The Australian federal government has unveiled ambitious plans to establish a comprehensive national medication database, aiming to tackle growing concerns about unsafe medication use, stockpiling, and the practice known as "doctor shopping." The announcement comes amid warnings about pharmacy closures and increasing medication-related harm affecting millions of Australians annually.
Addressing a Critical Gap in Healthcare
Currently, Australia lacks a centralised, mandatory register that records all medicines prescribed and dispensed to individuals. Prescribing information remains fragmented across various systems including hospital records, aged care documentation, general practice files, and online telehealth platforms like Instant Scripts, 13SICK, and Hola Health.
This fragmentation prevents healthcare professionals from accessing complete medication histories, potentially leading to harmful drug interactions and adverse effects. Recent research indicates nearly two million Australians took five or more regular medicines in 2024, highlighting the scale of polypharmacy and associated risks.
The Human Cost of Medication Fragmentation
Health Minister Mark Butler referenced a tragic case that prompted government action: an Australian woman who died from an overdose after stockpiling medication. Her parents' advocacy highlighted how the absence of comprehensive medication records contributed to this preventable death.
An estimated 1.5 million Australians experience harmful side effects from medication use each year, with older adults taking multiple medications and those transitioning between healthcare settings being particularly vulnerable. These incidents often result in hospital admissions and worsening health conditions.
Two-Stage Reform Approach
The government's strategy involves two distinct phases designed to gradually implement better medication tracking across the healthcare system.
Stage One: Strengthening My Health Record
Initially, the government will require all online and telehealth prescribing platforms to upload detailed medication information to patients' My Health Records. This will include not just prescription details but also clinical reasoning behind prescribing decisions.
My Health Record is a government-operated platform providing secure online access to patient health information. While many general practices already upload medication data, online prescribing platforms have been inconsistent in their participation. Pharmacist organisations have long advocated for this change to improve medication safety.
Stage Two: Creating a National Medicines Record
The second phase involves developing a comprehensive National Medicines Record that would serve as an overarching database registering all current prescriptions. This platform would link to My Health Record and other digital health systems, though specific implementation details remain under development.
A consultation process is currently underway, with healthcare practitioner and pharmacy bodies expressing broad support for the initiative despite some concerns about implementation challenges.
Implementation Challenges and Limitations
While theoretically representing significant progress, the reforms face practical hurdles. The My Health Record system remains underutilised, with one in ten Australians having no record (the system operates on an opt-out basis). Among those with records, many have never accessed their own information.
Data indicates that while most GPs, pharmacies, and public hospitals are registered for My Health Record, pharmacies primarily use the system to upload information rather than reviewing records uploaded by others. This raises questions about whether improved data availability will translate to better information access during prescribing and dispensing.
The tragic case referenced by Minister Butler illustrates this concern: warnings placed on the young woman's My Health Record by hospital services were not accessed by telehealth providers or pharmacies that subsequently prescribed and supplied her with medication.
Existing Monitoring Systems and Industry Concerns
For high-risk medications like opioids, Australia already operates a Real Time Prescription Monitoring system, with Victoria implementing a similar program called SafeScript. However, these systems don't cover the full range of prescription medications, leaving gaps in monitoring.
Some healthcare practitioner and pharmacy bodies have criticised the online prescribing industry specifically for contributing to inappropriate prescribing and medication misuse. The new requirements aim to address these concerns by bringing online prescribing into the national medication tracking framework.
The Path Forward
The government's initiative represents a significant step toward addressing medication safety concerns that affect millions of Australians. By creating more comprehensive medication records and requiring broader participation from prescribing platforms, the reforms aim to reduce harmful drug interactions, prevent medication stockpiling, and curb doctor shopping practices.
However, success will depend on overcoming implementation challenges, improving system usage among both healthcare providers and patients, and ensuring that available information is actually accessed and understood during clinical decision-making. The consultation process and subsequent design of the National Medicines Record will be crucial in determining the effectiveness of these ambitious reforms.
