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Telehealth Prescriptions in Australia: A Brave
New Era of Medicine (with its growing pains)

Imagine this: It’s 8pm in a rural town in NSW. The nearest clinic is two hours away. You’re running low on your asthma inhaler. Instead of organizing the trip, you fire up your phone, video call your GP, get assessed, and receive a prescription via SMS. By morning, your script reaches the pharmacy of your choice. That’s telehealth prescription in practice — convenience, access, speed. But like most things with great promise, there are nuances.

What are Telehealth & Electronic Prescriptions?

First, let’s clarify the terms (they’re related but not quite the same).

. Telehealth consultations: Doctor-patient interactions conducted remotely (by phone or video), which may lead to prescribing medication.
. Electronic prescribing (e-prescribing / electronic prescriptions): The prescription itself is digital — rather than a handwritten paper one. The “token,” often a QR code sent via SMS or email, unlocks the prescription digitally at a pharmacy of the patient’s choice.

Since May 2020, Australia has been ramping up its e-prescribing infrastructure. By April 2024, over 219 million electronic prescriptions had been issued by more than 85,958 prescribers (GPs, nurse practitioners etc.)

Why the Push? What’s Driving Change

Several factors are pushing Australia toward more telehealth + e-prescribing:

. COVID-19 pandemic: Lockdowns and social distancing made in-person visits harder. Telehealth became not just a convenience but a necessity.  Geographical & resource constraints: Rural/remote Australia has historically suffered access issues. Telehealth helps bridge that gap. Patient convenience: Less travel, less waiting, more flexibility.
. Efficiency & safety improvements: Digital prescriptions can reduce transcription errors, improve tracking, and simplify renewals.

What the Research Shows

Here are some interesting findings — the good, the not-so-good, and the in-between:

A large retrospective observational study (≈13.6 million consultations in Victoria & NSW during April–Dec 2020) found that 39.3% of face-to-face GP visits resulted in at least one prescription vs 33.0% for telehealth. (This suggests that prescribing via telehealth tends to be somewhat more conservative — or that some conditions are less amenable to remote diagnosis/prescribing.)

Nature of medications prescribed
Almost all drug categories (using the ATC classification) followed that trend: fewer prescriptions via telehealth, except for nervous system drugs.
‘Unintended consequences’
A critical interpretive synthesis of over 90 studies about telehealth in Australia found that while there are many positive unintended consequences (better access, patient satisfaction, etc.), there are also issues: safety concerns, increased socioeconomic disparities for some, and regulatory complexities.

Prescription error interception by pharmacists in digital / unbundled telehealth services. In services where prescribing is more separated from in-person care ("unbundled"), errors do occur. In one 12-month case study focused on sexual healthcare (ED, PE medications) in Australia, 5.31% of the prescriptions (out of 43,792) had errors, some of which were serious (drug contraindications etc.), but pharmacists intercepted many of them.
Barriers and Facilitators from the Ground
Interviews with GPs and pharmacists (Greater Sydney) revealed what helps, and what hinders, e-prescribing:
- Facilitators: convenience; reducing paper hassles; contactless delivery; managing multiple prescriptions; less risk during pandemics.
- Barriers: tech problems; resistance from providers or patients used to paper; lack of clear info or training; costs; concerns about governance, privacy, and best practice being lost.

Source: synthesized notes from healthcare studies (layout mockup).

Policy, Regulation & Ethical Issues

Because medicine is serious business, policy has had to keep up. Some key regulatory shifts.

. Electronic prescribing legislative framework: Several instruments under the National Health (Pharmaceutical Benefits) Regulations regulate how electronic prescriptions work, what software must do, etc.
. New guidelines from AHPRA / Medical Board: From 1 September (year not always specified, but recent), strictures were put in place: doctors are no longer allowed to prescribe medication or give medical certificates under purely questionnaire-based or asynchronous online services unless a real-time consultation (video/phone or face-to-face) has occurred. AHPRA requires justification for when telehealth is used.

Role of pharmacies and the PBS: The Pharmaceutical Benefits Scheme (PBS) regulations have been updated to allow electronic scripts for PBS medicines, etc. Pharmacists must use conformant dispensing software, etc.

