Real Time Prescription Monitoring in Australia: Why State-Specific Systems Fall Short and Why Insurers Should Care

State-Specific Systems Create Data Silos In Australia, each state and territory maintains its own RTPM system. These systems track prescribing and dispensing within their jurisdiction but do not provide full cross-border visibility. A NSW clinician, for example, can only view data captured within NSW, even if a patient has prescriptions issued or dispensed interstate. This siloed design means gaps remain in the clinical picture when patients receive care in multiple states.

Victoria’s Mandatory Checking Requirement Victoria stands out in mandating that prescribers and pharmacists check the RTPM system (SafeScript) before prescribing or dispensing monitored medicines. SafeScript requires clinicians to access a patient’s prescription history for certain high-risk medicines during each encounter, unless a specific exception applies. SafeScript integrates with software clinicians already use and generates real-time alerts to indicate risk situations such as multiple prescribers or high-dose regimens. Health Victoria

In contrast, in most other states checking the system before prescribing or dispensing is voluntary or only mandatory under limited circumstances. The variability in legal requirements across states undermines consistent clinical use and reduces the opportunity to prevent high-risk prescribing patterns.

Low Usage Despite High Risk From experience across 12,000+ insurance claims, we find utilization of RTPM by prescribers is alarmingly low outside mandated settings. Clinicians often do not check for additional prescribers or recent dispensing history before writing high-risk prescriptions. This under-use of RTPM systems limits their effectiveness in identifying doctor shopping, overlapping prescriptions and cumulative risk. Routinely checking RTPM during medication reviews is uncommon, even though it provides crucial context for high-risk cases.

Insurance Use Cases: Why Independent Checks Add Value Insurers have a vested interest in medication safety and appropriateness. When we perform medication reviews for insurers, incorporating RTPM checks adds a layer of objective risk intelligence that is frequently missing in standard clinical workflows. It reveals patterns such as multiple prescribers in different states or recent high-risk dispensing that may not appear in state-only systems. This enhances risk stratification, supports better claim outcomes and strengthens clinical governance.

National Integration Efforts and the Future The Australian Government’s RTPM policy envisions integration through a National Data Exchange designed to aggregate state data and share it in authorised circumstances. Despite this policy framework, full cross-jurisdictional interoperability is not yet realised. Each state retains control over its system’s operation, data definitions and mandated use. Health, Disability & Ageing Australia

Conclusion RTPM systems represent a significant advance in medication safety infrastructure. However, their state-specific implementation, variable mandates and low utilisation by prescribers limit their impact. Insurers should incorporate independent RTPM checks into medication review workflows to close critical visibility gaps and support safer, more coordinated care.

References Safety and Quality Health Care: Real-time prescription monitoring overview: https://www.safetyandquality.gov.au/our-work/e-health-safety/real-time-prescription-monitoring Department of Health: National Real Time Prescription Monitoring: https://www.health.gov.au/our-work/national-real-time-prescription-monitoring-rtpm Victorian SafeScript prescriber guidance: https://www.health.vic.gov.au/safescript/safescript-for-prescribers-and-pharmacists Australian Digital Health Agency: RTPM infrastructure details: https://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/real-time-prescription-monitoring