Pilot moving to e-scripts but industry scepticism remains

To capitalise on the government’s push towards electronic scripts, online men’s sexual health provider Pilot has confirmed it is moving to e-scripts later in the year.

The self-titled “health navigator for Australian men” would look to align its e-script offering with one of the Active Script List platforms. My Script Launch, the first ASL compliant with the Department of Health, was recently activated in Tasmania and is expected to be rolled out across the country in May 2021.

ASL was on track to trump the token model launched in May 2020 as it provided GPs and pharmacists access to a shared cloud-like list of prescriptions for the patient. This would be especially helpful for people on regular medication who frequented multiple pharmacies, with QR codes and paper prescriptions to become things of the past.

“Because the ASL provides approved healthcare professionals with a shared view of prescriptions available for dispense, clinical decision-making should be more fact based, leading to a reduction in prescribing and dispensing errors,” the Pharmacy Guild of Australia said.

Chemist2U, an online business offering same-day delivery of pharmacy drugs to homes, had been working with e-scripts since February 2021, with 5–10% of its patients adopting the technology.

“The real value of the technology will come into play when the ASL component is active,” Dr Matthew Cullen, CEO of Chemist2U, told Wild Health. “The e-script infrastructure will enable innovative solutions to be developed that will be of great benefit to polypharmacy users in helping them to manage their health.”

E-script integration would mean Pilot’s patients could opt to never visit a GP or pharmacy in person, or even talk to a GP online. Patients seeking help for sensitive issues such as premature ejaculation, erectile dysfunction and hair loss would fill out questionnaires before texting with a GP for a standard consultation time period. Treatment would come in the form of subscription-based packages.

“Sometimes there is medication involved and sometimes there is advice or direction to seek treatment from a physical clinic,” Pilot co-founder Tim Doyle told Wild Health.

Some professionals in the sexual health industry, such as Dr Emma Boulton, Director of Clinic 66, were sceptical of Pilot’s ability to adequately address patient needs.

“We deal with a lot of young men with sexual difficulties and for 99% of them it is due to underlying mental health issues that need to be unpacked,” said Dr Boulton. “Those kinds of issues you cannot really address over SMS with a doctor you haven’t met before.

“They [Pilot] appear to be shifting products off the shelf rather than providing a holistic model of care.”

Dr Matt Vickers, one of 15 GPs on Pilot’s books, had been with the startup since it launched in 2019.

“Technology is often feared as an erosion to patient safety and the notion of the ‘holistic GP’; however, we have found that this is simply not true,” said Dr Vickers. “I was surprised by the volume of men in Australia who struggled to discuss these issues face to face and glad that I have been able to assist them in a safe and controlled manner through Pilot. 

“We have the benefit of a wealth of pre-filled data from patients that allows us to focus on the important aspects of their problem and treatment options. We routinely screen for blood pressure abnormalities, and advise on preventive care and co-morbidities that may be impacting on the specific issue.”

Dr Boulton’s clinic offered online abortion care to women in remote regions who cannot make it to her practice but viewed this arrangement as an exception.

“You need to be able to offer face-to-face consultation,” said Dr Boulton. “You also need a safety net which is integrated into your business model so there is a single individual record and we know about the individual instead of treating the symptom.”

But, said Dr Vickers, “we actively encourage them (patients) to engage with a local GP and allied health professionals, such as psychologists and physiotherapists, to ensure that they are not just receiving compartmentalised care or missing out on important health screenings”.

Since 2019, Pilot had completed more than 20,000 consultations with almost 1,000 people giving the service a 4.6 out of a 5-star rating on ProductReview.com.au.