The Trade-offs / Concerns

All this progress comes with trade-offs. Some of the thornier issues include:

Diagnostic limitations: Some conditions are harder to assess remotely. Visual cues, physical examinations, subtle signs might be missed.
Prescribing conservatively vs undertreating: If doctors prescribe less via telehealth, could there be under-treatment of issues? Or else, is it safe caution?
Privacy, trust & safety: Digital systems and remote consults need to guard patient privacy, ensure secure software, avoid fraud or misuse.
Over-commercialization: There’s concern about platforms that offer “instant scripts” via minimal interaction; or prescribing for profit rather than need. AHPRA’s recent guidelines aim to curb “tick-and-flick” prescribing.
Equity: Not everyone has digital access, internet bandwidth, or the comfort to use remote tools. Also some cultural or elderly patients may be less trusting of telehealth.
Errors in unbundled services: As in the ED/PE telehealth example, when a prescribing service is decoupled from traditional clinical oversight, errors creep in. Pharmacists play a catchment role, but that’s reactive.

Stories & Real-World Impacts

To make this more human, consider:

Rural patients: For someone living in the bush, telehealth + e-scripts can mean the difference between taking a daily medication or going without (due to travel, time, cost).

During COVID-19 lockdowns: Patients who were isolating or shielding, elderly people, etc., benefited from electronic prescriptions that could be delivered or processed digitally.

Platforms like Medmate: Telehealth firms are offering fast GP consultations online, prescriptions via smartphone, deliverables. For many users, this has been liberating — especially where wait times and GP shortages make face-to-face care hard. But such services also bring up concerns around continuity of care, record-sharing and whether they know your medical history well enough.

What’s Next: Opportunities & Suggestions

If telehealth prescriptions are to reach their full potential in Australia (while minimizing risk), several steps seem important:

Better guideline clarity & enforcement
  Clear criteria for when telehealth prescribing is appropriate; when face-to-face or in-person follow-up is needed. Enforce against “questionnaire only” prescribing unless adequate checks are in place..
Improved tech infrastructure & training
  Support for GPs, clinics, pharmacies to adopt conformant software; ensure patient privacy and security; train practitioners and patients in using e-scripts.
Patient education & inclusion
  Ensuring patients understand their rights: they can choose pharmacies; that prescriptions are theirs; what to expect from telehealth; what to ask. Also ensuring digital equity: addressing access issues for remote/low-bandwidth/older populations.
Monitoring & research
  Continue studies to see what conditions are suitable for telehealth prescribing, what leads to errors, how prescribing behaviour changes over time. For example, are some drug classes more risky when prescribed remotely? How does telehealth affect long-term outcomes?
Regulatory safeguards
  Oversight of telehealth platforms; transparency in pricing; accountability for prescribers; protecting patients from over-advertisement or over-prescribing.

Final Reflections

Telehealth prescriptions in Australia are already transforming how many people access medical care, offering speed, convenience, and in many cases better reach. But it's not a magic wand. There’s a balance to be struck: convenience vs safety; broad access vs ensuring diagnostic accuracy; innovation vs regulation.

The ideal may be somewhere in between: telehealth as a powerful tool in a broader ecosystem. Used well, it reduces barriers. Used poorly, it risks fragmenting care or compromising safety. As with much in medicine, the promise is huge — the challenge is to guide it well.

References

. Medication prescribing in face-to-face versus telehealth consultations during the COVID-19 pandemic in Australian general practice: a retrospective observational study (https://pubmed.ncbi.nlm.nih.gov/34819296/).
. The Unintended Consequences of Telehealth in Australia: Critical Interpretive Synthesis (https://www.jmir.org/2024/1/e57848).
. The Role of Pharmacists in Minimizing the Risk Inherent in Unbundled Telehealth Services: A 12-Month Retrospective Case Study (https://doaj.org/article/e4299f9219b640abaf5f1ef65ee06322)
. Experiences with e-prescription among GPs and community pharmacists in Greater Sydney (https://www.publish.csiro.au/py/PY22240).
. Australian Government Department of Health Electronic Prescribing materials (https://www.health.gov.au/our-work/electronic-prescribing).
. AHPRA / Medical Board recent guidelines re prescribing via online/telehealth platforms (https://www.abc.net.au/news/2023-09-04/online-telehealth-services-grow-in-australia/102590886).

Disclaimer

This blog is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Medicinal cannabis is a prescription-only medicine in Australia and may not be suitable for everyone. Any decision about treatment should be made in consultation with a qualified healthcare professional.

Telehealth Prescriptions in Australia: A Brave New Era of Medicine (with its growing pains)