Medication management for health practitioners

Medication charts

Medication charts enable safe and accountable medication management by providing a full picture of a patient’s medicine and health records, including:

• what medicines have been prescribed, supplied and administered
• patient allergies and adverse medicine reactions
• any special needs, such as difficulty swallowing or cognitive impairment
• prescription due dates.

This helps to:

• improve the safety of patients, by reducing medication errors and preventing negative medicine interactions
• support communication between all those involved in a patient’s care
• ensure continuity of medication
• make prescribing and dispensing easier and more efficient.

You can take an online course to learn more about completing national medication charts. 

National Residential Medication Chart (NRMC)

The paper-based NRMC can be used in residential aged care services, as well as National Aboriginal and Torres Strait Islander Flexible Aged Care and Multi-Purpose Services that provide residential aged care. It enables health practitioners to prescribe and supply most PBS and RPBS medicines without a separate prescription.

The only exceptions that still need a prescription when using the paper NRMC are:

• medicines requiring telephone or written authority
• medicines only available under special arrangement (Section 100)
• controlled substances (Schedule 8 medicines)

See the NRMC and related information, including user guides.

Electronic National Residential Medication Chart (eNRMC)

eNRMC products can be used in:

• residential aged care services
• National Aboriginal and Torres Strait Islander Flexible Aged Care that provide residential aged care
• Multi-Purpose Services that provide residential aged care.

They enable health practitioners to prescribe all PBS and RPBS medicines electronically without the need for a paper chart or separate prescription (apart from Section 100 medicines, which still require a prescription).  

While not mandatory, we encourage you to adopt these systems, which can significantly reduce administrative burden and increase patient safety.

Benefits of eNRMC

Through real time medication prescription and administration data, eNRMC products reduce medication errors and provide greater flexibility and coordination by:

• sending automated alerts and reminders of:
  • allergies
  • medication interactions
  • prescription due dates 
  • follow-up consultation due dates
• enabling prescribers, suppliers and staff to understand a patient’s medication history and needs quickly and easily
• reducing the number of daily medications taken by an individual (polypharmacy)
• ensuring medications are provided quickly
• ensuring stronger privacy security for patients
• enabling better and faster reporting and auditing
• reducing administration burden for aged care providers, prescribers and pharmacists.

We are supporting the rollout of eNRMC products in response to recommendation 68 of the Royal Commission into Aged Care Quality and Safety final report.

See more information about eNRMC products, including a user guide for residential aged care facilities and a software vendor information book. 

Status of eNRMC rollout

We have been trialling eNRMC products in residential aged care sites, and are working with software vendors to make them available nationally.

Several software vendors are developing eNRMC products that meet:

• legislative requirements for electronic prescribing
• PBS information requirements for medication charts
• electronic prescribing technical conformance requirements.

Once approved, these systems will be listed on the Australian Digital Health Agency’s electronic prescribing conformance register.

We expect conformant eNRMC products to be available from the end of 2024. In the meantime, all residential aged care providers can adopt transitional eNRMC products under the special arrangement legislation.

For their product to be approved for use under the transitional arrangement, vendors must provide the Australian Digital Health Agency with evidence that it meets conformance requirements.

A transitional eNRMC product can be used for legal PBS and RPBS electronic medication chart prescribing, dispensing and administration purposes. But it must not send prescription information to a prescription delivery service.

PBS hospital medication chart (PBS HMC)

The PBS HMC is for use in Australian public and private hospitals. These are available either as paper-based or electronic charts.

See more information about PBS HMC, including a user guide and fact sheets for prescribers and pharmacists.

Electronic medication charts for chemotherapy patients

We have worked with industry and the Australian Commission on Safety and Quality in Health Care to develop information requirements for electronic chemotherapy charts. Once legislated, they will support safe electronic prescribing, dispensing, claiming and administration of chemotherapy medicines. 

In the meantime, we have put in place a temporary special arrangement for chemotherapy patients during the COVID-19 pandemic. This allows the prescribing, supply and claiming of PBS benefits for chemotherapy patients (excluding Section 100 medicines) directly from a paper or electronic medication chart.

Once the information requirements are legislated, we will then work with software vendors to help them implement the change. The special arrangement will then cease.

Medication management guiding principles

Under the National Medicines Policy, a series of guiding principles help to promote safe, quality use of medicines and medication management:

• in residential aged care facilities
• in the community
• to achieve continuity in medication management.

The Australian Commission on Safety and Quality in Health Care are currently reviewing these guiding principles.

Related information

See more information about:

• electronic prescribing
• prescribing and dispensing PBS medicines
• Instrument of approval for PBS National Residential Medication Charts.

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