital and aged care systems, general practice records and those of online telehealth providers such as Instant Scripts, 13SICK and Hola Health.

This can prevent any single doctor or pharmacist from having clear, comprehensive information about a patient’s medications.

Some healthcare practitioners and pharmacy bodies have criticised the online prescribing industry, in particular, for contributing to inappropriate prescribing and medication misuse.

For high-risk medications such as opioids, there is already a Real Time Prescription Monitoring system. Victoria has a similar system called SafeScript, but this doesn’t record the full range of prescription medications.

Announcing the reforms on Wednesday, Health Minister Mark Butler referred to an Australian woman who died from an overdose after stockpiling her medicine. He explained her parents’ advocacy prompted the government to address the lack of a comprehensive medicines record.

What will change?

First, the government will require online and telehealth prescribing platforms to add information to the My Health Record system about prescribed medications. This will include information about the clinical reasoning for prescribing.

My Health Record is a government-run platform providing a secure, online collection of a patient’s health information. Both patients and their treating health-care professionals can access it.

So any medication or related clinical information uploaded by a prescriber would be accessible via My Health Record, to the patient as well as to their health-care providers and pharmacists.

Many general practices already upload this information, but online prescribing platforms may not. Organisations representing pharmacists have long called for this kind of change.

Will it work?

In theory, it is a step forward. The challenge is that the My Health Record system remains underused. One in 10 Australians have no My Health Record (the system is opt-out).

For the millions of Australians who do have a My Health Record, usage is increasing. But many still have never accessed their own record.

It is also not clear whether, and how, a patient’s access to their own My Health Record would reduce medication harm (particularly if the patient is deliberately stockpiling medication).

Almost all GPs, pharmacies and public hospitals are registered for My Health Record and have used the system. But data shows pharmacies are mainly using it to upload information rather than looking at records others have uploaded.

Overall, ensuring that all medicines information is available on the My Health Record is a positive step.

But it does not mean that the information will be accessed (or understood) by others who are prescribing and dispensing medication to a patient.

The warnings that were placed by hospital services on the My Health Record of the young woman who died from an overdose were not accessed by telehealth services nor pharmacies prescribing and supplying her with medication.

What’s next?

As a second step, the government says it will design and build a National Medicines Record. This would be an overarching platform linked to My Health Record and other digital health systems, to register all current prescriptions.

At this stage, detail is lacking, but healthcare practitioners and pharmacy bodies are broadly supportive.

A consultation is underway.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Megan Prictor is a member of the Australasian Association of Bioethics and Health Law, the European Association for Health Law and the World Association of Medical Law.